Oxandrolone

Anavar, Oxandrin, Lonavar, Var

Oral steroidsControlled substanceWADA S1.1 · prohibitedEvidence: approved medicine

A 17α-alkylated oral steroid derived from DHT, mildly androgenic and moderately anabolic. Seen as a 'mild' steroid, yet it lowers HDL sharply and suppresses testosterone.

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 to keep muscle and strength while dieting and for a harder look. Medically used for weight regain after surgery, trauma or burns; US approval was withdrawn in 2023: the FDA cited serious liver and lipid risks and a lack of proven benefit.

What people seek and what studies show

Its effects are well measured in medicine. In older men lean mass rose by about 3 kg (nearly matched by a rise in body water), strength by 5–9%, and trunk fat fell; three months after stopping, the lean-mass and strength gains were gone, while most of the fat loss remained. In severe burns it reduced weight and lean-mass loss and shortened hospital stays. Trials in trained athletes are lacking.

Effects

Keeping muscle in a deficitStrengthHard, dry lookMuscle growthFat loss

Evidence: Approved medicine — studied in people for its medical use

Sought effects by goal (as reported)

Mass
Sought for: muscle growth, strength
Cutting
Sought for: fat loss, keeping muscle in a deficit, hard, dry look
Recomposition
Sought for: muscle growth, fat loss, keeping muscle in a deficit
Strength
Sought for: strength, muscle growth
Endurance
Sought for: fat loss

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.

11 possible side effects

level · how often it is reported
Elevated
Worse cholesterol (HDL↓ LDL↑)
At a medical dose in older men HDL fell by about 0.5 mmol/L and LDL rose by a similar amount, largely reversing after stopping. The change is silent — only a lipid panel shows it.
How to notice: No symptoms — only visible on a lipid panel.
common
Moderate
Suppression of natural testosterone & fertility
In a controlled trial it lowered LH, FSH and total and free testosterone; usually milder than with strong oral steroids, but dose-dependent. Low libido or fatigue after stopping can signal it.
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.
common
Moderate
Black-market quality risk (fakes, contamination)
Since the US withdrawal it comes almost only from underground labs; products are often underdosed or contain a different steroid with stronger side effects.
How to notice: Unexpected effects, pain or infection, a stronger or weaker effect than expected.
common
Moderate
Thick blood (hematocrit) / clot risk
In a small study in Fanconi anemia it improved blood counts in 7 of 9 patients; in healthy users it can raise hematocrit, more so in stacks. A blood count tracks it.
How to notice: Often silent; sometimes headaches, flushed face, itch after a hot shower.
possible
Moderate
Liver strain
Milder than most 17α-alkylated oral steroids, but enzyme rises and cholestasis occur, and the FDA cited peliosis hepatis and 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.
possible
Moderate
Heart strain / heart-muscle thickening
No oxandrolone-specific heart data; it adds to the class link between years of AAS use and heart-muscle changes, and its HDL drop raises cardiovascular risk.
How to notice: Shortness of breath on effort, lower endurance, palpitations.
rare
Moderate
Kidney strain
Long-term AAS use has been linked to kidney scarring (FSGS); severe cholestasis, rarer than with stronger oral steroids, can also injure the kidneys (bile cast nephropathy).
How to notice: Usually silent; foamy urine or swelling in later stages.
rare
MenLow
WomenHigh
Virilization in women (often irreversible)
Less frequent than with other AAS, but voice deepening, hair growth and clitoral enlargement still occur and may not reverse.
How to notice: Hoarse or deeper voice, new facial or body hair, menstrual changes, clitoral enlargement.
possible
Low
Too-low estrogen (joints, libido, mood, lipids)
Not aromatized: used without testosterone, it lowers estradiol, which can bring low libido and joint aches.
How to notice: Aching, stiff joints, low libido, flat mood, poor sleep.
possible
Low
Androgenic hair loss
DHT-derived: can speed up hair loss in genetically prone men, though less than stronger androgens.
How to notice: More hair in the shower, thinning at the temples or crown.
possible
Low
Acne, oily skin
Oily skin and acne are possible but usually mild.
How to notice: Oily skin, spots on back, shoulders and face.
possible

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 10 of 11 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
Regular blood testsWorking with a doctorAvoiding alcohol and other liver stressorsRegular cardio training
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.
ModerateSuppression of natural testosterone & fertility

Check hormones before and after; if they stay low, see an endocrinologist.

Measure
Regular blood testsWorking with a doctor
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.
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).

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
Regular blood testsTherapeutic phlebotomy prescribed by a doctorWorking with a doctor
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.
ModerateLiver strain

No alcohol, no other liver stressors, limit oral steroids and their combinations, check liver enzymes.

Measure
Avoiding alcohol and other liver stressorsRegular blood tests
How each option helps (5)
  • 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.
ModerateHeart strain / heart-muscle thickening

Regular cardio, blood pressure control, an echo as a baseline and then yearly.

Measure
Heart screening: ECG and echocardiogramWorking with a doctorHome blood-pressure monitoringRegular cardio training
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.
ModerateKidney strain

Drink enough water, control blood pressure, avoid regular painkillers (NSAIDs).

Measure
Fluid & electrolyte managementRegular blood testsWorking with a doctor
How each option helps (3)
  • 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.
MenLow
WomenHigh
Virilization in women (often irreversible)

Stop at the first voice change and see a doctor — early stopping matters.

Measure
Working with a doctor
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
Regular blood tests
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.
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.
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
Testosterone (total, free), LH, FSH, SHBGnatural testosterone
Estradiol (sensitive assay)low estrogen
Home blood-pressure logheart, kidneys
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
Estradiol (sensitive assay)low estrogen
Home blood-pressure logheart, kidneys
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
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, hematocrit, heart
Endocrinologistlow estrogen, natural testosterone
Gastroenterologist / hepatologistliver
Nephrologistkidneys
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

  • 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.
  • 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.
  • 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

Often presented to women as 'mild': virilization is less frequent at low exposure but still occurs. Voice deepening, clitoral enlargement and facial or body hair can appear and may be permanent; risk rises with dose and duration.

Myth & fact

Myth

“Anavar is mild, so it's basically safe.”

Fact

'Mild' means less water and fewer androgenic effects, not safe. It sharply lowers HDL, suppresses testosterone and can virilize women; the FDA withdrew it, citing liver and lipid risks and unproven benefit.

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-TestosteroneStanozololOxymetholoneMesteroloneMethasteroneTrenboloneTrestoloneMethyl-1-testosterone (M1T)Desoxymethyltestosterone (DMT, Madol, Pheraplex)Epistane (methylepitiostanol, Havoc)ProstanozolMestanoloneStenbolone1-Andro (1-androsterone) and related prohormonesEpiandrosterone (Epi-Andro)Androstanolone (dihydrotestosterone, DHT)

Check combinations →

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