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Deca-use may hide tuberculosis

If nandrolone users have tuberculosis, they run the risk that doctors might not pick up on the fact. The tests that doctors do to detect the early stages of tuberculosis don't work on nandrolone users.

We base this statement on a medical case study from Venezuela, published in the Open Access publication Journal of Medical Case Reports. In the article the authors describe the case of a 31-year-old steroids user who had been running a fever for two weeks.

Deca-use may hide tuberculosis
He was sweating and was out of breath. His lungs were full of fluid and that was making breathing difficult.

Before the man became ill he had been using steroids. He injected himself with 50 mg of nandrolone decanoate daily the quality stuff from Organon, if we are to believe the article.

The doctors suspected that the man had tuberculosis. Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis, shown in the photo below. Two million people die from tuberculosis each year. That sounds like a lot, but things could be a lot worse: a third of the world's human population carries Mycobacterium tuberculosis. So three cheers for the human immune system.

Deca-use may hide tuberculosis
When the doctors examined the guy, their tests showed no signs of Mycobacterium tuberculosis infection. They did a number of tests, including measuring the concentration of the enzyme adenosine deaminase in the man's lung fluid. If you have tuberculosis, you have increased concentrations of this enzyme. But according to the test results, the guy wasn't sick at all. So the doctors pumped his lungs clean and sent him home.

Four months later the doctors examined the man again. He was much sicker and had lost five kilos in weight. This time round, the signs were clear. It was tuberculosis. The man got medicine and recovered. Just in time.

Why, the doctors asked themselves, hadn't their tests picked up the infection earlier?

Because the guy was using nandrolone, they think.

Nandrolone decanoate neutralises the production of interferon-gamma. This is the protein in charge of the immune cells that function as the first-line defence when pathogens like Mycobacterium tuberculosis try to infect the body. Interferon-gamma also stimulates cells to produce more adenosine deaminase which is the biomarker that doctors look for as a sign of tuberculosis.

If doctors encounter someone with tuberculosis-like symptoms, but for whom the tests give no indication of tuberculosis bacteria infection, then the doctors should check whether they are dealing with a nandrolone user, the article concludes.

J Med Case Reports. 2009 Jan 28;3(1):30.