Iron Game
Veteran
It is no longer sold under the brand name Anavar, but oxandrolone remains one of the most popular oral AAS among bodybuilders and physique-oriented individuals. It is often considered to be semi-equivalent to oral Winstrol (stanozolol) as it provides relatively hard, dry lean mass gains, though nowhere near the gains of most other commonly used AAS. Like stanozolol, oxandrolone is a DHT-derivative, meaning it is protected against aromatization, which makes estrogen conversion and buildup a non-issue.
Oxandrolone is bioavailable as an oral AAS due to a modification called 17-alpha alkylation. This involves the addition of a short carbon chain to a specific position on the molecule to prevent/delay metabolism of the AAS by enzymes in the liver and intestines. Though very effective, this modification is the cause of liver toxicity experienced by a significant percentage of users. For decades, oral AAS have fallen from therapeutic favor due to this adverse effect. However, a few very recent papers suggest that oxandrolone, which is still prescribed for a very few indications, could be used with a reasonable expectation of safety if proper monitoring is performed.[SUP]1,2[/SUP] Additionally, a topical form of oxandrolone is being developed, which may alleviate some of the liver strain resulting from oral delivery.[SUP]3[/SUP]
New Research
The two studies involved very frail subjects, making the findings both less and more relevant to bodybuilders. Less relevant due to the greater responsiveness that elderly women and severe burn patients will have to a relatively low androgen dose; more so as these populations would be at greater risk and more susceptible to potential adverse side effects. As few bodybuilders would use oxandrolone as a solo AAS in a cycle, the safety data is more compelling. Some female competitors or physique-oriented individuals may use oxandrolone solo and in the doses used in these studies, so there is some practical value in the reports. Recall, even mild AAS are controlled substances and therefore illegal to possess or use, and hold the potential for harm.
The first study is a review of 15 studies involving patients at burn centers who were suffering from extreme loss of lean mass as a result of the extent of their injuries. Of course, there was a wide variability that makes statistics a lesson in frustration. While the findings were not statistically significant, the trend was for better survival and lower rate of infection. The rate of liver dysfunction (changes in liver enzymes) was not statistically different, though trended higher for the oxandrolone-treated patients. However, no “hepatic insufficiency” occurred, so the liver function was not adversely affected. The healing was much improved among the oxandrolone group. During rehab over the period of one year, the oxandrolone group gained nearly 11 percent greater lean mass. So, safe and effective.
The second study involved elderly women (average age of 75) who were given 10 milligrams of oxandrolone for 12 weeks, compared to a control group, and both groups were provided physical therapy three times a week. The oxandrolone group benefited from significantly greater lean mass (5+ pounds) and reduced body fat (over 2 pounds), compared to the control group. The only adverse effects were a reduction in HDL (good) cholesterol, and one subject demonstrated an increase in facial and pubic hair, indicative of virilization. Recall, these are estrogen-deficient, elderly women. Liver enzymes increases in about 40 percent of the oxandrolone group, but none were considered to be clinically significant. There was no strength benefit difference between the groups. So again, safe and effective relative to body composition changes.
Topical Oxandrolone
It is necessary to monitor patients receiving oxandrolone, to watch for changes in liver enzymes and/or HDL that may become a concern. However, a final paper describes the results of a limited trial of topical oxandrolone that may make that route available— and thus avoid the liver-related issues by reducing the high peak concentration experienced with “first-pass clearance” after taking the drug orally. This would be one area where topical delivery of an androgen may offer some benefit over the traditional route.
All together, the potential for oxandrolone in therapeutic use, and relative safety in all use with appropriate monitoring for periods of 12 weeks or so, are more supported. These findings may not necessarily apply to higher doses or prolonged use.
References:
1. Li H, Guo Y, et al. The efficacy and safety of oxandrolone treatment for patients with severe burns: A systematic review and meta-analysis. Burns 2015 Oct 7. [Epub, ahead of print]
2. Mavros Y, O'Neill E, et al. Oxandrolone augmentation of resistance training in older women: a randomized trial. Med Sci Sports Exerc 2015 Nov;47(11):2257-67.
