Anabolic Steroids (AAS)
Synthetic testosterone derivatives
Effective for muscle — and genuinely dangerous and illegal.
Evidence tier
Banned / Harmful
Research weight
Not supported
Citations
16 verified / 16
Classification
Banned & Harmful
⊘
What the evidence says. Linked to serious harm and/or banned in sport and many jurisdictions. Listed for awareness and safety only — NOT a recommendation.
⚠
Health warning. Anabolic-androgenic steroids do build muscle, but non-medical use causes serious cardiovascular, hormonal, hepatic and psychiatric harm, can be fatal, and is illegal without a prescription. Included strictly as a warning.
What is Anabolic Steroids (AAS)?
Anabolic Steroids (AAS) (Synthetic testosterone derivatives) is a banned or harmful substance marketed for muscle & strength gains. NutriDex grades the human evidence as Banned / Harmful. Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone. Unlike most entries here, they are pharmacologically effective at increasing muscle mass and strength — which is exactly why their illicit use is so widespread and so dangerous. Common forms span injectable esters — testosterone (enanthate, cypionate, propionate), nandrolone (Deca-Durabolin), trenbolone and boldenone (Equipoise) — and oral 17-α-alkylated agents such as methandrostenolone (Dianabol), oxymetholone (Anadrol), stanozolol (Winstrol) and oxandrolone (Anavar), the oral compounds carrying the greatest liver toxicity. Non-medical use is associated with a substantial burden of harm: cardiovascular disease, hormonal disruption, liver injury (especially oral 17-α-alkylated compounds), and psychiatric effects. They are controlled substances and banned in virtually all sport. This entry exists to document the risks, not to guide use.
Marketed Claims (unproven)
✕(Claimed) muscle & strength gains
✕(Claimed) faster recovery
Dosing & Compounds
Use & Legality
No safe non-medical dose. Use only legitimate where prescribed and monitored by a physician for a diagnosed condition.
Active Compounds
Safety & Cautions
⚠ SERIOUS HARM. Cardiovascular: left-ventricular hypertrophy, cardiomyopathy, accelerated atherosclerosis, hypertension, blood clots, heart attack and sudden cardiac death. Hormonal: shutdown of natural testosterone, testicular atrophy, infertility, gynecomastia; in women irreversible virilization (voice deepening, facial hair); in adolescents premature closure of growth plates (stunted height). Liver: oral steroids cause cholestasis, peliosis hepatis and tumors. Psychiatric: aggression, mania, depression and dependence. Injecting risks abscesses and blood-borne infection (HIV/HCV). Illegal without prescription and banned in sport. Educational only — always check with your doctor or pharmacist before combining Anabolic Steroids (AAS) with any medicine.
Evidence & Risk Findings ★ 16 studies
Meta-analysis
Int J Cardiol 2025
✓ PubMed
Meta-analysis of 35 studies (2,000 men) found AAS-using resistance-trained athletes had lower LV ejection fraction (MD -2.25%, 95% CI -3.41 to -1.09) and worse global longitudinal strain (MD 3.34%, 95% CI 2.93 to 3.76) versus non-using athletes, indicating adverse cardiac remodeling.
RCT
Lincoff et al. (TRAVERSE) 2023
✓ PubMed
Landmark RCT in 5246 hypogonadal men (45-80y) with high cardiovascular risk: transdermal testosterone (to physiologic levels) was noninferior to placebo for major adverse cardiac events (primary endpoint 7.0% vs 7.3%; HR 0.96, 95% CI 0.78-1.17; P<0.001 for noninferiority), but testosterone caused higher rates of atrial fibrillation, acute kidney injury, and pulmonary embolism. Establishes that physiologic-dose TRT does not raise MACE, distinct from supraphysiologic AAS abuse.
