What are Prohormones

Hormones are the chemicals naturally produced in our body to regulate growth, development, and metabolism. Modern medicine is focusing on developing supplements or compounds that make one’s body naturally produce the required hormones. Prohormones are one such supplement that is gaining popularity in recent days. While prohormones are a “pro” for certain therapeutic purposes, they might be a “con” as it has the potential to cause harm if someone misuses them. 

Prohormones

Prohormones are a group of artificially synthesised inactive precursor forms of peptides made from the most biologically active hormones. Prohormones are not real hormones; instead, they open a pathway for the body to naturally produce its hormones. Prohormones can only become hormones after entering the body and being contacted by enzymes when it enters a cell.^1,2  

Prohormones serve as an ideal container for the storage and delivery of inactive hormones because they are naturally produced by the body to control hormone expression. One of the naturally produced prohormones is proinsulin, a precursor which makes insulin in our body. A widely produced synthetic prohormone is known as “ anabolic steroid precursors”, and is associated with enhancing muscle growth, protein synthesis, and insulin production.^2,3 

What do prohormones do to the body?

Prohormones are transformed into a type of hormone called anabolic hormones by the enzymes present in the body. Prohormones promote protein synthesis, muscle growth, and increased lean muscle mass. These effects on the body make these prohormones very appealing to athletes and individuals interested in bodybuilding. 

Prohormones have an effect on protein metabolism, including an increase in protein synthesis and a decrease in protein breakdown, which could result in the growth of muscles and improvement when paired with resistance exercise training. Prohormones have very instant effects in a short time span, but these effects are linked to increased production of male hormones in the body.^2,4,5

The production of increased levels of testosterone by these prohormones makes it androgenic, meaning they produce male characteristics. These characteristics could include face and body hair, as well as a deeper voice. The effects of prohormones are very similar to anabolic steroids. 

Some of the prominent effects of prohormones are:²

• Healthier and stronger bones
• Well-built toned muscles
• Increased body mass
• Increased libido
• Enhanced athletic performance

Although these effects might be considered positive side effects, they come with an increase in aggression or an overall hormonal imbalance, as many prohormones are said to act on the central nervous system.⁵

Benefits of prohormones

Prohormones are not only linked to athletic use. A 2017 study showed patients with hyperparathyroidism, which is brought on by a decline in renal function in chronic kidney disease (CKD), may benefit from taking vitamin D prohormones medicinally. Prohormones may be added to various medications to help patients during specific therapy periods. Patients with atrophied muscles or vitamin deficits may find this especially beneficial.⁶

The natural prohormone pro-opiomelanocortin (POMC) plays an essential role in controlling physiological responses such as immune response, metabolism, nervous system responses, adrenal responses (hormones produced to control stress and blood pressure), and obesity. 

Certain people have a deficiency of POMC, leading to problems such as low blood sugar, higher cortisol (stress hormone), paler skin, and a disrupted energy balance leading to binge eating. In cases of POMC deficiency, the use of its prohormone is beneficial for helping patients lead a healthy lifestyle.⁷

Prohormones work best when combined with a balanced, healthy diet and regular exercise (weight training and cardio) if you want to see athletic benefits. In other words, if you do not exercise and lead a healthy lifestyle, you cannot expect prohormones to work. They are intended to complement your health rather than substitute a healthy lifestyle, just like any other supplement.²

Side effects of prohormones

Prohormones are advertised as supplements, which makes many believe it is safe. There is not a lot of research supporting how safe prohormones are but their consumption is associated with a lot of side effects. The severity of the side effects differs between individuals, as everyone’s body processes the prohormones depending on factors like maintaining a balanced diet or regular exercise.

Prominent side effects linked to prohormone usage:^3,4

• Severe headaches
• Palpitations, increased heart rate
• Stomach cramps
• Nausea
• Insomnia caused by an energy imbalance
• Mood swings and drastic changes in personality
• Increased anxiety and lack of motivation
• Acne, hair loss

The side effects will differ depending on the prohormone consumed. For example, certain prohormones for muscle building in men cause an increase in female hormones (oestrogen) which leads to the enlargement of breast tissues.⁴ 

Studies also found long-term effects like increased cholesterol levels, irreparable kidney damage, and a decrease in heart and liver functions. Prohormones also contributed to hormone imbalances in the brain, such as fluctuating levels of serotonin and dopamine, which unpredictably alters the mood of a person.^3,4,5 

Types of prohormones

Prohormones are made up of ergogenic (physical performance-enhancing substances) and anabolic agents in oral supplements. Many prohormones were banned worldwide after witnessing the side effects, substance abuse by athletes, and the lack of scientific evidence backing how it works in one’s body.⁴ The use of prohormones is becoming a huge legal grey area, but there are still certain prohormones available on the market without a prescription. 

Some of the commonly available prohormones are:^2,8,9

• Two-step conversion prohormones: To get the desired prohormone, these prohormones undergo two conversions in the body. For example, the prohormone 1-Andro, which was converted into 1-AD and 1-Testosterone ( a 2004 banned anabolic steroid). Some of the prohormones that work by this mechanism are DHEA, androstenolone, and prasterone.

• Methylated prohormones: These prohormones use a methyl group at the beginning of their compound to prevent the active component (the hormone precursor) from being broken down and to retain it longer in the body. M1T is one such example, but it harms the liver.

• Non-Methylated prohormones: As the name suggests these do not use a methyl group to ensure their safety on the liver. Some examples are DHEA and androdiol.

• DHEA (dehydroepiandrosterone): DHEA is a naturally produced hormone in the body by the adrenal gland. DHEA is a substance that initiates the production of testosterone (male hormone). This is one of the most commonly used legal prohormones worldwide. 

Who should take prohormones?

Prohormone supplementation may be beneficial for you, but there isn't enough evidence to say so with any degree of certainty. It is better to refrain from using prohormones for athletic purposes, as there are healthier alternatives such as an increased protein diet or intensity training to achieve long-term muscle gain. 

It is best to talk with a dietician or your athletic trainer if you want to experiment with any prohormone supplements. It is very important to make an informed decision, as prohormones have long-term effects on one’s body.

The use of prohormones for medicinal purposes is still experimental and not very common. In recent days, prescribed prohormones are given to individuals with hormonal deficiency (reduced male or female hormones).⁴ Even if they are prescribed to you, talk with your GP regarding the possible side effects and how you go about managing them. 

Who should avoid using prohormones?

In general, it is best for everyone to avoid the use of prohormones due to their adverse side effects. Although many prohormones are banned, there are still many supplements with prohormones available over the counter. 

Groups of people who must avoid prohormones at all costs are:^3,4

• Children and people under the age of 18
• Pregnant women and women who are trying to conceive 
• Breastfeeding mothers
• People working towards losing weight
• People with mood disorders  
• People with a history of heart or kidney disease 

Prohormones have effects similar to steroids, making them addictive in nature. They can very easily be misused, and should be taken with extreme caution.

Summary

Prohormones are substances that enhance the production of hormones in one’s body. These are oral supplements that are primarily used for athletic muscle building, but are being used for other medicinal purposes. Prohormones cause many adverse side effects in an individual. They are also known to be addictive, hence it is best to avoid them and seek out alternatives for athletic body development. Reach out to a GP before using them, or if you have used them in the past, make sure to get regular overall body wellness check-ups.