3. Polonini H, de Oliveira Ferreira A, et al. Transdermal Oxandrolone: ex vivo percutaneous absorption study. Curr Drug Deliv 2016 May 2. [Epub, ahead
Oxandrolone is bioavailable as an oral AAS due to a modification called 17-alpha alkylation. This involves the addition of a short carbon chain to a specific position on the molecule to prevent/delay metabolism of the AAS by enzymes in the liver and intestines. Though very effective, this modification is the cause of liver toxicity experienced by a significant percentage of users. For decades, oral AAS have fallen from therapeutic favor due to this adverse effect. However, a few very recent papers suggest that oxandrolone, which is still prescribed for a very few indications, could be used with a reasonable expectation of safety if proper monitoring is performed.[SUP]1,2[/SUP] Additionally, a topical form of oxandrolone is being developed, which may alleviate some of the liver strain resulting from oral delivery.[SUP]3[/SUP]
New Research
The two studies involved very frail subjects, making the findings both less and more relevant to bodybuilders. Less relevant due to the greater responsiveness that elderly women and severe burn patients will have to a relatively low androgen dose; more so as these populations would be at greater risk and more susceptible to potential adverse side effects. As few bodybuilders would use oxandrolone as a solo AAS in a cycle, the safety data is more compelling. Some female competitors or physique-oriented individuals may use oxandrolone solo and in the doses used in these studies, so there is some practical value in the reports. Recall, even mild AAS are controlled substances and therefore illegal to possess or use, and hold the potential for harm.
The first study is a review of 15 studies involving patients at burn centers who were suffering from extreme loss of lean mass as a result of the extent of their injuries. Of course, there was a wide variability that makes statistics a lesson in frustration. While the findings were not statistically significant, the trend was for better survival and lower rate of infection. The rate of liver dysfunction (changes in liver enzymes) was not statistically different, though trended higher for the oxandrolone-treated patients. However, no “hepatic insufficiency” occurred, so the liver function was not adversely affected. The healing was much improved among the oxandrolone group. During rehab over the period of one year, the oxandrolone group gained nearly 11 percent greater lean mass. So, safe and effective.
The second study involved elderly women (average age of 75) who were given 10 milligrams of oxandrolone for 12 weeks, compared to a control group, and both groups were provided physical therapy three times a week. The oxandrolone group benefited from significantly greater lean mass (5+ pounds) and reduced body fat (over 2 pounds), compared to the control group. The only adverse effects were a reduction in HDL (good) cholesterol, and one subject demonstrated an increase in facial and pubic hair, indicative of virilization. Recall, these are estrogen-deficient, elderly women. Liver enzymes increases in about 40 percent of the oxandrolone group, but none were considered to be clinically significant. There was no strength benefit difference between the groups. So again, safe and effective relative to body composition changes.
Topical Oxandrolone
It is necessary to monitor patients receiving oxandrolone, to watch for changes in liver enzymes and/or HDL that may become a concern. However, a final paper describes the results of a limited trial of topical oxandrolone that may make that route available— and thus avoid the liver-related issues by reducing the high peak concentration experienced with “first-pass clearance” after taking the drug orally. This would be one area where topical delivery of an androgen may offer some benefit over the traditional route.
All together, the potential for oxandrolone in therapeutic use, and relative safety in all use with appropriate monitoring for periods of 12 weeks or so, are more supported. These findings may not necessarily apply to higher doses or prolonged use.
References:
1. Li H, Guo Y, et al. The efficacy and safety of oxandrolone treatment for patients with severe burns: A systematic review and meta-analysis. Burns 2015 Oct 7. [Epub, ahead of print]
2. Mavros Y, O'Neill E, et al. Oxandrolone augmentation of resistance training in older women: a randomized trial. Med Sci Sports Exerc 2015 Nov;47(11):2257-67.
3. Polonini H, de Oliveira Ferreira A, et al. Transdermal Oxandrolone: ex vivo percutaneous absorption study. Curr Drug Deliv 2016 May 2. [Epub, ahead
