Steroid side effects: how much of it is true?

Short answer

Mostly true. All 100 users had at least one side effect, and one 16-week cycle thickened the heart wall. Liver injury was rare but meant a hospital stay. 1 in 3 users could not stop, and the risk of death was 3 times higher.

Steroid side effects: how much of it is true?
'Use them and everyone gets side effects → liver, heart and hormones break down' — true?
Some say steroid side effects are exaggerated; others say they wreck everyone. We checked each claim with a study that followed 100 users for 1 year and studies that pooled records from thousands of people.
Nobody escaped side effects
All 100 had at least one
When 100 people about to start steroids were followed for 1 year, all of them got stronger, and all had at least one side effect. During use, 56% retained fluid and 36% felt agitated. 4 had a serious event, such as heart failure or pancreatitis.
Hormone side effects were common
58% lost sex drive after the cycle
In the same 100 people, 28% got acne and 19% got gynecomastia (breast growth in men). After the cycle, 58% had lower sex drive. A Danish study of 545 users also found acne, gynecomastia and erectile dysfunction each above 10%.
Heart: one cycle was enough to change it
Heart muscle grew by 28 g in 16 weeks
In 31 people measured before and after a 16-week cycle, heart muscle grew by 28.3 g, and the share of blood the heart pumps out per beat fell by 4.9%. Higher doses meant more thickening. After 8 months off following this one cycle, all 25 people measured were back to baseline.
Blood pressure and cholesterol went up too
Top blood pressure number was 12 higher
An analysis that pooled several studies found users had a top (systolic) blood pressure 12 points higher and a bottom (diastolic) number 8 points higher. Bad (LDL) cholesterol was higher too. Liver test values (AST, ALT) were 12-14 higher, which leads to the liver.
Liver: rare, but it meant a hospital stay
All 44 people with liver injury turned yellow
All 44 people whose liver was injured by steroids or bodybuilding supplements developed jaundice, and 71% were hospitalized. Some products contained steroids not listed on the label. In 23 Australian cases, liver values took a median of 175 days to normalize, and 1 person needed a liver transplant.
Lesser-known side effects: dependence and early death
1 in 3 could not stop
An analysis pooling 1,782 people found 34% of users developed dependence (being unable to stop). In Denmark, 545 men who tested positive for steroids had 3 times the risk of death of non-users, and visited hospital 0.81 times a year versus 0.36.
Summary: most side effects are real
Everyone gets some, and some get serious ones
All 100 users had at least one side effect, and acne, gynecomastia and lower sex drive were common. One 16-week cycle thickened heart muscle and raised blood pressure. Liver injury was rare but meant a hospital stay, 1 in 3 developed dependence, and the risk of death was 3 times higher.