Testosterone undecanoate (oral)
Andriol, Jatenzo, Tlando, Kyzatrex, Andriol Testocaps, Oral testosterone undecanoate
Forms: Andriol (Testocaps) is sold in many countries; Jatenzo, Tlando and Kyzatrex are newer US capsules. Injectable undecanoate and other forms have their own cards.
Other esters and forms: Testosterone enanthate, Sustanon (testosterone ester blend), Testosterone cypionate, Testosterone decanoate, Testosterone gel, patch, nasal gel, implant, Testosterone isocaproate, Testosterone phenylpropionate, Testosterone propionate, Testosterone suspension (no ester), Testosterone undecanoate (injection)
Testosterone undecanoate in capsules, absorbed together with dietary fat. Not 17α-alkylated: it is not known to cause the liver injury of alkylated oral steroids, but absorption varies.
Legal status: Prescription medicine for hypogonadism; controlled as an anabolic steroid in many countries (US Schedule III); rules vary 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
Medically used for confirmed male hypogonadism by men who prefer capsules to injections or gels; the aim is normal levels. The capsules are designed for replacement levels, not the high levels typical of steroid use in sport.
What people seek and what studies show
It is testosterone itself, so effects follow the blood level reached. Absorption depends on fat in food: without food, levels stayed very low in one study. Newer capsules restored normal levels in most hypogonadal men. There are no studies in athletes; the capsules aim at normal levels, not the high levels used in sport.
Effects
Evidence: Approved medicine — studied in people for its medical use
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.
17 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 16 of 17 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.
Check hormones before and after; if they stay low, see an endocrinologist. Hard training on too little food (RED-S) also lowers testosterone.
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.
- Choriogonadotropin alfa (recombinant hCG) — A doctor may consider it off-label to preserve fertility (it keeps the testes working); it does not restart the pituitary. Risks: higher estradiol, gynecomastia. Has side effects of its own.
- Clomiphene — A doctor may consider it after stopping, guided by hormone tests; most men recover on their own within months, and lasting benefit is unproven. Risks: vision changes, mood swings, rare clots. Has side effects of its own.
- hCG (urinary human chorionic gonadotropin) — 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.
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. Dehydration in long or hot sessions and long flights add to clot risk.
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; dehydration, long flights and injury immobilization add to clot risk in athletes.
Regular cardio, blood pressure control, an echo as a baseline and then yearly, read by a cardiologist who knows athletes’ hearts.
How each option helps (9)
- 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.
- ACE inhibitors (ramipril, perindopril, lisinopril) — Standard treatment for heart failure; shrink a thickened heart wall in hypertension. An echo helps tell athlete's heart from hypertensive or steroid thickening; the steroid risk remains. Has side effects of its own.
- Bisoprolol — In heart failure with weak pumping it lowered deaths in trials; doctors add it to standard therapy. Not studied in steroid users; the steroid risk to the heart remains. Has side effects of its own.
- Carvedilol — A doctor may add it when tests show weak heart pumping; in heart failure it lowered deaths. Not studied in steroid users, and it does not undo steroid damage. Has side effects of its own.
- Losartan / valsartan (angiotensin receptor blockers) — Shrink a thickened heart wall in hypertension at least as well as other BP drugs. An echo helps tell athlete's heart from hypertensive or steroid thickening; the steroid risk remains. Has side effects of its own.
- Telmisartan — In high blood pressure, ARBs shrink a thickened heart wall at least as well as other BP drugs. Not studied in steroid users; the steroid risk to the heart remains. Has side effects of its own.
Less salt, regular cardio, good sleep, home readings; if it stays high — a doctor, and a talk about maximal lifts.
How each option helps (18)
- Home blood-pressure monitoring — Persistently high resting readings mean seeing a doctor. For athletes, guidance prefers ARBs or ACE inhibitors, which don't limit exercise capacity; diuretics are banned in sport.
- Regular cardio training — In a meta-analysis of trials, endurance training lowered resting BP by about 8/5 mmHg in people with high BP and only slightly in those with normal 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 34 trials in adults, not athletes: about 2 mmHg lower systolic pressure on average.
- Magnesium aspartate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium chloride — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium citrate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium gluconate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium glycinate (bisglycinate) — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium lactate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium malate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium orotate — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium oxide — On average magnesium lowers blood pressure only slightly — not a substitute for a doctor's assessment of high pressure found at a sports check.
