Anabolic Androgenic Steroids Effects on Liver and Kidneys

When it comes to anabolic androgenic steroid side effects the liver and kidneys receive the most media attention. This ain't surprising as these organs are vital to your health.

There's no doubt steroids and especially c-17 alkylated androgenic and anabolic steroids are toxic to the liver and kidneys. How toxic depends on who you listen to.

You've got the media and many in the medical profession who consider steroids to be deadly. Whereas the on-line Bro-science fraternity think they're harmless. This causes a lot of confusion.

So, who to believe?

It really comes down to the individual and their 

  • genetic make-up
  • susceptibility to negative effects of steroids 
  • dosage levels and cycle duration

There are a small number of cases involving long term steroid users developing very serious conditions such as hepatocellular carcinoma, the most common liver cancer and  Focal Segmental Glomerulosclerosis (FSGS), an irreversible disease that can lead to kidney failure.

Most steroid users probably will never develop any problems however, there will always be a few who will as they guy found out 

Could it be you? Why take the risk?

The first step to protect your liver and kidneys is understanding how they function and the effects anabolic androgenic steroids have on them.

Role and Functions of the Liver

anabolic steroids side effects liver

Your liver is the largest solid organ in the body weighing in at nearly 2 kg for men and 1.3 kgs for women. At any given time your liver holds up to 1 pint of blood.

The primary role of the liver is to filter blood flowing from the digestive tract. It also works with the gallbladder, pancreas and intestines to digest, absorb and process food.

Did you know that the liver has over 500 functions.

I'm not going to list all of them here, but the 3 most important are:

  • Detoxifying and removal of waste
  • Fighting infections
  • Energy production

Over 60% of the liver consists of hepatocytes cells which cleanse and remove toxic substances from the body as well as absorb important nutrients. These hardworking cells replenish themselves every 150 days.

The liver breaks down food and converts it into energy. For example, carbohydrates such as pasta and rice are broken down into glucose and then stored in the liver as glycogen.

The liver also plays a vital role in combating infections, especially those that develop in the lower intestines.

In fact, the liver contains more than 50% of the total bodies macrophage cells which devour harmful bacteria and pathogens. For all the work that it does the liver can take a lot of abuse and can work tirelessly while under stress.

Liver Fact File 

Facts and functions of how important your Liver is:

  • Its the largest and most complex internal organ in the body
  • Its also a gland responsible for secreting hormones and chemicals
  • It fights infections, neutralizes toxins and clots the blood
  • Its the only organ that regenerates itself 
  • Contains up 10% of body's blood supply and pumps 1.5 litres per minute
  • Stores the essential vitamins and minerals A, B,D, K and Iron 
  • Makes Bile which is essential for a digestion 
  • It breaks down and coverts medications, drugs and alcohol  
  • It produces its own source of protein essential for muscle growth
  • Human equivalent of a super battery as it stores and releases glucose when you need it.

However, it has its breaking point and long term steroid use and abuse can seriously damage the liver.

Steroid Use and Liver Side Effects

Along with the cardiovascular system your liver is most susceptible to the toxic effects of anabolic androgenic steroid compounds.

All steroids pose a potential risk however, alkylated steroids are considered far more toxic to the liver compared to non-alkylated steroids

Alkylated oral steroids vs non-alkylated steroids

The risk of serious kidney and liver damage is higher with oral alkylated steroids than non alkylated injectable steroids. The increased hepatotoxicity of orals is due to their chemical structure has been modified.

Why does it need to be modified? Because of the journey it needs to take.

The Journey of the Oral Steroid

When you take an oral steroid it's absorbed by the digestive system and then taken to the liver for processing.

For the body to absorb the anabolic properties of oral steroids they need to pass through the liver without being broken down and metabolized.

To make ​oral steroids more bio-available scientists modified the chemical structure of synthetic testosterone. 

The modification known as 17 alpha alkylation (17aa) simply adds an extra alkyl group to the 17th carbon of the steroids DNA. This makes orals more resistant to being metabolized by the liver.

Non-alkylated steroids or a non altered forms of synthetic of testosterone and wouldn't survive this journey this is why they're injected directly into the blood stream.

