Mr.Testosterone
Newbie
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In recent years! It seems like a lot of people have been turning to anabolic androgenic steroids (AAS), you know, to give their physique or performance a boost. And yes, I won't deny that they help you gain muscle and strength, but be careful, they come with their own risks, and the liver takes the brunt of it. In this post, we're going to dive into how AAS affect our liver health,, what the differences are between oral and injectable versions, how the heck do we detect if there's already damage, and yes, which supplements, the ones that actually have some science behind them, could help keep things from getting too bad.
How do steroids affect the liver?
Look, steroid-induced liver damage occurs primarily through three pathways, almost like a three-pronged attack:
Cholestasis (when bile flow is blocked):: Some oral steroids, especially those that are chemically modified (think methyltestosterone or stanozolol), can block bile transport within the liver It's like a clogged pipe...
Reference: Björnsson, E. (2017). Archives of Toxicology.
Oxidative stress and mitochondrial damage: AAS have a tendency to generate nasty molecules called reactive oxygen species (ROS). These, in turrn, mess with our mitochondria (which are like the energy centers of cells) and, ultimately, can kill liver cells. It's not a great plan, really.
Reference: Neri, M. et al. (2011). Current Medicinal Chemistry.
Formation of liver tumors: This is where things get more serious. Continued steroid use has been linked to the development of liver tumors, such as adenomas. The mechanisms are still unclear, but it is suspected that uncontrolled cell proliferation and hormonal changes play a role. And yes, in that study I cited, what was seen was in bodybuilders who GOT OVER THE TOP, that is, abused them. This is important; we're not talking about moderate use.
Reference: Socas, L. et al. (2005). British Journal of Sports Medicine.
Oral or injectable? That's the liver question...
Here comes the million-dollar question: which one messes up the liver more?
Oral steroids: In order for them to take effect when taken orally, many have to be modified with a chemical group (called 17α methylation). This allows them to survive the first pass through the liver. The problem is that this very modification makes them much more toxic to our poor organ! Quite a chore, right?
Injectable steroids: By going directly to the muscle, they skip that "first pass" through the liver. This, in theory, significantly reduces their direct toxicity.
Reference: Hartgens, F. & Kuipers, H. (2004). Sports Medicine.
Liver supplements: a boon or a mirage?
Now, let's talk about what supplements could help us with our liver. And when I say "help," I'm completely honest if we keep injecting substances that are crushing it, and on top of that at high doses, the supplements will do little to nothing! The ideal, always, is to reduce the load (especially if you're using oral steroids), adjust the doses, and, if necessary, restructure the cycle. Only then, can we think of supplements as support, not as the magic bullet that fixes everything.
TUDCA (Tauroursodeoxycholic Acid) 230 to 750 mg per day
Beuers, U. et al. (1992). Tauroursodeoxycholic acid for primary biliary cirrhosis: a pilot study. Hepatology.
Rodrigues, C.M. et al. (2003). Tauroursodeoxycholic acid reduces endoplasmic reticulum stress in liver cells. Journal of Biological Chemistry.
Silimarina (the well-known "milk thistle") 140 mg of standardized extract (with 70-80% silymarin) 2 times a day (total 280-420 mg/day).
Ladas, E.J. et al. (2010). Milk thistle (Silybum marianum) for the treatment of liver disease. Integrative Cancer Therapies.
N-Acetylcysteine (NAC) 600-1200 mg daily orally divided into 2 doses.
*Prescott, L.F. (1983). Paracetamol: past, present, and future. American Journal of Therapeutics.
Curcumin (Turmeric Extract) 700 to 1500 mg daily of standardized extract, divided into 2 doses.
Panahi, Y. et al. (2016). Curcumin and Liver Disease: From Basic Research to Clinical Applications. World Journal of Gastroenterology.
Liver Damage Test Summary
-ALT (Alanine Aminotransferase)
Liver enzyme.
Indicates direct damage to liver cells.
-AST (Aspartate Aminotransferase)
Liver and muscle enzyme.
Indicates liver damage, but can also be elevated due to problems in other organs.
-Alkaline Phosphatase (ALP)
Enzyme related to the bile ducts.
Increases in biliary obstruction or inflammation.
-Gamma-glutamyl transferase (GGT)
Enzyme sensitive to liver damage from alcohol and toxins.
Also elevated in biliary problems.
-Total and direct bilirubin
Waste product processed by the liver.
-Albumin
-Prothrombin time (PT) / INR
Evaluates the liver's ability to produce clotting factors.
