The use of anabolic steroids and other performance-enhancing drugs continues to occur, despite being banned by major sports organizations and users knowing the negative long term effects they can have on their body.

Despite knowing about the adverse effects, bodybuilders still all types of anabolic steroids to increase muscle mass, enhance strength, improve recovery, to achieve their fitness goals.

Although steroids can help in muscle building and strength, its use comes with significant risks and side effects. The misuse of anabolic steroids can lead to liver damage, cardiovascular problems, hormonal imbalances, psychiatric disorders and worse.

This article explains the benefits and the potential dangers of anabolic steroid use.

Anabolic steroids, also known as anabolic androgen steroids, are a type of performance-enhancing drug that athletes and bodybuilders use to boost strength, build muscle mass and improve their performance. 

These substances are manufactured testosterone hormones and work like the testosterone hormone found in humans, mainly in men. You can take them orally, apply them on your skin or inject them. 

While bodybuilders use different types anabolic steroids to increase their performance and build muscles, most forms of it are illegal for use. Many of the types have been banned in most of the leading sports organizations worldwide because its adverse effects outweigh the benefits, and they are also easily misused by bodybuilders.

However, they are approved for some medical conditions under a healthcare practitioner’s prescription. A health practitioner can prescribe anabolic steroids for the treatment of medical conditions like low testosterone levels in men, arthritis, asthma, and other respiratory diseases.

Anabolic steroids are used during training and competition for various reasons, including the following.

1. Increased Muscle Mass

Anabolic steroids promote protein synthesis, the process by which cells build new proteins. This results in a net increase in muscle protein content, and since protein is the building block for muscle growth, an increase in it leads to muscle growth (hypertrophy).

Increased protein synthesis caused by anabolic steroids also allows muscles to repair and rebuild quickly after exercise, facilitating faster muscle growth.

2. Enhanced Performance

As a bodybuilder, you need power, strength and endurance to perform well in strength sports such as Olympic weightlifting, bodybuilding, and powerlifting.

Although advanced strength training, cardio exercises and balanced nutrition can help you with this, anabolic steroids can double the benefits. Anabolic steroids can improve your performance by increasing strength, power, and endurance. This can allow you to train harder and longer, potentially leading to greater muscle size and strength gains.

3. Improved Recovery

During intense workouts, muscles are damaged by pressure, causing soreness and pain that might take time to heal.

Anabolic steroids may help you recover quickly from intense workouts by reducing muscle damage and inflammation. When consumed, the anti-inflammatory properties of anabolic steroids reduce inflammation and swelling in muscles following intense workouts, contributing to faster recovery and less discomfort during the post-exercise period.

Anabolic steroids also enhance the body’s overall recovery capacity by increasing red blood cell production and oxygen delivery to muscles. This improved oxygenation facilitates the removal of metabolic waste products such as lactic acid, which can accumulate during intense exercise and contribute to muscle fatigue and soreness.

4. Reduced Body Fat

Some anabolic steroids have been shown to increase metabolism and promote fat loss. This can help bodybuilders achieve a leaner, more defined physique, especially when combined with a calorie-controlled diet and regular exercise during the cutting phase.

5. Preserve Muscle Mass

There is also use of certain anabolic steroids to preserve muscles if you have a muscle-wasting disease such as AIDS and chronic obstructive pulmonary disease (COPD), but under a doctor’s prescription.

They modulate the body’s hormonal environment, promoting anabolic (muscle-building) processes while suppressing catabolic (muscle-breaking) ones. For example, steroids increase the levels of anabolic hormones like testosterone, insulin-like growth factor 1 (IGF-1), and growth hormone, which stimulate muscle growth and repair. 

At the same time, they decrease the levels of catabolic hormones like cortisol, which degrade muscle tissue. This hormonal balance favors muscle preservation and growth for individuals with muscle-wasting diseases such as AIDS, cancer, and liver and kidney disease.

While anabolic steroids offer some benefits to bodybuilders, the use comes with significant risks and potential side effects. Here are some adverse effects:

1. Cardiovascular Complications

Anabolic steroids have can have harmful effects on your cardiovascular system when used for long periods.

When taken, it causes your body to produce more testosterone, increasing your heart rate and bloodstream levels.  The heart rate increase can lead to health problems such as abnormal heart rhythms, kidney damage, heart attack or high blood pressure.

Anabolic steroids also increase LDL cholesterol (the “bad” cholesterol) and decrease HDL cholesterol (the “good” cholesterol), leading to an increased risk of atherosclerosis. 