Agency / regulator
WADA / DEA classification
✓ Source
Banned in sport; Schedule III controlled substances in the US.
scoping review
Solanki 2023 (Endocrine Connections)
✓ PubMed
Scoping review of AAS-induced hypogonadism reporting near-complete testosterone recovery over months and gonadotropin recovery in 3-6 months, but spermatogenesis and testicular atrophy recovery taking months to years and gynaecomastia often irreversible.
review
Abusive AAS use & sexual/reproductive health 2024 (review)
✓ PubMed
Updated review concluding AAS abuse suppresses the hypothalamic-pituitary-gonadal axis, lowering endogenous testosterone and impairing spermatogenesis, causing sexual dysfunction and frequently reversible-but-prolonged infertility.
cohort study
Windfeld-Mathiasen 2024 (JAMA)
✓ PubMed
Danish matched cohort of 545 male AAS users vs 5,450 controls found all-cause mortality roughly tripled among users (HR 3.0, 95% CI 1.3-7.0).
cohort study
Windfeld-Mathiasen 2025 (Circulation)
✓ PubMed
Prospective cohort of 1,189 AAS users vs 59,450 controls over ~11 years showed markedly elevated cardiovascular risk: cardiomyopathy (aHR 8.9), heart failure (aHR 3.6), myocardial infarction (aHR 3.0), and venous thromboembolism (aHR 2.4).
Observational
Kaufman/Pope 2024
✓ PubMed
Study of 76 middle-aged male weightlifters (51 with >=2 years AAS use vs 25 non-users) found no significant cognitive differences across visuospatial memory, verbal memory, emotion recognition, or executive function domains.
FDA safety communication
FDA: Bodybuilding products with steroid/steroid-like substances
✓ Source
FDA consumer warning advising people to immediately stop using over-the-counter bodybuilding products labeled to contain steroid or steroid-like substances (including SARMs) due to risks of serious liver injury, kidney injury, increased heart attack and stroke risk, testicular shrinkage, and male infertility.
cohort study
Windfeld-Mathiasen 2022 (Depression & Anxiety)
✓ PubMed
Matched cohort of 545 male AAS users vs 5,450 controls found increased psychiatric morbidity after doping sanction, including antipsychotic (HR 2.69), anxiolytic (HR 2.34), and antidepressant (HR 1.65) treatment.
Peer-reviewed case-control study
Bjornebekk 2019 (Neuropsychology)
✓ PubMed
Cross-sectional study of 84 AAS-using vs 69 non-using male weightlifters (n=153) found AAS users performed significantly worse on cognition, with strongest deficits in problem solving, working memory, and processing speed, and longer use associated with poorer memory plus structural brain correlates.
Review
Pope 2014 (Endocrine Reviews)
✓ PubMed
Comprehensive review documenting cardiovascular, endocrine, hepatic and psychiatric harms of AAS.
Cohort
Horwitz et al. 2018
✓ PubMed
Retrospective matched Danish cohort (545 AAS-positive men vs 5450 controls, replicated in a second cohort): all-cause mortality was 3-fold higher among AAS users (HR 3.0, 95% CI 1.3-7.0), with more than double the hospital contacts (0.81 vs 0.36 per year) and high prevalence of acne, gynecomastia, and erectile dysfunction (>10%).
Study
Baggish 2017 (Circulation)
✓ PubMed
Long-term AAS use linked to reduced cardiac function and coronary atherosclerosis.
NIH authoritative database (LiverTox)
LiverTox: Androgenic Steroids (NIH/NIDDK)
✓ Full text
NIH LiverTox authoritative review concludes that C-17alpha-alkylated oral AAS cause a distinctive bland cholestatic liver injury (onset 1-4 months) and, with prolonged use (typically 5-15 years), peliosis hepatis and hepatic tumors including adenoma and hepatocellular carcinoma; non-alkylated injectable testosterone esters rarely do so.
NIH authoritative body (NIDA)
NIDA: Anabolic Steroids and Other APEDs
✓ Source
NIH National Institute on Drug Abuse states AAS can lead to a substance use disorder, with withdrawal symptoms (including depression that can lead to suicide attempts) on cessation, and notes some users progress to opioids to manage steroid-induced sleep and irritability problems.