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24.01.2021

Designersteroid methylepithiostanol damages liver and kidneys

Methylepithiostanol entered the market in 2006 as a designer steroid. For a moment it seemed that methylepithiostanol was an effective muscle builder with, compared with other oral anabolic steroids, relatively few side effects. However, a number of recent Spanish studies paint a different picture. Methylepithiostanol is probably quite toxic to the liver after all. And to the kidneys.

25 cases
In 2015, Spanish researchers at the University of Malaga published 25 cases of liver damage in Spanish and Latin American steroids users. [Aliment Pharmacol Ther 2015;41:116-25.] The cases date from the period 2001-2013.

In the Spanish study, the steroid most frequently causing liver damage was stanozolol. Not surprising, since stanozolol is a popular anabolic steroid in the steroids scene. More surprising was the number 2 in the Steroids Liver Toxic Top 5 compiled by the Spaniards. That was methylpithiostanol, a designer steroid still on the market that you might know better as Epistane.

Another 4 cases
In 2020, other Spanish researchers affiliated with the Instituto de Investigacion Sanitaria La Fe published four more cases of liver damage from methylepithiostanol. [Arch Toxicol. 2020 Feb;94(2):589-607.]

When oral anabolic steroids cause liver damage, cholestasis is usually involved. This means that the liver can no longer properly transport bile to the intestines because the bile ducts are blocked. The body makes bile from cholesterol, and the body gets rid of cholesterol through bile. If the discharge of bile is compromised, the cholesterol balance deteriorates.

At the same time, the disposal of bilirubin [structural formula shown here] is also compromised. Bilirubin is released during the breakdown of red blood cells. Bilirubin leaves the body through bile.

In the 2020 study, the total amount of bile acid in the methylepithostanol users' body had increased by a factor of 14 to 61. The figure below shows that the concentration of bilirubin in three of the users exceeded 20 milligrams per deciliter.

Kidney damage
At that concentration, bilirubin can damage the kidneys. This happened to another 40-year-old bodybuilder and methylepithiostanol user, about whose case Spanish nephrologist Monica Milla Castellanos published a case study in 2018. [Nefrologia. Mar-Apr 2018;38(2):221-3.]

The man presented with the classic symptoms of liver damage, such as jaundice and itching. The concentration of bilirubin in his blood was high. Initially, his creatinine concentration was normal. A normal creatinine level fluctuates between 0.84 and 1.21. After a few days, however, the creatinine level rose to unhealthy levels. The researcher found bilirubin in the man's urine.

Apparently the high concentration of bilirubin damaged the man's kidneys, so the doctors decided to treat the bodybuilders with drugs such as corticosteroids and, when that proved not to help enough, with dialysis therapy [MARS, CVVHD].

Damage to the kidneys from anabolics is not rare. In the University of Malaga study mentioned above, 31 percent of steroids users with liver damage also developed kidney damage.

Source:
Nefrologia. Mar-Apr 2018;38(2):221-3.

More:
Wrong steroid in IBE's Epistane 27.04.2010

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Roids Gone Wrong
Anabolic Steroids
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