Testosterone is a naturally produced anabolic steroid in the human body and is considered the safest compound among all anabolic steroids with potential side effects.
This is based on the logic that using a hormone the body already produces and is familiar with is far more reliable and safer than using altered forms of testosterone (i.e., all other anabolic steroid analogs).
Altered testosterone analogs act in the body in a manner nearly identical to testosterone, but these alterations create new compounds that are inherently foreign to the human body.
Consequently, some individuals may react positively to testosterone but negatively to specific anabolic steroid variants.
In the case of Sustanon, it is a blend of esterified testosterone variants, but it is crucial to understand clearly that this is not an altered analog of testosterone itself.
The esters contained in Sustanon, once removed by bodily enzymes, do not alter the inherent chemical structure of testosterone; they only serve to regulate the release rate and half-life of testosterone.
Therefore, Sustanon does not affect the fundamental effects and characteristics of testosterone itself.
However, it is not that testosterone is entirely free from potential side effects.
There are undesirable side effects that can occur related to the properties of testosterone, and since Sustanon is also a testosterone preparation, it carries the same potential for these side effects.
Bodybuilders must clearly understand the advantages and disadvantages of testosterone and use it based on sufficient preparation for managing side effects; only then can they achieve safe and effective results.
Estrogenic Side Effects
Since Sustanon, a testosterone ester blend, aromatizes into estrogen in the body, estrogen-related side effects can occur with its use.
The rate of this conversion to estrogen is closely linked to the dosage of Sustanon used, with higher doses leading to an increased rate of aromatization.
Elevated estrogen levels can lead to side effects such as water retention and bloating, increased blood pressure (due to water retention), potential fat gain, and gynecomastia.
These side effects can become particularly pronounced with high doses of Sustanon, making proper measures to prevent or manage them necessary.
Using an Aromatase Inhibitor (AI) is essential to control estrogenic side effects caused by Sustanon use.
Aromatase Inhibitors neutralize the aromatase enzyme, which converts testosterone into estrogen, thereby blocking the very production of estrogen at its source.
Through this, most estrogen-related side effects can be effectively prevented or managed.
Additionally, utilizing a SERM (Selective Estrogen Receptor Modulator) is also possible; SERMs like Nolvadex block estrogen from binding to receptors in breast tissue, making them useful for addressing gynecomastia issues.
However, since SERMs do not lower serum estrogen levels in the body, an Aromatase Inhibitor is still necessary for fundamental estrogen management.
In conclusion, to prevent and manage estrogen-related side effects during Sustanon use, the concurrent use of appropriate medications like Aromatase Inhibitors is absolutely essential, and users must proceed with their cycle while closely monitoring their body’s response.
Androgenic Side Effects
Testosterone is the body’s primary male androgen, with moderate androgenicity (Androgenic Rating: 100), and androgenic side effects can occur with Sustanon use.
Particularly, the more severe androgenic side effects from testosterone occur when testosterone is reduced by the 5-alpha reductase enzyme into the much more potent androgen, Dihydrotestosterone (DHT).
The 5-alpha reductase enzyme is abundant in specific tissues like the scalp, prostate, and skin, and when testosterone reaches these tissues, it is rapidly converted into DHT.
This process is the primary cause of most androgenic side effects, resulting in an increased likelihood of sebum production, worsened acne, growth of body and facial hair, and Male Pattern Baldness (MPB) in genetically predisposed individuals.
To manage these side effects, 5-alpha reductase inhibitors like Proscar or Dutasteride can be used adjunctively.
These medications help reduce DHT-related side effects by blocking its conversion.
However, since testosterone itself possesses a certain level of androgenic activity, these drugs cannot completely eliminate all androgenic side effects.
Furthermore, using a shampoo containing Ketoconazole (Nizoral) topically on the scalp is another method to reduce DHT-related side effects there.
Ketoconazole can effectively reduce the risk of Male Pattern Baldness (MPB) and acne by blocking DHT receptor binding in the scalp.
In conclusion, to reduce androgenic side effects from Sustanon use, a strategy involving close observation of the body’s response and the utilization of adjunctive medications or topical treatments is necessary.
These measures can help minimize side effects while maximizing the effects of Sustanon.
HPTA and Endogenous Testosterone Production Side Effects
Like all anabolic steroids, Sustanon is no exception and has the ability to suppress or even shut down the body’s endogenous testosterone production.
The administration of exogenous testosterone from Sustanon will inevitably suppress natural endogenous production during the period of use, and in the worst case, can completely halt it.
After the cycle ends, it is crucial to restore natural testosterone production through an appropriate PCT (Post-Cycle Therapy) period of 4-6 weeks.
For this, using testosterone-stimulating ancillary compounds like Nolvadex or HCG (Human Chorionic Gonadotropin) is recommended.
Failure to perform PCT can lead to permanent damage to the HPTA (Hypothalamic-Pituitary-Testicular Axis), potentially resulting in a lifelong inability to produce adequate testosterone, necessitating medical intervention such as TRT (Testosterone Replacement Therapy).
Hepatotoxic Side Effects
Sustanon’s side effects do not include hepatotoxic (liver toxicity) side effects.
This is because testosterone lacks the structural modifications, such as the C17-alpha alkylation common in oral anabolic steroids, that can cause hepatotoxicity.
In fact, a study involved administering high doses of testosterone (400mg daily, 2,800mg weekly) for 20 days, specifically investigating oral administration and the potential for hepatotoxicity.
The purpose of this experiment was to saturate the liver, and the study results observed no changes in the liver whatsoever.
This demonstrates that Sustanon does not cause hepatotoxicity. [1]
Cardiovascular Side Effects
One of Sustanon’s side effects involves negative cholesterol changes related to cardiovascular issues.
This is a side effect common to most anabolic steroids, resulting in a decrease in HDL (good cholesterol) and an increase in LDL (bad cholesterol).
These changes increase the risk of atherosclerosis, and the degree of negative change depends on the dosage.
Higher doses lead to greater cholesterol changes and associated risks.
However, testosterone has a lesser impact on cholesterol compared to other anabolic steroids.
This is because testosterone is metabolized relatively easily by the liver, unlike other anabolic steroids that are more resistant to liver metabolism.
According to clinical studies, administering 280mg of Testosterone Enanthate weekly for 12 weeks had only a mild impact on HDL cholesterol, but concurrent use of an aromatase inhibitor resulted in a 25% decrease in HDL cholesterol. [2]
Conversely, a study injecting 300mg of testosterone without an aromatase inhibitor showed a 13% decrease in HDL cholesterol, and increasing the dose to 600mg led to a 21% decrease. [3]
This data suggests that increased estrogen may somewhat mitigate the negative cholesterol changes.
This is because estrogen has a positive influence on cholesterol.
Therefore, when using an aromatase inhibitor, it is crucial to avoid excessive use and manage estrogen levels within a normal range using the minimum effective dose.
Managing estrogen so it does not spike or crash is the method for achieving optimal results.
Reference Medical Papers
[1] Enzyme induction by oral testosterone. Johnsen SG, Kampman JP, Bennet EP, Jørgensen F. 1976 Clin Pharmacol Ther 20:233-237
[2] High-density lipoprotein cholesterol is not decreased if an aromatizable androgen is administered. Friedl K, Hannan C et al. Metabolism 39 1990;
[3] Testosterone dose-response relationships in healthy young men. Bhasin S, Woodhouse L. et al. Am J Physiol Endocrinol Metab 281E1172 81 2001
