Anabolic Steroids & Liver [GI]

[Michael Scally MD]

I thought this topic would be of interest. I will go through Meso to find posts relevant to this thread and copy/paste. If anyone knows of a post that should be included, let me know. In the meantime, for a first post.

El Sherrif Y, Potts JR, Howard MR, et al. Hepatotoxicity from anabolic androgenic steroids marketed as dietary supplements: contribution from ATP8B1/ABCB11 mutations? Liver Int. Hepatotoxicity from anabolic androgenic steroids marketed as dietary supplements: contribution from ATP8B1/ABCB11 mutations? - El Sherrif - 2013 - Liver International - Wiley Online Library

BACKGROUND: Though possession of androgenic anabolic steroids (AAS) is illegal, non-prescription use of AAS persists.

METHODS: We describe two Caucasian males (aged 25 and 45 years) with cholestatic hepatitis following ingestion of the dietary supplement Mass-Drol ('Celtic Dragon') containing the AAS 2alpha-17alpha-dimethyl-etiocholan-3-one,17beta-ol.

RESULTS: Despite substantial hyperbilirubinaemia peak gamma-glutamyl transferase (GGT) remained normal. Besides 'bland' intralobular cholestasis, liver biopsy in both found deficiency of canalicular expression of ectoenzymes as seen in ATP8B1 disease. In the older patient, bile salt export pump marking (encoded by ABCB11) was focally diminished. We hypothesized that AAS had either induced inhibition of normal ATP8B1/ABCB11 expression or triggered initial episodes of benign recurrent intrahepatic cholestasis (BRIC) type 1/or 2. On sequencing, ATP8B1 was normal in both patients although the younger was heterozygous for the c.2093G>A mutation in ABCB11, a polymorphism previously encountered in drug-induced liver injury.

CONCLUSION: AAS marketed as dietary supplements continue to cause hepatotoxicity in the UK; underlying mechanisms may include unmasking of genetic cholestatic syndromes.

 

[Hulk]

These Pro-Hormones have been known for a long time as being very harsh on the liver, and the body in general. Sure they are easily accessible and pretty cheap, but there is a price to pay. I stopped all forms of orals long ago and have never looked back. My blood tests have thanked me ever since.

 

[Gunrunner]

My blood tests have thanked me ever since.

I agree. With the exception of front loading a cycle the 1st week I don't use orals. I do like to have some drinks on the weekend so I gotta take care of the ole liver.

 

[Michael Scally MD]

Vilella AL, Limsuwat C, Williams DR, Seifert CF. Cholestatic Jaundice as a Result of Combination Designer Supplement Ingestion (July/August). Ann Pharmacother. http://www.theannals.com/content/early/2013/06/11/aph.1R405.abstract

OBJECTIVE: To report a case of cholestatic jaundice as a result of combination herbal and designer supplement use.

CASE SUMMARY: A 50-year-old Hispanic male presented to the hospital with a 1-week history of significant painless jaundice; total bilirubin on admission was 29.4 mg/dL. He reported use of both herbal (creatine and whey protein) and designer (Incredible Bulk and Spartan 45) supplements concurrently for approximately 2 months. Upon admission, all supplements were discontinued and multiple laboratory and diagnostic tests were ordered. On day 6 of his hospital admission, a liver biopsy was performed, the results of which indicated drug-induced hepatotoxicity. On day 9 he was discharged with prescriptions for ursodeoxycholic acid and hydroxyzine. Three months post hospital discharge, the patient continued to be supplement-free and bilirubin had decreased substantially.

DISCUSSION: Anabolic-androgenic steroids are capable of causing hepatotoxicity, and multiple cases reported in the literature support this. A case report described hepatotoxicity secondary to both creatine and whey protein consumption, and several reports have described liver damage secondary to designer supplement use. To our knowledge, this is the first case to describe hepatotoxicity as a result of combination herbal and designer supplement use. The Roussel Uclaf Causality Assessment Method (RUCAM) score for drug-induced hepatotoxicity indicated a highly probable correlation between the use of combination supplements and cholestatic jaundice.

CONCLUSIONS: Health care professionals need to be aware of complications associated with designer supplement use and should be able to identify patients who would benefit from education on herbal and designer supplement use.

