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Liver Damage from Designer Steroids

Liver Damage from Designer Steroids

If you are considering the use of 17-aa oral steroids, or are already using 17-aa oral steroids, here's some information you might want to know.

Improper use of oral steroids can cause liver damage adn result in serious health problems. No matter how big or ripped you may be, a faulty liver will drive your hard earned gains right down the toilet and send you strait to a hospital bed.

This article contains information on:
  • How oral steroids impair liver function and damage the liver
  • Warning signs that your liver may be damaged
  • Which legal steroids pose the most risk and which are the safest
  • How to get an at home liver test for less than $5
  • How the right support supplements can reduce liver damage
Legal Oral Steroids Toxicity Ratings

Not all oral steroids negatively affect the liver. For instance, DHEA, androstenediol and pregnenolone are steroids that can be taken orally, but none of them are liver toxic. What makes a steroid liver toxic is a modification to its structure known as a methylation in the 17th position. Such a steroid is typically referred to as "17 alpha alkylated" or "17-aa" oral steroid. This modification allows the steroid to pass the liver and avoid excretion, enabling higher potency than non-17-aa steroids. (1-7) 17-aa steroids also negatively affect the liver which I will explain later.

Popular methylated (17-aa) legal oral steroids and their toxicity rating:
  • Superdrol and clones: 17-aa steroid, Toxicity rating (1-5): 5
  • Dimethazine and clones: 17-aa steroid, Toxicity rating (1-5): 5
  • Halodrol and clones: 17-aa steroid, Toxicity rating (1-5): 2
  • Epistane and clones (including Havoc): 17-aa steroid, Toxicity rating (1-5): 3
  • Methyl 1,4-AD and clones: 17-aa steroid, Toxicity rating (1-5): 3
  • DHEA and clones: Non 17-aa steroid, Toxicity rating (1-5): 0
  • 1-DHEA and clones: Non 17-aa steroid, Toxicity rating (1-5): 0
  • Androsterone (epiandrosterone) amd clones: Non 17-aa steroid, Toxicity rating (1-5): 0
How do 17-aa oral steroids cause liver damage?

Despite a lot of discussion about the "toxicity" of different oral steroids, most users are unaware of the mechanism or implications around these toxic effects. 17-aa steroids are toxic to the liver because they inhibit the excretory functions of the liver. (1-7) More specifically, the more liver toxic a 17-aa steroid is, the more it inhibits the production and flow of bile from the liver.

Bile salts are known as the liver's cleansing agents because they carry away toxins and flush them into the intestines for excretion. If the bile flow is restricted in the liver, then the liver can't rid itself of toxins. When the liver loses its ability to excrete toxins, it creates a buildup of toxins throughout the entire body. (1-13)

This condition is known as cholestasis [Kola-sta-sis]. By definition, cholestasis is a condition where the bile can't flow from the liver.(1) This is the most common liver condition developed from 17-aa steroids. (1-7)

If a liver becomes cholestatic for too long, the condition can begin damaging liver cells by causing necrosis (premature death of liver cells) from excessive toxin build up. This can eventually lead to cirrhosis of the liver (development of fibrous scar tissue) when the liver attempts to regenerate the damaged liver cells. This leads to loss of liver function from the replacement of healthy liver cells with fibrous connective tissue. (2)

Although cholestasis is reversible and generally not a lethal condition, it can lead to the more serious problems mentioned above if left untreated. To avoid serious health complications it's important to protect the liver before it becomes cholestatic or seriously damaged from prolonged cholestasis.

What are signs that my liver is damaged?

When the liver has been damaged by oral steroids, there are certain signs that may become obvious to the user. Warning signs usually appear in the following order, with the later signs being the most serious:
  • Reduced appetite
  • Nausea and fever
  • Excessive Itchiness
  • Yellow eyes or skin (jaundice)
  • Very dark urine (dark amber colored)
  • Bloody stools
Waiting for all these signs to appear means you have waited too long. You want to take action BEFORE these signs appear. This is why you should get full lab values on liver function before, during and after any 17-aa oral steroid cycle. When performing lab tests for liver function, the following values are considered normal:
  • Total bilirubin range: 0.3-1.7 mg/dl
  • Alanine aminotransferase (ALT) range: 10-40 IU/L
  • Aspartate aminotransferase (AST) range: 10-40 IU/L
  • Alkaline phosphatase (ALP) range: 34-125 IU/L
  • Gamma-glutamyl-transpeptidase (GGT) range: 7-32 IU/L
Levels above these normal values doesn't necessarily mean you have liver damage. It's common for healthy weight training athletes or bodybuilders to be slightly outside of the "normal" in ALT, AST and ALP values. Therefore, the following values have been established as more appropriate levels to indicate a serious liver toxicity issue. (1-7)
  • Total bilirubin: 10 mg/dl or higher
  • Alanine aminotransferase (ALT): 50 IU/L or higher
  • Aspartate aminotransferase (AST): 50 IU/L or higher
  • Alkaline phosphatase (ALP): 150 IU/L or higher
  • Gamma-glutamyl-transpeptidase (GGT) range: 50 IU/L or higher
Historical research from 17-aa oral steroid induced liver toxicity suggests that lab values higher than the above "Danger Values" indicate you may be suffering from cholestasis. (1-7) If your lab values are higher than the values listed above, you should discontinue any current oral steroid use and seek medical treatment.

