S9 Glucocorticoids


Glucocorticoids belong to the group of corticosteroids, a class of steroid hormones produced in the adrenal cortex. Like all corticosteroids, they arise from the starting substance cholesterol. Glucocorticoids have pain-relieving and anti-inflammatory effects, which is the reason why they are abused for doping purposes. Glucocorticoids are steroid hormones produced by the body or manufactured synthetically that influence the body's metabolism and have pain-relieving and anti-inflammatory effects.

Effect of glucocorticoids

Glucocorticoids have a boosting effect on the new formation of glucose (gluconeogenesis). Protein and fat deposits are broken down and used for the production of energy. Glucocorticoids reduce inflammation and relieve pain. In addition, they suppress the sensation of physical fatigue and have a mildly euphoriant (i.e. mood-lifting) effect.

The body's own glucocorticoids are produced in the adrenal cortex and released when the body has to cope with a stress situation.

They reach the blood circulation, are distributed throughout the body and bind to glucocorticoid receptors which are present in nearly all tissues. Additionally administered glucocorticoids also bind to these receptors.

By this mechanism, the administration of glucocorticoids promotes gluconeogenesis and the breakdown of protein and fat in the body. In addition, glucocorticoids have anti-inflammatory and pain-relieving effects.

⬆ Gluconeogenesis

⬆ Protein breakdown

⬆ Fat breakdown

⬇ Inflammation

⬇ Pain perception

Route of administration

Glucocorticoids are used in the treatment of various illnesses e.g. allergies, asthma, sudden hearing loss and rheumatological disorders. The prohibited status of glucocorticoids is dependent on their route of administration.

All glucocorticoids are prohibited in-competition if they are administered via the following routes:

  • any injectable route of administration, i.e. all injections administered with a needle [(e.g. intra-articular (into a joint), intrabursal (into a bursa), intramuscular (into a muscle), intravenous (into a vein), peritendinous (around a tendon) or subcutaneous (under the skin)];
  • oral, i.e. administration where medication is swallowed by mouth, including oromucosal use (for example buccal (via oral mucosa), gingival (on the gums) or sublingual (under the tongue)];
  • rectal, i.e. administration into or through the rectum.

Other routes for administering glucocorticoids are permitted at any time (in-competition and out-of-competition). Examples:

  • Dermatological (e.g. application of a cream on the skin)
  • Inhalation into the lungs
  • Intranasal (e.g. nasal spray)
  • Ophthalmological (e.g. eye drops)
  • Perianal (e.g. external application of a cream around the anus)
  • Intracanal dental administration (into a root canal)

Check the prohibited status of your medication with the medication inquiry service Global DRO.

Side effects and consequences of glucocorticoid abuse

Because glucocorticoids affect many systems of the body, they also have numerous potential adverse effects. On the one hand, they inhibit the body's own production of glucocorticoids via the hypothalamic-pituitary axis. This effect is called negative feedback. On the other hand, they suppress the immune system and have a catabolic (tissue-reducing) effect leading to a reduction of bone density (osteoporosis) and muscle wasting. Other adverse effects after long-term abuse include diabetes, increased risk of stomach ulcers, central obesity (= deposition of fat in the abdominal area), eye disorders, growth disorders and psychological alterations.