However, by making C17- alpha alkylated oral steroids more bio-degradable also makes them more hepatoxic because their greater resistance to being broken down puts more stress on the liver.

Which Steroids are Alpha Alkylated and Non Alkylated?

C17 Alpha Alkylated Oral Steroids

  • ​Dianabol
  • Anavar (oxandrolone)
  • Winstrol
  • Anadrol

Non-Alpha Alkylated Steroids 

  • Testosterone
  • Trenbolone
  • Masteron
  • Deca Durabolin (nandrolone)
  • Primobolan

Steroid Liver Damage Symptoms 

A condition often associated with the long term use and high dosage levels of oral anabolic and androgen steroids is cholestasis. 

Steroid Induced Cholestasis

Steroid induced cholestasis is a condition where the flow of bile is either slowed down or stopped completely.

Bile is dark green alkaline fluid produced by the liver and released into small intestines to aid digestion and the absorption of fats.

A blockage prevents the release of bile salts causing a build-up that becomes toxic and destroys the hepatocytes cells of the liver.

Mild forms of cholestasis can cause mild discomfort, however extreme cases can be life-threatening.

Common symptoms to watch....

  • Fatigue
  • light colored stools
  • itchiness
  • Nausea and vomiting
  • dark colored urine
  • Jaundice (skin and whites of the eyes turn yellow)

Of course, if you notice these symptoms while on steroids stop immediately and see your doctor.

There's only been a small number of cases involving athletes and bodybuilders developing serious conditions including cholestasis, liver cancer and hepatic tumors.

These cases often involve long term users and with dosage levels well above the safe recommended levels. Although in recent years the cases have been rising.

Keep in mind, competitive bodybuilders and athletes know what they're doing. They have coaches administering safe dosages, ensuring strict protective protocols are adhered to during and post cycle. They're also taking regular liver function tests.

The average gym rat and hardgainer is not. Instead, many are relying on bro-science and advice from the Arnie wannabe down at the local gym.

In most cases the majority of steroid users may never experience serious side effects or develop a life threatening condition, but some will.

Which category you fall into depends on the choices you make and when it involves a vital organ like the liver, why risk it?

General Symptoms of an Unhealthy Liver

  • Jaundice
  • Fatigue
  • Fever
  • Nausea
  • Amber colored urine
  • Lack of appetite

5 Steps to Protect Your Liver 

Without a doubt, your liver needs protection when taking oral or methylated steroids.

Here's 5 simple steps to help protect, detoxify and cleanse your liver during and after a bulking cycle.

1: Get your blood checked to ensure your liver enzyme levels are within a healthy range. For example, taking prescription meds or drinking alcohol will elevate levels meaning your liver is already working hard.

2: Abstain from alcohol and prescription meds during and 6 weeks after a cycle.

3: Take a good herbal liver detoxifier before and post cycle.

4: Increase your intake of water -  water is an effective detoxifier and its free!

5: Reduce your salt intake - salt and steroids increases water retention which can lead to hypertension and put further stress on the liver.

Role and Functions of the Kidney

steroid side effects kidneys

The kidneys are your body's filtering system.

When you think of a filter its main job is to keep important things from getting dirty or contaminated. Just like the air filters in your home, they keep the air in the rooms clean by preventing dust and dirty particles from getting in.

Your kidney's do a similar job by removing waste and excess water from the body. However, the kidney are far more complex and have many vital functions that keep you alive.

Kidney Fact File 

Facts and functions to hit home how important your kidneys are:

  • Cleanses blood of toxins
  • Filters 200 litres of fluid evry 24 hours
  • Converts toxins into waste as urine
  • Holds onto essential nutrients and sends them back into the body
  • Activates production of vitamin A to maintain healthy bones and muscles
  • Releases hormones that stimulate production of red blood cells

Regulation of sodium, potassium and acid levels in the body is critical for your health and this function is carried out by the kidneys.

In addition, the kidneys produce hormones that influence other parts of the body that include regulating blood pressure and stimulating the production of red blood cells.

