From the Guidelines
Testosterone and its synthetic derivatives, such as nandrolone and stanozolol, are the most effective medications for increasing muscle size, as they directly promote muscle protein synthesis. According to the most recent and highest quality study, 1, there is insufficient consistent clinical data to recommend currently approved androgenic steroids to increase muscle mass. However, typical testosterone replacement therapy doses range from 50-400mg weekly, while performance-enhancing doses may exceed 500mg weekly. Growth hormone at 2-4 IU daily can also enhance muscle growth when combined with resistance training. Selective androgen receptor modulators (SARMs) like Ostarine and Ligandrol offer more targeted muscle-building effects with potentially fewer side effects. Certain prescription medications like insulin and beta-2 agonists like clenbuterol can indirectly support muscle growth. These medications work by increasing protein synthesis, enhancing nutrient delivery to muscles, and improving recovery. However, most of these substances have significant health risks, including cardiovascular problems, liver damage, hormonal imbalances, and psychological effects. Many are also banned in sports and require medical supervision or are illegal without prescription.
Some key points to consider:
- Testosterone therapy may be considered in patients with HIV wasting syndrome to reverse muscle loss, but there is a concern about the adverse metabolic effects of long-term testosterone administration 1.
- Recombinant human growth hormone (rhGH) may increase fat-free mass and muscle mass, but it is much more expensive than other treatment options and may have adverse effects 1.
- Anabolic steroids, such as oxymetholone, may increase body weight, muscle mass, and functional parameters, but they can have significant dose-dependent liver toxicity 1.
- Other medications, such as megestrol acetate and thalidomide, may have some benefits, but they are limited by high cost and adverse reactions 1.
It is essential to weigh the potential benefits and risks of these medications and to consider individual patient needs and circumstances before making any recommendations. Additionally, it is crucial to prioritize the patient's overall health and well-being, rather than just focusing on increasing muscle size.
From the FDA Drug Label
Androgens have been reported to increase protein anabolism and decrease protein catabolism. Nitrogen balance is improved only when there is sufficient intake of calories and protein Androgens are responsible for the growth spurt of adolescence and for eventual termination of linear growth, brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates, but may cause disproportionate advancement in bone maturation Androgens have been reported to stimulate production of red blood cells by enhancing production of erythropoietic stimulation factor
The medication testosterone (IM) can increase muscle size by increasing protein anabolism and decreasing protein catabolism, and improving nitrogen balance when there is sufficient intake of calories and protein 2.
From the Research
Medications for Increasing Muscle Size
The following medications can increase muscle size:
- Testosterone replacement therapy (TRT) [ 3, 4,5,6 ]
- Selective estrogen receptor modulators 5
- Gonadotropins 5
- Aromatase inhibitors 3, 5
- Anabolic-androgenic steroids 5
- Selective androgen receptor modulators 5
Mechanism of Action
These medications work by:
- Increasing serum testosterone concentrations 3, 4, 6
- Stimulating endogenous testosterone production 3
- Relieving symptoms of hypogonadism, such as decreased muscle mass and strength 4
- Promoting muscle hypertrophy 7
Important Considerations
When using these medications, it is essential to: