Oral Steroids Introduction

Table of contents:

Oral Steroids: What They Are and How They Work

Oral Steroids and Hepatotoxicity (Liver Toxicity)

Oral steroids and Negative Cholesterol Changes

Newcomers and prospective anabolic steroid users always are very interested to find out more information about oral steroids. This topic is perhaps one of the most popular because first-time users are attracted by the convenience of anabolic steroids in a very convenient easy to swallow pill or capsule format.

There are several misconceptions about oral anabolic steroids that needed to be clarified:

Misconception #1: Oral steroids are safer than injectable.
Misconception #2: Oral steroids are less effective/strong or more effective/strong than injectable.
Misconception #3: Oral steroids are easier to obtain.
Misconception #4: Oral steroids are cheaper.

First of all -misconception #1: Oral steroids are safer than injectable. Looks like that is the biggest misconception among oral anabolic steroids, and is perhaps the second overall largest misconception in regards to anabolic steroids in general. First one largest misconception about anabolic steroids is the rumor that they will generate massive muscles without any hard work, training, or diet. In reality, injectable and oral steroids both contain various risky compounds in each category. Some of the oral steroids present a higher risk of various dangers to the body, at the same time there are also injectable steroids that also present higher risks. Oral steroids are both harsher on the body's subsystems than the majority of injectable, and despite the fact that there are one or two ‘milder' and ‘safer' oral steroids, the majority of them present the possibility of hepatotoxicity (liver toxicity) and negative cholesterol alterations that are far more impacting than most injectable.

Misconception #2: Oral steroids are less effective/strong or more effective/strong comparing to injectable. That is not so - oral steroids are not stronger than injectable steroids, nor are they weaker. The anabolic strength rating of various oral anabolic steroids does match or surpass the anabolic strength rating of many injectable compounds, while several oral anabolic steroids fall short when compared to injectable compounds as well.

Misconception #3: Oral steroids are easier to obtain. This is also not true. There are very popular anabolic steroids in both categories that are very easy to obtain, but the fact is that the most popular anabolic steroid of all time is an oral steroid (DIANAMED 10 (Methandienone)). And only after them the next two most popular anabolic steroids are the injectable ones: DECAMED 250 (Nandrolone Decanoate) and WINIMED 10 (Stanozolol).

Misconception #4: Oral steroids are cheaper. This is also not true. You can find expensive and cheaper compounds in both categories (oral and injectable). The price depends on various factors such as the popularity of the compound, ease of manufacture, ease of access, and others. That is advised to plan anabolic steroid cycles and calculate all costs and dosages before purchase.

Oral Steroids: What They Are and How They Work

There are only three conventionally and commercially available oral steroids that are bioavailable orally without the need for chemical modification: Andriol, Primobolan, and Proviron. All other oral anabolic steroids must have previously undergone a specific modification to allow oral bioavailability. When Testosterone (or any other anabolic steroid) is ingested orally, too little of it will enter the bloodstream, which is not enough to impart any significant effects on the body. This is so because all ingested substances that are swallowed and processed through the gastrointestinal (GI) tract must always undergo a first pass through the liver before finally entering the bloodstream. Almost all anabolic steroids are very easily metabolized and broken down by the liver, leaving a very miniscule percentage that survives this liver metabolism.

Figure 1: A basic image of the basic steroid structure indicating the numbered carbon positions

It was discovered that by modifying the chemical structure and adding a methyl group (also known as an alkyl group) to the 17th carbon on the steroid structure (also known as carbon 17-alpha), allows the anabolic steroid to become more resistant to hepatic metabolism. This chemical bonding of a methyl group onto the 17th carbon is known as C17-alpha alkylation. After an anabolic steroid becomes C17-alpha-alkylated, it also becomes orally active and bioavailable – without it, the anabolic steroid would not survive liver metabolism. But there is the negative side of this process - increased hepatotoxicity (increased liver toxicity). C17-alpha alkylation allows an anabolic steroid to become more resistant to hepatic breakdown, and any compound that is further resistant to hepatic breakdown will always have greater hepatotoxicity associated with it for various reasons.

Figure 2: A methyl group, which is a central carbon atom bound to three hydrogen atoms, with one available opening to bond to the steroid molecule

Indicated above is the difference between Testosterone without methylation (C17-alpha alkylation) and beside it is an image of Methyltestosterone, which is basically, C17-alpha-alkylated Testosterone to allow Testosterone hormone to become bioavailable orally and survive liver metabolism.

The added methyl group is then indicated by the broken-up red lines forming an arrow-like point at the 17th carbon position, indicating that the methyl group is resting behind the visible orientation of the molecule shown (a solid line forming an arrow-like point indicates the methyl group is situated in front of the visible orientation of the molecule). The C17-alpha alkylation of an anabolic steroid, therefore, places select limitations on how it can be utilized, how long it can be used, and the dosing schemes of an oral steroid. These limitations surround its hepatotoxic effects on the liver and its deleterious effects on cholesterol levels in the body.

The most popular and most common C17-alpha-alkylated oral steroids are (in order of popularity):

Oral Steroids and Hepatotoxicity (Liver Toxicity)

It is very important to realize that not all C17-alpha-alkylated oral steroids exhibit the same amount or level of hepatotoxicity. Various oral steroids are existing that are known to be significantly hepatotoxic (such as ANADROMED 50 (Oxymetholone)), while there are oral steroids that are known as being fairly mild (such as ANAVAMED 10 (Oxandrolone)). That is so because various anabolic steroids are naturally more resistant to hepatic metabolism before they undergo the methylation, and following the methylation, their hepatic metabolism resistance is furthered to even greater degrees.

Studies have shown that all C17- alpha-alkylated oral steroids have displayed some level of hepatotoxicity. The doses utilized in many of these studies were medical therapeutic prescription doses that are generally doses of oral steroids that are far lower than those the doses of oral steroids required for performance and physique enhancement. Those therapeutic prescription doses in the aforementioned study are much lesser compared to bodybuilding doses. Meaning that liver toxicity could potentially become an issue because the minimum beginner dose for bodybuilding purposes for something like DIANAMED 10 (Methandienone) is no less than 25mg per day on average.

The most common form of hepatotoxicity as a result of excessive oral anabolic steroid use is known as a condition called Cholestasis. This is a condition whereby bile flow in the liver becomes either completely halted or at the very least disrupted. This happens as the result from either a physical blockage or a chemical one - the blockage or chemical impairment results in a build-up of bile salts and bilirubin in the liver and bloodstream. In large quantities, this build-up can become very toxic to the hepatic cells of the liver and kill them. The severity of this condition can range from very minor and discomforting and even life-threatening. Minor cases are recoverable in weeks while in case of more severe condition may require months of recovery time. All users must be aware that the excessive abuse of oral steroid doses, as well as oral steroid cycle lengths, can potentially cause very serious liver problems that can become life-threatening. Many users have developed liver cysts, hepatocellular necrotic lesions (liver cell death and scarring of liver tissue), and, although in rare cases, hepatic angiosarcomas and hepatocellular carcinoma (liver cancers).

Oral steroids and Negative Cholesterol Changes

It is a widely-known fact that anabolic steroids can exhibit negative cholesterol changes on the body, some anabolic steroids exhibit this to a lesser extent, while some to a greater extent, and very rare, but still some anabolic steroids have displayed the ability to alter cholesterol levels positively. If we are talking about oral steroids, this negative impact on cholesterol levels is the worst of all types of anabolic steroids. These changes involve the reduction of HDL (the good cholesterol) and increases of LDL (the bad cholesterol). The result of such changes involves an increased risk of arteriosclerosis, and the degree to which these changes occur for the worse are usually dose-dependent (with higher doses increasing the negative changes and the risks). Other factors that affect these negative cholesterol changes are the duration of use, and route of administration.

This is where oral anabolic steroids hold a negative reputation for exhibiting a far worse negative impact on cholesterol in comparison to injectable anabolic steroids. This happens because the liver serves to function as the cholesterol processing center for the human body, and the increased hepatotoxicity associated with anabolic steroids will result in even worse negative cholesterol changes. The use of anabolic steroids has a profound effect on increasing an enzyme in the liver known as hepatic lipase, which is the enzyme that actively metabolizes and breaks down the ‘good' HDL cholesterol. This results in less HDL cholesterol in circulation in the body during the anabolic steroid cycle. There is evidence that the negative impact on cholesterol by oral steroids is significant enough to warrant concern.