Although the kidneys can take a lot of abuse, long term abuse will lead to irreversible damage. If you reach this stage its a life time on dialysis or a kidney transplant. For these reasons, its important to protect the kidneys when taking steroids.

AAS Use and Kidney Side Effects

Anabolic steroids, especially oral methlyalated compounds will stress out the kidneys. This is a result of the kidneys having to increase the filtration rate to ensure the toxic compounds are removed.

In the short term your kidneys can handle this, however over time excessive stress causes inflammation and permanent scarring of the kidneys filters. The implications of this can be very serious as you only have set number of filters. Once damaged they can't be regenerated.

Turns out, bodybuilders are more prone to kidney damage and renal failure because of their higher muscle density and high protein diets. Both increase renal blood flow which elevates the kidneys filtration rate.

For most people's this isn't a problem however, a 250 pound man on a high protein diet while taking bulking steroids is putting his kidneys under serious stress.

You've also got to factor in high blood pressure. Steroids, especially in high dosage cycles, increase the bodies systematic blood pressure. Again, this is putting extra stress on the kidneys filters and over time effectively destroys them.

A compromised kidney function causes toxins and infections to flood the body. This overwhelms the immune system forcing the kidneys to shut down.

High Profile Case 

flex wheeler kidney steroid side effects

Elite bodybuilder Kenneth 'Flex' Wheeler was forced to end his career because of kidney damage. Source

in contrast to the liver, there's a lack of scientific research that shows a clear link to steroid use and kidney damage.

However, the high profile case of elite bodybuilder Kenneth 'Flex' Wheeler brought to attention the potential threat steroids can have on the kidneys.

Wheeler was forced to end his successful career after developing chronic kidney disease and needed a kidney transplant to stay alive.

It turned out that Wheeler's kidney disease was heredity and he believed AAS drugs were not the cause. However, he did believe that steroids did make the condition worse.

The Columbia University Study

controversial study in 2009 provided the strongest evidence that long term steroid use can damage the kidneys.

The 10 year study by Doctors at Columbia University was presented at the American Society of Nephrology in 2009. It involved 9 bodybuilders and 1 power-lifter who were steroids users and each one had developed permanent damage to their kidneys.

It turns out, 9 of the men developed a condition called Focal Segmental Glomerulosclerosis (FSGS) an irreversible chronic kidney disease that attacks the glomeruli, the kidneys filtering units. BTW, FSGS was the condition that ended Flex Wheelers career.

What is FSGS? 

  • FSGS stands for Focal Segmental Glomerulosclerosis
  • FSGS is a rare disease that results in the kidneys filters (glomeruli) becoming scarred and damaged.
  •  Kidney filters cannot be regenerated so FSGS can lead to kidney failure
  • African Americans are more prone to developing FSGS
  • Long term steroid abuse may increase risk of developing FSGS

Critics of the study argued that other factors could've contributed to the men's kidney problems. However, one participant's story, builds a persuasive case.

The 30 year old man developed kidney damage after 10 years of bodybuilding. His conditioned improved once he stopped taking steroids. Unfortunately, his steroid addiction was too strong, he relapsed and his kidney problems returned.

So, what can we conclude from this.

There needs to be more scientific research that determines a clear link between steroid use and kidney damage. However, the Columbia University study shows us that steroids can have a damaging effect.

In particular, the guy whose kidney problems returned after relapsing strengthens the case of steroids toxic effects on the kidneys.

It may only be one study, but its finding should act as a cautionary tale that protecting the kidneys from anabolic and androgenic steroids is vital. So, how can you do that?

These are simple kidney support and protective measures you can take during and post cycle:

How To Protect The Kidneys During An Anabolic Cycle


  • Drink plenty of clean natural water
  • Avoid alcohol
  • Avoid caffiene
  • Reduce salt intake
  • Reduce meat protein*
  • No smoking
  • Get plenty of quality sleep time 

* High protein meat diets increases acid load in the kidneys which increases the risk of kidney stones - decreases urinary citrate, a compound that inhibits the formation of kidney stones.

BTW, many herbs have properties that naturally protect and support kidney function. 

For more details read my post The Best Herbs To Protect The Kidneys While On Cycle.