#Middlebury
DEAR DR. ROACH: My 23-year-old son is a bodybuilder, and much to my dismay, he takes steroids. I know he takes testosterone, and I don’t know what else. How will this affect him? – Anon.
ANSWER: Testosterone has many bad long-term effects, and he really should stop it. As a resident, I took care of a seemingly very healthy, very muscular 30-year-old man with terrible heart failure due to a heart attack. Many similar reports have led to suspicion that steroids taken for bodybuilding increase risk of heart attack and even sudden death. There appear to be many other long-term effects, including neuropsychiatric effects of anger and aggressive behavior. They also may reduce sperm count and affect fertility.
I don’t know what else he may be taking, but I would strongly urge him to evaluate all supplements carefully.
DEAR DR. ROACH: I was a healthy female until I had an injury to my back. I experience pain and tingling in my right side, going down the back of my right leg. Sitting is especially painful, as is standing in one place for too long.
Now the pain has started in my left side also. I have tried chiropractors, acupuncture, physical therapy, epidural shots and pain pills. I also had two laminectomies (decompression surgery on the spinal canal) on L4/L5 last year, with no relief from the pain. Upon seeing another neurosurgeon, I have been told that I have some large Tarlov cysts (1 cm).
There does not seem to be a great amount of information about these on the internet, plus I am not sure what information out there is accurate. One doctor on the Internet is all about having surgery on them. The neurosurgeon I am seeing does not want to do surgery just yet. He says that surgery does not always bring about pain relief.
Can you share some information about these Tarlov cysts and what can be done for the continued back and leg pain? Dealing with this for several years has caused me much emotional distress and depression. – F.H.
ANSWER: Tarlov cysts, also called perineurial cysts, occur along the lining of the spinal cord and nerve roots. In one study, in 500 people with MRI scans, 23 had Tarlov cysts, but only five had any symptoms from them. In this study, the cysts were drained by a needle, which relieved the pain, although the pain usually came back as the cysts refilled with fluid.
I agree with your neurosurgeon that surgery on these does not guarantee success. Since you have had two surgeries and multiple types of therapies that haven’t worked, I can understand your frustration. It might be worth talking to the neurosurgeon about a trial of draining the cysts to see if that helps the symptoms.
The booklet on back problems gives an overview of the causes and treatments for the most-common back maladies. Readers can order a copy by writing: Dr. Roach – No. 303W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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