The history of the development of the class of chemicals we call “steroids” goes back several decades. There are a couple of interesting stories regarding this history I would like to relate to the reader in this week’s column.
The first story is about the earliest documented clinical use of the hormone cortisol obtained from the adrenal glands of animals. At the time cortisol was known as “Compound E” because scientists did not know the actual chemical structure but knew there was a powerful substance produced by these glands.
On Sept. 21, 1948, Dr. Charles Slocumbe and Dr. Philip Hench injected 50mg of Compound E into a young woman suffering from acute rheumatoid arthritis. The same injection was repeated twice the next day. Remarkably, the patient improved so much that she went into remission and was discharged home. It is said that the patient felt so good she was able to immediately go shopping. News of this treatment spread quickly and the demand for this substance increased greatly.
Shortly after this occurred, the chemical structure for cortisol was discovered. Also, at this time many other hormone structures were discovered and found to be similar, though how they act on the body varied significantly. The production of these steroids took several tons of animal glands and was costly to produce; so costly that it was too expensive to be used routinely. Soon another production process was found that took the bile from an ox to make the different steroids. However, even this was too expensive, complicated, and impractical.
During this time, it was discovered that certain female hormones (also steroids) could prevent pregnancy. A determined search for a less costly process to produce steroids was undertaken by the pharmaceutical industry because of the demand for cortisol-like compounds, but also the female hormones which promised to make oral contraception a reality.
Prior to these events, it was known that plants produced chemicals called sterols, structurally similar to steroids. A scientist named Russell Marker discovered that the Mexican Yam (Dioscorea mexicana) produced a high quantity of a chemical, diosgenin, which could easily be converted to the basic steroid structure. He started a company in Mexico called Syntex to produce steroids.
Because of the discovery of a relatively inexpensive way of producing steroids the price of these medications dropped so much that they became commonly used. In fact, it is thought that the hormones estrogen and progesterone (both steroids) are the most used medications in the history of medicine. However, it was the discovery of the Mexican Yam as a source of the basic building block chemical that made the production of steroids affordable to the world.
Stay informed and stay healthy.
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William Garst is a consultant pharmacist who resides in Alachua, Florida. He received his B.S. in Pharmacy from Auburn University in 1975. He earned a master’s degree in Public Health in 1988 from the University of South Florida, and a Master’s in Pharmacy from UF in 2001. In 2007 he received his Doctor of Pharmacy from the University of Colorado. Dr. Garst is a member of many national, state, and local professional associations. He serves on the Alachua County Health Care Advisory Board and stays active as a relief pharmacist. In 2016 he retired from the VA. Dr. Garst enjoys golf, reading (especially history), and family. He writes a blog called The Pharmacy Newsletter (https://thepharmacynewsletter.com/). William Garst can be contacted at firstname.lastname@example.org.
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