T Nation

Read This Before Considering Nandrolone or Any AAS

Usually I’d just leave this info “buried” in the other thread but it’s important enough to daylight it on the main page. Nandrolone based “HRT” and nandrolone use for joint/pain relief continues to garner much discussion and attention and it’s picking up.

Please care for yourself. Your long term cardiovascular health is much more important than some short term muscular gain.

Please see below. This was pasted from post on the TRT forum:

Back to the topic, if you wanted to do nandrolone topically, you wouldn’t use the ester (although your comments are well taken and using the ester would be potentially feasible but with very low absorption).

irocktheyellow, you’d use nandrolone USP since there is a reference standard and you could compound that just like testosterone with the USP bulk.

But again you wouldn’t want to (hence my poor attempt at humor with the video above). So what’s driving my bias? The guy you linked (see the More Plates More Dates web article dated Feb 1, 2020) to does a meticulous job with the blood work but never connects the dots on the isolated rise in systolic blood pressure. It’s a subtle tell that I don’t see ever getting discussed properly.

What’s my hypothesis for this?

What he doesn’t mention is that nandrolone can strongly upregulate beta-1 / beta-2 adrenergic receptors in the heart (dose response much more potent that testosterone):

Significance

This study indicated that nandrolone, whether associated with resistance training or not, induces cardiac hypertrophy, which is associated with enhanced collagen content, re-expression of fetal genes the in left ventricle, and impaired diastolic and systolic function.

Abstract

To investigate whether nandrolone decanoate (ND)-pretreatment can modulate (1) beta-adrenoceptor expression and (2) myocardial contractility in response to beta-adrenoceptors stimulation with isoproterenol (ISO), in hearts of both normal and stressed rats. Rats were treated with 15 mg/(kgday) of Deca-Durabolin (ND, 1 ml i.m.) or with vehicle (oil) for 14 days. The day after the last injection, the dose-response to ISO (1 x 10(-8), 5 x 10(-8) and 10(-7)M), was studied in isolated rat hearts harvested from unstressed animals (unstressed+vehicle (control) or unstressed+ND) or from stressed animals (stressed+vehicle or stressed+ND): acute stress protocol consisted in restrain for 1h immediately before sacrifice. ND-pretreatment increased beta(2)-adrenoceptor expression. In baseline conditions all hearts had a similar left ventricular developed pressure (LVDP) and maximum rate of increase of LVDP (dP/dt(max)). In hearts of unstressed+vehicle or unstressed+ND, ISO caused a similar increase in LVDP (+90-100%) and dP/dt(max) (+120-150%). However, hearts of stressed+vehicle animals showed a marked depression of inotropic response to ISO (i.e. for ISO 1 x 10(-8),-55% in LVDP response versus unstressed). Yet, in hearts of stressed+ND-animals the effect of stress was reversed, showing the highest response to ISO (i.e. for ISO 1 x 10(-7), +30% LVDP response versus unstressed). The ND-induced beta(2)-adrenoceptor overexpression does not affect ISO-response in unstressed animals. However, acute stress induces a down-regulation of ISO-response, which is reversed by ND-pretreatment. Since the physiological post-stress down-regulation of adrenergic-response is absent after nandrolone treatment, the heart may be exposed to a sympathetic over-stimulation. This might represent a risk for cardiovascular incidents in anabolic steroid addicts under stressing conditions.

Abstract

Aims

This study was performed to assess isolated and combined effects of nandrolone and resistance training on the blood pressure, cardiac electrophysiology, and expression of the β1- and β2-adrenergic receptors in the heart of rats.

Main methods

Wistar rats were randomly divided into four groups and submitted to a 6-week treatment with nandrolone and/or resistance training. Cardiac hypertrophy was accessed by the ratio of heart weight to the final body weight. Blood pressure was determined by a computerized tail-cuff system. Electrocardiography analyses were performed. Western blotting was used to access the protein levels of the β1- and β2-adrenergic receptors in the right atrium and left ventricle.

