Anadrol: A Powerful Oral Mass Builder
Last updated: October 2026
Oxymetholone (Anadrol) is a potent oral anabolic-androgenic steroid, FDA-labeled for anemias caused by deficient red cell production (including aplastic anemia). In a 16-week placebo-controlled trial, 100mg/day produced about 3.5kg of weight gain (vs 1.0kg on placebo) — gains that come with significant hepatotoxicity and water retention that demands careful monitoring and harm-reduction protocols.
Community-Reported
(FDA Label, Anemia)
Mechanism
How Anadrol Works
Oxymetholone's unique pharmacology sets it apart from other oral steroids. It activates androgen receptors; its estrogen-like effects (edema, gynecomastia) occur without aromatization by a mechanism that has not been established.
The 17α-methyl group prevents first-pass hepatic breakdown, allowing oral bioavailability. This same modification is responsible for Anadrol's severe hepatotoxicity. The FDA label notes cholestatic hepatitis and jaundice with 17α-alkylated androgens even at relatively low doses; drug-induced jaundice is usually reversible on stopping, but continued therapy has been associated with hepatic coma and death. In a 16-week HIV-wasting trial, more than 5× baseline ALT rises occurred in 27% of patients on 100mg/day and 35% on 150mg/day vs none on placebo (PMID 12646793) — liver toxicity rose with dose.
Unlike most androgens, oxymetholone is not thought to aromatize to estradiol, yet its FDA label lists edema and gynecomastia among adverse reactions. Direct partial agonism at the estrogen receptor has been proposed to explain this, but it has not been established.
Anadrol's clinical approval rests on erythropoiesis (red blood cell production): per its FDA label, oxymetholone enhances erythropoietin production in anemias due to bone marrow failure and often stimulates erythropoiesis. The labeled indication is anemias caused by deficient red cell production — acquired and congenital aplastic anemia, myelofibrosis, and hypoplastic anemias from myelotoxic drugs. HIV wasting was studied in trials but never became a labeled indication, and FDA now lists Anadrol-50 as discontinued. The label advises periodic hemoglobin and hematocrit checks for polycythemia at high doses.
Anabolic steroids improve nitrogen balance when calorie and protein intake is sufficient (FDA label). In a 16-week placebo-controlled HIV-wasting trial, 100mg/day produced a mean 3.5kg body-weight gain and 3.8kg body-cell-mass gain vs 1.0kg weight gain on placebo (PMID 12646793); an earlier 30-week pilot reported a mean peak weight gain of 8.2kg (PMID 8785183). Larger, faster gains reported in community settings are anecdotal and unmeasured.
What the Evidence Shows
Clinical data from HIV-wasting trials and the FDA label, supplemented with community-reported outcomes (labeled).
Risks & Side Effects
Key Takeaways
- FDA-labeled (Anadrol-50) for anemias caused by deficient red cell production, such as aplastic anemia — never for HIV wasting; FDA now lists it as discontinued
- The FDA label describes it as "a potent anabolic and androgenic drug"
- Not thought to aromatize, yet edema and gynecomastia are labeled adverse reactions — the mechanism is unresolved
- Placebo-controlled trial (HIV wasting): +3.5kg body weight at 100mg/day over 16 weeks, vs +1.0kg on placebo
- TUDCA and NAC are popular community liver-support supplements, but their protection against oxymetholone liver injury is unproven
- How much of the gain is water vs lean tissue is not well characterized; in the placebo-controlled trial, body-cell-mass gain (3.8kg) matched total weight gain (3.5kg)
- 17α-alkylated oral with documented liver-enzyme elevations — never use without liver bloodwork
- No safe cycle length has been established; the cited trials ran 16 and 30 weeks
- FDA-label contraindications include severe hepatic dysfunction, pregnancy, nephrosis, and prostate or male breast cancer
- Peliosis hepatis (blood-filled liver cysts) is a rare but life-threatening risk
- Polycythemia (high RBC) raises stroke and thrombosis risk — monitor hematocrit
🛒 Liver Support & Monitoring
If researching Anadrol, liver bloodwork monitoring is the essential harm-reduction practice. Liver-support supplements below are popular, but their protection against oxymetholone liver injury is unproven.
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This page is for educational and harm-reduction purposes only. Oxymetholone (Anadrol) is a Schedule III controlled substance under the Anabolic Steroid Control Act. Possession without a valid prescription is illegal in the United States and many other countries. This content does not constitute medical advice and is not a recommendation to use this substance. Always consult a licensed physician before using any anabolic agent. Misuse of anabolic steroids carries serious legal and health consequences.
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