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Steroids, Sterols, Anabolic Steroids, and Corticosteroids: What's the Difference?

Steroids are important compounds used in medicine, but people often misunderstand what they are.

The term steroid and sterol simply refer to chemical molecules that share a common chemical ring stricture. There are many steroids and sterols that are important in health and medicine, and some that may be used as medications. Some steroids are called hormones. Hormones are chemicals that are made in the brain, kidneys, or sex organs but carry a signal to other cells in the body to change the way that part of the body is working. Other steroids are not hormones and have a direct action on their own.

The adrenal glands in your body make several types of steroids, each of which has a specific purpose. Steroids are also found in other animals, and in plants. For example, the drug digitalis comes from the foxglove plant and was one of the first steroids used in medicine.

These types of steroids are made by your body:

  • Sex hormones. These are the male hormones, including testosterone, which collectively are called androgens, and the female hormones, including estradiol, a type of estrogen. Anabolic steroids are another name for androgens.

  • Corticosteroids. These hormones include cortisone and cortisol. They are thought to have a role in the immune system.

  • Mineralocorticoids. These hormones maintain the balance of sodium and potassium in the body and include aldosterone.

  • Bile salts or bile acid. These steroids are made in the liver, don't function as hormones, but are essential for digestion and absorption of fats.

  • Sterols. The most commonly known of these is cholesterol. Other sterols help your body to make vitamin D from sunlight and to build cell walls.

Commercially produced corticosteroids are steroids that reduce inflammation and include hydrocortisone, prednisone, dexamethasone, triamcinolone, budesonide, betamethasone, fluticasone, and flunisolide. More than 100 corticosteroids have been approved by the FDA for patent use. They are used in pills, ointments, inhalers, and by injection to treat diseases that cause inflammation, including multiple sclerosis, lupus, rheumatoid arthritis and other autoimmune diseases, as well as numerous skin conditions. They also are used to treat leukemia and other cancers.

Corticosteroids are extremely important in the treatment of asthma and COPD, helping to decrease inflammation in the lungs' airways. They can be prescribed by a doctor in various forms, but most people use the inhaled form because it has fewer side effects.

Rarely, after using inhaled steroids, people experience side effects, such as thrush. But, this oral yeast infection can be minimized by cleansing the mouth with water after use. When taken over a long period of time, oral corticosteroids also can have side effects, such as weight gain, ulcers, high blood glucose and cataracts. But, when taken under a doctor's supervision, using the recommended dosage, they are considered safe.

Anabolic steroids are male hormones like testosterone or commercially produced chemicals identical to male hormones. When produced naturally by the body, they increase muscle mass and direct proteins to make muscle. As men age, their testosterone production may decrease resulting in mood changes or loss of bone density. Testosterone is sometimes prescribed to treat low testosterone levels. Anabolic steroids are also commonly taken and abused by athletes to boost athletic performance and build muscle mass. Some teenagers abuse them, too.

Taking doses of anabolic steroids beyond the body's normal level increases the risk for prostate cancer, stroke, and heart attack. People who take excessive doses of anabolic steroids may exhibit violent behavior and drastic mood swings, and may suffer from depression. Unfortunately, they can cause lasting damage, according to the National Institute on Drug Abuse.

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