Testosterone Suspension Side Effects

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Testosterone Suspension Side Effects

While testosterone may exhibit certain side effects (such as aromatization to estrogen) that other anabolic steroid analogs have effectively eliminated, testosterone actually remains the safest anabolic steroid anyone can choose.

This is because testosterone is literally the original anabolic steroid that is endogenously and naturally produced in humans and almost all animals.

This makes it a safe choice, especially for beginners or first time testosterone users, no matter what form of testosterone they use for their first cycle.

Since testosterone is already naturally produced by humans, the body is already familiar with its effects on cells and systems, and so many clinical studies have been conducted on testosterone and its effects on the body that almost all knowledge of possible testosterone suspension side effects is well documented and well known.

This information is easily accessible to most people, especially in today's internet age.

It is true that there is more clinical and medical data (and general information) on testosterone and its various esterified variants than any other anabolic steroid in existence.

However, while testosterone is not without potential side effects, a near-complete understanding of testosterone suspension side effects allows us to better understand them and prevent or deal with them appropriately.

Estrogenic side effects

Testosterone Suspension side effects actually have elements of estrogen related side effects.

Testosterone is classified as moderately aromatizing and is easily converted to estrogen in the body.

This is accomplished by the enzyme aromatase, which seeks out testosterone as a target substrate and carries out a chemical reaction that converts (aromatizes) it into estrogen.

Due to the very fast-acting nature of testosterone suspension, estrogen-related side effects may be more severe in some individuals than with other forms of testosterone.

However, estrogenic side effects are known to occur in relation to the dosage of testosterone (or any anabolic steroid).

The higher the dose of testosterone suspension, the greater the probability and amount of aromatization that occurs, which increases the incidence of estrogen-related side effects.

The use of testosterone suspension in bodybuilding (supraphysiologic) doses typically results in a greater amount of estrogen buildup, which must be dealt with in some way.

A popular option is to use a SERM (selective estrogen receptor modulator) such as Nolvadex (tamoxifen), but SERMs only work to block the activity of estrogen in certain tissues (e.g. breast tissue).

Therefore, SERMs only block specific side effects, such as gynecomastia (breast tissue development), and do not lower total circulating estrogen levels in the body.

To do this, you need to use an aromatase inhibitor (AI).

Aromatase inhibitors, such as Aromasin (Exemestane), Arimidex (Anastrozole), or Letrozole (Femara), work by binding to the aromatase enzyme and inhibiting its ability to interact with testosterone.

Thus, the source of estrogen production in the body is effectively shut down, resulting in a decrease in total circulating estrogen levels.

This can effectively reduce or eliminate estrogen-related side effects such as bloating, water retention, and gynecomastia.

SERMs only act to block or prevent gynecomastia and do not have any effect on bloating or water retention.

Estrogenic side effects include water retention and bloating, increased blood pressure (due to water retention), increased likelihood of fat retention/gain, and gynecomastia.

Androgenic side effects

Since testosterone is the primary androgen in men, testosterone suspension side effects have the potential to cause androgenic side effects.

Bodybuilding doses of testosterone increase the likelihood of androgenic side effects.

It is also known that the overwhelming majority of androgenic side effects caused by testosterone are actually the result of dihydrotestosterone (DHT), a metabolite of testosterone.

When testosterone passes through certain tissues, such as the scalp, skin, and prostate, an enzyme called 5-alpha reductase (5AR), which is abundant in these tissues, converts (or reduces) testosterone to dihydrotestosterone.

Dihydrotestosterone is a much more potent androgenic hormone than testosterone (about five times more potent), and it is this DHT that is the primary cause of many androgenic side effects of testosterone use, including male pattern baldness, acne, and oily skin.

These potential testosterone suspension side effects can be effectively reduced or significantly controlled by the use of 5-alpha reductase inhibitors such as Proscar, Propecia, or Finasteride.

These drugs inhibit the 5AR enzyme in much the same way that aromatase inhibitors inhibit the aromatase enzyme.

As a result, DHT levels drop dramatically because no DHT is produced.

However, it is important for all individuals to understand that the use of a 5AR inhibitor will not completely eliminate the androgenic side effects of testosterone suspension, as testosterone itself is also somewhat androgenic in the body and androgenic side effects can occur even if it is not converted to DHT.

In these cases, some individuals may choose to use a topical DHT blocker such as Nizoral for areas that are problematic due to androgens (e.g., the scalp and areas of the body prone to severe acne during anabolic steroid use).

Ketoconazole, the active ingredient in Nizoral shampoo, acts as a topical DHT blocker on the skin and scalp, effectively reducing the likelihood of androgens causing male pattern baldness and reducing acne breakouts caused by increased oily skin.

