**Euro-Pharmacies are not medical physicians; therefore, the information provided is for educational purposes only.**
Euro-pharmacies do not have the qualifications or expertise of medical physicians. The information presented here is intended solely for educational purposes. It should not be considered as medical advice. It is important to consult with a qualified healthcare professional for any medical concerns or issues.
Disclaimer: The following results are typical for adult men, but may vary slightly from laboratory to laboratory.
1) “Point in case: work consistently, use wisely, and take breaks. Utilizing AAS can yield incredible results when done safely. At Euro-Pharmacies, we require all customers to submit their progress and we reward them for sharing their results, as we believe in the power of accountability. With proper training and AAS, you can achieve a long, healthy, and successful life. The possibilities are endless and the rewards are worth it!”
Hello, everyone! Euro-Pharmacies wants to emphasize the absolute importance of regularly getting lab work and blood tests done, not only when you are on a cycle, but also when you are off. It is crucial to monitor your health and ensure everything is in check.
Specifically, it is vital to get blood tests done. when you are on a cycle to ensure that your liver functions are at the appropriate levels.
Below, you will find some information on this topic, as well as some charts and basic laboratory values to help you understand how to read your liver test results. Let’s dive in and take control of our health!
Should I have my liver values tested annually or even quarterly? Euro-Pharmacies strongly encourages, so YES! That’s like asking if you need to eat food to grow. There are many factors to consider here. Age, genetics, cycle length, ability to recover, past cycles, compounds used, and dosage are just a few examples to review.
This is a complex topic that cannot be easily generalized. Each cycle and protocol is unique, and while we have guidelines to follow, it ultimately depends on the individual. It is crucial to prioritize health and well-being when using AAS to avoid potential health issues.
If someone chooses to use AAS, they must be prepared to take responsibility for their actions. There are consequences to using these substances, and one must be willing to face them. It is important to take measures to prevent any negative health effects and not assume immunity to potential risks.
In conclusion, it is essential to value your health and make informed decisions when using AAS. Taking the necessary precautions and following a proper course of action can help minimize any potential harm. Remember, with great power comes great responsibility. (Euro-Pharmacies says – GET TO WORK)
Remember, knowledge is power when it comes to maintaining a healthy lifestyle.
Cholestatic Enzymes: Alkaline Phosphatase (ALP) and Gamma-glutamyl Transferase (GGT)
Alkaline Phosphatase (ALP) is present in high concentrations in bone and liver, with lesser amounts found in the intestines, kidneys, or white blood cells. While ALP is not a definitive marker of liver damage on its own, elevated levels in conjunction with other liver enzymes may indicate liver issues.
Gamma-glutamyl Transferase (GGT) is primarily found in the liver and is a significant indicator of liver function. GGT is a microsomal enzyme that is highly sensitive to hepatotoxic drugs, such as anabolic steroids. Elevated GGT levels, especially when accompanied by increased AST and ALT levels, suggest a need to pause steroid use to allow the liver to recover. It is advisable to have your liver function tested before starting a new cycle, even after taking a break, to ensure the liver has had time to regenerate before being exposed to anabolic substances again.
Normal ranges for these enzymes, based on recent personal tests, are as follows:
– ALT: 10-40 U/L (units per liter)
– AST: 15-50 U/L
– ALP: 37-116 U/L
– GGT: 3-60 IU/L
Monitoring these enzyme levels through regular testing can provide valuable insights into liver health and guide decisions regarding anabolic steroid use.