 

[jacked44]

The methylated designer steroids that are out there are very liver toxic. I ran a cycle of Havoc, M-Sten and Halo-Extreme at 30mg/20mg/20mg per day respectively. After three weeks I felt like shit and had to discontinue. I am an older guy though, and probably more prone to liver issues than a guy in his 30's. Back in the day I had no problem running 50 mg of dbol per day. I stick with injectibles only these days with no issues.

 

[maxsource08]

Have u ever make your own steroids?

 

[johnnyBALLZ]

Have u ever make your own steroids?

Time for you to go home max..

 

[Michael Scally MD]

Stanozolol-Induced Bland Cholestasis
[For Full-Text Email

mscally@alum.mit.edu

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We report the case of a 37-year-old European Caucasian man, who was admitted to our hospital after developing acute severe jaundice and itching, but without fever or chill. Furthermore, he reported passing dark urine simultaneously. During admission, he admitted to have self-administered high doses of stanozolol (Winstrol®) by injections (intramuscularly, three times a week) for three weeks prior to the onset of symptoms.

On admission, physical examination revealed jaundice. The biochemical test showed serum levels of bilirrubin of 19.16 mg/dL (normally <1) (direct fraction 15.84 mg/dL), with aspartate aminotransferase (AST) 45 U/L (normally 5---37), alanine aminotransferase (ALT) 58 U/L (normally 5---41), alkaline phosphatase (AP) 152 U/L (normally 40---129) and gamma-glutamyl-transpeptidase (GGT) 19 U/L (normally 10---66). An ultrasound scan of the abdomen was performed, showing a normal volume of the liver and no evidence of biliary dilation.

The patient was provided with supportive medical treatment and showed a good progress. Eight weeks after discontinuation of stanozolol, biochemical tests gradually improved, itching disappeared and he was completely asymptomatic. Finally, in three months, all tests were normal. Therefore, clinical signs and laboratory findings improved substantially in following weeks after discontinuation of stanozolol.

Ampuero J, Garcia ES, Lorenzo MM, Calle R, Ferrero P, Gomez MR. Stanozolol-induced bland cholestasis. Gastroenterol Hepatol. Stanozolol-induced bland cholestasis

 

[MR10X]

FRIDAY, December 27, 2013 (HealthDay News) — Consumers should not use Mass Destruction, a dietary supplement used to stimulate muscle growth, the U.S. Food and Drug Administration warned Monday.

The body-building product, available in retail stores, fitness gyms and online, contains potentially harmful synthetic steroids and anyone currently using it should stop immediately, the FDA said.

The warning was prompted by a report from the North Carolina Department of Health and Human Services involving a serious injury related to use of Mass Destruction. A healthy 28-year-old man who used the product for several weeks experienced liver failure, which required a transplant, according to the FDA.

"Products marketed as supplements that contain anabolic steroids pose a real danger to consumers," Howard Sklamberg, director of the Office of Compliance in the FDA's Center for Drug Evaluation and Research, said in an agency news release. "The FDA is committed to ensuring that products marketed as dietary supplements and vitamins do not pose harm to consumers."

The FDA explained that liver damage is a known risk associated with use of anabolic steroids and steroid-like substances. Although Mass Destruction's ingredients are undergoing additional analysis, the FDA said it contains at least one synthetic anabolic steroid, according to the product's label.

An investigation is also under way to identify the manufacturer of Mass Destruction, which is produced for Blunt Force Nutrition, based in Sims, N.C.

 

[strongsafety41]

After reading this thread you made think twice about running dbol in my upcoming cycle. I am getting up there in age so I was only going to run it in my first 3-4 weeks to kick start things but I may have to do without ... Or atleast shorten the duration of usage. Very good read ... Thanks for sharing

 

[dnoyez]

My days of orals are about over as well as I get older.The heartburn alone is almost not worth it any more and there are to many good options with short esters to get things going.I remember the triple and quad stack designers back in the day allways ending with shitty results.

 

[Gunrunner]

After reading this thread you made think twice about running dbol in my upcoming cycle. I am getting up there in age so I was only going to run it in my first 3-4 weeks to kick start things but I may have to do without ... Or atleast shorten the duration of usage. Very good read ... Thanks for sharing

You can start the cycle with a short and a longer estered AAS. It won't kick in as fast as the orals but it will be start faster than the long ester alone.

