Methandienone
Metandienone, Methandrostenolone, Dianabol, D-bol, Dbol, Danabol, Anabol, Naposim
Oral steroidsControlled substanceWADA S1.1 · prohibitedEvidence: approved medicine
A 17α-alkylated oral steroid derived from testosterone and one of the oldest in use. Strongly anabolic, it converts to a potent estrogen and strains the liver.
Legal status: Controlled as an anabolic steroid in many countries (US Schedule III, UK Class C); no longer approved in the US; 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 fast gains in body weight and strength during mass-building phases. Developed by CIBA in the 1950s as Dianabol; US approval was revoked in 1985, though a few countries still make it as a medicine.
What people seek and what studies show
In a double-blind crossover trial in trained weight-lifters, body weight (about 2.3 kg), muscle size and leg strength rose on the drug but not on placebo; an earlier trial found more weight gain but no clear strength advantage. Body potassium and nitrogen rose out of proportion to the weight, so the gain was not normal muscle. Effects at the doses used in sport today are known only from users.
Effects
Evidence: Approved medicine — studied in people for its medical use
Sought effects by goal (as reported)
Mass
Sought for: muscle growth, strength
Recomposition
Sought for: muscle growth
Works against it: water retention / bloating
Strength
Sought for: strength, muscle growth
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.
15 possible side effects
level · how often it is reportedElevated
Suppression of natural testosterone & fertility
commonShuts down natural testosterone and sperm production; low libido, low mood and fatigue after stopping are common until recovery.
How to notice: Lower libido and energy, smaller testicles; low natural testosterone on tests after stopping.
In women: Menstrual changes or missed periods, lower libido and energy; reduced fertility.
Elevated
Worse cholesterol (HDL↓ LDL↑)
commonLike other 17α-alkylated oral steroids, it lowers HDL more than injectable testosterone does, and LDL tends to rise. The change is silent — only a lipid panel shows it.
How to notice: No symptoms — only visible on a lipid panel.
Elevated
Liver strain
possible17α-alkylated: liver enzymes often rise and cholestatic jaundice is reported; long use is linked to liver tumors. Dark urine or itching is a reason for prompt liver tests.
How to notice: Usually silent early; later tiredness, nausea, itch, dark urine.
Elevated
Kidney strain
rareRare: severe cholestasis can injure the kidneys — a published case had acute kidney injury alongside jaundice and pancreatitis.
How to notice: Usually silent; foamy urine or swelling in later stages.
Moderate
High estrogen (water, gyno risk)
commonAromatized to 17α-methylestradiol, a potent estrogen that resists breakdown; puffiness and nipple tenderness are typical signs.
How to notice: Puffiness, sensitive or itchy nipples, mood swings, water weight.
Moderate
Gynecomastia
commonThe first sign is a tender lump under the nipple. Early changes can settle, but established gland tissue usually needs surgery, so it deserves a doctor's look early.
How to notice: A tender lump or swelling under the nipple.
Moderate
Water retention / bloating
commonRapid fluid gain and a puffy, smooth look are typical; part of the quick weight gain is water that leaves after stopping.
How to notice: Puffy face and ankles, softer look, quick weight jumps.
Moderate
Higher blood pressure
commonFluid and sodium retention commonly push blood pressure up, usually without symptoms; home readings show the trend.
How to notice: Often silent; sometimes headaches, flushing, nosebleeds — a home monitor shows it.
Moderate
Black-market quality risk (fakes, contamination)
commonMostly made by underground labs: tablets are often mislabeled in strength or contain a different steroid.
How to notice: Unexpected effects, pain or infection, a stronger or weaker effect than expected.
Moderate
Insulin resistance / higher blood sugar
possibleIn a small clinical study insulin sensitivity fell about fourfold and glucose tolerance worsened, yet fasting glucose did not rise — a fasting test alone can miss it.
How to notice: Thirst, more hunger, energy crashes after carbs.
Moderate
Thick blood (hematocrit) / clot risk
possibleCan raise hemoglobin and hematocrit, especially combined with injectable steroids; a blood count shows it before symptoms do.
How to notice: Often silent; sometimes headaches, flushed face, itch after a hot shower.
Moderate
Heart strain / heart-muscle thickening
possibleFluid load, higher blood pressure and worse lipids together add strain on the heart, more so with long or repeated use.
How to notice: Shortness of breath on effort, lower endurance, palpitations.
Moderate
Androgenic hair loss
possibleBarely converted by 5α-reductase, yet it can still speed up genetic hair loss.
How to notice: More hair in the shower, thinning at the temples or crown.
MenLow
WomenHigh
Virilization in women (often irreversible)
commonIn women it often causes voice deepening, facial and body hair and clitoral enlargement, which may be permanent.
How to notice: Hoarse or deeper voice, new facial or body hair, menstrual changes, clitoral enlargement.
