From the Guidelines
Trestolone, as an anabolic steroid, can cause abnormal liver biochemistry, and its use should be approached with caution, especially in patients with pre-existing liver conditions. When considering the potential hepatotoxic effects of trestolone, it's crucial to understand that anabolic steroids, in general, can lead to liver enzyme abnormalities, as noted in guidelines on managing osteoporosis associated with chronic liver disease 1. This suggests that while trestolone itself may not be as commonly associated with hepatotoxicity as some other oral anabolic steroids due to its non-oral administration routes, the class of drugs it belongs to does pose a risk to liver health.
Key Considerations
- The potential for liver enzyme abnormalities with anabolic steroid use, including trestolone, necessitates regular monitoring of liver function tests for individuals using these substances.
- The route of administration (e.g., injectable vs. oral) can influence the degree of hepatotoxic risk, with oral anabolic steroids generally posing a higher risk due to first-pass metabolism.
- Beyond hepatotoxicity, trestolone and other anabolic steroids can lead to a range of other significant health issues, including cardiovascular problems, hormonal imbalances, and potential legal consequences in many jurisdictions.
Clinical Recommendations
- Regular blood work is essential for monitoring liver enzymes, lipid profiles, hematocrit levels, hormone levels, and other health markers in individuals using trestolone or other anabolic steroids.
- Patients with chronic liver disease or other pre-existing liver conditions should avoid using anabolic steroids, including trestolone, due to the potential for exacerbating liver damage, as advised in guidelines on managing osteoporosis associated with chronic liver disease 1.
- Healthcare providers should counsel patients on the potential risks and benefits of anabolic steroid use, emphasizing the importance of legal and medically supervised use to mitigate health risks.
From the Research
Liver Enzyme Abnormalities and Hepatotoxicity
- Trestolone, an anabolic steroid, can cause liver enzyme abnormalities and hepatotoxicity due to its chemical structure and mechanism of action 2, 3.
- The 17-α-alkylation modification in trestolone allows it to be taken orally, but it also makes it more hepatotoxic due to slower clearance in the liver 2.
- Hepatotoxicity can manifest as elevated liver transaminases, acute cholestatic syndrome, chronic vascular injury, hepatic tumors, and toxicant-associated fatty liver disease 2, 3.
Prevalence of Liver Injuries
- Studies have shown that anabolic steroid users, including those using trestolone, are at risk of developing liver injuries, including hepatotoxicity, fatty liver, and liver neoplasms 4, 5.
- The prevalence of liver injuries in anabolic steroid users can be as high as 38.5%, with elevated liver enzyme levels being a common finding 4.
- The risk of liver injuries associated with anabolic steroid use may be greater than the aesthetic benefits, highlighting the importance of screening users for liver injuries 4.
Mechanisms of Liver Injury
- The mechanisms of liver injury associated with anabolic steroid use, including trestolone, are not fully understood but may involve oxidative stress, cholestasis, and disturbance of antioxidative factors 3, 6.
- The use of 17 alpha-alkylated anabolic steroids, such as trestolone, can lead to sub-massive hepatic necrosis and subsequent liver failure, which can be fatal 6.
- Healthcare providers and the public should be informed about the dangers of anabolic steroid use, including the risk of liver injuries, to prevent potentially life-threatening consequences 6.