Our patients sometimes comment that Dianabol reduces their appetite, which is due to the strain on the liver. This structural change enables Dianabol to survive liver metabolism. Being an oral steroid, Dianabol will cause C17-alpha alkylation, which is a modification to the 17th carbon position. This is why we utilize Nolvadex (tamoxifen), which reduces estrogen levels while simultaneously having a positive effect on cholesterol levels (15). Research has found estrogen to have a positive effect on HDL cholesterol levels (14). Tamoxifen (Nolvadex) appears to be the most effective drug, according to research (12) and our experience. Alternatively, trenbolone is an alternative option for experienced users as it does not aromatize. However, we have seen such protocols decrease strength gains due to the removal of intracellular fluid (inside the muscle cell). Fish oil, even without the presence of anabolic steroids, has been found ineffective in reducing systolic blood pressure in normal middle-aged men (7, 8). The severity of these side effects will depend on the dose, duration of the cycle, genetics, and other steroids stacked with Dianabol. Other steroids, such as trenbolone or Anavar, are superior in this regard because they don’t cause extracellular water retention. This can allow bodybuilders to train for longer periods of time without fatiguing or overtraining from strenuous workouts. Thirdly, side effects will depend on an individual’s needs and sensitivity levels so if Trenbolone is the primary steroid Tren’s side effects will take precedence over any other compound that a person takes. Users typically gain between 4.5 to 9 kilograms (10 to 20 pounds) of muscle mass within a few weeks of using Dbol, making it an effective choice for rapid muscle growth. Tren could also stimulate collagen protein synthesis, linked to gains in lean body mass. It’s also a very potent and dangerous anabolic steroid, meaning that it helps to build muscle tissue. However, occasionally, you might increase the calorie intake temporarily before an intense workout or competition to boost energy levels, but this isn't considered calorie dumping in the traditional sense. However, this approach may not suit everyone and should be approached cautiously as it can lead to discomfort and potential digestive issues. The idea is that after a period of restricted calorie intake, the body becomes more efficient at utilizing nutrients, making it more receptive to absorbing and utilizing the surplus calories in a short period. "Calorie dumping" in bodybuilding refers to a strategy where an individual consumes a large number of calories in a single meal, often following a period of low-calorie intake. Studies have found that prolonged use of AAS (anabolic-androgenic steroids) can cause a 100% increase in LDL cholesterol and a 90% reduction in HDL cholesterol (6). In our experience, any anabolic steroid that causes a powerful positive reaction will also cause a negative one (typically in similar measure). We have found that bodybuilders on Dianabol can experience an increase in vascularity. Not only do we see users’ muscle fibers increase in size, but they also repair quicker than before due to enhanced recovery levels. In order for new muscle tissue to synthesize, the body must be in an anabolic environment. It also provides a hard and dry appearance to the muscles, giving users a lean and defined look even while in a calorie surplus. Trenbolone’s ability to prevent muscle breakdown (anti-catabolic effect) makes it valuable during bulking cycles. It promotes muscle growth, enhances protein synthesis, and increases nitrogen retention. Free testosterone is the most important testosterone score for a bodybuilder, as this is the testosterone that’s unbound or free for the body to synthesize new muscle tissue from. It became illegal in the US for non-medicinal reasons, due to a new understanding of the steroid’s potential to cause severe side effects. Ziegler had created a steroid with more than double the anabolic rating of testosterone (210 vs. 100). In both cases, user experiences emphasize the importance of adhering to recommended dosages and monitoring health markers to mitigate adverse effects while maximizing benefits. Also, Dianabol and other anabolic steroids can be bought easily in Thailand, where they’re technically illegal to purchase without a prescription (being a class S controlled drug). During the 60s/70s era, bodybuilders could simply go to their doctors and ask for Dianabol (and other steroids) to get bigger and stronger, and their request would be granted. Many users claim it delivers exceptional vascularity and strength without significant water retention. However, in this case, it would exacerbate progesterone levels, increasing the chance of gynecomastia from trenbolone. If cycles are used sparingly, we have seen hair loss reverse post-cycle; however, if someone aggressively utilizes these steroids long-term, hair loss will be permanent. We find hair loss, thinning, and recession on the scalp are common when using these two steroids due to heightened levels of DHT, causing damaged hair follicles. Some studies report testosterone exhibiting mild negative effects on LDL and HDL cholesterol levels. However, a man was diagnosed with acute hepatitis following trenbolone use in a case review; therefore, liver complications remain possible (3).