Metabolic side effects have included osteolytic-induced hypercalcemia in immobilized patients or those with metastatic breast disease. Anabolic steroids affect electrolyte balance, nitrogen retention, and urinary calcium excretion. Edema, with and without congestive heart failure, has occurred during anabolic steroid therapy. Decreased glucose tolerance requiring adjustments in hyperglycemic control has been noted in diabetic patients. The androgenic activity of anabolic steroids may decrease levels of thyroxin-binding globulin and result in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged and there is no clinical evidence of thyroid dysfunction. Significant increases in low density lipoproteins (LDL) and decreases in high density lipoproteins (HDL) have occurred. [ Ref ]
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