Limitations of Oral Steroids

That is advised to run oral steroids for short periods no greater than 6 – 8 weeks at any given time in a cycle. This should be done to ensure healthy liver function and proper liver recovery following the cycle. Several oral steroids that are known to exhibit liver toxicity than others are advised to be used in the range of 4 – 6 weeks, while others can be utilized in the range of 6 – 8 weeks and some perhaps slightly longer (10 weeks maximum). Taking into account the risk of hepatotoxicity, the main function of oral steroids in any cycle should be to primarily serve as a supplementary compound to a solid base of injectable compounds or as a supportive kickstarting compound. All users, especially beginners, must understand that no oral steroid should ever be run solitarily on its own. Injectable compounds are the base compounds of any cycle.

Testosterone in some form no lower than a TRT (Testosterone Replacement Therapy) dose should always be run with an oral steroid. Oral steroids will exhibit suppression of endogenous Testosterone production as severely as any other anabolic steroid, even the oral steroids such as Anavar that are regarded as ‘mild' compounds. Testosterone should always be utilized in some form or another in every single cycle to maintain normal physiological functions during a period in which exogenous hormones are used that will suppress and/or shut down the body's HPTA (Hypothalamic Pituitary Testicular Axis) and endogenous Testosterone production.

Examples of Oral Steroid Cycles

Oral Steroid Cycle as supplementary components or a kickstart to a base of injectable compounds:

Oral Steroid Cycle Example #1

Weeks 1 – 12:

TESTOMED E 250 (Testosterone Enanthate) at 300 – 500mg/week
DECAMED 250 (Nandrolone Decanoate) at 400mg/week

Weeks 1 – 4:

DIANAMED 10 (Methandienone) at 25mg/day

Oral Steroid Cycle Example #2

Weeks 1-12:

TESTOMED E 250 (Testosterone Enanthate) at 100mg/week
DECAMED 250 (Nandrolone Decanoate) at 400mg/week

Weeks 1-6:

ANADROMED 50 (Oxymetholone) at 50mg/day

Oral Steroid Cycle Example #3 (high-dose short-term advanced level cycle of 4 weeks)

Weeks 1 – 4:

TESTOMED P 100 (Testosterone Propionate) at 150mg daily (1,050mg/week)
TRENBOMED A 100 (Trenbolone Acetate) at 150mg daily (1,050mg/week)
ANAVAMED 10 (Oxandrolone) at 100mg/day

Examples of Oral-Only Cycles

That is a very bad idea to run such cycles. Without any form of exogenous Testosterone, the body will be incapable of maintaining its normal physiological functions that are normally governed by Testosterone. Other anabolic steroid analogues and derivatives such as oral steroids might be several times as anabolic as Testosterone, but those are all the benefits most of these compounds possess. For example, DIANAMED 10 (Methandienone) is a very strong oral steroid with fairly low androgenic effects and very strong anabolic effects – however, it is not a proper androgen for normal bodily function. The human body and endocrine system are not simple. ‘Normal bodily function' means much more than just functions such as libido or other superficial functions that are often over-focused upon by many individuals. Testosterone hormone is vital for proper libido function, it is a regulator of cognitive and physical energy, it regulates the population of thromboxane A2 receptors on megakaryocytes and platelets, and hence platelet aggregation in humans. It is also essential for proper mental and psychological function, and many other essential. Even if a particular oral steroid is ‘better' than Testosterone in one or two areas and the fact that it might be more convenient to administer, does not mean that it is better than it in every single aspect and function.

The compounding of two or more oral anabolic steroids is very improper decision than the liver is concerned. No more than one oral steroid should be stacked at any one given time, even within properly structured anabolic steroid cycles. Because of the limitations in oral-only cycles, no individual can ever possibly expect the proper physique changes and gains that could be accomplished with a properly structured anabolic steroid cycle. Instead, the potential for gains is limited or gains are often lost very shortly after the end of the cycle.

Here are some examples of oral-only cycles:

Oral-only Steroid Cycle Example #1

Weeks 1 – 8: