Oxymetholone (Anadrol)
Also known as: Anadrol, Adrol, A50, Anapolon, Oxymetholon, Oxymethalone
The most powerful oral steroid in circulation and the most liver-toxic — with estrogenic side effects that an aromatase inhibitor cannot control, because it does not aromatize at all.
Substance family
Derived from dihydrotestosterone. They do not convert to estradiol, so no water retention — but also no estrogen of their own. Finasteride is useless against their hair loss, because they are already past the step it blocks. Hardest on the lipid profile.
Effects on
Which outcomes this substance acts on — descriptive, not a recommendation.
Strain profile
Where this substance is most likely to hit — a rough orientation, individually dependent on dose, duration and predisposition.
Dosing & protocols by goal
Rough orientation ranges as reported in harm-reduction literature — not an individual treatment plan. Doses are individual and open-ended; frequency depends on the ester or half-life.
Medical (aplastic anemia)
MedicalDose
1–5 mg / kg body weight / day
Frequency
Daily
Cycle length
Medically supervised, with close monitoring
Approved for aplastic anemia and used in HIV-related wasting — always with regular liver monitoring.
Mass building — Advanced
AdvancedDose
50 mg / day
Frequency
Daily, split into 2 doses
Cycle length
4 weeks
Strength and body weight rise very quickly. The short duration is dictated by liver strain, not by preference.
Higher doses
AdvancedDose
> 50 mg / day
Frequency
Daily
Cycle length
4 weeks
Studies show little additional benefit above 50 mg, while liver values and blood pressure deteriorate considerably further.
Side effect & countermeasure
Typical problems and what you can do to reduce harm — at a glance. Does not replace medical monitoring.
Problem
Gynecomastia that does not respond to an aromatase inhibitor
Countermeasure
Oxymetholone does not aromatizearomatizeThe body converting testosterone into estrogen via the aromatase enzyme. — it activates the estrogen receptor directly. Anastrozole is therefore ineffective here, which is the single most important point about this substance. Tamoxifen blocks the receptor and is the appropriate option; if breast tissue reacts, act quickly rather than waiting.
Problem
Severe liver strain — the most liver-toxic common oral compound
Countermeasure
Check ALT, AST, GGT and bilirubin before, during and after use. Avoid alcohol entirely, never combine with other orals, limit to 4 weeks. Jaundice, dark urine or persistent upper abdominal pain require immediate medical attention — the risk of liver damage is real and documented. TUDCA at 500–1000 mg daily addresses the cholestaticcholestaticBile backing up in the liver because its flow is obstructed — the specific liver injury oral steroids cause. mechanism directly; NAC supports the antioxidant system alongside it.
Problem
Markedly elevated blood pressure
Countermeasure
Measure at home daily. Control salt and water balance, keep cardio in the plan; medically, telmisartan, amlodipine or lisinopril, and low-dose tadalafil. Blood pressure often rises within days here rather than weeks.
Problem
Severe drop in HDL, rise in LDL
Countermeasure
Cardio, omega-3 and citrus bergamot as the base; with strongly deteriorated values, ezetimibe or pitavastatin under medical guidance. Measure a lipid baseline before starting. If a statin is started, CoQ10 belongs alongside it — statins deplete it through the same pathway.
Problem
Strongly elevated hematocrit
Countermeasure
Oxymetholone was developed to treat anemia — raising red blood cell production is its intended medical effect. Check hematocrithematocritThe percentage of blood made up of red cells — rises on androgens and thickens the blood. and hemoglobin; donate blood if markedly elevated. Nattokinase supports fibrinolysis but does not lower the cell count — donation remains the measure that works.
Problem
Headache, nausea, loss of appetite
Countermeasure
Common and dose-dependent. Loss of appetite in particular defeats the purpose in a mass phase. If it appears, the dose is too high — this is not something to push through.
Problem
Suppression of natural testosterone production
Countermeasure
SuppressionSuppressionThe body shutting down its own testosterone production because an external source is present. is pronounced and sets in quickly. A post-cycle plan belongs in place before starting; plan with the PCTPCTThe protocol after a cycle intended to restart the body's own testosterone production. timeline alongside the injected compounds in the cycle.
