Can You Safely Take Steroids? The Truth

Dr George TouliatosDisclaimer: The following article is for educational purposes only and does not promote the use of illegal steroids. If you have any questions or concerns, Dr. Touliatos is currently available for consultation.

Today, the benefits and side effects of anabolic steroids are well documented.

However, is there a middle ground whereby a person can take steroids in a safe manner?

Discover how a person can amplify or reduce the risk of taking steroids by controlling a variety of different factors, based on our experience treating thousands of bodybuilders with harm-reduction practices. 

FDA-Approved Steroids

During the 1970s, in the golden era, bodybuilders such as Arnold Schwarzenegger could simply book an appointment with their doctor and be prescribed steroids to aid their bodybuilding endeavors.

However, doctors ceased giving out prescriptions when the side effects of steroids became well known.

Furthermore, anabolic steroids are now classified as controlled substances and are thus illegal in many countries today.

Thus, several anabolic steroids that were once used in medicine to treat osteoporosis and cachexia are no longer used.

However, a limited number of steroids remain FDA-approved today, such as Anavar (Oxandrolone), Testosterone, Anadrol (Oxymetholone), and Deca Durabolin (Nandrolone).

Thus, medically, the above steroids are considered safe, at least when taken in therapeutic dosages and under expert supervision to treat a medical condition. Yet, these same steroids remain illegal when taken for cosmetic or bodybuilding purposes.

Some Steroids Are Safer Than Others

The health implications of each anabolic steroid can vary. As a general rule, the more advantageous the steroid, the more side effects it will produce.

Testosterone is perhaps the exception to this rule, hence its popularity among beginners during a first steroid cycle.

Testosterone, Deca Durabolin, and Anavar are some anabolic steroids that can be viewed as mild, based on our patient’s labs.

However, steroids such as Anadrol, Trenbolone and Winstrol should be considered harsh, as we typically see them having a severe effect on blood lipids.

Equally, stacking steroids together will increase the severity of side effects.

In our experience, here is a list of the 7 main steroids used today in bodybuilding, in order of safest to most dangerous.


  1. Testosterone
  2. Deca Durabolin
  3. Anavar
  4. Dianabol
  5. Winstrol
  6. Trenbolone
  7. Anadrol

Least Safe

This is just a general list, and exceptions apply. For example, we have had patients who are genetically more susceptible to certain steroids than others.

For more information on the safest steroids for bodybuilders, read this post.

Pharmaceutical Grade vs Underground Labs

test enanthate
The manufacturer of a product can also influence whether it is safe or not to take.

For example, a pharmaceutical-grade steroid produced by scientists in a certified and regulated laboratory is much safer than a dealer making the product in their own kitchen or basement.

This is why pharma-grade steroids fetch a significantly higher price on the black market, versus an underground lab product.

Minimizing Steroid Side Effects

We have found it is possible to treat and minimize steroid side effects by using natural supplements and medications. For example, TUDCA (tauroursodeoxycholic acid) is a naturally occurring bile salt that can be taken in supplement form and has been shown to reduce liver damage (1).

Thus, we advise bodybuilders to take 500 mg/day of TUDCA when taking hepatotoxic oral steroids such as Winstrol, Dianabol, and Anadrol, which typically produce success in reducing hepatic inflammation.

We have also found that bodybuilders supplementing with 4-6 g/day of fish oil typically improve their high-density lipoprotein (HDL) values and decrease the risk of myocardial infarction. Some research suggests this can be beneficial for users suffering from high blood pressure, albeit ineffective in normotensive people (2).

Less serious side effects, such as hair loss and gynecomastia, can also be treated, with our patients successfully using DHT-inhibitors such as Finasteride to decrease scalp inflammation.

Bodybuilders can also take aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs) to prevent gynecomastia. However, users should be cautious about using AIs, as we have found them to reduce the conversion of testosterone to estrogen and thus exacerbate blood pressure.

SERMs are a more preferred option to prevent gynecomastia in our experience, as they inhibit estrogenic activity specifically in the mammary glands as opposed to reducing total estrogen in the body.