- Magnesium taurate — Meta-analysis of trials: about 2 mmHg lower systolic pressure on average — too small to replace a doctor's assessment of high pressure found at a sports check.
- 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.
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) — Lowers triglycerides but does not fix the steroid HDL drop, the main lipid harm; omega-3 supplements may even raise LDL (IOC).
- 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 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.
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.
Limit caffeine, pre-workouts and other stimulants; with palpitations, stop the suspected drug, pause hard training and get an ECG. Don’t add potassium on your own (supplements, Asparkam/Panangin, salt substitutes): it is dangerous with spironolactone, ARBs/ACE inhibitors or kidney problems; a blood test shows the level.
How each option helps (1)
- Heart screening: ECG and echocardiogram — An ECG read by athlete criteria separates normal training changes from arrhythmias, conduction or QT problems — key with stimulants, clenbuterol, thyroid hormone or diuretics.
Ketoconazole shampoo, minoxidil, a dermatologist early if you are prone to it.
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.
PSA as a baseline, especially after 40; a urologist if urination changes.
How each option helps (1)
- Regular blood tests — PSA tracks prostate changes on androgens — most relevant after 40 or with urinary symptoms.
Good sleep, fewer stressors, tell someone close what to watch for. About one in three androgen users becomes dependent; if you cannot stop or never feel big enough, talk to a doctor or psychologist.
How each option helps (2)
- Avoiding alcohol and other liver stressors — Alcohol and other drugs on top of steroids explain much of the link between steroid use and violence.
- Sleep hygiene — Enough sleep lowers irritability and improves impulse control.
Keep routine and social contact; talk to a specialist if low mood persists; a sports physician can check for overtraining and RED-S.
How each option helps (2)
- Working with a doctor — Mood problems, including the low after stopping steroids, are treatable; a doctor can refer you to mental-health care.
- Sleep hygiene — Good sleep supports mood, especially in the low-hormone phase after stopping steroids.
Products obtained without a prescription are often fake, mislabeled or non-sterile, and there is no way to check at home. For legal supplements, third-party testing (Informed Sport, NSF) lowers, but does not remove, the risk of a positive doping test.
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.
Low-level side effects
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.
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, towels and training clothes; rarely, serious allergy. Severe steroid acne needs a dermatologist.
- Zinc — Trials show a modest drop in inflamed spots, weaker than antibiotics; steroid acne is driven by androgens.
How each option helps (2)
- Working with a doctor — Assesses persistent vomiting or severe belly pain (possible pancreatitis or gallstones) and adjusts prescribed GLP-1 treatment when nausea persists.
- Pancreatin + dimeticone (Pankreoflat) — May ease heaviness and gas after meals; can cause nausea or diarrhea. Not for pork or cow's milk protein allergy (anaphylaxis reported) or early acute pancreatitis.
Check-ups and blood tests
Which tests and check-ups to do and when. This is a guide — agree the exact schedule with a sports physician.
Which doctors can help
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 (especially after a long flight) — urgent care; sudden breathlessness, chest pain, one-sided weakness or numbness, trouble speaking or seeing — call your local emergency number.
- Chest pain or pressure, fainting or near-fainting on exertion, breathlessness on light effort, swollen ankles — stop training and seek urgent care; collapse — call your local emergency number.
- 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.
- Difficulty or pain when urinating, blood in urine; unable to pass urine at all — urgent care.
- Sudden severe headache, vision changes, numbness or weakness on one side, trouble speaking — call your local emergency number.
- Racing or irregular heartbeat that does not settle at rest, dizziness, fainting (especially during exercise), chest pain — call your local emergency number.
- Losing control of anger, thoughts of harming yourself or others — stop and get help today.
- Thoughts of suicide or self-harm — call your local emergency number or a crisis line right 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
Testosterone virilizes women: deeper voice, facial and body hair, clitoral enlargement and menstrual changes can appear quickly, and voice and clitoral changes are often permanent. No level above the female range is free of this risk.
Myth & fact
“Every oral steroid is hard on the liver.”
Classic liver injury comes from 17α-alkylated steroids such as methyltestosterone. Oral undecanoate is not alkylated, and its US label says it is not known to cause that damage.
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