Hepatotoxicity Overstated

Updated: May 26, 2019

"CONCLUSION: Prior reports of anabolic steroid-induced hepatotoxicity based on elevated aminotransferase levels may have been overstated, because no exercising subjects, including steroid users, demonstrated hepatic dysfunction based on GGT levels. Such reports may have misled the medical community to emphasize steroid-induced hepatotoxicity when interpreting elevated aminotransferase levels and disregard muscle damage. For these reasons, when evaluating hepatic function in cases of anabolic steroid therapy or abuse, CK and GGT levels should be considered in addition to ALT and AST levels as essential elements of the assessment."


What do the author's mean when they say hepatotoxicity is possibly overstated? When digging into this article further, I found that in most cases a linear approach to toxicity rating was taken in regards to AAS compounds. This means that most if not all of the toxicity ratings surrounding the subsequent use of orally applied exogenous hormones is drastically skewed.

The only problem area for this article is that those involved in the study did not list the dosing or compounds being used by the athletes inside the study group. This presents a problem in the findings in that the reader cannot ascertain specifically which compounds at what doses were found to cause little to no liver dysfunction as expected. (ie: DBOL, Anadrol, Superdrol and so on were not identified either by scientific name or commercial name within the studies. No dosing was released). Due to this one issue, the study falls into question and thus results in scrutiny.

That is until you find redundant studies showing the same results with further detail.

"The use of anabolic steroids among competitive athletes, particularly bodybuilders, is widespread. Numerous reports have noted "hepatic" dysfunction secondary to anabolic steroid use based on elevated serum aminotransferase levels. The authors' objective was to assess whether primary care physicians accurately distinguish between anabolic steroid-induced hepatotoxicity and serum aminotransferase elevations that are secondary to acute rhabdomyolysis resulting from intense resistance training. Surveys were sent to physicians listed as practicing family medicine or sports medicine in the yellow pages of seven metropolitan areas. Physicians were asked to provide a differential diagnosis for a 28-year-old, anabolic steroid-using male bodybuilder with an abnormal serum chemistry profile. The blood chemistries showed elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatine kinase (CK) levels, and normal gamma-glutamyltransferase (GGT) levels. In the physician survey (n = 84 responses), 56% failed to mention muscle damage or muscle disease as a potential diagnosis, despite the markedly elevated CK level of the patient. Sixty-three percent indicated liver disease as their primary diagnosis despite normal GGT levels. Prior reports of anabolic steroid-induced hepatotoxicity that were based on aminotransferase elevations may have overstated the role of anabolic steroids. Correspondingly, the medical community may have been led to emphasize anabolic steroid-induced hepatotoxicity and disregard muscle damage when interpreting elevated aminotransferase levels. Therefore, when evaluating enzyme elevations in patients who use anabolic steroids, physicians should consider the CK and GGT levels as essential elements in distinguishing muscle damage from liver damage."

PMID: 11476029

This study goes on to elaborate that suspected hepatotoxicity has been misdiagnosed by physicians. During a survey conducted in this study over half of the physicians failed to include the actual medical condition as their potential diagnosis. This is stark. What this means for people taking AAS is that even medical professionals are ill-equipped to accurately consult them on the use of exogenous hormones.

The solution for many has then become blackmarket websites, forums, and well blogs that lead them into the seventh circle of disinformation hell. Before you bite the bullet and begin taking exogenous hormones, reach out to us on our contact page. We can help prevent serious harm or injury that may befall the improper use of them.


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