It’s a miracle! No, I don’t have stigmata, I haven’t tasted a Circus Peanut and enjoyed it, and I haven’t heard Steve Miller apologize for ripping off other artists. What has happened is that I’ve found relief for my asthma in a medication known as a steroid (Azmacort). I assume it’s not the same kind of steroid that pumps up men and women with low self-esteem or athletes with no conscience. But what’s the difference? Why am I being told there are no “side effects”? This sounds too good to be true.
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Steroids are a lot like the Internet–versatile, dangerous in the wrong hands, and seemingly impossible to describe in comprehensible English. A typical encyclopedia account begins with the fascinating news that steroids are “any of a class of natural or synthetic organic chemical compounds characterized by a molecular structure of 17 carbon atoms arranged in four rings.” Not to put too fine a point on it, but so freaking what? Eventually we get the picture: steroids are an important type of hormone, the chemicals by which the body regulates growth and other functions. Sex hormones, bile acids, vitamin D–they’re all steroids. Ordinarily the body manufactures steroid hormones naturally (out of cholesterol, interestingly). For good reasons and bad, though, people sometimes hot-wire the system, dosing themselves with ‘roids to get bigger muscles or, in your case, to continue breathing. The results are often dramatic. But over the long term, in some cases, the system fries.
You’re right that the steroids in your inhaler aren’t the same as the ones used by bodybuilders. All steroids are chemically similar (17 carbon atoms in four rings, remember?), but because of differences in the odd atom here and there they have widely varying effects. Anabolic (tissue-building) steroids, the kind some bodybuilders and athletes use, are basically synthetic testosterone. The glucocorticoids used in inhalers, on the other hand, are of a type produced by the adrenal cortex. High doses of glucocorticoids–much higher than the body normally produces–prevent the inflammation that causes asthma. But when taken in pill form they can also cause severe side effects, including suppression of the adrenal gland, cataracts, and osteoporosis.
A page of fun facts making the rounds says “I am” is the shortest complete sentence in English. Can this be true? –Jim Kepler, Chicago
You object again: That’s cheating! The subject is elliptical! Who could possibly call that a sentence?