Key findings

Both resistance training and nandrolone induced cardiac hypertrophy. Nandrolone increased systolic blood pressure depending on the treatment time. Resistance training decreased systolic, diastolic and mean arterial blood pressure, as well as induced resting bradycardia. Nandrolone prolonged the QTc interval for both trained and non-trained groups when they were compared to their respective vehicle-treated one. Nandrolone increased the expression of β1- and β2-adrenergic receptors in the right atrium for both trained and non-trained groups when they were compared to their respective vehicle-treated one.

Electrocardiographic Profile and Muscle Glycogen Content of Rats Treated with Nandrolone

I can post these all day. When I used ND along with TRT I watched my pulse pressure (systolic minus diastolic) slowly increase from 40 mmHg to over 60 mmHg. The systolic kept going up and diastolic dropped 10 points.

Take a look at this:

Circulating Catecholamines

Guess what the ND effect on BP looks just like: that’s right, acute dosing of epinephrine.

So your sensitizing your heart to catecholamines you naturally produce and potentially changing the morphology and electrical signalling of your heart. This is not stuff you want to mess with long term, especially as part of some replacement strategy.

I fell for all this too originally even after meticulous research (but not meticulous enough). In my case I was also doing combination thyroid treatment, and I am sure there was interplay there between the lithyronine and ND. Went a little too high on testosterone and voila, went into AFIB.

Please leave the nandrolone (nortestosterone derivatives) alone if you value your long term health.

BTW, You may get collagen synthesis, just not where you want it (heart instead of joints). Also, please someone point me to one reputable source that shows nandrolone has any localized effect on synovial fluid. Given what we know about chronic pain and perception, my hypothesis is the significant effect of ND on chronic pain/join pain happens at the brain (neurotransmitters), not regeneration of the joint.

There we go, back on topic. Thanks youthful55guy.

Seriously, if you guys take the time to read anything on here, study up on this. ED, mood swings are serious concern, but not as serious as long term electrical issues with the heart and CARDIOVASCULAR complications from nandrolone.

EDIT: Also, proper recognition to unreal24278 who has daylighted these concerns in previous threads (after just searching the archives).

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Two thumbs up. I couldn’t agree more. If you’re using it as PED for the short term and are willing to take the risks then so be it. Those that think it has a place as a TRT regimen adjunct are plain wrong or misinformed. My fear is that many men will take it simply because the doctor allows it without fully understanding the consequences. I know so many guys on TRT that have no idea what they are doing. They can’t even communicate their dose properly and yet somehow they are supposed to understand the long term ramifications of choosing to use these alternative compounds now being prescribed.

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Thank you sir for taking the time. It’s like pushing a rope sometimes. Obviously daylighted in the literature for those that dig, but I haven’t seen proper discussion of upregulated beta adrenoceptor expression in the heart wrt nandrolone use even in what may seem to be low, “therapeutic” dosing. It’s a complex subject and nandrolone use accompanied with widening pulse pressure appears subtle unless you know what you are looking at. I just want guys to consider the risks vs reward if they consider using nandrolone as part of anabolic therapy. It’s not all roses.

Mood swings and ED almost minor compared to inducing cardiac electrical dysfunction or potential HF.

I have thought about trying a low dose deca cycle eg 100mg/wk for 12 weeks plus test TRT dose(125mg) to see If I get joint relief. Then off for deca for 3 months, as opposed to taking deca all the time. Surely that would be a safer option than always being on low dose deca.
If find a little legit pharma seems to go a lot further than UGL gear. eg 250 of test seems to give me as much hypertrophy as 500mg of UGL test.
When I used to do genuine cycles with EQ, I got a lot of joint relief, that continued nearly all the way until the next cycle 3-4 months later.

I’ve glossed over this numerous times as a byproduct of talking about mechanisms behind AAS induced cardiotoxicity. The upregulation of beta adrenergic receptors/catecholamine sensitisation isn’t sole to Nandrolone either. Nandrolone/19-nors merely seem more potent with regards to inducing this unwanted side effect.

Hypothetically speaking, during vigorous exercise these aforementioned mechanisms could be enough to trigger arrhythmia. Throw in some pathologic LVH and it’s ventricular… Fibrillation… city…

That didn’t sound so smooth.

