Anadrol (oxymetholone) is most likely second only to Dianabol (methandrostenolone) as a bodybuilding anabolic steroid. Additionally, it has had considerable medical importance particularly for treatment of anemia, and more recently to help maintain lean body mass in HIV-compromised patients. While many have the subjective opinion that Anadrol is a harsh drug in terms of side effects, medical findings and the findings of many athletes are quite different.

Stacking Anadrol with Other Steroids

An interesting further question concerns combination of Anadrol with other anabolic steroids. For exmaple, adding Anadrol to 50 mg/day of Dianabol gives little added benefit to a steroid cycle; in contrast, adding Anadrol to 50-100 mg/day trenbolone acetate or 60-80 mg/day Anavar (oxandrolone) gives dramatic improvement. In this its stacking behavior is similar to that of Dianabol, but not to that of trenbolone. Likely this is because unlike trenbolone, oxymetholone does not bind strongly to the androgen receptor, and most of its anabolic effect is likely not genomically mediated via the AR.

Anadrol Side Effects

With regard to harsh side effects sometimes perceived in bodybuilding, this principally or only occurs when estrogen levels are elevated. While oxymetholone does not itself aromatize and does not have estrogenic activity, it may be that it can interfere with estrogen metabolism. Whether that it is the cause of the problem or not, keeping estradiol levels under control keeps Anadrol similar in side effects to other oral anabolic steroids. Estradiol levels may be kept under control either by using an aromatase inhibitor such as letrozole or Arimidex, or by limiting use of aromatizing steroids such as testosterone.

Anadrol and Liver Toxicity

The principal side effect of concern is liver toxicity, as is the case for all alkylated oral anabolic steroids. This may be addressed simply by limiting duration of use to 6-8 weeks, and allowing suitable time off of the drug after each period of use. Because the liver regenerates quickly, a time of even half the period of use is often sufficient. However, allowing an equal amount of time is more conservative.

Per milligram, Anadrol appears less liver toxic than any other alkylated anabolic steroid, but per amount of anabolic effect, the ratio of toxicity to anabolic effect seems similar.

Other side effects of concern are the same as with other anabolic steroids in general, including potential increase in blood pressure and/or hematocrit, worsening of blood lipid profile, prostate enlargement which may be temporary, and possible promotion of acne and/or male pattern baldness, if having the gene for male pattern baldness.

Anadrol Dosages

Typical usage is 50-150 mg/day. In some cases larger doses such as 300 mg/day are used, but when suitably stacked with one or more other anabolic steroids, often there is little further benefit from exceeding 150 mg/day.

Anadrol and Women

While it’s common for bodybuilders to suspect that Anadrol would be an even riskier choice for use by women than most anabolic steroids, actually the reverse is true. Medically, once per day dosing of 50 mg/day over extended periods has shown only a moderate rate of virilization problems. The same certainly cannot be said of Anavar, Dianabol, or Winstrol (stanozolol.)

While not necessarily sufficient for high level female bodybuilding competition by today’s standards, such a dose actually is considerably more than needed by most women for excellent results in adding muscle, losing fat, and generally improving their physiques. Half this dose — 25 mg/day, preferably taken as divided doses — is very effective and is so far as I know the lowest-risk way to obtain this degree of benefit from anabolic steroids.

Even 12.5 mg/day in divided doses can be remarkably effective.

Anadrol and Virilization

This is not to say, however, that at even these reduced doses there is no risk of virilization. As seen from the fact that some women with time develop facial hair and voice hoarseness simply from their natural androgen levels, it’s possible for an individual woman to be on the threshold of virilization in the first place. In these cases, any added androgen, even oral DHEA supplementation, can trigger virilizing side effects. So it must be understood that risk does exist.

Anadrol Guidelines

Briefly: Using Anadrol, or Dianabol, in combination with injectable anabolic steroids is one of the most effective ways to improve a steroid cycle. It is not necessary to use both Dianabol and Anadrol simultaneously: usually only one or the other is chosen. With proper care, side effects are generally very tolerable and pose a health risk low enough to generally be acceptable by bodybuilding standards.