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The Difference Between Steroid and Cortisone (From a Doctor)

Tyler Sellers
Published by Tyler Sellers | Senior Coach
Last updated: June 22, 2023
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Here at TotalShape, our take on steroid use has always been avoiding them at all costs.

In my career as a fitness trainer for over a decade, I’ve seen many athletes take steroids illegally. But I’ve also come across those who’ve been accused of steroid use for taking cortisone shots to treat certain ailments.

Since there’s a lot of confusion out there about different steroids, I teamed up with an endocrinologist and spent a few weeks reviewing and discussing the different medical uses for steroids, as well as the scientific literature on the matter.

Let’s dive in.

Quick Summary

  • Anabolic steroid is a manmade steroid, whereas cortisone is an anti-inflammatory steroid.
  • Cortisone controls the immune system from causing inflammation, whereas anabolic steroid helps build body muscles within a short period.
  • Some side effects of steroid usage include mood swings, severe fatigue, stomach upset, and high blood pressure.

What’s the Difference Between Anabolic Steroids and Cortisone Injections?

A person injecting a syringe into a bottle

The main difference between anabolic steroids and cortisone injections is their chemical makeup and effects.

Anabolic steroids are a manmade version of testosterone, whereas cortisone is a corticosteroid, a type of anti-inflammatory steroid.

People often confuse anabolic steroids and corticosteroids.

While possessing both is illegal, you can obtain them strictly for medical purposes with a doctor’s prescription.

Let’s get into the differences between anabolic steroids and corticosteroids.

What They Are

Anabolics are synthetic steroids that resemble the male sex hormone testosterone. Anabolic steroids work as an external source of testosterone to help you gain muscle size and strength quickly.

Corticosteroids are natural systemic steroids produced by the adrenal glands, but they also exist as synthetic derivatives of the natural steroid cortisol. They have strong anti-inflammation effects.

The words systemic steroids, corticosteroids, glucocorticoids, and cortisones are often used interchangeably.

How They Work

A doctor injecting a syringe into a bottle

Anabolics mimic testosterone and spike your body’s T-levels beyond what it can produce so that you can build more muscle in a short span of time.

Cortisone works by preventing your immune system from producing substances that cause inflammation [1].

Who Uses Them

Anabolics are often used by competitive athletes to gain an unfair advantage over other competitors.

People with genetic muscular defects, injuries, or certain diseases like cancer also take anabolic steroids under medical supervision.

Cortisone shots are usually administered to athletes who’ve suffered sports-related muscle injuries.

People who suffer from ailments such as rheumatoid arthritis, inflammatory bowel disease (IBD), asthma, allergies, and other medical conditions are treated with cortisone [2].

How They’re Taken

Anabolic steroids are administered in the following ways:

  • Injections
  • Tablets
  • Creams
  • Gels
  • Pellet implantation under the skin

Corticosteroids are taken in the following forms:

  • Shot
  • Skin cream
  • Inhaler
  • Nasal spray
  • Liquid
  • Pills
  • IV

Benefits and Side Effects of Cortisone

Close up shot of a syringe and a bottle

Cortisone injections have many benefits and side effects. We’ll explore some of the most common ones.


Cortisone injections are used as a treatment for several conditions [3].

Here are some examples:

  • Asthma
  • Hay fever
  • Allergic rhinitis
  • Hives
  • Atopic eczema
  • Chronic obstructive pulmonary disease (COPD)
  • Inflamed and painful joints, muscles, or tendons
  • Lupus
  • Inflammatory conditions like IBD (inflammatory bowels disease)
  • Multiple sclerosis
  • Giant cell arteritis

Board-certified physician Dr. Nicholas Anastasio adds that cortisone injections are useful because they take effect very quickly, within a few days.

It is also more effective because the injection allows us to deliver a more potent dose of the medication directly to the problem area.

Side Effects

Oral or injected corticosteroids carry multiple side effects [4].

The most common are:

  • Fluid retention
  • High blood pressure
  • Mood, memory, and behavioral problems
  • Puffiness in the face, back of the neck, and abdomen
  • Stomach upset
  • Elevated eye pressure
  • Clouding of the lens in one eye or both
  • High blood sugar
  • Blurred vision
  • Muscle weakness
  • Thinning skin and bones
  • Increased risk of infection
  • Severe fatigue

If you are considering taking any inflammation medication, make sure to first seek professional medical advice from relevant authorities, like board-certified physicians, to minimize these side effects.

Benefits and Side Effects of Anabolic Steroids

Close up shot of a syringe and a bottle

Anabolic steroids are used by 0.5% of the American population for the benefits they provide for certain conditions, but to a great extent, illegally for performance [5].

However, taking anabolics has many serious side effects as well.

Here are some of the most common benefits and side effects of anabolics.


  • Muscle building and recovery: In addition to increasing muscle size and strength, athletes inject steroids to reduce muscle damage during strenuous workouts [6]. This can help athletes recover quickly and push hard in their next workout.
  • Treatment of certain medical conditions [7]. Examples:
  • Helps with steroid weight gain after severe injury, illness, or infection
  • Treats certain kinds of anemia
  • Treats certain kinds of breast cancer
  • Treats hereditary angioedema, which causes swelling of the face, throat, arms, bowels, legs, and sexual organs

Side Effects

  • Testicular shrinkage: One of the most common side effects of anabolics is testicular shrinkage, also called hypogonadism [8].
  • Infertility: A symptom of hypogonadism from steroid abuse is male infertility [9].
  • Mood swings: Steroids throw off your hormonal balance and make you more susceptible to aggression and irritability [10].
  • Gynecomastia: Another symptom of hormonal imbalance from steroid abuse is gynecomastia (aka man boobs) [11].
  • Side effects in women: In women anabolic steroid abuse can lead to male-pattern baldness, excessive body hair growth, coarse skin, decreased breast size, and deepened voice [12].
  • Heart muscle damage: Fat-burning steroids like clenbuterol can damage the heart muscle [13].

“Anabolic steroid use has been associated with a range of medical and psychological side effects.”

- Dr. Astrid Bjørnebekk, PhD


Do Professional Athletes Take Cortisone Injections?

Yes, some professional athletes take cortisone injections. Some athletes take them to gain an unfair advantage in their event, whereas other athletes take them under medical supervision.

Are Cortisones Banned From Athletic Competitions?

Yes, cortisones are banned from most athletic competitions because they can give athletes an unfair advantage in the event. However, if an athlete requires it for medical purposes during a sporting event, they can receive an in-advance Therapeutic Use Exemption for steroid injections.

How Quickly Do Cortisone Shots Work?

Cortisone shots work within one to three days after injection. After the shot, you may feel numbness for about a day and a flare-up that fades away within 48 hours. If your symptoms don’t go away, seek immediate professional medical advice.

Why Are Steroids Injected?

Steroids are injected so that your healthcare provider can deliver a higher dose of medication if you need it. It also allows them to focus on treating specific areas.

Why the Difference Matters

While both anabolics and cortisones have their benefits, we recommend not using them unless you receive professional medical advice to do so.

If you’re trying to gain muscle and lose fat, going natural with the best legal steroids is the recommended route, by far. Check out our top lists:

We’ve tested these products ourselves and with clients and consistently found very positive results in terms of both subjective and objective data.

Because they naturally boost testosterone levels, legal steroids can help you get over fitness plateaus without wreaking havoc on your health.


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