Anabolic Steroid Use for Weight and Strength Gain in Critically Ill Patients: A Case Series and Review of the Literature
Table 1
Overview of indications and results of anabolic steroid supplementation.
Indication for anabolic steroids
Date of first dose administered
Testosterone level before administration
Weight change after administration
Grip strength change
Strength change
Patient 1
Profound critical illness weakness
Day 32 of ICU stay
0.6 nmol/L (<2.0 nmol/L)
+7.3 kg 45 kg (22/4) 52.3 (15/5)
(L) +4.4 kg (R) +6 kg
From 1/5 power globally to ambulation with minimal assist on discharge
Patient 2
Profound critical illness weakness
Day 82 of ICU stay
5.7 nmol/L (1035 nmol/L)
−3.8 kg 115.8 kg (3/9) 112 (17/9)
(L) −0.6 kg (R) +5.7 kg
From profound generalised weakness (0-1/5) to multiple repetitions of assisted sitting to stand exercises and tracheostomy decannulation
Patient 3
Profound critical illness weakness
Day 30 of ICU stay
Not available
+1.5 kg 72.5 kg (23/5) 74 kg (26/5)
Grip strengths not assessed
From profound weakness (flicker contraction 1/5) to increased strength in all muscle groups (3-4/5)
Patient 4
Long-term malnutrition and inability to gain weight or strength
Day 70 of admission and ICU review for ongoing TPN/nutritional advice
6.5 nmol/L (10–35 nmol/L)
+4.4 kg
(L) −3.6 kg (R) −3.4 kg
Power globally 3/5. From fatigue on transfers to ambulating independently for very short distances with frame
Handgrip threshold of 11 kg force in males and 7 kg force in females for the diagnosis of ICU acquired weakness (sensitivity 80.6%, specificity 83.2%, NPV 92.3%, and PPV 63.0%) [13].