Dianabol

The original bodybuilding steroid — the oral that built the golden era and still the most common first (and most casually taken) AAS because it is cheap, oral, and fast. Rapid size and strength, much of it water.

Methandrostenolone binds the androgen receptor and drives protein synthesis hard, with strong oestrogen conversion alongside it. The rapid weight gain it is famous for is substantially water and glycogen rather than tissue, which is why the scale moves within days — faster than muscle can physically be built. Oral 17-alpha-alkylated steroids share one design feature: a methyl group added at the 17 position so the molecule survives first-pass liver metabolism instead of being destroyed. That modification is what makes them orally active and it is strongly associated with the highest cholestatic risk in this class, though the exact injury mechanism is not settled. Liver strain is not an unlucky accident with these compounds; it travels with the chemistry that makes them oral.

Old, sparse clinical record; effectiveness for rapid mass is not in dispute and never was. What the decades established instead is the cost structure: heavy aromatization, liver strain, and blood-pressure elevation arriving within weeks.

• Developed in the 1950s and used clinically before being withdrawn; it has a real if dated human pharmacology literature.
• LIMITED, not settled. The controlled literature is old and tiny: an 11-man double-blind crossover found weight and muscle-size gains but no significantly greater strength than placebo, a 7-man trial found nitrogen and potassium changes out of proportion to ordinary muscle gain, and a 13-man crossover reported better performance alongside water-associated weight gain and raised systolic pressure. No adequate modern randomised trial establishing benefit and safety for non-medical physique use was identified.
• Case reports document cholestatic jaundice, peliosis hepatis (blood-filled cysts in the liver) and liver tumours with 17-alpha-alkylated orals as a class.
• HDL suppression on oral steroids is rapid and severe, frequently reported as a fall of half or more within weeks.

Orally active and short-acting, so blood levels swing rather than holding steady. It aromatises readily to oestrogen, which drives the water retention, raised blood pressure and gynaecomastia. Prohibited in tested sport.

17-alpha-alkylated liver load, aggressive aromatization (gyno and water/BP spikes that hit fast), lipid damage, full suppression. Its danger is sociological as much as pharmacological: it is the steroid people take WITHOUT a plan, because a bottle of pills feels casual in a way a vial does not.

• Class-level severe outcomes reported with anabolic steroids, which no compound here is exempt from: cardiac arrest, heart attack, thickened heart muscle, heart failure and stroke; serious liver injury; and mania, paranoia, psychosis, hostility, aggression, dependence and depression on withdrawal.
• Pregnancy and breastfeeding: androgens can cause fetal harm including virilisation of a female fetus. Avoid in both.
• Anyone with any liver condition or raised liver enzymes
• Anyone with high blood pressure or cardiovascular disease
• Children and adolescents, where androgens can close growth plates prematurely
• Anyone who wants children in the foreseeable future
• Women — virilisation from this compound includes irreversible voice change

• Alcohol, paracetamol and any other hepatotoxic drug — compounding an already liver-stressing compound.
• Anticoagulants, which oral steroids can potentiate.
• Tell any clinician treating your blood pressure that you are using it — do not adjust prescribed medicines around it yourself.
• Other oral 17-alpha-alkylated compounds, where liver burden is additive.

Documented interactions with other things people research. A compound not listed here does not mean the combination is safe — only that no specific interaction is on file.

• Liver enzymes and bilirubin — the marker that most often moves first and matters most on an oral.
• Lipids, particularly HDL, which falls fast.
• Blood pressure, which rises with the water retention.
• Haematocrit.
• Oestradiol, where gynaecomastia or heavy water retention is developing.

Water weight leaves within a couple of weeks and a visible share of the gain goes with it. Natural testosterone production is suppressed and takes weeks to months to recover, with the usual hypogonadal gap of fatigue, low mood and low libido in between. Liver enzymes typically normalise after stopping, but jaundice, dark urine, pale stools or right-upper-abdominal pain need medical assessment rather than waiting.

US: Schedule III, no legitimate US pharmaceutical production — all underground.

Papers about this compound, not proof of the claims above. A title says what was studied, which is sometimes a negative result or a different question entirely.

• A double-blind crossover trial of methandienone (Dianabol, CIBA) in moderate dosage on highly trained experienced athletes
  Br J Sports Med, 1975
• Appetite and weight gain in children: a double-blind trial using cyproheptadine and methandrostenolone
  Cent Afr J Med, 1969
• Changes in body composition following therapy of osteoporosis with methandrostenolone
  Metabolism, 1981

• [METHANDROSTENOLONE]Med Prom SSSR · 1964
• Methandrostenolone metabolism in humans: potential problems associated with isolation and identification of metabolitesJ Steroid Biochem · 1990
• METHANDROSTENOLONE, AN ORAL ANABOLIC AGENTSouth Med J · 1964
• [Thymolytic effects of methandrostenolone]Biull Eksp Biol Med · 1990
• Methandrostenolone in rheumatic diseases and osteoporosisGeriatrics · 1962
• DermatomyositisIndian J Pediatr · 1973
• Determination of methandrostenolone and its metabolites in equine plasma and urine by coupled-column liquid chromatography with ultraviolet detection and confirmation by tandem mass spectrometryJ Chromatogr · 1989
• HORMONE-SULPHATASE RELATIONSHIPSActa Endocrinol (Copenh) · 1965
• Methandrostenolone therapy in children with growth retardationJAMA · 1963
• [Methandrostenolone in constitutional thinness and malnutrition]Sem Med · 1961
• Neurotoxic properties of the anabolic androgenic steroids nandrolone and methandrostenolone in primary neuronal culturesJ Neurosci Res · 2011
• Quantitative fluorometric determination of methandrostenoloneJ Pharm Sci · 1962