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A very typical case of severe cholestasis due to anabolic steroid use.  Because the steroids were being used without medical supervision, the dose and actual duration of use of each preparation was unclear, but cholestasis usually arises within 4 to 12 weeks of starting a C-17 alkylated androgenic steroid.  The jaundice can be severe and prolonged and accompanied by severe pruritus and marked weight loss.  The serum enzymes are typically minimally elevated except for a short period immediately after stopping therapy.  The pattern of enzyme elevations can be hepatocellular, cholestatic or mixed.  Liver biopsy shows a “bland” cholestasis with minimal inflammation and hepatocellular necrosis.  Ma Huang has also been implicated in cases of drug induced liver injury, but is associated with an acute hepatocellular pattern of injury.

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Oxandrolone is most certainly a hepatotoxic steroid. It does not carry the strongest level of hepatotoxicity among anabolic steroids, but it is stronger than most. This is due to it being a C17-aa anabolic steroid. All C17-aa steroids are hepatic, but the level of toxicity varies greatly between them. Due to this steroid’s strong hepatotoxicity, this is why total use must be limited (see administration section).

Due to use, those who supplement with Anadrol will find their liver enzyme values increase. An increase in values is not a sign of damage but rather a sign of stress that can lead to damage if responsible practices are not followed and the stress is allowed to remain. Proper dosing and duration of use protocols are imperative when it comes to this steroid. Further, it is important the individual avoids excess alcohol consumption when supplementing with this steroid due to the liver stress such consumption will cause. In fact, most will find avoiding all alcohol to be best during use. If this is a problem and you are supplementing for the purpose of performance enhancement remember there is nothing on earth that is as anti-performance as alcohol. Those who supplement are also encouraged to limit their use of Over the Counter (OTC) medications. Many OTC medications carry strong hepatic natures, and the added stress can be extensive when coupled with Anadrol. Use should be limited to when only absolutely needed. If these rules can be followed, once use is discontinued liver enzyme values will return to normal and no damage will be done. As a final note, Anadrol should not be used if the liver is unhealthy.

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