Androgenic side effects include increased sebum secretion (oily skin), increased acne breakouts (associated with increased sebum secretion), body and facial hair growth, benign prostatic hyperplasia (BPH), and an increased risk of developing male pattern baldness (MPB) in individuals with the genetic traits necessary to develop androgenic alopecia.

HPTA and endogenous testosterone production side effects

All anabolic steroids, including testosterone suspension, when administered in excess of physiologic doses, cause the body to suppress or completely stop the natural endogenous production of testosterone.

This is also known as HPTA (hypothalamic-pituitary-testicular axis) suppression/interruption.

Testosterone Suspension side effects are common with all anabolic steroids.

At the end of a cycle, the user should begin a proper post cycle therapy (PCT) program, which typically lasts 4-6 weeks after the end of the cycle.

PCT involves the use of compounds that stimulate the body's production of testosterone and allow the HPTA to resume normal function once again.

If anabolic steroid users do not engage in proper PCT, they significantly increase their chances of developing permanent hypogonadism (low testosterone production), which may require medical treatment in the form of testosterone replacement therapy (TRT) for the rest of their lives.

Hepatotoxic side effects

Testosterone is not C17-alpha alkylated (C17AA), a modification required to make anabolic steroid hormones orally active, and therefore does not have a negative effect on the liver.

Clinical studies have shown no liver toxicity from testosterone use.

In one particular study, testosterone was administered to several male subjects at very high doses (400 mg daily, equivalent to 2,800 mg weekly) for 20 days, and the route of administration was actually oral rather than intramuscular injection.

The idea of oral administration, rather than the traditional intramuscular injection, is to saturate the liver with large amounts of testosterone (all orally ingested substances make a 'first pass' through the liver and interact with it to a much greater degree than the injection route of administration).

Studies have shown no change in liver enzyme levels in test subjects [1].

Since testosterone suspension is administered via injection anyway, even if testosterone is found to affect the liver, hepatotoxicity is even less likely to occur.

Therefore, hepatotoxicity is not a concern when it comes to testosterone suspension side effects.

Cardiovascular side effects

Negative cardiovascular side effects (especially negative effects on cholesterol levels) are a common side effect of all anabolic steroids, and testosterone suspension side effects are no exception.

Oral anabolic steroids tend to have the worst impact on cardiovascular risk because they have a disproportionately negative effect on cholesterol levels compared to injectables.

Negative cholesterol changes include a decrease in HDL, the good cholesterol, and an increase in LDL, the bad cholesterol.

The result of these changes is an increased risk of atherosclerosis, and the degree of these changes is generally dose-dependent (the higher the dose, the greater the negative changes and risk).

Other factors that influence these negative cholesterol changes include duration of use and route of administration.

Testosterone itself actually has a much smaller effect on cholesterol levels than all other anabolic steroids, in part due to the liver's ability to metabolize testosterone freely and easily compared to other anabolic steroids, and the fact that it is not as resistant to hepatic breakdown and metabolism.

Most of the problems associated with hepatotoxicity stem from certain anabolic steroids having characteristics that make them more resistant to hepatic metabolism than testosterone.

C17-alpha alkylation is the biggest reason why oral anabolic steroids are more hepatotoxic, as it makes the anabolic steroid more resistant to being metabolized or broken down by the liver.

Whether an anabolic steroid is more or less resistant to hepatic metabolism is a concern for how much a particular anabolic steroid affects the liver's regulation of cholesterol levels and production.

Testosterone, in particular, was shown in one clinical study to have only a mild negative effect on HDL cholesterol after 12 weeks of 280 mg of testosterone enanthate administered weekly.

Subsequent administration of an aromatase inhibitor resulted in a worse cholesterol profile, resulting in a 25% decrease in HDL cholesterol [2].

Conversely, another study using 300 mg of testosterone enanthate weekly for 20 weeks without the use of an aromatase inhibitor showed a 13% reduction in HDL cholesterol, but when the testosterone dose was increased to 600 mg weekly, the HDL cholesterol reduction dropped to 21% [3].

These studies are perfect examples of how the increase in estrogen through aromatization and hepatic metabolism is actually beneficial because it offsets the negative cholesterol changes caused by bodybuilding use of testosterone or other anabolic steroids.

This is not surprising considering that estrogen itself is known to promote positive changes in cholesterol levels.

So while using an aromatase inhibitor, you should always be mindful of its use and its effect on cholesterol levels.

Therefore, it is better to use minimal aromatase inhibitor doses during an anabolic steroid cycle for estrogen control purposes only, rather than to eliminate overall estrogen levels.

This method aims to keep estrogen levels in the normal (or as close to normal as possible) physiological range, preventing them from spiking due to aromatization, while at the same time preventing them from plummeting to near zero due to a full or overdose of an aromatase inhibitor.