Honestly, I think it's more than reasonable to say that diet plays a fundamental role.. Sometimes, eating poorly can do even more damage than, I don't know, 300mg of testosterone. The liver is a vital organ, a key part of our machinery, and keeping it healthy and well cared for should, without a doubt, be our number one priority.
How do steroids affect the liver?
Look, steroid-induced liver damage occurs primarily through three pathways, almost like a three-pronged attack:
Cholestasis (when bile flow is blocked):: Some oral steroids, especially those that are chemically modified (think methyltestosterone or stanozolol), can block bile transport within the liver It's like a clogged pipe...
Reference: Björnsson, E. (2017). Archives of Toxicology.
Oxidative stress and mitochondrial damage: AAS have a tendency to generate nasty molecules called reactive oxygen species (ROS). These, in turrn, mess with our mitochondria (which are like the energy centers of cells) and, ultimately, can kill liver cells. It's not a great plan, really.
Reference: Neri, M. et al. (2011). Current Medicinal Chemistry.
Formation of liver tumors: This is where things get more serious. Continued steroid use has been linked to the development of liver tumors, such as adenomas. The mechanisms are still unclear, but it is suspected that uncontrolled cell proliferation and hormonal changes play a role. And yes, in that study I cited, what was seen was in bodybuilders who GOT OVER THE TOP, that is, abused them. This is important; we're not talking about moderate use.
Reference: Socas, L. et al. (2005). British Journal of Sports Medicine.
Oral or injectable? That's the liver question...
Here comes the million-dollar question: which one messes up the liver more?
Oral steroids: In order for them to take effect when taken orally, many have to be modified with a chemical group (called 17α methylation). This allows them to survive the first pass through the liver. The problem is that this very modification makes them much more toxic to our poor organ! Quite a chore, right?
Injectable steroids: By going directly to the muscle, they skip that "first pass" through the liver. This, in theory, significantly reduces their direct toxicity.
Reference: Hartgens, F. & Kuipers, H. (2004). Sports Medicine.
Liver supplements: a boon or a mirage?
Now, let's talk about what supplements could help us with our liver. And when I say "help," I'm completely honest if we keep injecting substances that are crushing it, and on top of that at high doses, the supplements will do little to nothing! The ideal, always, is to reduce the load (especially if you're using oral steroids), adjust the doses, and, if necessary, restructure the cycle. Only then, can we think of supplements as support, not as the magic bullet that fixes everything.
TUDCA (Tauroursodeoxycholic Acid) 230 to 750 mg per dayBeuers, U. et al. (1992). Tauroursodeoxycholic acid for primary biliary cirrhosis: a pilot study. Hepatology.
Rodrigues, C.M. et al. (2003). Tauroursodeoxycholic acid reduces endoplasmic reticulum stress in liver cells. Journal of Biological Chemistry.
Silimarina (the well-known "milk thistle") 140 mg of standardized extract (with 70-80% silymarin) 2 times a day (total 280-420 mg/day).Ladas, E.J. et al. (2010). Milk thistle (Silybum marianum) for the treatment of liver disease. Integrative Cancer Therapies.
N-Acetylcysteine (NAC) 600-1200 mg daily orally divided into 2 doses.*Prescott, L.F. (1983). Paracetamol: past, present, and future. American Journal of Therapeutics.
Curcumin (Turmeric Extract) 700 to 1500 mg daily of standardized extract, divided into 2 doses.Panahi, Y. et al. (2016). Curcumin and Liver Disease: From Basic Research to Clinical Applications. World Journal of Gastroenterology.
Liver Damage Test Summary
-ALT (Alanine Aminotransferase)
Liver enzyme.
Indicates direct damage to liver cells.
-AST (Aspartate Aminotransferase)
Liver and muscle enzyme.
Indicates liver damage, but can also be elevated due to problems in other organs.
-Alkaline Phosphatase (ALP)
Enzyme related to the bile ducts.
Increases in biliary obstruction or inflammation.
-Gamma-glutamyl transferase (GGT)
Enzyme sensitive to liver damage from alcohol and toxins.
Also elevated in biliary problems.
-Total and direct bilirubin
Waste product processed by the liver.
-Albumin
-Prothrombin time (PT) / INR
Evaluates the liver's ability to produce clotting factors.
Honestly, I think it's more than reasonable to say that diet plays a fundamental role.. Sometimes, eating poorly can do even more damage than, I don't know, 300mg of testosterone. The liver is a vital organ, a key part of our machinery, and keeping it healthy and well cared for should, without a doubt, be our number one priority.
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