Question

A 33-year-old man is brought to the medical department because of extreme fatigue, weight loss, abdominal pain, and darkening of his skin (hyperpigmentation). On physical examination, he has a low blood pressure. Blood tests reveal low blood sugar (hypoglycemia). He is a bodybuilder who has been using steroids for 10 years. The doctor explains to him that his symptoms are due to loss of endocrine stimulation of his adrenal glands which led to reduced adrenal function. Answer the following questions regarding cellular adaptations in this patient?

Q. What happened to his muscles after using steroids?
Q. What happened to his muscles after he stopped using steroids?

Answer 1

After using steroids, the man's muscles likely grew larger due to increased protein synthesis. Post withdrawal, muscle atrophy occurred due to lack of endogenous steroid production and adrenal suppression. He also has symptoms of adrenal insufficiency, including fatigue, weight loss, hyperpigmentation, and hypotension.

Step-by-step explanation:

Impact of Steroid Use on Muscles:

When the 33-year-old bodybuilder used steroids, they likely caused the muscles to become larger and stronger due to the anabolic effects, which increase protein synthesis and muscle growth. However, when he stopped using steroids, his muscles probably underwent atrophy or loss of muscle mass due to the sudden withdrawal from the high levels of synthetic hormones his body was accustomed to. This effect is compounded by his body's reduced ability to produce natural steroids (cortisol) because of adrenal gland suppression, which is a typical side effect of long-term steroid use.

Effects of Adrenal Insufficiency:

Adrenal insufficiency, or Addison's disease, manifests in this patient through symptoms such as extreme fatigue, weight loss, abdominal pain, hyperpigmentation, low blood pressure (hypotension), and low blood sugar (hypoglycemia). These symptoms are because of the lack of cortisol and other corticosteroids that help regulate metabolism, immune response, and maintain normal electrolyte and water balance.

Answer 2

Steroid use can cause an increase in muscle mass due to the anabolic effects of the steroids. In this patient's case, it is likely that his muscles increased in size and strength during the 10 years he was using steroids as a bodybuilder.

When the patient stopped using steroids, his muscles may have undergone a process called atrophy, which is the decrease in muscle size and strength. This is because the anabolic effects of steroids are no longer present to maintain the increased muscle mass. However, it's important to note that the exact changes that occur in a person's muscles after they stop using steroids can vary depending on factors such as the duration and dosage of steroid use, as well as other individual factors such as diet and exercise habits.