Low
Acne, oily skin
commonOily skin and acne on the face, back and chest are common.
How to notice: Oily skin, spots on back, shoulders and face.
What the levels mean
Lowbackground — just be aware
Moderatewatch for signs
Elevatedneeds regular control
Highcritical — can be life-threatening or permanent
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 14 of 15 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. Prescription medicines are listed only for a doctor to decide on, after tests — they have side effects of their own.
ElevatedSuppression of natural testosterone & fertility
Check hormones before and after; if they stay low, see an endocrinologist.
Measure
Only if a doctor prescribes
How each option helps (7)
- 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.
- Clomiphene — A doctor may consider it after stopping, guided by hormone tests; recovery after long use can still take months. Risks: vision changes, mood swings, rare clots. Has side effects of its own.
- Human chorionic gonadotropin (hCG) — A doctor may consider it to preserve fertility (in men it keeps the testes working); it does not restart the pituitary, so natural LH still has to recover. Risks: higher estradiol, gynecomastia. Has side effects of its own.
- Tamoxifen — A doctor may consider it after steroids are stopped, guided by hormone tests; it has not been tested for this after steroid use. Risks: blood clots, vision changes. Has side effects of its own. Not offered to women: in the women’s view it adds to a risk this substance already carries.
- Follicle-stimulating hormone (follitropins, menotropins) — A fertility doctor may consider adding it to hCG when semen tests and FSH stay low; it does not restart the pituitary. Risks: gynecomastia, acne. Has side effects of its own.
- Toremifene — A doctor may consider it after steroids are stopped, guided by hormone tests; it raised testosterone in subfertile men but was never tested after steroids. Risks: QT prolongation, clots. Has side effects of its own. Not offered to women: in the women’s view it adds to a risk this substance already carries.
ElevatedWorse cholesterol (HDL↓ LDL↑)
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.
Measure
Supplement or OTC product
Only if a doctor prescribes
How each option helps (12)
- 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.
- Atorvastatin — A doctor may consider it when LDL or ApoB stay high; it strongly lowers them but barely lifts steroid-lowered HDL. Risks: muscle aches, drug interactions, rarely muscle or liver injury. Has side effects of its own.
- Rosuvastatin — A doctor may consider it when LDL or ApoB stay high; it strongly lowers them but barely lifts steroid-lowered HDL. Risks: muscle aches, rarely muscle or liver injury, slightly higher diabetes risk. Has side effects of its own.
- Ezetimibe — A doctor may consider it when LDL stays high on a statin or a statin isn't tolerated; it lowers LDL moderately but does not raise HDL. Risks: rare liver-enzyme rises. Has side effects of its own.
- Pravastatin / pitavastatin (low-interaction statins) — A doctor may consider them when LDL is high and other statins aren't tolerated; they lower LDL moderately and barely lift HDL. Risks: muscle aches, slightly higher diabetes risk. Has side effects of its own.
ElevatedLiver strain
No alcohol, no other liver stressors, limit oral steroids and their combinations, check liver enzymes.
Measure
Supplement or OTC product
Only if a doctor prescribes
How each option helps (6)
- Avoiding alcohol and other liver stressors — Removes a major extra liver stressor during oral steroids and other hepatotoxic drugs.
- Regular blood tests — ALT, AST, GGT and bilirubin show liver strain before symptoms; heavy lifting alone raises AST/ALT for days, and GGT helps tell muscle from liver.
- Ademetionine (SAMe) — Used for intrahepatic cholestasis in some countries, but trials are small and of low quality; untested in steroid users. Stopping the oral steroid matters most.
- N-acetylcysteine (NAC) — Restores glutathione; proven in paracetamol poisoning and helped in early acute liver failure of other causes, but untested in steroid users.
- TUDCA (tauroursodeoxycholic acid) — Improves bile flow in cholestatic disease; in steroid cholestasis only case reports, with failures in severe cases. Stopping the oral steroid matters most.
- Ursodeoxycholic acid (UDCA) — A doctor may consider it to improve bile flow; in steroid cholestasis benefit is unproven and severe cases often did not respond. Stopping the oral steroid comes first. Has side effects of its own.
ElevatedKidney strain
Drink enough water, control blood pressure, avoid regular painkillers (NSAIDs).
Measure
Only if a doctor prescribes
How each option helps (6)
- Fluid & electrolyte management — Good hydration eases kidney stress from heavy training and heat; dehydration plus NSAIDs is a classic cause of acute kidney injury.
- Regular blood tests — Creatinine reads high in muscular people and with creatine; cystatin C and a urine test give a truer picture of the kidneys.
- Working with a doctor — Investigates protein in the urine or falling kidney function and can start treatment that slows kidney damage.