Atherosclerosis is a condition in which plaque, consisting of fatty deposits, builds up inside the arteries. Over time, the plaque hardens and narrows the arteries, restricting blood flow to vital organs and tissues. If the condition persists, it may cause heart attacks and strokes.

Steroids can also elevate blood pressure, further increasing the risk of cardiovascular events.

2. Hormonal Imbalances

Anabolic steroids disrupt the body’s natural hormone balance, leading to potential complications such as infertility, testicular atrophy, decreased sperm production and breast enlargement in males. In women, it can cause menstrual irregularities and masculinization, such as deepening of the voice or the growth of facial hair. 

3. Mood Disorder

Anabolic steroid use has been linked to mood swings, aggression, irritability, and depression. The side effects of different experiences have veen anxiety, nervousness, insomnia, as well as psychotic episodes and in the worse cases, delusions.

4. Acne and Skin Problems

Anabolic steroids cause or exacerbate acne, particularly on the face, chest, and back. This is due to the stimulation of sebaceous gland activity and increased oil production in the skin. Steroid use can also lead to other skin problems, such as cysts, abscesses and jaundice due to liver damage caused by anabolic steroids,

5. Hair Loss

Anabolic steroids can accelerate male pattern baldness (androgenic alopecia) in individuals who are genetically predisposed to this condition. This is because steroids increase dihydrotestosterone (DHT) levels, a hormone implicated in hair loss. Women may also experience hair thinning with steroid use.

6. Legal and Ethical Issues

Using steroids without a prescription is illegal in many countries and is against the rules of most major and amatuer sports organizations. Bodybuilders who use steroids illegally risk legal consequences, including fines and bans from competition. The use of steroids can also damage your repetation because it undermine the principles of fair play and integrity in sports and competition.

7. Infections

If administered improperly or in unsterile conditions, anabolic steroid injections can increase the risk of infections. This can lead to abscesses, cellulitis, and systemic illnesses like sepsis. 

Sharing needles or vials can also transmit blood-borne diseases such as HIV and hepatitis B and C.

8. Liver Damage

The liver metabolizes anabolic steroids, and prolonged use of oral steroids or high-dose use, especially those that are 17-alpha alkylated, can lead to liver tumors, hepatitis, and liver failure.  The symptoms of liver damage may manifest as jaundice (yellowing of the skin and eyes), liver cysts, or liver cancer.

Even injectable steroids can put a strain on the liver since many anabolic steroids are hepatotoxic—they can cause damage to the liver. 

9. Fluid Retention and Oedema

Anabolic steroids can cause fluid retention and oedema (swelling) due to sodium and water retention, leading to bloating, puffiness, and an increased risk of hypertension and congestive heart failure.

10. Dependency and Addiction

Some types of anabolic steroids can be addictive, leading some users to develop a dependence on them to maintain their physique and performance. Withdrawal symptoms can occur when stopping steroid use, further complicating matters.

Comprehending the risks and side effects associated with different types of anabolic steroids is crucial if you are considering these using any forms to enhance your physique and performance.

While different types of anabolic steroids may offer several benefits such as increased muscle mass, strength, and athletic performance, they come with significant potential harms that cannot be ignored.

From cardiovascular complications to liver damage, hormonal imbalances, psychiatric effects, and reproductive issues, these negative effects on your body are extensive. Infections, fluid retention, and skin problems are even more of the potential risks involved.

For your health safety and longevity of your life, it is recommended to not take forms of anabolic steriods. If you are considering, consult with a healthcare professional or expert in sports medicine for additional advice, guidance or support. 

This award “recognizes excellence in current textbooks and learning materials.”

TAA is a group of textbook and scholarly authors who work together as peers in striving to improve our effectiveness.  The honor of receiving this award is enhanced by the fact that it was thoroughly examined by accomplished textbook authors in our discipline—a very humbling experience.

I think the judges have recognized that our book has a unique combination of strong text narrative, illustrations, and learning features that sets it apart as an effective learning tool.

I think the award also recognizes the excellent work of the many members of our team responsible for the continuing success of this textbook. Besides Gary and I as authors, there are many contributors, reviewers, editors, other publishing professionals, illustrators and designers, learning consultants, and many other colleagues, who have critical roles in producing our textbook.

If you haven’t had a chance to check out what sets this A&P textbook apart, click here and see for yourself.

For over a decade at StrongFirst we have advised against pushing sets to failure and advocated towards always keeping a few reps “in the tank.”

In recent years we have heard more and more often from well-known strength coaches, and on the web, about the Rate of Perceived Exertion (RPE) and Reps in Reserve (RIR).

