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All bets are off the table when high-dose testosterone and its many metabolites are used illegally, such as with anabolic steroid abuse. Strokes, embolisms, and cardiovascular disease are all more likely, as is sudden death, and liver and kidney disease. 44 In women, acne, irreversible deepening of the voice, baldness, increased facial hair, enlarged sex organs, breast reduction, depression, and infertility have all been reported. In adult men that abuse anabolic steroids, acne, baldness, permanent infertility, gynecomastia, loss of libido, erectile dysfunction, testicle shrinkage, and profuse sweating are all reported side effects. Increased testicular cancer hasn't been reported, though. 45,46

Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.

Anabolic steroids are synthetic substances related to male sex hormones (androgens). Although it is illegal in the United States to possess or distribute anabolic steroids for nonmedical use, a "black market" for them exists, and many amateur and professional athletes take them to enhance performance. In many cases, the athletes take doses that are extremely high—perhaps 100 times the doses that might be prescribed for medical use. As a result, they put themselves in real danger of short-term and long-term health problems. Blood testing, as has been used in the Olympic Games, can detect, identify, and quantify the presence of anabolic steroids in the blood of athletes, which can lead to the disqualification of an athlete.

Steroid hormones regulate gene expression by

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