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Old 09-26-18, 08:55 PM
Trenbolone - Is It Liver Toxic?
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by William Llewellyn

Sept 26th 2018

Trenbolone: Sometimes Liver Toxic



People like to see things in black and white. A particular food is either healthy or unhealthy … an action is good or bad … a person is to be liked or disliked. Perhaps it is easier to navigate through a complex day with a simpler outlook like this. We can lose much time in the nuances that lie in the gray areas, after all. But in truth, life is rarely so cut and dry. Most things that we define as one way or the other actually fall somewhere in the middle. Anabolic steroids are a good example. One can find many instances of people forming too simplistic of views here. We won’t get lost exploring them all this month, but there is one topic in particular that caught my eye when reading a recent medical journal: the liver toxicity (or not) of trenbolone. Do we actually have a clear yes or no answer here?



Why Orals Are Toxic

Before I get into trenbolone specifically, we need to review some background on liver toxicity. As you may know, the liver is in effect a processing and filtering machine. It is exceptionally good at breaking substances down and preparing them for excretion, hormones included. This is why we can’t take injectable steroids like nandrolone, testosterone and boldenone in tablet form. Your body will not absorb them. Nearly every milligram will be broken down by the liver, made into a water-soluble byproduct, and excreted via the kidneys. This challenge was met head-on by steroid scientists in the early and mid-1900s. They found a solution, though it has been causing us a bit of trouble ever since.

We have many oral anabolic steroids today. Most of these contain the same chemical modification. If you look at their molecular structures, you’ll notice an extra methyl group at carbon-17. This “17-alkylation" occupies a bond that is needed to undertake an important step of metabolism … to convert a steroid’s 17-beta hydroxyl group into a not-so-functional ketone. With this blocked, most of the original unaltered steroid reaches the blood. One problem: this modification also places some strain on the liver. Take too much for too long, and you have notable toxicity. This association is so strong that we regard all alkylated oral steroids as liver toxic (in effect, all oral steroids). But are orals the ONLY liver-toxic steroids we need to worry about?



Not Oral, Not Toxic?

This brings us to a basic oversimplification in the anabolic-androgenic steroids (AAS) community. Oral steroids are liver toxic. They can harm our liver. You need to limit doses and take them for short periods of time. Injectable steroids are not liver toxic. They are “safe,” so we can take them for much longer and in higher doses. Of course, we make exceptions when we find a normally oral steroid prepared as an injectable. A good example is stanozolol. Otherwise, however, we feel comfortable with the knowledge that injectables simply won’t harm our liver. And trenbolone, of course, is an injectable steroid. It is not 17-alkylated. It is safe … right?

Not so fast.

Sometimes Liver Toxic

Admittedly, we don’t have a lot of clinical data on trenbolone to review. It is not a medicine used in the West these days. It hasn’t been used here for decades, and was exceedingly rare before that. Its production and use today are almost exclusively illicit. This means no modern clinical trials, no body of treatment outcomes to review. What we have is largely isolated to anecdotal reports. Though generally coming without incident, there are often enough reports of elevated liver enzymes. These usually come from men taking formidable doses, and seeing out-of-range blood values during routine blood testing. Occasionally, more serious side effects are noticed.

A couple of case studies involving trenbolone have even appeared in the medical literature in recent years. One incident comes from a December 2016 report published in the Journal of Sports Science. It concerns a young bodybuilder who was submitted to an outpatient clinic with severe jaundice, characterized by a notable yellowing of the skin and eyes. The jaundice was caused by cholestatic hepatitis, or bile duct obstruction. With this disorder, the bile ducts become blocked, and the liver can no longer efficiently clear bile. The yellow bilirubin accumulates in the body tissues. This can be very serious if left untreated. This man was successfully treated. We normally associate this with orals, but the toxicity in this case was associated solely with trenbolone enanthate.



Summary

In ANABOLICS 10th Edition, I explained the not so black-and-white nature of trenbolone and liver toxicity in the following passage: “Trenbolone is not c-17 alpha alkylated, and is generally not considered a hepatotoxic steroid; liver toxicity is unlikely. This steroid does have a strong level of resistance to hepatic breakdown, however, and significant liver toxicity has been noted in bodybuilders abusing trenbolone. Although unlikely, hepatotoxicity cannot be completely excluded, especially with high doses.”

I think the advice I put in the book still applies. Perhaps it should even be updated, placing slightly greater emphasis on hepatic risk given the growing number of reports of issue or injury. Likewise, it is time we all stop considering trenbolone “just an injectable” where liver toxicity is concerned. True, it is not likely to cause serious liver issues. But then again, sometimes it still does. Trenbolone is a “middle area” drug … a good reminder that not all things can be placed on one side of a line. As is always good advice with steroids, stay informed and be cautious. Until next time.
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