It seems like many are finally coming to the conclusions we came to a long time ago. In fact, these are the conclusions that many Soviet sports scientists reached in the late 1900s, which we have endorsed and implemented in our system.

RPE and RIR

But what are RPE and RIR all about?

RPE is a subjective measure of effort, frequently measured on a scale from 1 to 10.

Related to the RPE, a “buffer” or RIR indicates the difference between the maximum number of repetitions that could be executed in a row and those that are performed in a set with a given weight. For example, in a set of 6 reps with a 10RM (rep max) weight, the buffer is 4 reps (or RIR=4).

Powerlifting champion Mike Tuchscherer adapted Borg’s RPE scale to powerlifting and tied the RPE to the RIR.

At StrongFirst, in addition to the RIR, we also consider the drop in rep speed:

RIR Training vs. Training to Failure

In bodybuilding, it is a common practice to push sets until concentric failure, as it is a common belief that only the very last reps of a set—the most strenuous ones—are those that lead to results.

In strength training, on the other hand, it is common to train with a buffer and terminate a set before reaching failure.

In fact, most of the training volume is completed at a medium effort level (RPE=6-8 and RIR=4-2).

Only 5-10% of the volume is executed with a high effort (RPE>8.5-9 and RIR=2-1) and a maximal effort (RPE=9.5-10 and RIR=0). These are usually used only for testing 1RMs and attempting PRs, which is something that happens no more than 2-3 times a year.

A low effort (RPE<6 and RIR≥6) is used mostly for light/active recovery sets or sessions.

Some strength coaches prescribe interrupting the set before technique deteriorates and others stop the set as soon as the rep speed slows down.

Soviet weightlifting coaches used to prescribe a repetition range from 1/3 to 2/3 of the RM at a given weight.

At StrongFirst, we endorsed these guidelines.

But why do we want to stay away from failure? Let me explain using two different scenarios.

Let’s say your 6RM for the bench press is 225lb, this means you can do 6 reps at your maximum effort (RPE=10 and RIR=0).

Scenario 1—All-out sets

You load the bar at 225lb and do a set of 6 reps, pushing yourself to the very limit.

After a 2–3-minute rest, you try another set with the same weight, pushing until you can’t lift anymore. You likely won’t complete another full set of 6, perhaps reaching 4 reps.

If you keep doing all-out sets every 2-3 minutes, you will lose reps in each set. I can speculate that at the end of the game your rep count will progress along these lines: 6, 4, 2, 1.   

Now, let’s consider a few things.

You did 4 sets and a total of 13 reps (6+4+2+1).

Consider the technique of these reps. For most athletes, I’d estimate only about 50%-60% were performed with perfect technique.

In the first set, you were probably able to maintain perfect technique for the first 4-5 reps.

In the second set, the first couple of reps were likely perfect. By the third set, perhaps only the first rep was perfect, and in the fourth, the single rep completed was probably not.

So, you did 7-8 perfect reps out of 13. As I mentioned, 50-60%.

In addition, I’m pretty sure that the next day, towards the evening, you will feel sore, and the muscle soreness will last for a few days, which means that you will not be able to train the bench press again for some time.

Scenario 2—Sets with RIR

If you load the bar with 225lb and do 3 reps—half of your RM—and then rest for 2-3 minutes, you should be able to hit another set of 3 reps.

I speculate that you can easily complete 6 sets of 3 reps, and most likely even more.

Let’s assume you did 6 sets, which means a total of 18 reps.

Now, let’s make our analysis.

I’m sure you agree that 90-100% of these reps were technically perfect.

In addition, you won’t be sore the days following your session, which means that you will be able to train the bench press again, even on the next day if your plan calls for it or you wish to do so.

The bottom line is that training with RIR allows you to complete a higher volume in a session, maintain perfect technique, and train more frequently, which in turn allows you to train with a higher weekly or monthly volume.

Guess what a higher volume with perfect technique leads to? More strength gains and most likely, more muscle growth.

Static Reps vs. Variable Reps

In addition to what was discussed above, we at StrongFirst advise varying the number of reps from set to set, staying within 1/3 to 2/3 of the RM, often using ladders as an effective tool to manage high volumes and combat neural and metabolic fatigue.

Let me explain why we do so with two different scenarios.

Let’s say that you loaded the bar with your 8RM weight, and your session calls for a total volume of 25 reps (NL=25). One-third and 2/3 of the RM rounded to the closest integers are 3 and 5, respectively, hence your rep range is 3-5.

Scenario 1—Static reps at the top of the range

You do 5 sets of 5, the well-known 5×5.

Scenario 2—Variable reps

You do the following ladder composed of 6 sets: 3, 5, 4, 5, 3, 5.