- ACE inhibitors (ramipril, perindopril, lisinopril) — May reduce protein leakage into urine and slow kidney disease. But with dehydration, diuretics or NSAIDs (ibuprofen etc.) they can trigger acute kidney injury. Has side effects of its own.
- Losartan / valsartan (angiotensin receptor blockers) — May reduce protein leakage into urine. But with dehydration, water cuts, diuretics or NSAIDs (ibuprofen etc.) they can trigger acute kidney injury. Has side effects of its own.
- Telmisartan — May reduce protein leakage into urine. But with dehydration, diuretics or NSAIDs (ibuprofen etc.) it can trigger acute kidney injury. Has side effects of its own.
ModerateHigh estrogen (water, gyno risk)
Check estradiol by blood test before acting on symptoms; keep salt and body fat in check.
Measure
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.
ModerateGynecomastia
React early: see a doctor at the first lump, check estradiol and prolactin.
Measure
How each option helps (1)
- Working with a doctor — Early assessment of breast-tissue growth allows treatment before the change becomes permanent.
ModerateWater retention / bloating
Steady salt and water intake, cardio, check estradiol.
Measure
How each option helps (1)
- Working with a doctor — Tells harmless water retention from swelling due to heart, kidney or liver trouble; steroid labels warn that edema can come with heart failure.
ModerateHigher blood pressure
Less salt, regular cardio, good sleep; home readings; a doctor if it stays high.
Measure
Supplement or OTC product
How each option helps (8)
- Home blood-pressure monitoring — Seated, rested readings on several days show your true BP; persistently high values are a signal to see a doctor.
- Regular cardio training — Regular aerobic training lowers resting BP by a few mmHg, more in people with high BP.
- Working with a doctor — Diagnoses persistent hypertension and prescribes treatment when needed.
- Avoiding alcohol and other liver stressors — Regular drinking raises blood pressure; cutting it out lowers it.
- Coenzyme Q10 — Inconsistent: some analyses show a small systolic drop in cardiometabolic disease, but a Cochrane review found no clinically meaningful effect.
- Magnesium — Meta-analysis of trials: about 2 mmHg lower systolic pressure on average.
- Omega-3 (fish oil, EPA/DHA) — Small drop of a few mmHg, mainly in people with untreated high blood pressure.
- Taurine — Meta-analysis of 20 small trials: about 4 mmHg lower systolic pressure on average.
ModerateBlack-market quality risk (fakes, contamination)
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).
ModerateInsulin resistance / higher blood sugar
More daily movement, fewer fast carbs, check fasting glucose and HbA1c.
Measure
Supplement or OTC product
How each option helps (7)
- Glucose monitoring — Rising fasting readings reveal insulin resistance from GH or other drugs early.
- Regular blood tests — Fasting glucose, insulin and HbA1c catch rising blood sugar early — key with GH, its secretagogues and insulin.
- Regular cardio training — Improves insulin sensitivity — useful against the blood-sugar rise from GH and its secretagogues.
- Working with a doctor — Interprets glucose markers and treats early metabolic problems.
- Berberine — Meta-analyses: lower fasting glucose and HbA1c (about 0.6% in type 2 diabetes); smaller effect when glucose is normal.
- Alpha-lipoic acid — Small drops in fasting glucose, insulin and HbA1c in meta-analyses; no real counter to GH- or insulin-driven resistance.
- Psyllium husk fiber — Slows sugar absorption: lower fasting glucose and HbA1c, mostly in people with diabetes.
ModerateThick blood (hematocrit) / clot risk
Check the blood count regularly; if hematocrit stays high, a doctor decides — usually stopping or reducing the cause, sometimes therapeutic phlebotomy, never blood-bank donation. Avoid dehydration: it thickens the blood further.
Measure
How each option helps (3)
- Regular blood tests — A blood count shows hematocrit and hemoglobin climbing toward the range where clot and stroke risk rises.
- Therapeutic phlebotomy prescribed by a doctor — Only on a doctor's decision, never at a blood bank. Lowers hematocrit quickly but temporarily; repeated sessions drain iron, and a lower clot risk is unproven.
- Working with a doctor — Manages thick blood by changing what you use or, if justified, by therapeutic phlebotomy.
ModerateHeart strain / heart-muscle thickening
Regular cardio, blood pressure control, an echo as a baseline and then yearly.
Measure
How each option helps (4)
- Heart screening: ECG and echocardiogram — Echocardiography shows wall thickening and reduced pumping early, while stopping AAS and treating BP can still help.
- Working with a doctor — Orders ECG and echocardiography and treats early heart changes.
- Home blood-pressure monitoring — Keeping BP controlled is one of the main ways to limit heart-wall thickening.
- Regular cardio training — Supports heart and vessel function, but does not reverse steroid-related heart thickening or weakening.
ModerateAndrogenic hair loss
Ketoconazole shampoo, minoxidil, a dermatologist early if you are prone to it.
