Liver stress and liver damage is not a side effect of steroid use in general, but is specifically associated with the use of c17 alpha alkylated compounds. These structures contain chemical alterations that enable them to be administered orally. In surviving a first pass by the liver, these compounds place some level of stress on the organ. In some instances this has led to severe damage, even fatal liver cancer.

The disease peliosis hepatitis is one worry, which is an often life threatening condition where the liver develops blood filled cysts. Liver cancer (hepatic carcinoma) has also been noted in certain cases. While these very serious complications have occurred on certain occasions where liver-toxic compounds were prescribed for extended periods, it is important to stress however that this is not very common with steroid using athletes.

Most of the documented cases of liver cancer have in fact been in clinical situations, particularly with the use of the powerful oral androgen Anadrol (oxymetholone). This may be directly related to the high dosage of this preparation, as Anadrol contains a whopping 50mg of active steroid per tablet. This is a considerable jump from other oral preparations, most of which contain 5mg or less of a substance. With one Anadrol tablet, the liver will therefore have to process (roughly) the equivalent of 10 Dianabol tablets. This obvious stress is further amplified when we look at the unusually high dosage schedule for ill patients receiving this medication.

With Anadrol, the manufacturer recommendations may call for the use of as many as 8 or 10 tablets daily. This is of course a far greater amount than most athletes would ever think of consuming, with three or four tablets per day being considered the upper limit of safety. It is also important to note that the actual number of cases involving liver damage have been few, and have not been a significant enough of a problem to warrant discontinuing this compound. The average recreational steroid user who takes toxic orals at moderate dosages for relatively short periods is therefore very unlikely to face devastating liver damage.

Although severe liver damage may occur before the onset of noticeable symptoms, it is most common to notice jaundice during the early stages of such injury. Jaundice is characterized by the buildup of bilirubin in the body, which in this case will usually result from the obstruction of bile ducts in the liver. The individual will typically notice a yellowing of the skin and eye whites as this colored substance builds in the body tissues, which is a clear sign to terminate the use of any c17 alpha alkylated steroids. In most instances the immediate withdrawal of these compounds is sufficient to reverse and prevent any further damage. Of course the athlete should avoid using orals for an extended period of time, if not indefinitely, should jaundice occur repeatedly during treatment. It is also a good idea to visit your physician during oral treatment in order to monitor liver enzyme values. Since liver stress will be reflected in your enzyme counts well before jaundice is noticed, this can remove much of the worry with oral steroid treatment.