Gone are the days where you could go to a doctor and get a script to buy steroids from a pharmacy, due to steroids being abused by athletes and bodybuilders they are now illegal. The only way to buy steroids now is on the black market, either from a dealer or from an online source. When steroids were legal and were purchased from a pharmacy, the only steroids you could get were pharmaceutical grade which were extremely high quality and worked far better than the “underground” stuff. Today pharmaceutical steroids are harder to get hold of and cost a lot more, for this reason many people opt for black market steroids which usually are lower quality and can cause infections due to them being produced in an non-sterile environment. Only injectable steroids need to cause concern when purchased from an underground lab, oral steroids don’t need to be produced in a sterile environment.
In normal healthy patients there is a prompt secretion of cortisol with the onset of surgery and secretion remains elevated for several days after surgery. Glucocorticoids are not stored and must be synthesised when required - for example, during and after surgery. This response depends on the hypothalamopituitary axis which may be suppressed or unresponsive to stress when steroids have been taken. [ 1 ] Failure of cortisol secretion may result in the circulatory collapse and hypotension characteristic of an hypoadrenal or 'Addisonian' crisis. [ 2 ]