The 5 Most Dangerous Anabolic Steroids: Why Avoiding Them Protects Your Heart, Liver, and Brain

Oxymetholone (Anadrol)

Oxymetholone is an oral 17-alpha-alkylated steroid designed to survive first-pass metabolism. That chemical tweak makes it harsh on the liver. Oxymetholone commonly triggers cholestatic injury, where bile cannot flow properly, leading to jaundice, dark urine, and pale stools. Case series describe peliosis hepatis, a condition where blood-filled cysts develop in liver tissue and may rupture. Cardiometabolic harm is also profound. Oxymetholone can increase blood pressure through fluid and sodium retention and can crush protective HDL cholesterol while raising LDL, accelerating atherosclerosis. Neuropsychiatric effects such as irritability and headaches are frequent. Its “strength” reputation exists because it drives water and glycogen into muscle, but the same mechanism stresses the heart and blood vessels. The risk profile is simply not worth it.

Fluoxymesterone (Halotestin)

Fluoxymesterone is another oral 17-alpha-alkylated compound with a long record of hepatotoxicity at comparatively low doses. It has strong androgen receptor activity without meaningful aromatization, so users sometimes expect a “dry” look. In reality, the price is steep. The molecule exerts direct oxidative stress on hepatocytes and impairs bile transporters, making cholestasis more likely than with many injectables. As far as cholesterol goes, fluoxymesterone is among the worst offenders, rapidly driving HDL to very low levels and destabilizing plaque biology. Many users report a sharp, agitated mood profile, with increased aggression and sleep disruption. Taken together, the liver, cardiovascular, and mental health risks exceed any short-term performance "benefit."

Methasterone (Superdrol)

Methasterone is a so-called designer oral that never had legitimate human indications. It is 17-alpha-alkylated and highly potent, which concentrates stress on hepatic pathways that detoxify steroids. Published case reports describe fulminant hepatitis after short exposures, sometimes requiring hospitalization. The steroid also deranges lipid metabolism to an extreme degree and may impair endothelial function, which governs how blood vessels dilate. Users frequently describe lower back “pump” pain, which reflects altered blood flow and edema in working muscles. The combination of liver failure risk plus cardiovascular strain makes methasterone one of the most hazardous compounds circulating online.

Trenbolone

Trenbolone is a 19-nor derivative not approved for human therapy and among the most famous steroids. Unlike many orals, (since it is injectable) its danger lies less in direct cholestasis or liver stress and more in global cardiometabolic and neurologic effects. Trenbolone raises sympathetic tone, which increases resting heart rate and blood pressure, contributing to left ventricular hypertrophy over time. It powerfully suppresses HDL while raising LDL, promoting plaque formation. Its progestogenic activity can destabilize the hypothalamic-pituitary-gonadal axis even more than testosterone esters, worsening post-cycle hypogonadism. Many report anxiety, insomnia, and night sweats, which reflect central nervous system stimulation and altered neurosteroid signaling in the brain. Reports of dark urine and kidney strain likely reflect increased muscle breakdown products and renal vasoconstriction. Trenbolone’s reputation for rapid physique changes is tied to nutrient partitioning and water shifts, not durable health. The cardiovascular and mental health trade-offs are severe.

Mibolerone (Cheque Drops)

Mibolerone is an ultra-potent oral androgen originally developed for veterinary use. At microgram doses it can generate pronounced behavioral changes, including abrupt aggression and impulse control problems. As a 17-alpha-alkylated compound it places extreme pressure on hepatocytes and bile canaliculi, and it disrupts lipid metabolism even more than most orals. Because it is so potent, users may underestimate cumulative exposure. Short courses are still capable of producing dramatic HDL suppression, hypertension, and hepatic injury. There is no safe role for mibolerone in human performance or aesthetics.

Why These Five Stand Out

All anabolic steroids carry risk, but these five combine multiple high-risk mechanisms. Oral 17-alpha-alkylation concentrates toxicity in the liver and worsens lipid profiles. Progestogenic and neurostimulant properties increase blood pressure, sleep disruption, and mood instability. Suppression of the body’s own hormone axis is universal, and recovery can be prolonged. Pathologies that emerge include cholestatic hepatitis, peliosis hepatis, ventricular hypertrophy, accelerated atherosclerosis, endothelial dysfunction, and mood and cognition changes that affect work and relationships. The harm is not limited to “during the cycle” since vascular and hepatic damage can persist.

A Better Path Forward

If you or someone you know is weighing appearance against health, understand that the biological costs accumulate quietly. Choosing not to use these compounds protects your liver, heart, and brain, and it preserves long-term performance capacity. If past non medical steroid use has left you with fatigue, low mood, sleep problems, or sexual dysfunction, specialized medical support can help you stabilize hormones, address cardiometabolic risk, and return to sustainable training.

Learn more about evidence based care and support at True North Metabolic’s Anabolic Recovery clinic in Kitchener-Waterloo, Ontario.