Steroids: Do They Work and Are They Safe? “Legal steroids” is a catch-all term for muscle-building supplements that don’t fall under the category of “illegal.”Anabolic-androgenic steroids (AAS) are synthetic (manufactured) versions of the male sex hormone testosterone. These are sometimes used illegally. People who have muscle wasting or testosterone production disorders can take these hormone supplements for their condition if prescribed by a healthcare provider. However, some athletes and bodybuilders illegally use these steroids to boost muscle mass or performance. Some legal supplements do have science on their side and aren't entirely unsafe. But others may be completely ineffective or even cause harm. Creatine is one of the most well-known performance support options. It’s a naturally occurring substance found in foods like fish and meat. It’s also sold in many stores as a muscle-building supplement. Creatine has numerous documented benefits:A 1999 studyTrusted Source found that weightlifters who used creatine showed nearly three times as much growth in muscle fibers and doubled overall body mass than those who didn’t use creatine. A 2003 studyTrusted Source found that using creatine when you’re weight training can help build strength in your legs and increase your overall muscle mass.A 2007 reviewTrusted Source of muscle-building supplements indicated that creatine is the best supplement for increasing muscle mass. Research has also found no long-term health effects of using creatine.Look out for any extra ingredients in supplements that may have side effects or cause allergic reactions.Matrix metalloproteinase (MMP)MMP is a blend of creatine, betaine, and dendrobium extract that’s often sold as Craze or various other names. This supplement is relatively safe to use. However, it doesn’t result in the muscle-building claims this drug’s marketing copy might lead you to believe.2014 found that participants who used it for a 6-week training period reported higher energy and better concentration, but no increases in body mass or overall performance. As with other OTC supplements, look out for additional ingredients that can cause allergic reactions or long-term health effects. Dimethylamylamine (DMAA) DMAA has been found in numerous muscle-building and weight loss supplements, but it’s not safe. Any product that contains it and markets itself as a dietary supplement is illegal. The Food and Drug Administration (FDA)Trusted Source has released numerous warnings to consumers to steer clear of DMAA and its various forms in OTC supplements. Using DMAA can lead to one or more of the following complications: narrowing of blood vessels increased blood pressure shortness of breath feeling of chest tightness irregular heartbeat heart attack seizures neurological disorders mental health conditions Bodybuilder Injects Coconut Oil, Damages Arm Muscle Instead of just lifting weights, an amateur bodybuilder in the United Kingdom tried to plump up his arm muscles and by injecting them with Instead of just lifting weights, an amateur bodybuilder in the United Kingdom tried to plump up his arm muscles and by injecting them with coconut oil, according to a new report of the case. But he wound up developing cysts inside his arm muscles from the oil, and because he also used steroids, he ruptured his triceps and needed surgery, the report said. The 25-year-old-man first went to the doctor because his arm hurt and he had had trouble moving it for several months. He told the doctor that he had taken up bodybuilding four years earlier, and that he went to the gym three times a week. An ultrasound revealed a rupture in the tendon that connects the triceps muscle (in the upper arm) to the bone near the elbow. This type of injury is rare in young people, the report said. The ultrasound also showed multiple cysts inside his arm muscle. From these findings, the man's doctors suspected that he might be injecting substances into his arm. When he was asked about this, the patient admitted that he had injected coconut oil into his arm muscles to increase their size and definition. Although anabolic steroids are perhaps the most well-known substances that bodybuilders inject to bulk up muscle, they also sometimes inject other substances, including natural oils — like sesame oil, walnut oil and paraffin — to make their muscles appear to be larger, the report said. Natural oils are less expensive than anabolic steroids, which may make them an attractive option, particularly for amateur bodybuilders, the report said. "Alarmingly, this practice, used for the short-term enhancement of muscular appearance, seems to come at a significant cost," the man's doctors, from London North West Healthcare NHS Trust health system, wrote in the Dec. 1 issue of the journal BMJ Case Reports. In an earlier case, a bodybuilder in Germany who injected sesame seed oil into his muscles for eight years experienced scarring and deformity in his muscle tissue, and had irreversible muscle damage that prevented him from weightlifting normally. Other side effects of similar injections include skin sores, infection and potentially life-threatening blockages of blood vessels, due to the globbing up of the fat in the oils, the report said. A review of the U.K. man's medical history also revealed that he had engaged in several other problematic practices in order to bulk up his muscles. For example, he had used insulin without a prescription, which caused him to have seizures. He had also injected himself with vitamin B12, which resulted in a bacterial infection. And he had used anabolic steroids, which caused him to develop swollen breast tissue and benign tumors on his liver — and both conditions required surgery. It's likely that the man's triceps tendon rupture resulted from his use of anabolic steroids, which led to stiffening of the tendon and rupture after repeated weightlifting, the report said. The man underwent surgery to repair his tendon, which healed well. But he continued to practice unsafe bodybuilding techniques to maintain his desired body image, despite being counseled about the risks of those practices, the report said. "[Doctors] need to be aware of these cases," so that they can diagnose patients correctly and recognize potentially life-threatening practices among bodybuilders, the report said. Natural and Pharmaceutical Estrogen Blockers for Men These natural products may help block estrogen:Wild nettle root: Nettle root or nettle leaves are often used to make prostate medication. Nettles contain compounds that act as natural estrogen blockers. Taking supplements can regulate production of the hormone. Chrysin: This flavonoid is found in passionflower, honey, and bee propolis. Proponents argue that it blocks estrogen and increases testosterone, and others claim that there’s no evidence. Maca: Maca is a cruciferous plant that originates in Peru. Proponents say it has a host of benefits, including enhancing fertility and blocking estrogen in men. Although does contain many vitamins and nutrients, there’s little Grape seed extract: This extract has been shown to act as an aromatase inhibitor, or estrogen blocker, in postmenopausal women at high risk for breast cancer. Men may experience similar benefits when taking it as a supplement. Local Anesthetics Local anesthetics produce anesthesia by inhibiting excitation of nerve endings or by blocking conduction in peripheral nerves. Cocaine, a compound indigenous to the Andes Mountains, West Indies, and Java, was the first anesthetic to be discovered and is the only naturally occurring local anesthetic; all others are synthetically derived. Cocaine was introduced into Europe in the 1800s following its isolation from coca beans. Sigmund Freud, the noted Austrian psychoanalyst, used cocaine on his patients and became addicted through self-experimentation. In the latter half of the 1800s, interest in the drug became widespread, and many of cocaine's pharmacologic actions and adverse effects were elucidated during this time. In the 1880s, Koller introduced cocaine to the field of ophthalmology, and Hall introduced it to dentistry Types of active pharmaceutical ingredients APIs are broadly categorised into two types – synthetic and natural. Synthetic APIs are further classified into innovative and generic synthetic APIs, based on the type of synthesis used. Synthetic chemical APIs, also known as small molecules, constitute a large part of the pharmaceutical market, with many small molecule drugs commercially available in the market. Natural APIs are used in making biologics, which are increasingly becoming the top-selling drugs in the market. Despite the growing demand, biologics are currently significantly fewer in number compared to small molecule drugs. Based on the solubility, APIs are categorised into insoluble and soluble drugs. Pharmaceutical Technology has listed the leading suppliers of active pharmaceutical ingredients and intermediates based on its intel, insights and decades-long experience in the sector. The list includes companies that can develop and supply high-quality pharmaceutical materials, including, but not limited to: Fine chemicals and intermediates, such as high-docosahexaenoic acid oil for API productionAPIs for central nervous system therapies Natural cannabinoid (CBD) ingredients, CBD isolates and cannabis distillates The list also includes suppliers of mixing and drying technologies, polymer coatings for drug delivery, extraction technologies for high-purity APIs, and dispersion and wet milling technology. Providers of automatic capsule filling machines, dry powder and liquid-based material handling systems, analytic services for biological assays, pharma tablet manufacturing machines, and custom synthesis services are detailed in the document as well.