Overview
Oxymetholone, known as Anadrol, is the most potent oral anabolic steroid in general circulation — and simultaneously the one with the highest liver toxicity. It has a genuine medical approval for aplastic anemia and has been used in HIV-related wasting, always under close monitoring of liver function.
In the bodybuilding context, it produces very rapid gains in strength and body weight. What sets it apart from every other compound is a pharmacological peculiarity that is regularly misunderstood, and which makes the usual countermeasures useless.
Mechanism of Action
Oxymetholone is a DHT derivative with a 2-hydroxymethylene group and a 17-alpha-alkylation. The latter makes it orally available and is the source of its considerable liver strain — more pronounced here than with any other common oral compound.
The decisive peculiarity concerns its estrogenic effects. Oxymetholone cannot be converted to estradiol by the aromatase enzyme; it does not aromatize at all. Nevertheless, water retention and gynecomastia occur regularly, because the substance activates the estrogen receptor directly.
The practical consequence is central: an aromatase inhibitor such as anastrozole is ineffective here. It blocks a conversion that is not taking place. Anyone reacting to breast tissue symptoms with an aromatase inhibitor is treating the wrong mechanism and losing time while the tissue continues to develop. What works is a receptor blocker — tamoxifen occupies the receptor the substance is acting on.
Its effect on red blood cell production is likewise no side effect but the original medical purpose: oxymetholone was developed for anemia.
Typical Context
Oxymetholone is used at the start of mass phases, over roughly four weeks and generally at 50 mg per day. Studies comparing higher doses find little additional benefit beyond that point, while liver values and blood pressure deteriorate considerably further.
The gains in weight and strength are rapid and pronounced. As with methandienone, a large part is water, and a corresponding part disappears again after stopping.
The four-week limit is not conservatism. Liver strain accumulates, and oxymetholone is the compound where documented cases of serious liver damage are most frequent. Anyone extending the duration is increasing exactly the risk that distinguishes this substance from milder orals.
Side Effects & Risks
- Severe liver strain — the highest of any common oral compound
- Gynecomastia and water retention via direct estrogen receptor activation, not controllable with an aromatase inhibitor
- Markedly elevated blood pressure, often within days
- Severe drop in HDL, rise in LDL
- Strongly elevated hematocrit
- Headache, nausea, loss of appetite
- Suppression of natural testosterone production
- Acne, oily skin, accelerated hair loss with a genetic predisposition
Blood Work & Monitoring
- Liver values (ALT, AST, GGT, bilirubin) — baseline, during and after; the key markers here
- Blood pressure — measured at home, daily
- Hematocrit & hemoglobin — rises markedly
- Lipid profile (LDL, HDL, triglycerides) — baseline and during use
- Estradiol (sensitive) — informative, but note that symptoms can occur at normal values
- Total/free testosterone — to assess suppression
Harm-Reduction Notes
- An aromatase inhibitor does not work against gynecomastia here; tamoxifen blocks the relevant receptor
- Limit duration to 4 weeks — liver strain is the reason, and it is not negotiable
- Avoid alcohol entirely and never combine with other oral compounds
- Jaundice, dark urine or persistent upper abdominal pain: stop and seek medical attention immediately
- Do not push through loss of appetite or headache; both indicate the dose is too high
- Measure liver and lipid baselines before starting
- Do not read the rapid weight gain as muscle
Legal status by region
Regulation differs considerably between jurisdictions and changes over time. This is a rough orientation, not legal advice — check the rules that apply where you are.
| Region | Regulatory status |
|---|---|
| United States | Schedule III controlled substancePrescription required; possession without one is a federal offence. |
| EU / UK | Prescription-only medicineApproved for defined medical indications; supply without prescription is an offence. |
| Canada / Australia | Controlled substance, prescription-onlyImport for personal use is restricted. |
| Parts of Asia & Latin America | Pharmacy availability variesSome countries treat it as pharmacy-dispensed rather than strictly prescription-bound. Enforcement is inconsistent and rules change. |
| Competitive sport | Prohibited at all timesListed by WADA; national anti-doping law applies in addition. |