If professional lab tests aren't an option, it's possible to get an affordable at home test for bilirubin levels, which can help diagnose a liver damage from a 17-aa oral steroid. There are home liver tests available, such as the TestMedica Liver Home Scan, which can be purchased online for less than $5 per test. Although these home based tests lack accuracy or true diagnosis ability, they can offer valuable insight about the condition of the liver. However, whenever possible, get lab tests done in a clinical setting.

How can I protect my liver?

To prevent cholestasis, the primary condition caused by oral steroid use, it is important to ensure there is ample hydrophilic bile acid available in the liver for the proper clearance of toxins.

The recommended method for this is the drug known as Ursodiol (ursodeoxycholic acid). This naturally occurring bile acid is used for its ability to detoxify the liver by clearing out less hydrophilic bile acids and other toxins that cause a toxic build up, such as those caused by 17-aa oral steroids. (4,5) Ursodiol is typically prescribed to patients admitted to the hospital for steroid induced liver toxicity, but, unfortunately, it is an expensive prescription drug, and not easily obtainable. A typical dose is 1000mg - 1200mg daily before, during and after a cycle.

You've probably read about steroid users taking a milk thistle supplement. Unfortunately, when it comes to the specific type of problems caused by 17-aa steroids, the benefits of milk thistle remain unproven.

References -

1. Androgenic/anabolic steroid-induced intrahepatic cholestasis: a review with four additional case reports. Gurakar A, et al. J Okla State Med Assoc. 1994 Sep;87 (9):399-404

2. Androgenic/Anabolic Steroid-Induced Toxic Hepatitis, Davor S, et al., J Clin Gastroenterol 2002;35(4):350-352

3. Anabolic-Androgenic steroids and liver injury, Magdalena et al., Liver International ISSN 1478-3223

4. Severe Cholestasis and Renal Failure Associated with the Use of the Designer Steroid Superdrol (Methasteron): A Case Report and Literature Review John Nasr and Jawad Ahmad, Digestive Diseases and Sciences (2007)

5. Cholestatic Jaundice and IgA Nephropathy Induced by OTC Muscle Building Agent Superdrol, Beata Jasiurkowski MD, et al., The American Journal of Gastroenterology (2006) 101, 2659-2662;

6. Anabolic steroids and cholestasis, Nusinovici V., Med Chir Dig. 1974;3(3):167-71.

7. Cholestasis due to anabolic steroids, Horký J, et al., Cesk Gastroenterol Vyz. 1973 Dec;27(8):548-50.

8. Silymarin as a new hepatoprotective agent in experimental cholestasis: new possibilities for an ancient medication., Crocenzi FA, Roma MG. Curr Med Chem. 2006;13(9):1055-74. Review.

9. Silibinin prevents cholestasis-associated retrieval of the bile salt export pump, Bsep, in isolated rat hepatocyte couplets: possible involvement of cAMP. Crocenzi FA, et al., Biochem Pharmacol. 2005 Apr 1;69(7):1113-20.

10. Beneficial effects of silymarin on estrogen-induced cholestasis in the rat: a study in vivo and in isolated hepatocyte couplets. Crocenzi FA, et al., Hepatology. 2001 Aug;34(2):329-39.

11. Tauro alpha-muricholate is as effective as tauro beta-muricholate and tauroursodeoxycholate in preventing taurochenodeoxycholate-induced liver damage in the rat., Kitani K, et al., Hepatology. 1994 Apr;19(4):1007-12.

12. Tauro beta-muricholate is as effective as tauroursodeoxycholate in preventing taurochenodeoxycholate-induced liver damage in the rat. Kanai S, et al., Life Sci. 1990;47(26):2421-8.

13. Ursodeoxycholate reduces ethinylestradiol glucuronidation in the rat: Role in prevention of estrogen-induced cholestasis., Enrique J et al. The Journal of Pharmacology and experimental therapeutics, 2003 Vol. 306, No. 1 279-286
Comments on Liver Damage from Designer Steroids
Comment by Robert Coleman on 10/13/2014 7:49:00 AM
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Comment by Robert Coleman on 10/13/2014 7:53:00 AM
What can I take to clean up my liver what's best product to take on and off cycle
Comment by Robert Coleman on 10/13/2014 7:55:00 AM
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Comment by Robert Coleman on 10/13/2014 7:55:00 AM
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Comment by Robert Coleman on 10/13/2014 7:58:00 AM
Are transdermal prohormones toxic and they pass my liver and they better to use than orals prohormones

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