Are there natural steroid supplements that can be used as an alternative to anabolic steroids?

Natural Steroid Supplements Are Not Effective or Safe Alternatives to Anabolic Steroids

There are no natural steroid supplements that can safely or effectively replace anabolic steroids, and current evidence shows insufficient data to recommend any "natural" alternatives for muscle building or anabolic purposes. 1

Why Natural Alternatives Don't Work

The ESPEN guidelines explicitly state there are insufficient consistent clinical data to recommend currently approved androgenic steroids to increase muscle mass, with a low level of evidence even for pharmaceutical-grade anabolic steroids themselves. 1 If prescription anabolic steroids lack strong evidence, over-the-counter "natural" alternatives have even less support.

Specific "Natural" Compounds Evaluated:

β-Hydroxy-β-methyl butyrate (HMB):

• Promoted as a leucine metabolite to gain strength and lean mass at 3g/day 1
• Evidence is inconsistent and limited to young, untrained individuals 1
• A large RCT in 472 patients failed due to poor compliance (only 37% completed), with no significant differences observed 1
• Cannot be recommended for general use 1

Selective Androgen Receptor Modulators (SARMs):

• Non-steroidal molecules designed to avoid side effects of natural androgens 1
• Still in early phase clinical trials with none approved for clinical use 1
• Enobosarm showed some lean mass increases but remains investigational 1

Vitamin D:

• While technically a steroid hormone, vitamin D in excess may have physiological effects similar to glucocorticoids or anabolic steroids through cross-talk with other steroid receptors 1
• However, this is a toxicity concern, not a therapeutic benefit 1
• No evidence supports using vitamin D as an anabolic steroid alternative 1

Critical Safety Concerns

Contamination Risk:

• Studies show 15-25% of sports supplements contain undeclared prohibited substances, including actual anabolic steroids 2
• Over-the-counter supplements can be contaminated with anabolic steroids, causing hepatotoxicity in unsuspecting consumers 3

Anabolic Steroid Precursors:

• Supplements like androstenedione and DHEA are marketed as "natural" testosterone boosters 4
• Scientific data do not support manufacturers' ergogenic claims 4
• Associated with serious side effects including decreased HDL cholesterol and increased estrogen 4
• The risks outweigh any possible ergogenic benefits 4

Hepatotoxicity:

• Anabolic steroids cause elevated liver enzymes, cholestatic syndrome, vascular injury, hepatic tumors, and fatty liver disease 3
• Many changes stabilize with cessation, but some can be life-threatening 3

Cardiovascular and Endocrine Effects:

• AAS cause elevation of blood pressure, depression of HDL cholesterol, and disturbance of endogenous testosterone production 5
• Mood disturbances, aggression, and dependency can occur 5

What About Phytosteroids?

Compounds like kaempferol, apigenin, genistein, and glycyrrhetinic acid interact with steroid receptors but are primarily studied for endocrine disruption concerns, not therapeutic muscle-building effects 6. These are not viable anabolic alternatives and can interfere with normal endocrine function 6.

Clinical Recommendation Algorithm

If seeking muscle mass/strength gains:

1. Optimize resistance training and adequate protein intake (no supplementation needed)
2. If considering supplements, only creatine and caffeine have robust evidence (not covered here but superior to any "steroid alternative") 2
3. Avoid all "natural steroid" supplements - they either don't work or contain undeclared anabolic steroids 2, 4, 3

If prescribed actual anabolic steroids for medical conditions (e.g., cachexia):

• Anabolic steroids should be avoided in patients with chronic liver disease due to abnormal liver biochemistry risk 1
• Even in appropriate medical contexts, evidence for efficacy is limited 1

Common Pitfalls to Avoid

• Don't assume "natural" means safe - many supplements are contaminated with actual steroids or have their own toxicities 2, 3
• Don't trust marketing claims - the scientific evidence contradicts most supplement advertising 4
• Don't use steroid precursors - they're banned by most athletic organizations and carry significant health risks 4
• Don't expect third-party testing to guarantee safety - while helpful, contamination remains a significant concern even with tested products 2