5 Dianabol Side Effects (And How to Combat them)

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.

Dianabol (Methandrostenolone) is one of the most potent anabolic steroids on the market — appropriately nicknamed the ‘granddaddy of anabolic steroids‘.

Arnold Schwarzenegger and classic bodybuilders from the 1970s were prime examples of just how potent Dianabol is — in regards to adding size and strength.

Dianabol’s benefits certainly aren’t in doubt, with it remaining just as popular 50 years later. Its benefits are well known in the fitness and bodybuilding community; however, its side effects are sometimes downplayed; with beginners commonly taking dianabol during a first cycle.

Below are the most common Dianabol side effects users experience, so you can understand the risks and whether it is worth enduring such (in order to reap the benefits).

Dianabol Side Effects

Cholesterol & Blood Pressure

Dianabol has a marked negative effect on blood pressure and cholesterol, due to increased plaque build-up. Users can expect a hefty rise in LDL cholesterol levels, with an equally devastating drop in HDL. Consequently, this will spike a user’s blood pressure notably, increasing the risk of myocardial infarction (heart attack).

Dianabol is one of the more damaging anabolic steroids from a cardiovascular perspective, due to it being an oral steroid and thus passing through the liver.

Consequently, it stimulates hepatic lipase — an enzyme that exacerbates the lowering of HDL (good cholesterol).

Furthermore, Dianabol causes significant water retention, due to the aromatase enzyme being present. This, in turn, increases blood viscosity — impeding blood flow to and from the heart.

To reduce cardiovascular strain on Dianabol, bodybuilders may supplement with fish oil (4g/day). This can help to stabilize blood pressure, particularly in hypertensive individuals (1).

Regular cardio/aerobic exercise can also reduce elevations in blood pressure on Dianabol (2), due to an increase in nitric oxide (N.O) production — released from endothelium cells.

N.O essentially relaxes the blood vessels, improving blood flow throughout the body.

Regular cardiovascular activity can be particularly beneficial for bodybuilders, as weightlifting has the opposite effect on blood vessels (being constrictive).

Note: Anyone who has high blood pressure or has heart disease in their family should avoid Dianabol. 


dianabol gyno

Mild case of gynecomastia (on the left)

Dianabol is estrogenic due to the aromatase enzyme being present, thus it has the potential to cause gynecomastia.

Gynecomastia is when breast tissue accumulates in males, due to excessive estrogen levels. In mild cases, this may merely result in swollen nipples and in extreme cases — the chest region can resemble female breasts.

Swollen nipples are often reversible and thus disappear post-cycle; once hormones regulate back to normal (and estrogen levels drop).

However, breast tissue expansion in moderate/aggressive cases may only be corrected with surgery.

To prevent gynecomastia, an aromatase inhibitor (AI) or selective estrogen receptor modulator (SERM) may be taken. An aromatase inhibitor blocks the conversion of testosterone into estrogen; however, this can also exacerbate cholesterol levels; as estrogen increases good (HDL) cholesterol. Thus, blood pressure may worsen using an AI.

Alternatively, a SERM can prevent gynecomastia by blocking estrogen-like effects at a receptor level, thus not affecting the conversion of testosterone into estrogen (and keeping healthier cholesterol ratios).

Two popular SERMs used by bodybuilders are Nolvadex and Clomid. These may be utilized if nipples begin to swell, effectively preventing aggressive breast tissue formation.

Note: Combining Dianabol with other estrogenic compounds, such as Testosterone or Anadrol will also increase the risk of gynecomastia.

Legal Dianabol Alternative

dianabol rating

D-Bal is our #1 rated legal Dianabol product. It replicates the muscle-building and strength-enhancing effects of Dianabol, but without the unwanted side effects.

It is FDA-approved and can be purchased online without a prescription.

D-Bal is best suited for men wanting to build significant amounts of muscle; without shutting down their testosterone, straining their liver or elevating blood pressure levels.

Water Retention

Water retention is the byproduct of estrogen levels rising, causing users to gain 10lbs or more in fluid.

This causes a smooth, soft and less defined look to the muscles, hence how Dianabol is referred to as an off-season bulking steroid. It can also cause a person’s midsection to increase due to bloating, which may also be visible in the face.

Water retention in itself is not an issue for most users, considering it is temporary and beneficial for muscular strength — due to extra intracellular fluid.

If a person wants to reduce water retention on Dianabol, a diuretic may be used, such as Furosemide. This will enhance aesthetics, at the expense of less full muscles and a small decrease in strength. Diuretics may also improve blood pressure, due to the blood becoming less viscous and thus easier to circulate.

Generally, if a person wants to avoid water retention whilst building muscle, they may be more suited to cycling: Trenbolone, Superdrol or Winstrol — rather than trying to treat water-related Dianabol side effects.

Liver Toxicity

As with other oral steroids, Dianabol is c-17 alpha-alkylated and thus hepatotoxic. Dianabol will cause AST/ALT liver enzymes to shoot up, marking significant liver stress until cycle cessation.

To many bodybuilders such hepatotoxicity is not alarming, as the liver is a very resilient organ, often recovering after extensive abuse.

However, cholestasis is still possible and thus it is wise to take precautions, such as eliminating alcohol consumption and refraining from taking hepatotoxic medications (such as certain anti-depressants). Bodybuilders may take a liver support supplement such as TUDCA (tauroursodeoxycholic acid), which has been shown to drastically reduce AST/ALT scores (3), reducing inflammation and the risk of steroid-induced cholestasis.

Note: If someone has an unhealthy liver, taking Dianabol may be dangerous. Also stacking Dianabol with other hepatotoxic steroids, such as Winstrol or Anadrol should be avoided. 

Testosterone Suppression

All anabolic steroids are forms of exogenous testosterone, which cause a shut down of endogenous testosterone — due to damage to the HPTA axis.

During a cycle this is not initially problematic; however, once a cycle ceases users can often experience side effects of low testosterone.

Signs of low testosterone are:

  • Fatigue
  • Tiredness
  • Testicular atrophy
  • Decreased well-being
  • Diminished libido and sexual function

Users can experience the above for several weeks or months, depending on the severity of damage to the HPTA axis. Thus, bodybuilders will commonly utilize a post cycle therapy (PCT), to shorten this recovery period, and recover endogenous testosterone to normal levels.

Common and effective PCT medications taken by bodybuilders are Nolvadex, hCG and Clomid.

A dianabol-only cycle may only require one of these, however dianabol stacked with other potent steroids, may need 2 or all 3.

Dianabol-only cycle PCT:

  • Nolvadex – 2 x 20mg for 45 days

More powerful PCT for Dianabol stacks:

  • hCG – 2000 IU administered every other day for 20 days
  • Nolvadex – 2 x 20mg for 45 days
  • Clomid – 2 x 50mg for 30 days

The PCT trio (above) was a protocol used by Dr. Michael Scally, an expert in hormone replacement therapy. He used hCG, Nolvadex and Clomid in these doages to successfully treat 19 men, with 100% endogenous testosterone recovery within 45 days.


Dianabol is one of the better steroids for avoiding androgenic side effects such as acne vulgaris or male pattern baldness.

However, Dianabol certainly presents risks to users — particularly from cardiovascular and hepatic perspectives.

Therefore, it is essential that if someone is going to use dianabol — they take all the necessary precautions (as mentioned in this article) to limit damage during a cycle.

If anyone is experiencing excessively high blood pressure, or other troublesome symptoms on Dianabol — ring for an ambulance immediately and discontinue use.