Epistane (methylepitiostanol, Havoc)
Epistane methylepithiostanol Havoc, Methylepithiostanol, 17α-methylepithiostanol, Hemapolin
Oral steroidsControlled substanceWADA S1.1 · prohibitedEvidence: anecdotal
An oral 17α-methylated designer steroid with an unusual sulfur bridge in its A-ring. It activates the androgen receptor itself, and the body turns part of it into DMT (madol).
Legal status: Never approved; added to the US list of Schedule III anabolic steroids in 2014; banned in sport; 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 lean, 'dry' gains in muscle and strength; sold online as a 'dietary supplement' (Epistane, Havoc). Never approved as a medicine. A 2016 review named it among the steroids most often behind liver injury.
What people seek and what studies show
There are no efficacy studies in people or animals. In human liver cells it activated the androgen receptor at very low concentrations, and in a yeast test with the horse androgen receptor it and many of its madol-type metabolites were potent activators. Gains users describe are unmeasured; published human data concern liver and kidney injury.
Effects
Evidence: Anecdotal — no real studies
Sought effects by goal (as reported)
Mass
Sought for: muscle growth, strength
Cutting
Sought for: hard, dry look
Recomposition
Sought for: muscle growth
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.
13 possible side effects
level · how often it is reportedElevated
Worse cholesterol (HDL↓ LDL↑)
commonA non-aromatizing 17α-methylated steroid: a strong HDL drop is expected, though no controlled human data exist. Only a lipid panel shows it.
How to notice: No symptoms — only visible on a lipid panel.
Elevated
Suppression of natural testosterone & fertility
commonAn androgen like other oral AAS: suppresses natural testosterone and sperm production; low libido and fatigue after stopping are typical signs.
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
Liver strain
possibleLong-lasting cholestasis in four users is documented; in three tested, serum bile acids rose 14 to 61 times. The injury is unpredictable; itching or yellow eyes call for urgent liver tests.
How to notice: Usually silent early; later tiredness, nausea, itch, dark urine.
Elevated
Kidney strain
rareIn a published case of Havoc use, bilirubin rose to extreme levels and kidney injury needed dialysis; kidney function recovered over about four months.
How to notice: Usually silent; foamy urine or swelling in later stages.
Moderate
Black-market quality risk (fakes, contamination)
commonAn analyzed Epistane product also held another isomer and DMT not named on the label; contents of such 'supplements' are unpredictable.
How to notice: Unexpected effects, pain or infection, a stronger or weaker effect than expected.
Moderate
Higher blood pressure
possibleAndrogens can raise blood pressure, usually without symptoms; home readings show the trend.
How to notice: Often silent; sometimes headaches, flushing, nosebleeds — a home monitor shows it.
Moderate
Thick blood (hematocrit) / clot risk
possibleNo human data, but androgens as a class raise red-cell production; a blood count shows a rising hematocrit before symptoms do.
How to notice: Often silent; sometimes headaches, flushed face, itch after a hot shower.
Moderate
Heart strain / heart-muscle thickening
possibleNo compound-specific heart data; an HDL drop and higher blood pressure add to the class link between years of AAS use and heart-muscle changes.
How to notice: Shortness of breath on effort, lower endurance, palpitations.
Moderate
Androgenic hair loss
possibleA DHT-related androgen: can speed up genetic hair loss.
How to notice: More hair in the shower, thinning at the temples or crown.
Moderate
Unknown long-term safety (little human data)
possibleNever tested in human trials; what is known comes from lab studies, case reports and user accounts.
How to notice: Nothing to notice — the risk is what is not yet known.
MenLow
WomenHigh
Virilization in women (often irreversible)
commonIn women hoarseness, new facial hair and menstrual changes are early signs; voice and clitoral changes may be permanent.
How to notice: Hoarse or deeper voice, new facial or body hair, menstrual changes, clitoral enlargement.
Low
Too-low estrogen (joints, libido, mood, lipids)
possibleNot converted to estrogen: used without testosterone, estradiol drops — low libido, flat mood and joint aches can follow.
How to notice: Aching, stiff joints, low libido, flat mood, poor sleep.
Low
Acne, oily skin
possibleOily skin and acne are possible.
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 11 of 13 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.
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.
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.
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.
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).
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.
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.
ModerateUnknown long-term safety (little human data)
What is unknown cannot be lowered, only avoided; tell your doctor what you have taken.
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
Low estrogen
Avoid controlling estrogen blindly; adjust only by blood tests with a doctor.
Measure
How each option helps (1)
- Regular blood tests — Testing ends guesswork use of aromatase inhibitors — prescription drugs that can push estrogen too low and harm joints, libido, mood and lipids.
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, low estrogen
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Testosterone (total, free), LH, FSH, SHBGnatural testosterone
Estradiol (sensitive assay)low estrogen
Home blood-pressure logkidneys, blood pressure, heart
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, low estrogen
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
Estradiol (sensitive assay)low estrogen
Home blood-pressure logkidneys, blood pressure, heart
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, low estrogen
Liver panel (ALT, AST, GGT, bilirubin)liver
Complete blood count (hematocrit, hemoglobin)hematocrit
Kidney panel (creatinine, eGFR, cystatin C)kidneys, blood pressure
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, low estrogen
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.
- 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.
- 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
An androgen for women: voice, hair and clitoral changes may be permanent; the risk of severe cholestasis applies equally.
Myth & fact
Myth
“Epistane is a mild anti-estrogen, not a real steroid.”
Fact
It is a 17α-methylated androgen that activates the androgen receptor, is banned in sport, has been a US controlled steroid since 2014, and has caused long-lasting cholestasis.
Combinations
Overlap5α-reductase inhibitor with steroids it cannot affect
DHT-derived steroids, trenbolone and trestolone act without 5α-reductase, so finasteride and dutasteride do not lower their effect on hair or prostate; they only reduce DHT made from testosterone, while finasteride and dutasteride keep their own side effects.
DrostanoloneMetenolone1-TestosteroneOxandroloneStanozololOxymetholoneMesteroloneMethasteroneTrenboloneTrestoloneMethyl-1-testosterone (M1T)Desoxymethyltestosterone (DMT, Madol, Pheraplex)ProstanozolMestanoloneStenbolone1-Andro (1-androsterone) and related prohormonesEpiandrosterone (Epi-Andro)Androstanolone (dihydrotestosterone, DHT)Sources
Petrov PD et al., Arch Toxicol 2020: Epistane causes cholestasis (four users; bile-acid mechanism in human hepatocytes) (opens in a new tab)Milla Castellanos M et al., Nefrologia 2018: bile cast nephropathy with severe liver dysfunction after Havoc (methylepitiostanol) (opens in a new tab)Okano M et al., Drug Test Anal 2009: 17α-methylepithiostanol and desoxymethyltestosterone in dietary supplements (opens in a new tab)
Check how Epistane (methylepitiostanol, Havoc) 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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