Suspect steroids?
Warning signs and advice for parents

From Lyle Micheli, MD, director of Orthopaedic Surgery at Children's

Parents should know that teenagers do have access to steroids and know the telltale signs. These include:

• Changes in behavior, usually mood swings
• Rapid gain in muscle mass
• Acne
• Depression
• Rage and volatile temper

• We have to make better alternatives for safe exercise available to kids. We need more programs for adolescents to work on strength training and conditioning. Many health clubs have age limits of 16 or 18, so we should all be proactive by making sure programs are more available for kids through the YMCA or special programs at health clubs.

From Alison Field, ScD, an epidemiologist at Children's
• Anything you do in excess, even exercise, is bad for you, if you're not leading a life of balance. The message parents should try to impart to their children is to work toward balance and make time for family, friends, work, play and exercise. The message should be about being the healthiest, not the strongest or most in shape or most powerful.

• Help teenagers set up realistic expectations for themselves and realize that the images they're seeing in magazines have been changed with airbrushing. If the models can't even look perfect enough, then clearly, that's not a realistic expectation for anyone else to have either.

From Ximena Sanchez-Samper, MD, of Children's Adolescent Substance Abuse Program
• If parents begin to notice changes in their child's behavior and decide to get him screened for drug use, remember that steroids don't come up in usual urine screens. Online testing kits don't catch it either. You have to ask for a special screening at your child's doctor's appointment. If you do that, be upfront with your child and talk about it first, explaining that you want him screened for steroid use.

• If your kid is working out and taking supplements, make sure her doctor knows what she's taking—what brand and amount.

• If your kid plays organized sports, be sure you know the coach well and find out the coach's mentality toward sports. Is he a slave driver or someone who sees sports as a way of recreation, teamwork and staying healthy?

• If your child is using steroids, don't have her stop immediately since she needs to taper off under medical supervision. You need to find an endocrinologist—a physician who specializes in the body's glands and hormones—your child can trust who can outline how she can get off them while supporting her mentally. Treatment usually involves a therapist and sometime family therapy. You need to find other ways to maintain and enhance her self-esteem when she stops using steroids, since it'll be tempting for her to go back to them.