This is what I’ve read
“Despite some beneficial effects of anabolic androgenic steroids (AAS) compounds in improvement of physical performance, chronic using of high doses of these drugs is associated with numerous adverse effects on the cardiovascular system including hypertension, myocardial infarction, dysrhythmias, hypertrophic cardiomyopathy, and cardiac remodeling”
The research has been done on animals and mentions “chronic use of high doses” so I’m not sure if you can necessarily infer that low doses on humans for the purpose of taking advantage of some of the benefits would necessarily lead to the same negative issues. I can see that the research might give someone pause but I wouldn’t necessarily freak out about it either, especially if administered under doctors care/monitoring.

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Most people who use gear don’t run just a few cycles and/or dosages below 3-500mg/wk. It’s typically upwards of 1 gram +, with 2-3 cycles per year for decades.

There will be a spectrum of individualistic predisposition towards negative side effects, but my outlined pattern of use will cause issues for most people 20-30 years down the line.

For whatever reason we tend to think about the here/now, because we can’t see damage being done we like to pretend it doesn’t exist. People should be more focused on long term rammifications/legitimate potential side effects. Erectile dysfunction, while shitty… Won’t kill you. Heart failure and/or cardiomyopathy might though.

Absoluely, that’s why I give you recognition over on the thread I linked to here. It’s understandable most of us will always be a few steps behind you :-). Thanks for all your efforts.

To give folks a flavor, see here:

Question, post a-fib episode you’ve specified you have symptoms pertaining to arrhythmia and/or autonomic dysfunction but can’t take beta-blockers due to associated side effects.

Have you spoken to an MD about using a medication such as ivabradine? If you’ve got a fast RHR this medication can be tremendously beneficial in regards to symptom management.

Have you tried cardioselective beta-blockers

It’s used off label for IST, isn’t associated with the same unwanted side effects (altered glucose tolerance, fatigue, dyspnea predominantly associated with no selective bb’s etc)

No one should have to suffer needlessly with autonomic dysfunction @readalot

Off topic, but I think propranolol in low doses can work wonders for social anxiety when taken on an “as needed basis”.

Thanks for taking the time. I gave three examples in the thread linked here, mine, moreplates more dates, and also @wsmwannabe gave his experience. I am sure there are many more out there. What prompted all this was the more plates report (link got nuked by the Mod but you can find it). Incredible amount of bloodwork but the guy didn’t understand why his systolic pressure shot up or didn’t want to hypothesize. I haven’t seen any discussion of widened pulse pressure using ND (or nandrolone in general) and what this could mean.

No discussion here:

Cardiovascular issues mentioned here in the context of illicit AAS use:

You guys correct me if it’s on Youtube. I haven’t seen any mention. So I think the idea I am communicating is that significant complications can happen at therapeutic dosing 100-150 mg/week, especially in synergy with T3 usage, underlying pathology or arrythmia, etc. I have only used therapeutic dosing less than 150 mg/week of ND with Rx. Moreplatesmoredates mentions 100 mg/week. @wsmwannabe is at a little over 3 mg/kg/wk. Don’t think this only can happen after years and some obscene dosages.

I hope guys watch their systolic numbers but also watch for drops in the diastolic pressure. Tracking BP and HR (as @mnben87 has thrown out is great), but explicitly watching your pulse pressure will also help. If your diastolic is dropping below 60 mmHg or pulse pressure increasing above 60 mmHg, that could be telling you something important.

I don’t want guys having to experience waking up 4 nights out of 7 at 2AM with heart racing because their heart has been sensitized to modest release of catecholamine during a dream. It is no fun and once your mind is involved (anxiety, panic, etc) it is a viscous cycle. If I can help a few people, then it was worth it. Unless you have an issue where reward far outweighs risk, please leave this stuff alone. I thought Anabolic Therapy for autoimmune/joint/rheumatoid issues was worth it. This book lays out all the pros:

https://www.google.com/books/edition/Anabolic_Therapy_in_Modern_Medicine/RPUqffuFXqIC?hl=en&gbpv=1&printsec=frontcover

But there is a dark side that I think is vastly overlooked (except for the powerful mind of @unreal24278) even for “therapeutic” dosing. I hope my thoughtful regurgitation of most of @unreal24278 's points with the pulse pressure observation helps you all make the right decision.

