Oral steroids are one of the most popular topics among beginners and prospective anabolic steroid users.
The convenience of a pill or capsule is a major draw for first-time users.
Before explaining the definition, mechanism of action, role, and differences from injectables, it’s important to correct a few misconceptions.
Misconceptions About Oral Steroids
- Myth #1: Oral steroids are safer than injectables.
This is one of the biggest misconceptions. Both oral and injectable steroids include compounds that can pose risks. Specifically, oral steroids can have a greater impact on hepatotoxicity (liver toxicity) and cholesterol changes than injectables. With a few exceptions, injectables are generally better tolerated by the body. - Myth #2: Oral steroids are less effective or more potent than injectables.
Oral steroids are not inherently weaker or stronger than injectables. In terms of anabolic strength ratings, there are many cases where oral steroids surpass or are comparable to injectables. - Myth #3: Oral steroids are easier to obtain.
While some oral steroids are popular, injectables are also widely available. All steroid suppliers sell both oral and injectable forms in similar quantities. - Myth #4: Oral steroids are cheaper.
Prices depend on the compound’s popularity, ease of manufacture, and accessibility. The cost of an oral steroid cycle is often very similar to an injectable one, and a Testosterone-only injectable cycle can even be more economical than an oral-only cycle.
How Oral Steroids Work
There are only three steroids that are orally bioavailable without modification: Andriol, Primobolan, and Proviron.
Most oral anabolic steroids require a chemical modification to prevent them from being broken down by liver metabolism.
By modifying the chemical structure by adding a methyl group (an alkyl group) to the 17th carbon of the steroid structure (carbon 17-alpha), the anabolic steroid’s resistance to liver metabolism can be increased.
This process is called C17-alpha alkylation, which allows for oral activity and increased bioavailability.
Without this process, the anabolic steroid would not survive liver metabolism.
However, C17-alpha alkylation results in hepatotoxicity (increased liver toxicity), and drugs that are more resistant to liver breakdown always come with greater liver toxicity.
Modifying the chemical structure by adding a methyl group (an alkyl group) to the 17th carbon of the steroid structure (carbon 17-alpha) increases the anabolic steroid’s resistance to liver metabolism.
This is called C17-alpha alkylation, and this process increases oral activity and bioavailability.
Otherwise, the anabolic steroid could not survive metabolism in the liver.
However, C17-alpha alkylation comes with the downside of increased hepatotoxicity.
This creates limitations on how oral steroids can be used, their duration of use, and administration methods, and is associated with liver toxicity and changes in cholesterol levels.
The most popular C17-alpha alkylated oral steroids are as follows:
- Dianabol (Methandrostenolone)
- Winstrol (Stanozolol)
- Anavar (Oxandrolone)
- Anadrol (Oxymetholone)
- Turinabol (Chlorodehydromethyltestosterone)
Not all C17-alpha alkylated oral steroids exhibit the same level of hepatotoxicity.
For example, Anadrol (Oxymetholone) shows high hepatotoxicity, while Anavar (Oxandrolone) shows low hepatotoxicity.
The difference in liver toxicity is related to the degree of resistance to liver metabolism before methylation.
Trenbolone is not liver toxic without C17-alpha alkylation, but becomes extremely hepatotoxic when it becomes Methyltrienolone.
Studies show that all C17-alpha alkylated oral steroids exhibit some level of hepatotoxicity.
Specifically, Dianabol at doses over 15mg per day increases Bromsulphalein (BSP) levels, an indicator of liver strain, but this is minimized at doses of 10mg or less.
The hepatotoxicity of Dianabol is dose-dependent, and bodybuilding doses (25mg or more per day) can cause liver toxicity issues.
The most common form of hepatotoxicity from excessive oral anabolic steroid use is cholestasis.
Cholestasis is a condition where bile flow from the liver is completely stopped or at least minimally restricted, caused by a physical or chemical blockage (as in the case of anabolic steroids).
This leads to a buildup of bile salts and bilirubin in the liver and bloodstream, which is toxic to liver cells and can lead to cell death if severe.
The severity of this condition can range from minor discomfort to life-threatening symptoms. Mild cases may resolve within a few weeks, but severe cases can take several months or longer.
Excessive oral steroid use and cycle abuse can lead to serious, life-threatening liver problems, and there are documented cases of this.
In the past, cases of hepatic cysts, hepatocellular necrotic lesions (liver cell death and scar formation), and rarely, hepatic angiosarcoma and hepatocellular carcinoma (liver cancer) have been reported.
Notably, these liver problems occurred in two bodybuilders who used high-dose oral anabolic steroids [4], and one death has been recorded.
Oral Steroids and Negative Cholesterol Changes
It is well-known that anabolic steroids cause negative cholesterol changes in the body.
