Introduction to Oral Steroids

Oral steroids are a highly discussed topic, particularly among beginners and those considering anabolic steroids for the first time. The allure of oral steroids, which are convenient and easy to ingest in pill or capsule form, is undeniable. Before delving into the specifics of oral anabolic steroids, their functioning, effects, and differences from other forms like injectables, it's crucial to address several common misconceptions about them, prevalent among the uninformed public:

  • Oral steroids are safer than injectables.
  • Oral steroids are either less or more potent than injectables.
  • Oral steroids are more readily available.
  • Oral steroids are less expensive.

Misconception 1: Oral Steroids Are Safer

This is a major misunderstanding regarding oral anabolic steroids and a common myth in the wider context of steroids. The truth is, both injectable and oral steroids include various risky elements. Some oral steroids pose a higher risk to the body, just as some injectables do. However, oral steroids generally are harsher on the body’s systems compared to most injectables. Some oral steroids are milder and safer, but the majority pose risks like liver toxicity and adverse cholesterol changes, more so than injectables. This doesn't apply to most injectables, except a few, as the majority are well tolerated by the body.

Misconception 2: Oral Steroids' Efficacy Compared to Injectables

The potency of oral steroids is neither inferior nor superior to injectable steroids. The effectiveness of various oral anabolic steroids in muscle growth matches or surpasses that of many injectable compounds, although some oral steroids fall short compared to injectables.

Misconception 3: Accessibility of Oral Steroids

Contrary to popular belief, oral steroids are not easier to obtain. There are highly sought-after steroids in both oral and injectable forms, easily available. However, the most popular anabolic steroid is an oral one (Methandrostenolone), followed by two injectables: Nandrolone and Stanozolol. Vendors typically offer a balanced selection of oral and injectable steroids.

Misconception 4: Cost of Oral Steroids

This is also a misconception. The cost of steroids varies within both oral and injectable categories, depending on factors like popularity, manufacturing ease, and availability. The total cost of an anabolic steroid cycle is generally similar across different types, with variations depending on specific expensive compounds. However, simple cycles of injectable steroids can be more cost-effective than oral steroid cycles.

Understanding Oral Steroids: Function and Form

It's essential to know that only three orally bioavailable steroids without chemical modification are Andriol, Primobolan, and Proviron. Other oral anabolic steroids must undergo a specific modification for oral bioavailability. When ingested, most of the steroid does not enter the bloodstream due to liver metabolism. To counter this, a methyl group is added to the steroid structure (C17-alpha alkylation), enhancing resistance to liver metabolism. However, this increases liver toxicity. This modification allows oral steroids to be effective, but with greater hepatotoxicity.

The addition of a methyl group at the 17th carbon (C17-alpha alkylation) enables anabolic steroids to resist hepatic breakdown, but this increases liver toxicity. The difference between Testosterone with and without this modification is exemplified by Testosterone and Methyltestosterone. The methyl group addition is highlighted in the molecular structures.

C17-alpha alkylation limits how oral steroids are used, with considerations for hepatotoxic effects and cholesterol level impacts.

Most Common C17-alpha Alkylated Oral Steroids:

  • Methandrostenolone
  • Stanozolol
  • Oxandrolone
  • Oxymetholone
  • Chlorodehydromethyltestosterone

Oral Steroids and Liver Toxicity

Not all C17-alpha alkylated oral steroids have the same level of liver toxicity. Some, like Oxymetholone, are highly hepatotoxic, while others like Oxandrolone are milder. Hepatotoxicity varies based on the steroid's resistance to hepatic metabolism before and after methylation. Trenbolone, for example, is an injectable steroid without C17-alpha alkylation, with minimal hepatotoxicity. However, its methylated form, Methyltrienolone, is extremely liver toxic. Liver toxicity is a concern even at therapeutic doses lower than those used for bodybuilding. Dianabol exemplifies this, showing increased liver strain at doses above 15mg per day.

The most common liver issue from excessive oral steroid use is Cholestasis, which can range from minor discomfort to life-threatening conditions. Liver cysts, necrotic lesions, and in rare cases, liver cancers have been associated with high-dose oral steroid use.

Oral Steroids and Cholesterol

Oral steroids have a significant negative impact on cholesterol levels, more so than injectable steroids. They reduce HDL (good cholesterol) and increase LDL (bad cholesterol), with the extent of impact depending on the dose and other factors. This increases the risk of arteriosclerosis. Oral steroids, due to their liver strain, exacerbate cholesterol issues, as the liver processes cholesterol.

Comparison with Injectable Steroids

The cholesterol impact of injectable steroids like Testosterone Cypionate is less pronounced than oral steroids. Even at higher doses, injectable steroids do not significantly affect cholesterol levels. In contrast, oral steroids like Stanozolol can drastically reduce HDL and increase LDL, even at low doses.

Limitations of Oral Steroids

Due to hepatotoxicity and cholesterol issues, oral steroids should be used for no more than 6-8 weeks. Some more toxic steroids have shorter recommended usage periods. Oral steroids are typically supplementary to injectable compounds or used for kickstarting a cycle. No oral steroid should be used alone, and Testosterone should always accompany them to maintain normal physiological functions and counteract suppression by oral steroids.

Examples of Oral Steroid Cycles

For combination with injectable compounds or as a kickstart:

Cycle 1 (12 weeks):

  • Testosterone Enanthate and Nandrolone Decanoate, with Dianabol for the first 4 weeks.

Cycle 2 (12 weeks):

  • Testosterone Enanthate and Nandrolone Decanoate, with Anadrol for the first 6 weeks.

Cycle 3 (4 weeks, high-dose short-term):

  • Testosterone Propionate and Trenbolone Acetate, with Anavar for 4 weeks.

Oral-Only Steroid Cycles

While not recommended, here are examples of oral-only cycles:

Cycle 1 (8 weeks):

  • Andriol and Anavar

Cycle 2 (8 weeks):

  • Methandrostenolone

Cycle 3 (6 weeks):

  • Oxymetholone

Cycle 4 (8 weeks):

  • Stanozolol

These cycles illustrate that oral-only cycles are limited and less effective compared to combined cycles, often leading to short-lived or minimal gains.