Liver damage and steroids

If you are considering using 17-aa oral steroids or are already using 17-aa oral steroids, here is some information you may want to know.

Improper use of oral steroids can cause liver damage and lead to serious health problems. No matter how big or torn you may be, a malfunctioning liver will send your hard-earned gains straight to the toilet and send you to the confines of a hospital bed.

This article contains information about:

  • How oral steroids impair liver function and damage the liver
  • Warning signs that your liver may be damaged
  • Which legal steroids pose the greatest risk and which are safest
  • How to Get a Home Liver Test for Less Than $5
  • How the right nutritional supplements can reduce liver damage

Legal Oral Steroids Toxicity Ratings

Not all oral steroids have a negative effect on the liver. For example, 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 methylation at the 17th position. Such a steroid is typically referred to as a “17-alpha-alkylated” or “17-aa” oral steroid. This modification allows the steroid to pass through the liver and avoid excretion, achieving greater potency than steroids without 17 amino acids. (1-7) 17-aa steroids also have a negative effect on 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) and clones: non-17-aa steroid, toxicity rating (1-5): 0

 

How do 17-aa oral steroids cause liver damage?

Despite much debate about the “toxicity” of various oral steroids, most users are unaware of the mechanism or effects of these toxic effects. 17-aa steroids are toxic to the liver because they inhibit the excretory functions of the liver. (1-7) The more toxic a 17-aa steroid is, the more it inhibits the production and flow of bile from the liver.

Bile salts are known as liver cleansers because they remove toxins and flush them into the intestines for excretion. If the flow of bile in the liver is restricted, the liver cannot rid itself of toxins. When the liver loses its ability to eliminate toxins, a buildup of toxins forms throughout the body. (1-13)

This condition is known as cholestasis [kola-sta-sis]. By definition, cholestasis is a condition in which bile cannot flow from the liver. (1) This is the most common liver disease seen with 17-aa steroids. (1-7)

If a liver becomes cholestatic for too long, the disease can damage liver cells by causing necrosis (premature death of liver cells) caused by excessive buildup of toxins. This can eventually lead to liver cirrhosis (formation of fibrous scar tissue) as the liver attempts to regenerate the damaged liver cells. This leads to a loss of liver function due to the replacement of healthy liver cells with fibrous connective tissue. (2)

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

 

What are signs that my liver is damaged?

If the liver has been damaged by oral steroids, there are certain signs that may become apparent 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 itching
  • Yellow eyes or skin (jaundice)
  • Very dark urine (dark amber)
  • Blood in the stool

If you’re waiting for all of these characters to appear, you’ve waited too long. You want to take action BEFORE these characters appear. For this reason, you should obtain complete liver function laboratory values ​​before, during, and after each oral steroid cycle for 17 years. When conducting laboratory tests on 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 levels do not necessarily mean you have liver damage. It is common for healthy strength athletes or bodybuilders to have ALT, AST, and ALP levels slightly above “normal.” Therefore, the following values ​​were established as more appropriate values ​​to indicate a serious liver toxicity problem. (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 on liver toxicity caused by 17-aa steroid suggests that laboratory values above the “danger levels” listed above indicate that you may be suffering from cholestasis. (1-7) If your laboratory values are higher than the values listed above, you should discontinue current oral steroid use and seek medical attention.

If professional laboratory testing is not an option, it is possible to obtain an affordable home test for bilirubin that can help diagnose liver damage from a 17-year 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 tests lack accuracy or true diagnostic capabilities, they can provide valuable information about the condition of the liver. However, if possible, laboratory tests have been performed in a clinical setting.

 

How can I protect my liver?

To prevent cholestasis, it is important that there is sufficient hydrophilic bile acid in the liver to properly eliminate toxins.

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

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

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 & ndash; 404
2. Androgen/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 designer steroid Superdrol (methasterone): A case report and literature review John Nasr and Jawad Ahmad, Digestive Diseases and Sciences (2007)

5. Cholestatic jaundice and IgA nephropathy caused by the OTC muscle building agent Superdrol, Dr. Beata Jasiurkowski 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 & ndash; 71.

7. Cholestasis caused by anabolic steroids, Horký J et al., Cesk Gastroenterol Vyz. 1973 Dec; 27 (8): 548 & ndash; 50.

8. Silymarin as a new hepatoprotectant in experimental cholestasis: New possibilities for an old drug., Crocenzi FA, Roma MG. Curr Med Chem. 2006; 13 (9): 1055 & ndash; 74. Review.

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

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

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

12. Tauro Beta-muricholate is as effective as tauroursodeoxycholate in preventing taurochenodeoxycholate-induced liver injury in rats. Kanai S. et al., Life Sci. 1990; 47 (26): 2421 & ndash; 8.

13. Ursodeoxycholate reduces ethinyl estradiol glucuronidation in rats: role in preventing estrogen-induced cholestasis., Enrique J et al. The Journal of Pharmacology and Experimental Therapeutics, 2003 Vol. 306, No. 1 279-286