Now, let’s compare the two scenarios.

The ladder leads to a higher number of sets to totalize the prescribed volume. More sets lead to more set-ups, and the importance of practicing a perfect set-up as the first prerequisite for a perfect lift is well known.

With the ladder, even though the weight and volume are the same, only a few sets are pushed to the upper end of the rep range, allowing you to stay fresher throughout the session and maintain perfect technique.

Additionally, keeping the rep count static in the upper end of the rep range leads to more time under tension in each set, which leads to more muscle gains. Some fatigue will gradually build up throughout the session—but never to the point of leading to failure or compromising technique—and this teaches the lifter to struggle under high efforts, which is an important prerequisite for setting PRs.

The bottom line is that there are rationales that support both static reps at the top of the rep range and ladders, and this is why we use both according to several factors, including the athlete’s skill level and the goal of the plan.

The plan I’m about to share with you takes into consideration the principles and considerations above but applies them in an unconventional way. If you are ready to break your plateaus in strength and muscle gains, keep on reading.

The Triple-Tier Plan for Strength and Muscle Gains

I have explained why at StrongFirst we prescribe a rep-range according to the RM at a given weight and we usually vary the number of reps within that range. But while we usually do this from set to set within a session, this plan prescribes varying the reps from week to week within 3-week cycles.

The plan lasts 12 weeks and consists of two parts: a 9-week preparation phase followed by a 3-week peaking phase.

The preparation phase consists of three three-week blocks. During each block, you’ll keep the volume steady. However, the RPE will rise each week as you increase the reps per set and reduce the total number of sets.

When switching from one block to the next one, the RPE drops down, while the volume increases noticeably (≥20%).

The 3-week peaking phase foresees a sharp drop in the volume and a gradual decrease of RPE, with increased intensity towards the final testing week.  

You may choose to apply this strategy to two to six lifts, according to your goals and the time you can devote to your training. In this article, I will show you how to design a three-lift plan.

Here’s how to design your Triple-Tier Plan, step by step.

Step 1—Select the lifts

Pick one lift for each one of the movement patterns and enter them into your weekly schedule.

Example:

Step 2—Find your training weights

You will train each lift at three different intensities, heavy, medium, and light. To establish what is heavy, medium, and light, you will use specific RM ranges.

The table below outlines what heavy, medium, and light will be for you in terms of RM ranges.

According to the table above, you will select the following four weights for each lift:

1. One weight that allows you to complete 1-3 perfect reps.
2. One weight that allows you to complete 4-7 perfect reps.
3. One weight that allows you to complete 8-11 perfect reps.
4. One weight that allows you to complete 12-15 perfect reps.

Please take the time to test your exact RM with each weight, as it will be crucial for assigning the proper training parameters to your plan.

This plan relies on accurate rep counts based on your RMs. Guesswork could lead to miscalculations, rendering your sessions too light or too tough.

Hence, selecting the appropriate weights, and accurately testing your RMs, is your ground zero for this plan.

Example:

You can complete one perfect rep of double kettlebell military press with a pair of 36kg kettlebells and decide to test your RMs with a pair of 32s, 28s, and 24s. Below are your results:

• 36kg x 1RM
• 32kg x 4 reps
• 28kg x 8 reps
• 24kg x 15 reps

Step 3—Establish your rep counts

Once you have established your training weights and tested your RMs, use the table below to establish your rep count for each week and intensity for the preparation and the peaking phases.

Example:

Let’s stick with the previous example of the double kettlebell military press. The rep counts are as follows:

Step 4—Establish your progression

The table below illustrates the volume to be totalized each week per each intensity.

Now that you know your training weights, your rep counts, and the weekly volumes, you are in possession of all the elements you need to establish your progression. Let’s see how it works through two examples, the first covering the preparation phase and the second covering the peaking phase.

Example:

Once again, we will stick with the previous example of the double kettlebell military press. Let’s see how your training schedule looks like during the preparation phase.

Session A calls for your heavy day, and you will do the following:

• On week 1 you will do 8 singles.
• On week 2 you will do 4 sets of 2 reps.
• On week 3 you will do 2 sets of 3 reps, followed by a double.
• On week 4 you will do 11 singles.
• …and so on and so forth.

Note that it will not always be possible to complete the prescribed volume with the prescribed rep count, and hence the very last set may have a lower rep count.

Session B calls for your light day, and you will do the following:

• On week 1 you will do 7 sets of 5 reps, followed by a set of 4 reps.
• On week 2 you will do 4 sets of 8 reps, followed by a set of 7 reps.
• On week 3 you will do 3 sets of 10 reps, followed by a set of 9 reps.
• On week 4 you will do 9 sets of 5 reps, followed by a set of 4 reps.
• …and so on and so forth.