Low testosterone post-cycle can result in men and women having decreased well-being, libido, energy levels, and sexual function. Thus, by administering PCT (post-cycle therapy), typically Clomid, Nolvadex, or/and human chorionic gonadotropin (hCG), bodybuilders have restored their natural endogenous testosterone production faster under our care, alleviating such side effects.

Moderation vs Abuse

Several steroids that are FDA-approved can cause minimal side effects in clinical settings; however, the same steroids taken by bodybuilders can result in myocardial infarction or cirrhosis of the liver.

The reason for this is when a person has been prescribed steroids, they are often taken in therapeutic dosages and for a set amount of time.

However, bodybuilders can often be aggressive with their dosing and run extensive cycles (some of our patients have reported taking steroids all year round).

Thus, the safety of steroids also depends on if they are taken in moderation in sensible cycles or whether they are being abused.

If someone is looking to start taking steroids, they should be aware of the addictiveness of these drugs and thus understand that coming off them may not be as easy as planned.

Genetic Factor

Some people are genetically predisposed to heart disease, kidney disease, or liver disease and thus will be particularly vulnerable to steroids.

However, there are others who are genetic phenomena, and we see that no matter how much they seemingly abuse their bodies with high doses of steroids, their labs keep coming back as healthy, with numbers in the normal range.

Thus, 50 mg/day of Anadrol may be excessive for one person, whereas 100 mg/day may be perfectly tolerable for another.

This is the reason why regular checkups are vital when taking steroids, so we medical professionals can analyze how your body is coping and responding to each drug.

Mr. Olympia competitors are a good example of athletes who have won the genetic lottery, not just in terms of their ability to build exceptional amounts of muscle but also their ability to take large amounts of drugs without falling ill.

However, that is not to say steroid-using bodybuilders don’t ever fall ill or die, because unfortunately, it does happen.

Steroids Shorten Life Spans

There is research suggesting that anabolic steroids can shorten a person’s lifespan, which we also concur with anecdotally.

In one study, mice who were given anabolic steroids for 6 months experienced a significantly shorter life duration compared to non-treated mice (3).

In another study, male steroid users were over 3x more likely to die after a 7-year period than non-steroid users (4).

The number of fatalities still remained relatively small (only 1.3% of steroid users died). However, we consider a 7-year follow-up period to be a short period of time.

Many Can Take Steroids and Live Long Lives

Although steroids are potentially dangerous and there is evidence for a shorter life expectancy, many do take steroids and live long lives.

Here are some examples of classic bodybuilders who are still alive today (at the time of writing): Arnold Schwarzenegger (age 74), Lou Ferrigno (70), Robbie Robinson (75), Frank Zane (79), Tom Platz (66), and Mike Katz (77).

Also, Franco Columbu died at 78 years old, as did Serge Nubret (72) and Dave Draper (79).

Furthermore, these were bodybuilders taking steroids at a time when no one had established their safety. We have had bodybuilders report taking a handful of Dianabol pills and swallowing them instead of precisely tracking their dose.

Today, bodybuilders are able to mitigate the risks due to better knowledge of the compounds and careful dosing.

Thus, ex-steroid users (who are currently of old age) are living proof that some are able to take steroids safely long-term.

Medical Supervision

It is not merely genetics that explains why the majority of IFBB bodybuilders can take steroids and remain unscathed. This is because they are constantly being monitored by some of the best medical professionals.

Treating hypertension or rising ALT/AST enzymes early can make the difference in saving a person’s life.

The average man may not be able to hire elite doctors; however, the concept of regularly getting checkups and labs monitored is crucial and a wise investment for long-term health.

Note: Our clinic can connect you to doctors with elite knowledge regarding anabolic steroids, such as Dr. Touliatos, who provides affordable consultations for harm reduction. See our About page for more information. 

Counterfeit Steroids

As anabolic steroids are illegal and cannot be prescribed for cosmetic purposes, bodybuilders’ only option is to purchase them on the black market.

One study found that 37.5% of “steroids” on the black market contained different substances from what was listed on the label (5).

Some of these hidden ingredients can be dangerous, putting steroid users at risk. In most instances, dealers will swap expensive compounds like Anavar (Oxandrolone) and sneakily substitute them for a cheaper compound like Dianabol (Methandrostenolone) to increase their profit margin.

