Androstenediol (4- and 5-androstenediol)
4-Androstenediol, 4-AD, Androst-4-ene-3β,17β-diol, Androst-5-ene-3β,17β-diol, Androstenediol 5-androstenediol, 4-Diol, 5-Diol, 5-AD
Forms: Two isomers: 4-androstenediol (androst-4-ene-3β,17β-diol) and 5-androstenediol (androst-5-ene-3β,17β-diol), sold as oral and sublingual products. Not the same as 1-androstenediol, a precursor of 1-testosterone.
Two closely related testosterone precursors, 4- and 5-androstenediol, sold as over-the-counter 'andro' prohormones until the US classed both as anabolic steroids in 2005.
Legal status: Both isomers have been named Schedule III anabolic steroids in the US since 2005, and 5-androstenediol is controlled in Canada; varies by country.
What it gives
What people use it for and what the sources report. Strength is a general category from the literature: mild, clear or strong.
Purpose
Used for testosterone, muscle and strength, including sublingual products meant to bypass breakdown in the liver. Neither isomer was ever approved as a medicine.
What people seek and what studies show
In 8 strength-trained men, a single sublingual intake roughly doubled total testosterone for as long as it was measured and raised estradiol. In a 12-week trial in men aged 35–65, oral androstenediol added no muscle or strength over placebo, while estrogens rose and lipids worsened. No trial has shown a training benefit.
Effects
Evidence: Limited human data — some human studies, small or short
Sought effects by goal (as reported)
Possible side effects
Possible does not mean certain: whether they appear depends on dose, duration, individual response and monitoring. Below — what to watch for and how to notice it early.
7 possible side effects
level · how often it is reportedWhat the levels mean
Level: general category from the literature, not your personal risk
How often
- common
- reported often
- possible
- reported in some people
- rare
- reported occasionally
How to lower the risks
For 5 of 7 possible side effects there are specific ways to lower the chance: everyday measures, supplements and options a doctor may consider. For the rest — general advice. No measure removes a risk completely.
Check estradiol by blood test before acting on symptoms; keep salt and body fat in check.
How each option helps (2)
- Regular blood tests — A sensitive estradiol test shows whether water retention or nipple tenderness really comes from high estrogen.
- Working with a doctor — Prescription estrogen control is safer when adjusted by lab results than by guesswork.
Avoid combining several oral steroids; regular cardio, soluble fiber (psyllium), less saturated fat and alcohol; if LDL/ApoB stay high, a doctor may consider a statin. Omega-3 only lowers triglycerides.
How each option helps (8)
- Regular blood tests — A lipid panel with ApoB shows how far HDL has dropped and LDL risen — changes you cannot feel.
- Working with a doctor — Interprets lipids and ApoB and decides whether a statin or other therapy is warranted.
- Avoiding alcohol and other liver stressors — Alcohol raises triglycerides; its small HDL bump does not lower heart risk.
- Regular cardio training — Raises HDL a little and lowers triglycerides; it cannot offset a steroid-driven fall in HDL on its own.
- Berberine — Placebo-controlled meta-analysis: LDL about 0.5 and triglycerides about 0.4 mmol/L lower; HDL unchanged. Trials are mostly small; no statin substitute.
- Citrus bergamot — Pooled small trials show lower LDL and triglycerides, but certainty is low to very low; it is no replacement for statins.
- Omega-3 (fish oil, EPA/DHA) — Clearly lowers triglycerides but does not fix the steroid HDL drop, the main lipid harm; DHA-containing oils may even raise LDL slightly.
- Psyllium husk fiber — Lowers LDL by about 0.2–0.3 mmol/L (roughly 5–10%), also on top of doctor-prescribed statins; no effect on HDL.
Check hormones before and after; if they stay low, see an endocrinologist.
How each option helps (2)
- Regular blood tests — LH, FSH and testosterone show how deep suppression is and whether natural production has recovered afterwards.
- Working with a doctor — Assesses how deep suppression is and guides recovery afterwards, including fertility testing.
React early: see a doctor at the first lump, check estradiol and prolactin.
How each option helps (1)
- Working with a doctor — Early assessment of breast-tissue growth allows treatment before the change becomes permanent.
What is unknown cannot be lowered, only avoided; tell your doctor what you have taken.
Products obtained without a prescription are often fake, mislabeled or non-sterile, and there is no way to check at home. For legal supplements, look for third-party testing (Informed Sport, NSF).
Stop at the first voice change and see a doctor — early stopping matters.
How each option helps (1)
- Working with a doctor — Steroid labels say to stop at the first mild signs (hoarse voice, facial hair, clitoral growth) to prevent permanent change; checks catch them early but do not make use safe.
Check-ups and blood tests
Which tests and check-ups to do and when. This is a guide — agree the exact schedule with your doctor.
Which doctors can help
Get medical help at once if
- A painful lump under the nipple or nipple discharge — see a doctor early, while it can still regress; a hard, painless or fixed lump, skin dimpling or bloody discharge — see a doctor promptly.
- Deepening voice, new facial hair, clitoral enlargement — stop and see a doctor: changes can become permanent. (women)
In an emergency, call your local emergency number.
For women
There are no trials in women. Both isomers convert to testosterone and estrogens, so acne, hair growth, menstrual changes and voice deepening are possible; voice and clitoral changes may be permanent.
Myth & fact
“Sublingual androstenediol works because it bypasses the liver.”
In a small study it raised testosterone over the three hours measured — and estradiol too. No trial has shown added muscle or strength, and a 12-week trial of the oral form found none while lipids worsened.
Combinations
No specific combination notes for this substance yet. The stack check still adds up side effects that several substances share.
Sources
Possible side effects by body system, combinations, how to lower the risks and which tests to do — free.
Open the stack check