Session C calls for your medium day, and you will do the following:

• On week 1 you will do 8 sets of 3 reps, followed by a double.
• On week 2 you will do 6 sets of 4 reps, followed by a double.
• On week 3 you will do 5 sets of 5 reps, followed by a single.
• On week 4 you will do 10 sets of 3 reps, followed by a double.
• …and so on and so forth.

As you can see, while in each 3-week block the volume remains constant, the RPE increases from week to week, together with the number of reps per set. Within the block the increase in the RPE is counterbalanced by a reduction of the number of sets.

The volume increases from block to block during the 9-week preparation phase.

Things change in the 3-week peaking phase in which the volume drops down dramatically compared to the previous block.

During this final block the volume remains mostly constant, while the RPE decreases from week to week, together with the number of reps per set. Also, some singles with the 1-3RM heavier weight are introduced.

The drop in volume and RPE, together with the increased average intensity induced by the introduction of the heavy singles, sets the foundation for a successful final test.

You have several options for the final test. You may either:

1. Try to set a new 1RM/PR.
2. Test your RM with the 1-3RM weight and assess its increase.
3. A combination of 1 and 2. Once tested the 1RM, take a generous rest (ideally 10 minutes) and then test your RM with your 1-3RM weight.

Example:

Continuing to stick with the previous example, let’s see how your training schedule looks during the peaking phase.

Session A calls for your heavy day, and you will do the following:

• On week 10 you will do one triple with 32kg, one single with 36kg, and a double with 32kg.
• On week 11 you will do one double with 32kg, two singles with 36kg, and a double with 32kg.
• On week 12 you will do one double with 32kg, and then test your 1RM, RM, or both.

Note that the best strategy for this phase is to start your session with one set with the 4-7RM weight, then do the prescribed singles (or the test) with your 1-3RM weight, and finally switch back to the 4-7RM weight and do as many sets as necessary to complete the prescribed volume.

Session B calls for your light day, and you will do the following:

• On week 10 you will do 2 sets of 10 reps, followed by a set of 7 reps.
• On week 11 you will do 3 sets of 8 reps, followed by a set of 3 reps.
• On week 12 you will do 5 sets of 5 reps, followed by a set of 3 reps.

Session C calls for your medium day, and you will do the following:

• On week 10 you will do 3 sets of 5 reps, followed by a double.
• On week 11 you will do 4 sets of 4 reps, followed by a single.
• On week 12 you will do 5 sets of 3 reps, followed by a double.

Conclusion

The Triple-Tier Plan emerged from my deep dive into research and practical trials to evolve our Plan Strong™ and Built Strong seminar curriculums. While this plan is distinct from our seminar offerings, it’s rich with pivotal insights—such as nuanced applications of RPE, RIR, and methods for modulating training intensity—that we’ll incorporate into our updated seminar materials.

You’ll also find new concepts such as Relative Effort and Average Relative Effort, along with innovative weekly training layouts.

I’m excited to invite you to join the upcoming Plan Strong™ and Built Strong seminars this April and May. It’s the perfect arena to familiarize yourself with these innovative strategies and apply them to achieve peak results for you and your students.

And for those of you who have been with us before, remember that the Loyal Alumni Price is there for you, offering a substantial 50% off as a thank you for your continued dedication.

I’m currently deep into the Triple-Tier Plan alongside my training partner, as well as the friends and colleagues who’ve enthusiastically participated in these “training experiments” of mine. Should you choose to embrace this plan and implement it with your students, I’m eager to hear about your experiences. Your feedback is not only welcome but invaluable—it’s the driving force that shapes our continuous improvement.

Power to you—and here’s to advancing together in strength and skill!

Don’t miss our online seminars with Fabio Zonin:

Built Strong—November 16-17, 2024

Fabio Zonin is a StrongFirst Certified Master Instructor. He is a former powerlifter, natural bodybuilder, and owner of fitness centers. He was the first Italian to accomplish the Beast Tamer Challenge and has been a Master Teacher for FIF (Italian Federation of Fitness) for almost two decades (1994-2012).

He is the Former vice president of the AINBB (Italian Association of Natural Bodybuilding), and has trained many athletes at national and international level in natural bodybuilding, powerlifting and other sports.

He has authored numerous articles for Italian popular magazines and websites dedicated to fitness, bodybuilding, and strength training, and has worked with to leading Italian companies in the field of sports equipment, body composition evaluation software, and nutritional supplements.