 

[Demondosage]

The only oral that I think is worth a damn is Anavar

 

[Michael Scally MD]

Muscle Mass and Mortality in Chronic Liver Disease: The Impact of Testosterone

Letter to the Editor

We read with interest the recent publication in this journal describing a significant association between muscle mass and mortality in men following liver transplantation (1). This finding has also been demonstrated in a pre-transplant cohort for whom reduced muscle mass was associated with increased mortality independent of their MELD score (2). [The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease.]

What is particularly interesting is that the association was only significant in men. We hypothesise that this finding may be primarily due to reduced testosterone production in men with cirrhosis.

Low testosterone levels have been reported in up to 90% of males being evaluated for liver transplantation (3, 4). The magnitude of reduction in serum testosterone correlates with the severity of liver disease, as measured by the Child Pugh Score.

We have previously demonstrated a significant association between testosterone levels and mortality in men with liver disease (3). A drop in total testosterone of 1nmol/L or free testosterone of 10pmol/L was associated with an 8 % increase in mortality. This increase in mortality was independent of previously recognised markers of mortality, including the MELD score and serum sodium.

Many factors contribute to loss of muscle mass in advanced liver disease, including protein and energy malnutrition, systemic inflammation and immobility. However it is likely that testosterone insufficiency also plays an important role. Testosterone stimulates satellite cells and myocyte precursors, which leads to increased growth of new and existing muscle fibres (5).

Testosterone therapy has been shown to have a dose-dependent, linear relationship with muscle mass, in both healthy and hypogonadal men (6, 7). Given widespread expression of the androgen receptor, testosterone can also affect bone mineral density, haematocrit, insulin sensitivity, and may influence adipose tissue and immune function (8-10).

The data demonstrating that low muscle mass predicts mortality in men with cirrhosis (1) and our finding that testosterone deficiency is independently associated with mortality in this group (3) suggest a possible causal link.

The next logical step would be to explore the relationship between these two factors in an observational study in men with advanced liver disease. This may provide a rationale for conducting a prospective trial to explore the impact of testosterone therapy on muscle mass and mortality in advanced cirrhosis.

1. Dimartini A, Cruz RJ, Jr., Dew MA, Myaskovsky L, Goodpaster B, Fox K, et al. Muscle mass predicts outcomes following liver transplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2013. Epub 2013/08/21.

2. Montano-Loza AJ, Meza-Junco J, Prado CM, Lieffers JR, Baracos VE, Bain VG, et al. Muscle wasting is associated with mortality in patients with cirrhosis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2012;10(2):166-73, 73 e1. Epub 2011/09/07.

3. Grossmann M, Hoermann R, Gani L, Chan I, Cheung A, Gow PJ, et al. Low testosterone levels as an independent predictor of mortality in men with chronic liver disease. Clinical endocrinology. 2012;77(2):323-8. Epub 2012/01/28.

4. Zietz B, Lock G, Plach B, Drobnik W, Grossmann J, Scholmerich J, et al. Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis. European journal of gastroenterology & hepatology. 2003;15(5):495-501. Epub 2003/04/19.

5. Sinha-Hikim I, Taylor WE, Gonzalez-Cadavid NF, Zheng W, Bhasin S. Androgen receptor in human skeletal muscle and cultured muscle satellite cells: up-regulation by androgen treatment. The Journal of clinical endocrinology and metabolism. 2004;89(10):5245-55. Epub 2004/10/09.

6. Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. The New England journal of medicine. 1996;335(1):1-7. Epub 1996/07/04.

7. Bhasin S, Storer TW, Berman N, Yarasheski KE, Clevenger B, Phillips J, et al. Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. The Journal of clinical endocrinology and metabolism. 1997;82(2):407-13. Epub 1997/02/01.

8. Barrett-Connor E, Von Muhlen DG, Kritz-Silverstein D. Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo Study. The Journal of clinical endocrinology and metabolism. 1999;84(2):573-7. Epub 1999/02/18.

9. LeBlanc ES, Nielson CM, Marshall LM, Lapidus JA, Barrett-Connor E, Ensrud KE, et al. The effects of serum testosterone, estradiol, and sex hormone binding globulin levels on fracture risk in older men. The Journal of clinical endocrinology and metabolism. 2009;94(9):3337-46. Epub 2009/07/09.

