There are so many products on the market today each making claims to guard one’s liver from anabolic steroid induced damage, I thought I would read through a couple of scholarly articles and write something that is understandable and useful.

Steroid toxicity is not a widely researched topic in the medical community, probably, because it affects too few people.

The less the liver is able to metabolize a steroid, the more toxic it is. The more androgenic and less anabolic a steroid is, the more toxic it is. Liver toxicity is not confined to oral steroids, but those are the chemicals that do the most damage.

So, what does that mean? One of the most toxic steroids to the liver is mibolerone (cheque drops). It is not metabolizable at all and is excreted in the urine as unchanged mibolerone. It is not known exactly how the C17 alpha-alkylation of most oral anabolic steroids causes liver damage but it is observed as I stated above that the more androgenic an oral compound is, the more toxic it is, so we are left with the hypothesis that since C17 alpha-alkylation blocks the liver hormone that would normally break the steroid down into useless metabolic components and allows the steroid to pass into the bloodstream that the androgenic activity of the steroid in the liver is somehow the source of the problem.

How is the liver damaged? Bile flow is impaired. Steroids cause the liver cells to swell and hold bile that would normally be secreted into the digestive tract. The damage caused by bile acid accumulation in the liver is called cholestatic liver damage. As bile gets backed up in the liver we see increased serum levels of AST, ALT and GGT. The retained bile salts are so toxic to the liver cells that they can cause the liver cells to die and create an inflammatory response further exacerbating the situation. If enough liver cells die, bile ducts can be destroyed.

But, not all bile acids are toxic.

The oral administration of Tauroursodeoxycholic acid (TUDCA) will assist the liver in producing bile acid metabolizing enzymes that will break the toxic bile acids down into less toxic compounds. TUDCA is itself a non-toxic hydrophilic bile acid. While the exact mechanism is unknown, TUDCA will also reduce pre-programmed liver cell death called apoptosis and will stimulate impaired bile secretion of accumulated bile acids.

TUDCA is the most potent form of liver support currently available.

Milk Thistle extracts have liver tissue regenerative properties, are excellent anti-oxidants but don’t impact cholestasis. So, while they are excellent at overall general liver health they are not adequate protection against the ravaging effects or oral anabolics.

Essentiale Forte is a phospholipid complex that has been shown to help clear toxic bile acids from the liver. It is an excellent supplement and probably the next best thing to TUDCA. It is produced by the pharmaceutical company Sanofi-Aventis.

N-acetyl cysteine (NAC) supports the production of Glutathione, which itself is a powerful anti-oxidant that can protect the liver against toxicity but once again is limited in its ability to treat cholestasis and is marketed in many preparations with poor bioavailability.

Liv-52 is an excellent blend of antioxidants but will not treat cholestasis.

Dosing of TUDCA – 500 mg / day while on a cycle containing oral compounds. It should not be used more than 8 weeks at a time or for the duration of the cycle as it can have a negative impact on lipid values.

For general, year round, liver support, I would look to Milk Thistle.

References:
http://forums.steroidal.com/educational-forum/54-liver-aas-induced-hepat...
http://antaeuslabs.blogspot.com/2011/07/few-words-on-hepatotoxicity-of-1...
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089004/