**Laboratory tests may vary, so it is important to understand the normal ranges for different enzymes and proteins in the body. Here are the typical ranges for some common liver function tests:**
– ALT: 7 to 55 U/L
– AST: 8 to 48 U/L
– ALP: 45 to 115 U/L
– Albumin: 3.5 to 5.0 g/dL
– Total protein: 6.3 to 7.9 g/dL
– Bilirubin: 0.1 to 1.0 mg/dL
– GGT: 9 to 48 U/L
– sLD: 122 to 222 U/L
– PT: 9.5 to 13.8 seconds
**When reviewing your test results, pay close attention to the AST and ALT numbers as they are included in every basic liver function test. The GGT enzyme, however, may not always be included unless specifically requested by your doctor. If your AST and ALT levels fall within the normal range, it is highly likely that your liver is functioning properly. If you have any concerns, don’t hesitate to ask your doctor to include the GGT test in your next round of blood work. Your health is important, so stay informed and proactive about your liver function.**
If AST and ALT levels are elevated beyond the normal range, it is crucial to immediately cease the use of any substances that may be causing liver damage. It is highly recommended to undergo further testing that includes GGT levels to accurately assess the extent of liver damage. Monitoring AST, ALT, and GGT levels is the most reliable method to determine liver health. If all levels are elevated, it is imperative to take a break until they return to normal. Specifically, GGT levels should be within the normal range before resuming any substances.
During this break, focus on increasing antioxidant intake and consider taking silymarin (milk thistle) daily. NAC, an amino acid, also has protective and rejuvenating effects on the liver. A daily dose of 600mg of NAC and at least 125mg of milk thistle extract twice a day is recommended. Additionally, staying hydrated by drinking at least 0.5 ounces of water per pound of body weight is essential.
Remember, GGT levels are the most accurate indicator of liver stress when combined with elevated AST or ALT levels. Prioritize your liver health and take the necessary steps to ensure its well-being. Euro-Pharmacies cares about your sense of well being!
Overview:
Anabolic Steroids
Introduction:
Androgenic steroids are commonly used for male hormone replacement therapy and in the treatment of certain types of cancer. These steroids not only have androgenic effects, but also anabolic effects which are beneficial in conditions where muscle wasting occurs. In addition to their medical uses, synthetic anabolic steroids are often abused for bodybuilding purposes. However, it is important to note that many synthetic androgenic steroids can cause liver damage, specifically cholestatic liver injury. Prolonged use of androgens has also been linked to the development of liver tumors, such as hepatocellular carcinoma and hepatic adenoma. So, while these steroids may help you bulk up, they could also bulk up your risk of liver issues.
Overview:
Anabolic Steroids
Introduction:
Androgenic steroids are commonly used for male hormone replacement therapy and in the treatment of certain types of cancer. These steroids not only have androgenic effects, but also anabolic effects which are beneficial in conditions where muscle wasting occurs. In addition to their medical uses, synthetic anabolic steroids are often abused for bodybuilding purposes. However, it is important to note that many synthetic androgenic steroids can cause liver damage, specifically cholestatic liver injury. Prolonged use of androgens has also been linked to the development of liver tumors, such as hepatocellular carcinoma and hepatic adenoma. So, while these steroids may help you bulk up, they could also bulk up your risk of liver issues.
Background:
Testosterone is the primary male hormone, produced by the testes in men and to a lesser extent by the adrenal glands in both men and women. Unmodified testosterone cannot be taken orally, so it must be administered intramuscularly, sublingually, or through a transcutaneous patch. Various modifications of testosterone have been developed to enhance bioavailability or prolong its effects.
Esterification, such as with testosterone cypionate, enanthate, and propionate, maintains testosterone’s virializing effects while increasing potency and duration of action. Alkylation of the C-17 position of testosterone allows for oral administration and can alter the anabolic potency in relation to masculinizing effects. Alkylated testosterones, including methyltestosterone, methandrostenolone, oxymetholone, danazol, fluoxymesterone, stanozolol, norethandrolone, and oxandrolone, have been extensively studied for their ability to promote weight gain, muscle development, and improve athletic performance. They have also been used to treat aplastic anemia and bone marrow failure.
While these alkylated androgenic steroids are generally well-tolerated and have limited virializing activity, they have been associated with liver injury, including prolonged cholestasis, peliosis hepatis, nodular regeneration, hepatic adenomas, and hepatocellular carcinoma.
In contrast, esterified testosterones have rarely been associated with causing cholestasis. However, their long-term use may increase the risk of hepatic tumors and nodular transformation, albeit at a lower rate compared to 17-alkylated testosterones. Androgenic steroids are currently used for various medical conditions such as androgen deficiency, cancer, postpartum engorgement, hereditary angioneurotic edema, endometriosis, and fibrocystic disease.
