Anabolic Steroid Side Effect Management Table

Problem

Solution and Comments

• Accutane – a powerful prescription item – 40 mg/day for one week sometimes stops acne if started at the first sign or as directed by your doctor. Accutane is potentially highly liver toxic.
• Sporanox – Effective for some acne-like eruptions that are caused by fungi. Some doctors also prescribe antibiotics, like tetracycline, for acne with good results.
• Anti-bacterial soaps – Use a scrubbing brush and wash twice a day, especially after sweating during a workout.
• UV light or sunlight with moderation.

• Proxiphen salve and NANO shampoo/NANO conditioner – These and other hair loss products are formulated by Dr. Peter Proctor (713-960-1616).
• Nizoral shampoo– Available by prescription and over-the counter as a lower dose product.
• Rogaine – Available by prescription.
• Propecia (finesteride) – Available by prescription. A few males experience decreased erections with finesteride, though (visit www.medibolics.com)

• A problem? Sex drive can decrease in HIV. Sex drive is part of quality-of-life. This is not necessarily a bad side effect. Enjoy it.

• Viagra, Cialis, Levitra – Available by prescription; enables robust erections. Take an allergy medication and ibuoprofen with it to minimize sinus congestion and headaches.
• Yohimbine (Yocon) – Available by prescription; increases sex organ sensitivity. Can increase heart rate and blood pressure
• Muse – Available by prescription; pellet inserted into the urethra to produce erection.
• Trimix – Available by prescription. The best and cheapest formula for injection into the penis for lasting erections. Visit www.apsmeds.com
• Caverject – Available by prescription. An injection into the penis that produces an erection that can last 1 to 2 hours. Be careful with injecting too much since it can produce dangerously ling erections that need to be treated in emergency rooms! Follow instructions from your urologist.
• Papaverine – An older injectable medication, less expensive than Caverject.
• Wellbutrin – Prescription at 300 to 450 mg/day; increases dopamine.
• Human chorionic gonadatropin (HCG) – First dose is 5,000 IU, then taken again one week later. Note: If impotence happens while on testosterone, try varying the doses of testosterone. E.g. higher and lower.

• Sleeping medications – e.g. Ambien, Sonata, Restoril
• Melatonin – 1 to 3 mg before bedtime.
• Avoid working out too close to bedtime.
• Limit caffeine, especially after 3 pm.
• Do not administer oral steroids after 6 pm.
• Visit houstonbuyersclub.com for a comprehensive sleep formula with tryptophan, melatonin and inositol. Nutrients do not work as well as drugs, but they can help some people.

• Have a sleep specialist prescribe a sleep study. Some people may have to wear a C-PAP machine to breathe at night. Visit http://www.sleepapnea.org/ for more information

• HCG – One 5,000 unit injection per week for 2 weeks, followed by maintenance of 250 IU twice a week

• Count until 10 and be aware of your interaction with others.
• Decrease caffeine.
• Meditation, yoga, breathe from your belly for a few minutes when over reacting.
• The steroid dosage may be too high, especially testosterone and oxymetholone.

• Blood pressure medications – Elevated blood pressure is usually transient and stops within a few weeks of the end of a steroid cycle. However, ongoing or chronic steroid use is associated with high blood pressure. Try ACE or ACE II inhibitors since they seem to have fewer sexual dysfunction related effects
• Supplements – Magnesium (600 mg/day); vitamin B₆ (100 to 200 mg/day); may help reduce water retention.
• Water – Drink extra water every day to help flush the kidneys.

• Arimidex – Inhibits estrogen production. Available by prescription. 1 mg/day until sensitivity stops, then ½ mg per day. Some people take .5 mg three times a week for maintenance. Ensure that your estradiol is under 20 pg/dl but do not go too low since it is needed for bon, skin and hair health. Some people get it online if doctor does not prescribe.
• Nolvadex – Competes with estrogen for receptors. Available by prescription, 10 to 20 mg/day. Not as effective as Arimidex. Use of Nolvadex during a steroid cycle may reduce the net anabolic effect, as it decreases the production of GH[i] and IGF-1. Severe cases may require removal of the breast tissue by surgery.
• DHT cream– Some people have obtained great results by robbing a 10% DHT cream on their nipples. Ask your compounding pharmacy. By prescription only.

• Discontinue steroid use or only use steroids that have the lowest androgenic potential, like oxandrolone.
• We note that GH used with steroids seems to exacerbate body hair growth in males.
• Proscar – Available by prescription at 1 to 5 mg/day, for men.

• Proscar – Available by prescription. For men, 1 to 5 mg/day. (Note: Can cause decreased sex drive and erections in some men.)
• Hytrin, Flomax – Available by prescription.
• Saw palmetto extract – Very effective for reducing prostate problems, but one study suggests that this herb may reduce the effects of testosterone, too.[ii]
• Estrogen inhibitors like Arimidex. Estrogen dominance appears to increase prostate growth.[iii] [iv]
• Check your prostate specific antigen and have a digital rectal exam before starting any steroid program, to detect potential for prostate cancer, especially if you are over 35 or have a family history of prostate problems, and have it checked on a regular basis.

• Therapeutic phlebotomy means to have a pint or more of blood removed, usually 1 pint per week over several weeks. (1 pint usually will lower hematocrit by about 3 points.) Polycythemia is a compelling reason to avoid using higher steroid doses than are necessary. Taking the lowest effective dose reduces the risk of over-production of hemoglobin (red blood cells).

• Standardized silymarin (milk thistle herb) – 160 mg/three times/day
• LiverCare – two 640 mg tabs twice per day
• Evening primrose oil – 1300 mg/three times/day
• Lung Tan Xie Gan – Chinese herb formula
• Alpha lipoic acid – 100 to 300 mg/three times/day
• Glycyrrhizinate Forte – Three or more capsules/day, but this may increase blood pressure.
• N-acetyl cysteine – 600 mg/three times/day
• Glutamine powder – 4 to 12 grams/three times/day.
• Omega-3 fatty acids – 6 to 10 capsules per day.
• With a history of liver problems or Hepatitis C, avoid oral steroids and use only injectable steroids – testosterone or nandrolone.
• Antioxidant vitamins – Vitamin C – 1,000 to 2,000 mg/three times/day with vitamin E – 400 to 800 IU three times/day.
• Selenium – 200 mcg twice per day.
• Alpha lipoic acid – 100 to 300 mg twice per day. We recommend Jarrow brand slow-release alpha lipoic acid.
• Visit www.houstonbuyersclub.com for a comprehensive formula for liver health