Interesting info about myself. I’ve always had low BP. My diastolic is frequently below 60, I’ve had it as low as 48! Resting BP is typically around 100/55.

Hey thanks for asking. I taking the less is more approach and back to levothyroxine monotherapy (took out the T3) combined with taking TRT back to 50 mg/wk of TC (yes the ester). Peak/trough is 900/300 ng/dL (once weekly sub-Q).

I have used metoprolol tartrate (fast acting) intermittently when I get really panicked. Gradually coming along with lots of cardio and getting my confidence back when pushing back up above 80% effort. I think this will be reversible.

300ng/dl is seriously on the low side. Wouldn’t you prefer to space out shots 2x/week and not have such a nasty nadir. Like 25mg 2x/wk sub q?

My nadir is like 550-600ng/dl

Notice the pulse pressure in your example is 45. Should mention that someone would track vs their baseline. But at your age if you BP was 100/55 (baseline) then went to 120/55 or 120/50 with nandrolone, that’s probably worth bringing up with your physician I think. Scary part is I have asked both cardiologist and well respected TRT doc about this and got hand waved.

Hey compared to the 80 ng/dL I experienced a few months ago when I went cold turkey, I am all good right now. That gave me a whole new appreciation for low T!

I’ve had widened pulse pressure on just about everything. Don’t recall if it was particuarly exacerbated when I tried Nandrolone. Nandrolone was definately the nastiest in terms of exacerbating autonomic dysfunction. Testosterone second… Dbol was probably the mildest within that regard, though my exposure to it was very minimal (short duration + conservatively dosed)

Why did you drop T cold turkey? Was this decision anxiety related or in response to instructions from a doctor?

Dropped the T3 and TRT partly because of cardiologist recommendation. TRT cold turkey no fun but was tired of the arrythmmia and Hct was still up at low 50s. Wanted to methodically add back in the lower dose TRT and see what happened. Hence, wanted to get my Hct back down to 45%, take out the T3 and start over. Hard to be completely stone cold scientific when you are feeling palpitations 24 hours a day. Thanks for asking.

Thank you for this. I have been on NPP, trying various doses, for months now. I have not experienced any positive effects and HAVE experienced many negative effects. I’ve been seriously considering stopping it recently and this tipped the scales for me. Thank you!

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Thanks so much for sharing your experience. My pleasure, and one by one, we can make a difference. Take care of yourself. Sometimes I feel like it’s shoveling dirt out of one hole and putting in another with all the posts on here asking to rationalize the proposed “cycles/regimens” aka drug abuse. It’s this type of feedback and dialogue that makes the posting worthwhile.

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Whilst I generally agree with what you’ve said, I think the level of risk one is willing to take varies from person to person. Some people may very well be comfortable with taking the risks associated with AAS use, and at that point, on an individualistic basis I don’t think it’s our place to judge.

If a healthy, mentally in-tact individual decides to use after being educated/well aware of the potential ramifications, then live and let live. Drug use, for better or worse is present within our society and won’t go away anytime soon. Anabolic steroids are no exception to this rule.

Many people come up with insane theories to justify unhealthy and/or destructive behaviour… I don’t understand why people can’t just be honest about this… don’t live in denial… (i.e “I know this is unhealthy, I know what I’m doing dramatically increases my risk for X,Y and Z and I’m okay with that, it’s my decision to make”).

I think if we can allow people to gouge themselves until they die prematurely, smoke, drink to excess, gamble and more we can tolerate an individualistic decision to use gear. I don’t really feel it’s my place to judge unless the person is

  • unaware of ramifications and stake and/or literally knows nothing about what they’re using
  • in denial about potential consequences
  • supplying/selling dangerous substances to other people

I don’t think everyone choosing to run cycles fits under the bill of being ignorant, unaware or in denial. I think a portion of adults using are well aware of the risks associated, but after making a benefit/risk analysis decided to use anyway. What constitutes as being beneficial, rewarding or important will dramatically differ from person to person.

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