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The following conditions have been reported in patients receiving androgenic anabolic steroids as a general class of drugs: Peliosis hepatis, a condition in which liver and sometimes splenic tissue is replaced with blood-filled cysts, has been reported in patients receiving androgenic anabolic steroid therapy. These cysts are sometimes present with minimal hepatic dysfunction, but at other times they have been associated with liver failure. They are often not recognized until life-threatening liver failure or intra-abdominal hemorrhage develops. Withdrawal of drug usually results in complete disappearance of lesions. Liver cell tumors are also reported. Most often these tumors are benign and androgen-dependent, but fatal malignant tumors have been reported. Withdrawal of drug often results in regression or cessation of progression of the tumor. However, hepatic tumors associated with androgens or anabolic steroids are much more vascular than other hepatic tumors and may be silent until life-threatening intra-abdominal hemorrhage develops. Blood lipid changes that are known to be associated with increased risk of atherosclerosis are seen in patients treated with androgens and anabolic steroids. These changes include decreased high density lipoprotein and sometimes increased low density lipoprotein. The changes may be very marked and could have a serious impact on the risk of atherosclerosis and coronary artery disease. Cholestatic hepatitis and jaundice occur with 17-alpha-alkylated androgens at relatively low doses. Clinical jaundice may be painless, with or without pruritus. It may also be associated with acute hepatic enlargement and right upper-quadrant pain, which has been mistaken for acute (surgical) obstruction of the bile duct. Drug-induced jaundice is usually reversible when the medication is discontinued. Continued therapy has been associated with hepatic coma and death. Because of the hepatoxicity associated with oxymetholone administration, periodic liver function tests are recommended. In patients with breast cancer, anabolic steroid therapy may cause hypercalcemia by stimulating osteolysis. In this case, the drug should be discontinued. Edema with or without congestive heart failure may be a serious complication in patients with pre-existing cardiac, renal or hepatic disease. Concomitant administration with adrenal steroids or ACTH may add to the edema. This is generally controllable with appropriate diuretic and/or digitalis therapy. Geriatric male patients treated with androgenic anabolic steroids may be at an increased risk for the development of prostate hypertrophy and prostatic carcinoma. Anabolic steroids have not been shown to enhance athletic ability.
Anabolic steroids are synthetic derivatives of testosterone. Nitrogen balance is improved with anabolic agents but only when there is sufficient intake of calories and protein. Whether this positive nitrogen balance is of primary benefit in the utilization of protein-building dietary substances has not been established. Oxymetholone enhances the production and urinary excretion of erythropoietin in patients with anemias due to bone marrow failure and often stimulates erythropoiesis in anemias due to deficient red cell production.
Certain clinical effects and adverse reactions demonstrate the androgenic properties of this class of drugs. Complete dissociation of anabolic and androgenic effects has not been achieved. The actions of anabolic steroids are therefore similar to those of male sex hormones with the possibility of causing serious disturbances of growth and sexual development if given to young children. They suppress the gonadotropic functions of the pituitary and may exert a direct effect upon the testes. Oxymetholone, commonly known as Anadrol due to the first manufactured name of the steroid is derived from Dihydrotestosterone (DHT) and is a 17-Alpha-Alkylated steroid (17-aa.) The 17-aa alteration simply means the steroid has been chemically altered at the 17th carbon position to allow it to survive ingestion by surviving the first pass through the liver; without the 17-aa alteration the steroid would be destroyed before it ever entered the blood stream. The good news is by this alteration we are able to absorb a usable and powerful anabolic steroid; the bad news is this is toxic to the liver. As most oral steroids are 17-aa the toxic effect can be quite high but as it pertains to Anadrol this effect is more pronounced making it one of the most liver toxic steroids on the market. Once Anadrol enters the body, which is allowed by its 17-aa form it will become active very quickly and the effects will be dramatically fast. As we understand anabolic androgenic steroids the half-life associated with them largely affects the initial potency; Anadrol has a very short half-life of approximately 8.5 hours making the steroids activity almost instant but with a very short active duration. For this reason many athletes will split their Anadrol dose into two doses per day in order to keep a peak amount of the steroid active in their system around the clock during periods of use. However, one dose per day will be enough to keep an active amount of the steroid functioning in the body, although not at peak levels. With regard to harsh side effects sometimes perceived in bodybuilding, this principally or only occurs when estrogen levels are elevated. While oxymetholone does not itself aromatize and does not have estrogenic activity, it may be that it can interfere with estrogen metabolism. Whether that it is the cause of the problem or not, keeping estradiol levels under control keeps Anadrol similar in side effects to other oral anabolic steroids. Estradiol levels may be kept under control either by using an aromatase inhibitor such as letrozole or Arimidex, or by limiting use of aromatizing steroids such as testosterone.