Unfortunately, androgenic steroids are also being misused off-label and illegally to enhance muscle mass and athletic performance. This abuse is prevalent among bodybuilders and young male athletes, despite being prohibited in the Olympics and major professional and college sports. Shockingly, anabolic steroids have been detected in some over-the-counter nutritional supplements and online products claiming to improve well-being and muscle mass.
It is crucial to recognize the potential risks associated with the misuse of anabolic steroids and to promote safe and legal alternatives for individuals seeking to enhance their physical performance.
Hepatotoxicity
Androgenic and anabolic steroids have been linked to four distinct forms of liver injury: transient serum enzyme elevations, an acute cholestatic syndrome, chronic vascular injury to the liver (peliosis hepatis), and hepatic tumors including adenomas and hepatocellular carcinoma. These adverse events are most commonly associated with the C-17 alkylated testosterones, although tumors have also been reported with unmodified and esterified testosterone preparations.
The use of androgenic steroids can lead to a variable rate of serum enzyme elevations, which are typically asymptomatic and self-limiting. Danazol and oxymethalone have been most closely linked to these elevations, but they are usually temporary and do not necessitate dose adjustment or discontinuation.
Therapy with anabolic steroids is associated with a unique form of acute cholestasis, a condition where bile flow from the liver is impaired. Liver injury typically occurs within 1 to 4 months of starting therapy, but can be delayed up to 6 to 24 months. Symptoms usually start subtly with nausea, fatigue, and itching, progressing to dark urine and jaundice. Even after stopping the steroids, jaundice and itching can persist. Blood tests may show only slight elevations in liver enzymes, with ALT and alkaline phosphatase levels only 2 to 3 times higher than normal, or even within normal range despite severe jaundice. Liver biopsy usually reveals a bland cholestasis with minimal inflammation and cell death. Bile duct injury is usually mild or absent, and vanishing bile duct syndrome is rare. The exact frequency of acute cholestasis from anabolic steroids is unclear, but it may be dose-related and affect around 1% of patients using certain steroids. Cholestasis has not been reported in patients using unmodified testosterone. This specific pattern of liver injury is so characteristic of anabolic steroids that it can be suspected in patients who deny using them, or who unknowingly take herbal supplements containing steroids.
The use of anabolic steroids has been linked to vascular changes in the liver known as peliosis hepatis. Peliosis hepatis is a rare syndrome characterized by filled enlarged sinusoids and cysts throughout the liver. This condition is often accompanied by sinusoidal dilatation and loss of the normal endothelial barrier, resulting in an enlarged, deep red, and fragile liver.
Peliosis hepatis typically occurs in patients with advanced wasting diseases such as tuberculosis and cancer. However, it has also been associated with long-term use of anabolic steroids for conditions like aplastic anemia and hypogonadism, as well as in bodybuilding. Serum enzyme levels are usually normal or only mildly elevated, making diagnosis challenging.
Patients with peliosis hepatis may experience right upper quadrant discomfort, hepatomegaly, sudden abdominal pain, and even vascular collapse due to hepatic rupture and hemoperitoneum. This condition can also be an incidental finding during imaging of the liver, abdominal surgery, or autopsy.
Fortunately, peliosis hepatis associated with anabolic steroids can often improve, at least partially, with the cessation of steroid therapy. It’s important to note that peliosis can also affect other organs, most commonly the spleen.
In conclusion, the use of anabolic steroids can have serious consequences on liver health, leading to conditions like peliosis hepatis. It is crucial for healthcare providers and individuals using these substances to be aware of these potential risks and take appropriate measures to prevent harm.
The most serious complication of using anabolic steroids is the development of hepatic tumors, such as adenoma or hepatocellular carcinoma. These pesky tumors tend to pop up in patients who have been on androgenic steroids for a long time, usually as part of treatment for aplastic anemia or hypogonadism. However, they can also rear their ugly heads in athletes or bodybuilders who are using anabolic steroids illegally.