Supplement or OTC product
How each option helps (1)
- Minoxidil (topical) — Slows thinning and regrows some hair; scalp itching and early temporary shedding are common, unwanted facial hair possible. Gains fade once stopped.
MenLow
WomenHigh
Stop at the first voice change and see a doctor — early stopping matters.
Measure
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.
Low-level side effects
Acne
Gentle skin care, cleansing after training, a dermatologist if it spreads.
Supplement or OTC product
How each option helps (3)
- Adapalene — Reduces spots in many users. Redness, scaling, dryness and stinging are common early and usually ease; acne may look worse at first. Rarely, allergic swelling.
- Benzoyl peroxide — A first-line acne option. Dryness, redness and peeling are common at first; it bleaches hair and fabric; rarely, serious allergic reactions. Severe steroid acne needs a dermatologist.
- Zinc — Trials show a modest drop in inflamed spots, weaker than antibiotics; steroid acne is driven by androgens.
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.
Baseline tests
your own starting values — every later result is compared with them
Lipid panel (HDL, LDL, triglycerides, ApoB)cholesterol
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Fasting glucose, insulin, HbA1cblood sugar
Electrolytes (potassium, sodium, magnesium)water retention
Testosterone (total, free), LH, FSH, SHBGnatural testosterone
Estradiol (sensitive assay)high estrogen, gynecomastia
Prolactingynecomastia
Home blood-pressure logkidneys, blood pressure, heart, water retention
ECGheart
Echocardiogram (heart ultrasound)heart
Urinalysiskidneys
While taking
about 4–6 weeks in, then every 6–8 weeks — agree the exact schedule with your doctor
Lipid panel (HDL, LDL, triglycerides, ApoB)cholesterol
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Fasting glucose, insulin, HbA1cblood sugar
Electrolytes (potassium, sodium, magnesium)water retention
Estradiol (sensitive assay)high estrogen, gynecomastia
Prolactingynecomastia
Home blood-pressure logkidneys, blood pressure, heart, water retention
Urinalysiskidneys
After stopping
4–8 weeks after stopping (later after long-acting injections), then until values return to baseline
Lipid panel (HDL, LDL, triglycerides, ApoB)cholesterol
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Fasting glucose, insulin, HbA1cblood sugar
Testosterone (total, free), LH, FSH, SHBGnatural testosterone
Semen analysisnot earlier than 3 months after stopping, then every 3 months until normalnatural testosterone
Every year
with regular or repeated use
ECGheart
Echocardiogram (heart ultrasound)heart
Which doctors can help
Sports physiciancoordinates everything
Cardiologistcholesterol, blood pressure, hematocrit, heart
Endocrinologistnatural testosterone, high estrogen, gynecomastia, blood sugar
Gastroenterologist / hepatologistliver
Nephrologistkidneys
Dermatologisthair loss
Gynecologistvirilization, natural testosterone (women)
At home
- Home blood pressure: 2–3 times a week in the morning, keep a log
Get medical help at once if
- Yellow skin or eyes, dark urine, pale stools, intense itching, pain under the right ribs — see a doctor now; sudden severe abdominal pain with dizziness or fainting — call emergency services.
- Much less urine than usual, cola-colored urine, new swelling, flank pain — see a doctor now.
- 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.
- Sudden severe headache, vision changes, numbness or weakness on one side, trouble speaking — call emergency services.
- Swelling, pain or redness in one leg; sudden shortness of breath or chest pain; sudden one-sided weakness or numbness, trouble speaking or seeing — seek urgent care.
- Chest pain or pressure, breathlessness on light effort, swollen ankles, fainting — seek urgent care.
- Rapid weight gain with breathlessness, or swelling of one leg — 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
Strongly virilizing for women: voice deepening, facial hair and clitoral enlargement are common and may be permanent. No level is known to be free of this risk; it rises with dose and duration.
Myth & fact
Myth
“Dianabol gains are pure muscle.”
Fact
In classic double-blind trials in weightlifters, body weight rose on the drug, but the added tissue did not match normal muscle in composition. Part of the quick gain is also water, which leaves after stopping.
Combinations
No specific combination notes for this substance yet. The stack check still adds up side effects that several substances share.
Sources
Godsland IF et al. Insulin action and dynamics modelled in patients taking the anabolic steroid methandienone (Dianabol). Clin Sci 1986 (opens in a new tab)Rosenfeld GA et al. Cholestatic jaundice, acute kidney injury and acute pancreatitis secondary to the recreational use of methandrostenolone: a case report. J Med Case Rep 2011 (opens in a new tab)Hervey GR et al. Effects of methandienone on the performance and body composition of men undergoing athletic training. Clin Sci 1981 (opens in a new tab)
Check how Methandienone combines with your stack
Possible side effects by body system, combinations, how to lower the risks and which tests to do — free.
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