How harmful are steroids to your liver?

There is no doubt that anabolic steroids produce muscle mass and a feeling of well being. But they are known to be harmful to the liver. Just how harmful has always been an unknown to body builders.

Is it OK to try anabolic steroids for a first time without doing my liver any damage? How long can I take them before and liver damage occurs. Is any damage reversible? We try to answer those questions once and for all.

A brief Introduction to steroids

Steroids are a chemically altered version of the male hormone testosterone. Testosterone is cleared from the blood quite quickly so injecting pure testosterone is not a viable option. To get around this testosterone is modified for use in injection or to be taken as a pill.

When testosterone is modified so it can be injected it is said to be esterified and these include anabolic steroids such as testosterone enanthate ‘Test E” and testosterone propionate “Test Prop”.

When testosterone is modified so that it is taken in pill form it is said to be C-17 alkylated  and these include anabolic steroids such as dianabol and anadrol.

Both oral (c17 Alkylated) and injectable (Esterified) Anabolic steroids can be harmful to the liver but injectable steroids are much kinder to the liver and can be taken for prolonged periods with hardly any detrimental effect and are well tolerated

Injectable steroids are well tolerated but do carry a small but increased risk of liver damage when used long term. Oral steroids on the other hand have all been implicated when liver damage has occurred through anabolic steroid use.

Type of liver damage caused (mostly by) oral anabolic steroids

Cholestasis: This is liver damage caused by medicines or chemicals such as oral steroids and antibiotics and also alcohol. Specific liver enzymes are released from the liver due to damage and can be measured in the blood.

The liver comes under most stress 1-4 months after taking oral steroids but will return to normal after the pill popping has ceased.  There is no pain felt with cholestasis.

Peliosis hepatis. This is a quite rare form of liver damage caused by oral steroids and results in blood filled cysts throughout the liver. This condition can be quite painful but the liver is known to return to normal when the oral steroid taking has stopped.

Hepatocellular carcinoma. This is the most serious form of liver damage known to be caused by prolonged exposure to oral anabolic steroids. These usually occur 5-15 years after use but are usually associated with other risk factors such as cirrhosis.

Even if somebody gets liver cancer due to oral anabol steroid use they will often have a better outcome than those suffering from cirrhosis or chronic hepatitis B and C.


How do I know if I am doing any damage to my liver. What are the signs?

Very often you can have liver damage but with no pain. However if you get right upper quadrant discomfort or sudden abdominal pain this could be a sign. Also if you start itching, get jaundiced (yellow) or start feeling lethargic you should stop taking any steroids.

All steroid usage must stop if you experience any of the above symptoms. Changing the type of steroid you take is not an option. The above symptoms can persist for months even when you stop taking the steroids but will eventually improve.


I don’t like needles but want to try anabolic steroids. Can I use oral steroids for a few months without doing any damage to my liver?

The answer to this is a comforting yes. If you are sensible and keep cycles to between 6-8 weeks you should have no problems at all. However the more oral anabolic steroid cycles you do over the years the more at risk your are of liver disease.

The liver is one of the most forgiving organs in the body and responds well to treatment should you get any of the liver diseases we have mentioned.

Oral and injectable anabolic steroids

Some oral steroids are more damaging to the liver than others

So far we have said that oral anabolic steroid cycles should be kept to a minimum of 6-8 weeks and this is true for nearly all steroids except one.


Also known as oxytone, anadrol, androlic, anapolon (naps). This steroid is more toxic to the liver than most and each cycle should be kept to a minimum of 4 weeks.

Oxymetholone can be harsh on the liver (Pictured: Androlic)

Let’s take a look at a case study where one guy did actually get some liver damage by using steroids and what was the outcome

Bodybuilder takes oral steroids plus chromium, ephedrine and drinks a case of beer a days for 18 months, gets jaundice and goes to see a doctor after one month with no improvement

In this case study the 24 year old bodybuilder in question stopped all of the above supplements but after one month was still jaundiced. He was treated symptomatically for itching (pruritus) with antihistamines, cholestryamine and ursodiol. His jaundice gradually improved and pruritus waned. Six months after the onset of jaundice, he was well again, had regained most of his weight loss (40 pounds)

So it just goes to show even after all the abuse this guy gave his liver he was still able to recover with no lasting damage.


Injectable steroids pose nearly no risk at all to the liver and are well tolerated. They do slightly raise the risk after prolonged use of liver damage. However it would seem that its quite safe to use injectable steroids without having to worry about liver damage.

On the other hand whenever there has been a case of liver damage caused by steroid use it nearly always involves oral anabolic steroid use. However as long as you keep the use of oral anabolic steroids to a sensible minimum you should be fine.

Avoid alcohol whilst taking oral anabolic steroids. If you are injecting steroids you can drink as you normally would.

If you want to try one, two or three cycles of an oral anabolic steroid it should be considered safe to do so. After all these drugs are used in hospitals to treat certain wasting diseases and so cannot be all bad.


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