Can You Safely Take Steroids? The Truth

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

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/reduce the risk of steroids, by controlling a variety of different factors — and whether they are indeed safe. 

FDA-Approved Steroids

During the 70s 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 classed as controlled substances and thus are 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/bodybuilding purposes.

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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 perhaps is 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 are mild.

However, steroids such as Anadrol, Trenbolone and Winstrol are considered harsh.

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

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. Trenbolone
  6. Winstrol
  7. Anadrol

Least Safe

This is just a general list and exceptions apply, thus someone may be 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

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-graded steroids fetch a significantly higher price on the black market, versus an underground lab product.

Minimizing Steroid Side Effects

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, bodybuilders often take 500mg/day of TUDCA when taking hepatotoxic oral steroids — such as Winstrol, Dianabol and Anadrol.

Also, bodybuilders can supplement with 4-6g/day of fish oil to improve high-density lipoprotein (HDL) cholesterol 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 persons (2).

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

Also, bodybuilders can take aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs) to prevent gynecomastia. However, users should be cautious about using AIs as they will reduce the conversion of testosterone to estrogen, and thus can exacerbate blood pressure.

SERMs are a more preferred option to prevent gynecomastia, 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 a PCT (post cycle therapy), typically being Clomid, Nolvadex, or/and Human chorionic gonadotropin (hCG); bodybuilders can restore their natural endogenous testosterone production faster — 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 (with some 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 phenomenons and no matter how much they seemingly abuse their bodies with high dosages of steroids — their labs keep coming back as healthy, with numbers in the normal range.

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

This is the reason why regular checkups are vital when taking steroids, so you can see 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 it does happen.

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Steroids Shorten Lifespan

There is research suggesting that anabolic steroids can shorten a person’s lifespan.

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, a 7 year follow-up period is only 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), Mike Katz (77).

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

Furthermore, these were bodybuilders taking steroids at a time when no one had established their safety. Some bodybuilders even 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 as to 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 be the difference in saving a person’s life.

The average man may not be able to hire world-class doctors; however, the concept of regularly getting checkups and labs monitored is crucial and a wise investment in their 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 to what was listed on the label (5).

Some of these hidden ingredients can be dangerous, putting steroid users at risk. In most instances, it will be dealers swapping expensive compounds like Anavar (Oxandrolone) and sneakily substituting it 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/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 5 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 in 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 — administrating them is potentially lethal to the inexperienced.

Also, needle contamination is another risk and thus users should be wary of hygiene and 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’; such issues may affect their quality of life or relationships.

Here is a list of troublesome, albeit not dangerous side effects:

  • 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 to ‘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/violent, then taking steroids may exacerbate such behaviour; making steroids unsafe from a psychological perspective.

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


A person’s diet can also 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; their blood pressure will be lower than someone binging on junk food.

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 women is preventing masculinization. Thus, they 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.

Anavar and Anadrol however have shown to be effective steroids in preventing virilization, whilst promoting muscle gain and fat loss. These are both FDA-approved and have proven to be safe when taken in therapeutic dosages under expert supervision.

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/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).