Thus, it is important for users to test the substance before taking it; otherwise, you cannot know whether the pill you’re swallowing or the liquid you’re injecting is genuine or safe.

Legal Implications

Even if someone is taking steroids and in good health, due to the illegality of these compounds, there is a risk of going to prison.

In the US, being in possession of anabolic steroids can result in a minimum fine of $1,000 and prison time of one year (as a first offense).

If caught selling steroids, the maximum fine is $250,000 and five years in prison.

For repeat offenses, fines and prison time double.

Thus, anabolic steroids are never 100% safe in terms of staying out of prison and avoiding a criminal record.

Risks of Injecting

Injecting at the wrong location can result in paralysis or death.

Thus, although it could be argued that injectable steroids are safer in regards to having decreased hepatotoxicity, administering them is potentially lethal to the inexperienced.

Also, needle contamination is another risk, and thus users should be wary of hygiene and the sharing of needles.

Secondary Side Effects

Although the heart and liver are the most important organs to protect when taking steroids, there are multiple secondary side effects that can trouble users.

Thus, although someone may be able to take steroids safely, there are still side effects that can negatively affect a person’s quality of life or relationships.

Here is a list of troublesome, albeit not dangerous, side effects that we have seen:

  • Infertility
  • Acne vulgaris
  • Low testosterone
  • Gynecomastia
  • Bloating
  • Testicular atrophy
  • Anxiety
  • Depression
  • Increased aggression

The psychological impact of the above should not be underestimated, considering that over 47,000 people died of suicide in the US in 2019 (6).

Anabolic steroids are arguably just as dangerous psychologically as they are physically.

The comedown and significant reductions in testosterone can have detrimental effects on ‘feel good’ neurotransmitters in the brain, such as dopamine (7) and serotonin (8).

Roid Rage

The reason why men are naturally more aggressive than women is because they have higher testosterone levels. Thus, theoretically, as steroids cause higher testosterone levels, aggression should also increase.

This can potentially be unsafe for the steroid user or those around them. If someone is already angry, aggressive, or violent, then taking steroids may exacerbate such behavior, making steroids unsafe from a psychological perspective.

Research, however, shows that ‘roid rage’ is not a common side effect, although men with preexisting psychopathology could be vulnerable (9).


We have found that a person’s diet can exacerbate or blunt the effects of steroids. For example, if someone is taking a hepatotoxic steroid, such as Anadrol, and drinking excessive amounts of alcohol, there is a greater risk of hepatic damage.

Equally, if someone takes a cardiotoxic steroid such as Trenbolone and has a diet rich in unsaturated fats and reduced sodium, we find their blood pressure is typically lower than someone binge eating junk food (10).

Can Women Safely Take Steroids?

Women are vulnerable to the same cardiac and hepatic risks as men when taking steroids.

However, one of the biggest concerns with our female patients is preventing masculinization (11). Women are very limited in regards to which steroids they can take without experiencing: irregular periods, clitoral hypertrophy, deepened voice, hair loss (on the scalp), hair growth (on the body), and a wider jaw.

However, we have found Anavar and Anadrol (in the correct dosages) to be effective steroids in preventing virilization while promoting muscle gain and fat loss. These have both been used in medicine to treat cachexia, with medical literature also proving them to be safe when taken in therapeutic dosages under expert supervision in the short term (12).

Conclusion: Can You Safely Take Steroids?

One person may be able to safely take steroids long-term and remain in good health.

However, another person may end up in the hospital or die from taking steroids in the short term.

Thus, overall safety is dependent on the genetics of the person and how their body responds to steroids. It is very much a roll of the dice.

However, some universal rules still apply:

  1. When anabolic steroids are taken without a medical need, health will decline
  2. Higher dosages and excessive cycles will increase damage
  3. A shorter life expectancy is likely
  4. The potency or harshness of the steroid will determine the level of risk
  5. Stacking multiple steroids together will increase damage
  6. Buying steroids on the black market can be unsafe
  7. Legally, it is not safe to purchase steroids in almost every country worldwide.

Co Authors :