10. Muehlenbein MP, Bribiescas RG. Testosterone-mediated immune functions and male life histories. American journal of human biology : the official journal of the Human Biology Council. 2005;17(5):527-58. Epub 2005/09/02.

Sinclair M, Angus PW, Grossmann M, Gow PJ. Muscle mass and mortality in chronic liver disease: The impact of testosterone. Liver Transplantation. Muscle mass and mortality in chronic liver disease: The impact of testosterone - Sinclair - 2014 - Liver Transplantation - Wiley Online Library

 

[Back Alley Merchant]

Great read thanks for the info!

 

[PS LABS FOUNDER]

Anavar is by far worth its effects as an oral on the liver like demondosage said its great / anavar is also very easy and not harsh on ur liver / milk thistle in over 1gram a day helps tremendous amounts AND I DONT GIVE A RATZ AZZ WHO COMES ON HERE SAYING MILK THISTLE DOESNT WORK! IT WORKS AND U CAN EVEN SEE PRO BODYBUILDERS ( JAY CULTER) FOR ONE MENTION ITS EFFECTS AND HELP ON CLEANING THE LIVER AND REBUILDING CELLS ....BE SMART AND DONT DRINK A LOT OF ALCOHOL AND U SHOULD BE FINE WITH ORALS AS LONG AS U DONT RUN THEM FOR MONTHS AT A TIME

 

[solo47]

Anavar is by far worth its effects as an oral on the liver like demondosage said its great / anavar is also very easy and not harsh on ur liver / milk thistle in over 1gram a day helps tremendous amounts AND I DONT GIVE A RATZ AZZ WHO COMES ON HERE SAYING MILK THISTLE DOESNT WORK! IT WORKS AND U CAN EVEN SEE PRO BODYBUILDERS ( JAY CULTER) FOR ONE MENTION ITS EFFECTS AND HELP ON CLEANING THE LIVER AND REBUILDING CELLS ....BE SMART AND DONT DRINK A LOT OF ALCOHOL AND U SHOULD BE FINE WITH ORALS AS LONG AS U DONT RUN THEM FOR MONTHS AT A TIME

Anavar is easy on lot of things, including having much effect on muscle growth. It does nothing that Mast or EQ don't already do. So my question is: Why bother with orals at all? Just stick with the tried and true, use common sense, etc. But I probably do drink too much (as in too often, not large amounts), so I have reason to avoid anything else damaging. At my age, it's not the best choice, but it's awfully relaxing in the evenings.

Solo

 

[PS LABS FOUNDER]

Actually anavar does much different things then equi or masteron ...DOES EQUI BURN FAT OFF YOU? CAN EQUI CONVERT TO ESTROGEN? YES EQUI DOES CONVERT TO ESTROGEN AND OXANDROLONE (ANAVAR) CAN NOT ...JUST A EXAMPLE SHOWING THEY ARE DIFFERENT ...AND IF YOU HAVE EVER USED THEM ALL YOU WOULD CLEARLY KNOW THAT - ANAVAR SURPASSES EQUI OR MASTERON AT MG TO MG STRENGTH AND EFFECT....I CANT EVEN BELIEVE EQUI WAS COMPARED TO ANAVAR AT ALL!!

 

[solo47]

Actually anavar does much different things then equi or masteron ...DOES EQUI BURN FAT OFF YOU? CAN EQUI CONVERT TO ESTROGEN? YES EQUI DOES CONVERT TO ESTROGEN AND OXANDROLONE (ANAVAR) CAN NOT ...JUST A EXAMPLE SHOWING THEY ARE DIFFERENT ...AND IF YOU HAVE EVER USED THEM ALL YOU WOULD CLEARLY KNOW THAT - ANAVAR SURPASSES EQUI OR MASTERON AT MG TO MG STRENGTH AND EFFECT....I CANT EVEN BELIEVE EQUI WAS COMPARED TO ANAVAR AT ALL!!

Sorry, Bro. I hope you've overcome the shock.

Solo

 

[Guns_Muscle_G35]

Uncless used orals as football player and loved the results. . some 20 years later he has 40% of his liver working and is a couple months away from needing dialysis machine to do the work for him. When i told him about my cycle and plan he made ME SWEAR ON FAMILY MEMBERS GRAVE to inject and not use Orals. Painful as it maybe, experience is a far better teacher than reading.