Typically, these tumors don’t make an appearance until 5 to 15 years of steroid use, but there have been cases where they show up as early as 2 years into therapy with testosterone esters. Some patients who have developed these tumors also have other risk factors for cancer, like Fanconi’s syndrome, iron overload, or chronic hepatitis C from transfusions.
The good news is that in some cases, when the steroids are stopped, the tumors shrink on their own. However, there have been unfortunate instances of hepatic rupture or tumor spread and metastasis leading to death in patients with anabolic steroid-related hepatocellular carcinoma.
Exciting news! Nodular regenerative hyperplasia of the liver has been identified in rare cases of individuals who have been using anabolic or androgenic steroids for an extended period of time. This condition typically does not show any symptoms or only presents with mild abdominal discomfort caused by an enlarged liver. However, in some rare instances, there have been reports of severe nodular regenerative hyperplasia leading to portal hypertension and splenomegaly. Additionally, there is a potential link between the development of hepatic tumors and the use of androgenic steroids, as nodular regeneration has been observed in the surrounding “normal” liver tissue. This discovery sheds light on the potential risks associated with long-term steroid use and highlights the importance of monitoring liver health in individuals using these substances.
Mechanism of Injury
The androgens work by activating intracellular androgenic steroid receptors, which then move to the nucleus and bind to androgen response elements on DNA. This process triggers a series of androgen-stimulated genes that play a crucial role in cell growth and development. Uncontrolled growth stimulation in hepatocytes is believed to be the primary cause of nodular regeneration and hepatic tumors associated with anabolic steroid use. The exact reason for cholestasis caused by C-17 substituted androgens is not clearly understood, but high doses have been shown to induce a similar cholestasis in certain animal models. This syndrome resembles cholestasis of pregnancy and the jaundice linked to high doses of estrogens or birth control pills, possibly due to a partial deficiency or variation in bile salt transporter proteins.
Liver injury caused by anabolic steroids can range from minor enzyme elevations to severe cholestasis, hepatic peliosis, and liver tumors. The first step in managing this condition is to immediately stop using the androgenic steroid. Athletes and bodybuilders may resist this advice, but reducing the dosage or switching to a different form of the steroid is not recommended. (GET BLOOD WORK)
Patients with hypogonadism can switch to unmodified testosterone given by injection or patch. Those with severe cholestasis may benefit from treatment for symptoms like itching and vitamin supplementation. While Ursodiol is commonly used for drug-induced cholestasis, its effectiveness has not been proven in controlled studies. Corticosteroids are usually ineffective and should be avoided.
Liver damage caused by anabolic steroids is usually reversible once the therapy is stopped, but recovery can be slow. In some cases, fatalities have been reported due to severe cholestasis, malnutrition, renal failure, and infections.
Common androgenic steroids include danazol, fluoxymesterone, methandienone, methenolone, methyltestosterone, nandrolone, norethandrolone, oxandrolone, oxymetholone, stanozolol, and various forms of testosterone.
It is important to recognize that anabolic steroids fall under the drug class of Anabolic Steroids.
Case Report: Anabolic Steroids
Case 1: Cholestasis due to anabolic steroid use
A 24-year-old bodybuilder experienced pruritus and jaundice after using various anabolic steroids for one and a half years. In addition to the steroids, he was also consuming herbal products and dietary supplements such as Ma Huang (6% ephedrine), carnitine, and chromium. Furthermore, he was drinking alcohol, with an estimated intake of one case of beer per day for the past year. Despite stopping all medications and alcohol promptly, he remained jaundiced for a month and experienced worsening nausea and weight loss, prompting him to seek medical attention.
Upon examination, the patient appeared muscular and physically fit but was deeply jaundiced. He had an enlarged liver but no rash, fever, or splenomegaly. Laboratory tests revealed a total serum bilirubin level of 53 mg/dL, with only modest elevations in serum aminotransferase and a normal alkaline phosphatase level. Tests for hepatitis A, B, and C were negative, and abdominal ultrasound showed no evidence of biliary obstruction. Although a liver biopsy was not performed, the patient was treated symptomatically for pruritus with antihistamines, cholestyramine, and ursodiol.
