Oxymetholone is a potent synthetic anabolic-androgenic steroid, most recognized by its brand name, Anadrol. This man-made derivative of testosterone was first developed in the 1960s and possesses a dual identity in the worlds of medicine and athletics. It has been prescribed for specific medical conditions while also being widely used illicitly for non-medical purposes related to physique and performance enhancement.
Medical Applications of Oxymetholone
Historically, oxymetholone was prescribed to treat conditions requiring significant tissue growth and red blood cell production. Its primary medical application has been in the treatment of various forms of anemia, including aplastic anemia, myelofibrosis, and hypoplastic anemias. The steroid works by enhancing the production and urinary excretion of erythropoietin, a hormone that stimulates the bone marrow to produce more red blood cells.
Beyond anemia, oxymetholone found use in combating muscle-wasting syndromes, such as those associated with HIV/AIDS or severe illnesses. By binding to androgen receptors in muscle cells, it promotes protein synthesis and increases nitrogen retention. However, with the development of alternative treatments like epoetin alfa, its approved medical uses have become more limited in many regions.
Use in Bodybuilding and Performance Enhancement
Within bodybuilding and athletic circles, oxymetholone is sought after for its ability to produce rapid and substantial gains in muscle mass and strength. It is considered one of the most potent oral anabolic steroids available. Users have reported gaining a significant amount of weight, sometimes between 10 to 20 pounds, within a short cycle of just four to six weeks.
This steroid is frequently incorporated into what is known as a “bulking cycle,” where the primary goal is maximum size and strength accumulation. It is often used to “kick-start” a cycle, providing immediate and visible results while other, slower-acting injectable steroids build up in the system. The drug enhances performance by increasing muscle size and can also enhance endurance and recovery.
Significant Health Consequences
Hepatotoxicity (Liver Damage)
Oxymetholone is chemically modified as a 17-alpha-alkylated (C17-aa) oral steroid, a structural change that allows it to survive passage through the liver. This modification, however, makes it hepatotoxic, meaning it places significant stress on the liver. Prolonged use or high doses can lead to elevated liver enzymes, indicating cellular damage. In severe cases, this can progress to more serious conditions like cholestatic jaundice, liver tumors, or peliosis hepatis, a rare disorder characterized by blood-filled cysts in the liver.
Cardiovascular Strain
The use of oxymetholone can have a detrimental impact on the cardiovascular system. It is known to negatively alter cholesterol profiles by significantly lowering high-density lipoprotein (HDL), often called “good” cholesterol, while raising low-density lipoprotein (LDL), or “bad” cholesterol. This shift increases the risk of atherosclerosis, a condition where plaque builds up inside arteries. Additionally, the steroid can cause a sharp increase in blood pressure and water retention, further straining the heart and elevating the risk of cardiac events like heart attack or stroke.
Hormonal Disruption
Administering an external steroid like oxymetholone suppresses the body’s natural production of testosterone. This hormonal imbalance can lead to testicular atrophy and reduced sperm production in males. Although it doesn’t directly convert to estrogen, oxymetholone can still produce estrogenic side effects, such as gynecomastia (the development of male breast tissue). To mitigate these effects and restore natural hormone function, users often implement a post-cycle therapy (PCT) protocol after discontinuing the drug.
Androgenic Side Effects
As an androgenic compound, oxymetholone can cause a range of masculinizing side effects. Common issues include oily skin and severe acne. It can also accelerate male pattern baldness in individuals with a genetic predisposition. In women, the risks are particularly pronounced and can lead to virilization, which includes irreversible symptoms like a deepening of the voice, clitoral enlargement, and the growth of body hair.
Legal and Regulatory Status
The non-medical use of oxymetholone is illegal in many parts of the world. In the United States, it is classified as a Schedule III controlled substance under the Anabolic Steroid Control Act. This classification means that possessing or distributing the drug without a valid prescription from a licensed medical provider is a criminal offense, carrying potential fines and imprisonment.
Furthermore, oxymetholone is strictly forbidden in competitive sports. Major anti-doping organizations, including the World Anti-Doping Agency (WADA) and the International Olympic Committee (IOC), list it as a prohibited substance. Athletes are subject to testing for oxymetholone and other anabolic agents, and a positive result leads to disqualification, suspension, and other sanctions.