Q: Will most primary care Doctors prescribe Deca Durabolin to patients who need it? I am in good health with a totally supressed viral load but would like to put on some lean muscle mass. I do work out with weights but it is very difficult to add muscle. Can this steroid be taken safely? If my PCP provider will not prescribe it where can I obtain it. I live in Dallas.
A: This is the most detailed answer I have ever given at thebody.com on nandrolone since it seems that I am seeing more and more questions on this medication.
No, only the most progressive doctors prescribe nandrolone decanoate (old brand name: Deca Durabolin). All doctors are told in medical school that anabolic steroids are bad for people, much like what they hear about street drugs like cocaine or meth. This is unfortunate since nandrolone is the most studied compound in HIV related wasting. Like every drug, it needs to be prescribed by a physician that knows how to monitor the main variables in blood analysis. So, doctors who now prescribe it are those who learned on their own about its use through internet sources, my book Built to Survive
Wasting syndrome was one of the main killers of people with HIV before protease inhibitors and non nukes were introduced in 1996-1997. But now most people with HIV that get on HIV medications do not waste away to death (assuming their virus in controlled). However, a study performed by researchers at Tufts Medical School reported that around 25% of people with undetectable viral load are still under weight or losing weight involuntarily.
Nandrolone decanoate is actually a molecule very similar to testosterone but with a few changes that make it more anabolic with fewer side effects. A study performed in Australia found it more effective in treating wasting that testosterone, even at lower doses than testosterone: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1293.2006.00358.x/full
It is important to note that nandrolone decanoate is not an illegal drug. The FDA approved it as an “indication for the management of the anemia of renal
insufficiency and has been shown to increase hemoglobin and red cell mass.” In Australia, it is approved for osteoporosis “where other therapy is inappropriate OR patients on long term treatment with corticosteroids.” It is also listed as an Orphan Drug in Australia for this HIV indication: “for patients who have proven HIV infection who have lost at least 5% of their usual body weight.” So, physicians in the United States can prescribe it legally for building lean body mass and stregth in HIV as an off label use. Some physicians also prescribe it for those who have lost a lot of mass in their arms and legs and want to reshape their bodies after lipodystrophy.
Nandrolone is a cheap generic in the United States and no company was smart enough to gather all study data already available to present it to the FDA to get it approved here for an orphan drug indication similar to the one in Australia. It is available via compounding pharmacies with a prescription. Some doctors stopped prescribing it a few years ago when the main manufacturer, Watson Pharmaceuticals, stopped selling it without notice (here is a blog I wrote back then: Watson stops nandrolone ).
Many of these physicians still do not know it is still available via compounders like APSmeds.com, thecompoundingshop.com and many more compounding pharmacies around the country. To read more about what compounding medications are, I recommend this link: What are compounded medications?
The only drug approved in the United States for wasting syndrome is Serostim (growth hormone). At $6000 per month, it is over 100 times more expensive than nandrolone ($40 a month for 200 mg per week). A study showed that nandrolone is as effective as Serostim in increasing nitrogen retention in HIV (nitrogen retention is needed for increasing lean body mass). Nandrolone equals Serostim
Unlike the most commonly prescribed anabolic agent in HIV , Oxandrin or oxandrolone (generic name), nandrolone does not affect liver function. However, doctors like to prescribe Oxandrin more than nandrolone since Oxandrin is an oral agent. Oxandrin costs $1300 a month for the recommended dose of 20 mg per day.
Nandrolone, Oxandrin can shut down your body’s own testosterone production since the hormone feed back loop does not see the difference between it and testosterone. But there is a difference: only testosterone can preserve sexual function. So, it is important to use nandrolone along with testosterone replacement (gels or injections).
Nandrolone and testosterone can affect your hormonal axis (hypothalamic-pituitary-testicular axis , or HPTA). So, when people cycle these medications and get off, the HPTA may remain sluggish for a few weeks, making people lose lean body mass and present all symptoms of testosterone deficiency. There are ways to cycle nandrolone safely, though (for details, read Built to Survive and Dr Scally HPTA information
Doctors need to monitor blood pressure and hematocrit along with other parameters. Hematocrit is particularly important since testosterone )and anabolics increase red blood cell volume which can make blood more viscous which increases cardiovascular risks. More on this in Built to Survive.
I would love to see studies using nandrolone to reverse or prevent HIV aging related frailty, bone loss, and sarcopenia (age related loss of lean body mass).
My non profit, Program for Wellness Restoration, put together a doctor’s list years ago (not updated, so some doctors may no longer be in practice) here: Doctor’s List
I hope this long answer provided with enough information about nandrolone prescribing issues.
For more information, please visit powerusa.org or medibolics.com
Nelson
About the author
Nelson Vergel is the author of "Testosterone: A Man's Guide- Second Edition" and co-author of the book "Built to Survive: A Comprehensive Guide to the Medical Use of Anabolic Therapies, Nutrition and Exercise for HIV (+) men and women", the founder of the Body Positive Wellness Clinic in Houston, and an expert speaker on exercise, nutrition, testosterone replacement, metabolism , sexual function and therapies to increase lean body mass and decrease fat.
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