Over time, the patient’s jaundice gradually improved, and his pruritus subsided. Six months after the onset of symptoms, he was asymptomatic, had regained most of his weight loss (40 pounds), and his serum bilirubin level had decreased to 1.5 mg/dL, with normal serum enzyme levels.
Key Points: This case highlights the potential risks associated with the use of anabolic steroids, herbal products, and dietary supplements. It also underscores the importance of prompt medical attention and appropriate treatment in managing complications such as cholestasis.
Monitoring liver function is crucial when using anabolic agents, as demonstrated by the following results over a period of time. After approximately 1.5 years of anabolic agent use, the patient’s ALT levels were significantly elevated at 237 U/L, while Alk P levels were also high at 129 U/L. Bilirubin levels were elevated at 21 mg/dL.
After 6 weeks, there was a slight improvement in liver function, with ALT levels decreasing to 90 U/L, Alk P levels dropping to 121 U/L, and Bilirubin levels increasing to 53 mg/dL. However, at 10 weeks, liver function deteriorated again, with ALT levels rising to 203 U/L, Alk P levels increasing to 91 U/L, and Bilirubin levels remaining high at 51 mg/dL.
Treatment with Ursodiol was initiated at 12 weeks, resulting in a gradual improvement in liver function. By 14 weeks, ALT levels had decreased to 116 U/L, Alk P levels had dropped to 67 U/L, and Bilirubin levels had decreased to 8 mg/dL. Over the course of 4 months, liver function continued to improve, with ALT levels at 58 U/L, Alk P levels at 50 U/L, and Bilirubin levels at 4 mg/dL.
At 5 months, liver function had significantly improved, with ALT levels at 33 U/L, Alk P levels at 75 U/L, and Bilirubin levels at 1.5 mg/dL. The patient remained asymptomatic throughout this period.
It is important to note that normal values for liver function are typically less than 56 U/L for ALT, less than 139 U/L for Alk P, and less than 1.2 mg/dL for Bilirubin. Regular monitoring and appropriate treatment are essential in managing liver
Analysis:
This case presents a classic example of severe cholestasis caused by the use of anabolic steroids. The lack of medical supervision in this situation has led to uncertainty regarding the dosage and duration of each steroid preparation used. Typically, cholestasis occurs within 4 to 12 weeks of starting a C-17 alkylated androgenic steroid. The symptoms of jaundice, severe pruritus, and significant weight loss can be intense and prolonged. While serum enzymes are usually only slightly elevated, there may be a temporary spike immediately after discontinuing steroid therapy. The liver biopsy reveals a “bland” cholestasis with minimal inflammation and hepatocellular necrosis. It is worth noting that Ma Huang has also been linked to cases of drug-induced liver injury, characterized by an acute hepatocellular pattern of damage.
This case serves as a stark reminder of the dangers of using anabolic steroids without proper medical guidance. The consequences can be severe and long-lasting, impacting not only the liver but also overall health and well-being. It is crucial for individuals to be aware of the potential risks associated with these substances and to seek professional advice before embarking on any steroid regimen. Failure to do so can result in serious health complications, as demonstrated by this unfortunate case.
PRODUCT INFORMATION
**Anabolic Steroids**
REPRESENTATIVE TRADE NAMES
– Danazol: Generic, Danocrine
– Fluoxymesterone: Androxy
– Methandienone: Dianabol
– Methenolone: Primobolan
– Methyltestosterone: Android, Methitest, Testred
– Nandrolone: Generic, Deca-Durabolin
– Norethandrolone: Generic, Nilevar, Norlutin
– Oxandrolone: Generic, Oxandrin
– Oxymetholone: Anadrol
– Stanozolol: Winstrol
– Testosterone: Depo-Testosterone
DRUG CLASS
Anabolic Steroids
This list provides a selection of representative trade names for various anabolic steroids. These drugs belong to the drug class of anabolic steroids, which are commonly used for various medical purposes. It is important to consult with a healthcare professional before using any of these medications.