Hepatology and Pancreatic Science

Anabolic steroids: The biomarker and treatment for Crohns disease

Abstract

Edward M Lichten

The finding that the reduction within the Estrogen Receptor ER-beta/ ER-alpha ratio may be a pathologic biomarker for flairs in Crohn???s Disease has been scientifically linked, retrospectively, to 1) reduced bioavailable testosterone, 2)  hypothalamic-pituitarygonadal axis dysregulation and 3) environmental toxins as probable causation. Estrogen turns
off the ER-beta and must be avoided. Bioavailable testosterone is recognized because the biomarker, the Free Androgen Index (FAI). Decreased bioavailability is calculated because the ratio of decreasing Total Testosterone levels and increasing sex-hormone-binding globulin (SHBG). The FDA medication that increases serum total testosterone without increasing estrogen is nandrolone. The FDA medication that decreases SHBG is stanozolol. Using weekly intramuscular  injections, the FAI is used because the drug-related biomarker. Increases in FAI parallel the recovery and potential remission seen with 5 of seven Crohn???s patients followed  for up to five years. Each had exhausted all medication and surgical options; 2 had all the complications related to their Short Bowel Syndrome. The FAI is the scientific serum drugrelated biomarker that increases with treatment directed improvement in disease. These two available anabolic steroids offer a paradigm shift beyond biologics and surgical resection; these patients may now realize the compassionate relief from the devastation of inflammatory bowel disease