Different anabolic steroids exhibit this change to a lesser or greater degree, and while some can have a positive impact, this is rare.
Oral steroids have the most severe impact on cholesterol of all anabolic steroids.
This includes a decrease in HDL (good cholesterol) and an increase in LDL (bad cholesterol), which increases the risk of atherosclerosis.
The degree of change depends on the dosage, with higher doses leading to greater negative changes and risks.
The duration of use and route of administration also have an effect, with oral steroids having a worse impact than injectables.
This is because the liver acts as the body’s cholesterol processing center, and liver toxicity caused by steroids affects cholesterol changes.
Anabolic steroids increase hepatic lipase, which reduces HDL cholesterol.
Looking at the difference in cholesterol changes between injectable and oral steroids, injectable Testosterone Cypionate (300mg/week) reduced HDL by 21%, with no further reduction even when increased to 600mg/week.
This data shows that the impact of injectable testosterone is not as significant.
On the other hand, oral Winstrol, even at a low dose of 6mg for 6 weeks, reduced HDL by 33-71% and increased LDL by 29%.
In the same study, Testosterone Enanthate (200mg/week) reduced HDL by 9% and LDL by 16%.
The negative cholesterol changes from oral steroids are alarmingly severe.
Limitations of Oral Steroids
Due to hepatotoxicity and negative cholesterol changes, it is advisable to take oral steroids for no longer than 6-8 weeks per cycle. This is to ensure healthy liver function and allow for proper liver recovery.
Highly hepatotoxic oral steroids should be used for 4-6 weeks, other steroids for 6-8 weeks, and some can be used for up to 10 weeks.
Oral steroids must always be used with liver health in mind.
Oral steroids should only be used as an auxiliary drug to injectable steroids and should be avoided for standalone use.
Oral steroids suppress endogenous testosterone production, so they should always be used with at least a TRT dose of testosterone.
All individuals, especially beginners, should not construct a cycle with only oral steroids.
Oral steroids should be used as a supplementary drug in a cycle that includes injectable compounds, and injectables are the essential base of any cycle.
For those who insist on and are adamant about running oral-only cycles, a few examples will be briefly introduced at the end of this article.
Kickstarting
‘Kickstarting’ is a method where a beginner, after gaining cycle experience, uses an oral anabolic steroid along with other compounds.
During the “kick-in” period of injectable anabolic steroids, using an oral steroid allows the user to experience positive anabolic effects early on.
When the effects of the injectable fully kick in, the oral steroid is discontinued, allowing for a seamless transition between the effects of the two drugs.
Dianabol is often used as a kickstart drug due to its strong anabolic effects.
Examples of Oral Steroid Cycles
(As a kickstart to a supplemental compound or an injectable base)
Oral Steroid Cycle Example #1
| Weeks 1-12 | – Testosterone Enanthate at 300-500mg/week – Nandrolone Decanoate (aka Deca) at 400mg/week |
| Weeks 1-4 | – Dianabol at 25mg/day |
Oral Steroid Cycle Example #2
| Weeks 1-12 | – Testosterone Enanthate at 100mg/week – Nandrolone Decanoate at 400mg/week |
| Weeks 1-6 | – Anadrol at 50mg/day |
Oral Steroid Cycle Example #3 (4-week high-dose short-term advanced level cycle)
| Weeks 1-4 | – Testosterone Propionate at 150mg every other day (1,050mg/week) – Trenbolone Acetate at 150mg every other day (1,050mg/week) – Anavar at 50mg/day |
Examples of Oral-Only Cycles
A cycle consisting only of oral steroids is not advisable.
Without exogenous testosterone, the body cannot maintain normal function.
Oral steroids, such as Dianabol, have strong anabolic effects but cannot replace the many important physiological functions that testosterone performs.
Testosterone is necessary for many essential functions, including libido, energy, and mental and psychological well-being.
Oral-only cycles must be stopped early due to liver toxicity issues, and using a combination of oral steroids is detrimental to health.
Therefore, a properly constructed cycle should be used, and oral steroids should not be stacked.
With that said, here are some examples of oral-only cycles:
Oral-Only Steroid Cycle Example #1
| Weeks 1-8 | – Andriol at 300mg/day – Anavar at 50mg/day |
Oral-Only Steroid Cycle Example #2
| Weeks 1-8 | – Dianabol (Methandrostenolone) at 50mg/day |
Oral-Only Steroid Cycle Example #3
| Weeks 1-6 | – Anadrol (Oxymetholone) at 50mg/day |
Oral-Only Steroid Cycle Example #4
| Weeks 1-8 | – Winstrol (Stanozolol) at 50mg/day |
