Written by William Llewellyn
09 February 2010

anabolics2009 

Anabolic Research Update

Why is my nose bleeding?

 

            I started getting nosebleeds during my last cycle of testosterone and trenbolone. It happened several times while training during the same week and took awhile to stop each time. I don’t normally get nosebleeds, so I know it is the steroids. My friends tell me it is normal. It freaked me out, so I stopped taking steroids for awhile. I want to start again, but I’m nervous. I know people are talking. Can you help me understand what caused this and if I can avoid it in the future?

            As you suspect, nosebleeds are a known possible side effect of steroid use. They occur at one time or another to a fair percentage of users. Physiologically, this problem is most directly caused by a combination of two factors. To begin with, when used at therapeutic and moderately supratherapeutic (above normally prescribed) dosages, anabolic steroids tend to decrease blood-clotting ability. If you want to know specifically what is happening, it appears the drugs increase plasmin, antithrombin III, and protein S levels, stimulate fibrinolysis (clot breakdown), and suppress clotting factors II, V, VII, and X.[i],[ii] If you look, you’ll see that the prescribing guidelines for anabolic/androgenic steroids in the U.S. warn of potential increases in prothrombin time, a measure of how long it takes for a blood clot to form.[iii] This ‘thinning’ of the blood also seems to make a full noticeable nosebleed more likely, and when it does occur, slower to stop.

            Before we move on to the next factor, you need know that steroids don’t always reduce blood clotting. In fact, when used at high supratherapeutic dosages, these drugs can actually have the exact opposite effect on the blood. It seems that anabolic steroids can also elevate levels of thrombin[iv] and C-reactive protein,[v] as well as thromboxane A2 receptor density,[vi] which support clotting. At a certain dosage level, which is yet to be determined and likely varying between individuals, the pro-clotting changes in the blood appear to overtake the anti-clotting effects discussed earlier. These changes have been well-documented in some steroid abusing subjects,[vii] as are reports of (sometimes fatal) blood clots, embolisms, and strokes.[viii],[ix],[x],[xi],[xii] I don’t mean to confuse you, but I do think this is important to know. And in a small regard, the nosebleeds you reported may be a positive sign that your blood does not have an increased clotting tendency that would increase the risk of stroke.

            The second big factor is probably very obvious: blood pressure. Although clinically consistently elevated blood pressure (hypertension) is not common in steroid users, it does occur with some frequency. I would first and foremost make sure I was not suffering from hypertension, as this is something that should never be ignored and can contribute to serious health issues. Often, elevated estrogen can be a key culprit in this side effect and slight changes in BP might be mitigated with a reduction in the estrogen level. Note, however, that hypertension is sometimes also reported with the use of non-aromatizing (purely anabolic/androgenic) compounds, so you can’t always rely on estrogen exclusively. Of course, during intense training, your blood pressure may become temporarily elevated as well. This likely explains why the nosebleeds were occurring during your training sessions. So increased blood pressure and reduced clotting could both be working hand in hand to support those nosebleeds.

            I am not a physician and can’t advise you on what you need to do. With that said, as you probably know by reading my column, I believe you should always put safety first. The first thing I think any logical person would tell you is that you should go to the doctor for a full checkup. This is always a good idea when you cycle, and really a necessity if you are noticing strong side effects. If you don’t want to do this, you need to at least rule out hypertension. Blood pressure is an especially easy thing to check. I’d call some local large-chain pharmacies, as many of them will have a blood pressure machine on site for free use. I would say that, provided hypertension or any other pathological condition is not the cause, an occasional nosebleed is probably not serious. Certainly it can be very uncomfortable, frightening, troubling and even embarrassing to endure— and as you now know, it may indicate a more serious underlying issue, so you don’t want to just ignore it.

 

Trenbolone Acetate or Enanthate?

 

            I want to use trenbolone and don’t know if I should get acetate or enanthate. I have access to both. What is the difference? What do you like better?

            The first thing you need to keep in mind is that esters affect the release of the active steroid, in this case trenbolone. So either way, free trenbolone will be the drug actually doing the job. Provided both products were pharmaceutically pure and properly dosed, both would be acceptable choices if you wanted to use a trenbolone. But indeed there is a big difference between these two steroids, which is found in the rate in which trenbolone is released into the blood.

            Acetate is a very fast-acting ester and needs to be administered very frequently to maintain consistent blood levels. Usually it is given every other day, to every third day at the most. This can make for many repeat injections during a cycle. The short ester can also be painful for some people, caused by the inherent irritating properties of free short-chain fatty acids. Enanthate, on the other hand, is slow-acting (taken once per week usually) and more comfortable for most people to use.

            You might want to also consider that short-chain esters, such as acetate and propionate, are not widely used in human medicine at all. They were used regularly a long time (many decades) ago, but have since been brushed aside for longer esters, such as enanthate and cypionate. Enanthate actually dominates the global market for injectable testosterone right now. You won’t find testosterone acetate anywhere but in an obscure veterinary steroid these days. In general, if you do find a short-chain ester like an acetate or propionate, it is in a veterinary preparation. Obviously, the mental and physical comfort of an animal tends to be of a much lower priority. All things being equal, a long-chain ester like enanthate is preferable, as it would be more comfortable (if not necessarily more effective).

            There is another thing to consider, though. No registered drug company anywhere in the world is making a prescription trenbolone enanthate product. This material is used in the production of underground steroid products exclusively and while I’m sure there are many pure trenbolone enanthate products available, you should keep this in mind. Conversely, trenbolone acetate is still made by a number of U.S. and international drug companies. The U.S. Finaplix pellets, which have been sold in the U.S. without the same strict regulations, are also still available and almost guaranteed legitimate pharmaceutical quality. The chance of obtaining pharmaceutical-quality trenbolone acetate is, therefore, higher. So ultimately, there are some plusses and minuses whichever way you go— but either way, you are going trenbolone. If it were me, I’d make the choice based solely on my confidence in the sterility and purity of the preparation, regardless of the ester.

 

Liver Support?

 

            Do you think it is a good idea to take a natural liver supplement during oral cycles to help with liver stress? Is it necessary, or are all these products rip-offs?

            On the one hand, life-threatening liver toxicity is very rare with steroid use. Many steroid users take orals frequently and very few deaths are attributed to this. That is not to say they cannot cause liver failure— indeed, these drugs can and have. But I don’t want you to be too alarmed. If you use reasonable dosages and take the drugs for only periodic cycles, your odds of encountering a life-threatening issue are very low.

            On the other hand, serious issues like high elevations of hepatic enzymes and jaundice (bilirubin buildup caused by bile duct obstruction) are somewhat more common. Stories about yellowing of the skin or notable ‘sickness’ marked by nausea, vomiting, abdominal discomfort, or other ill feelings are quite common. I remember years ago my training partner telling me, “Dude, you’re turning yellow, man.” Sure enough, I was— so I’ve been there myself.

            While discontinuing the orals took care of the problem for me (and most people who have had these issues), I would have liked to have avoided getting there in the first place. In this regard, a good liver-support product can be a great thing to have. Indeed I don’t believe they are usually rip-offs, and in fact there are a lot of clinical data supporting the beneficial effects of certain natural ingredients. Products like Liv-52 (Himalaya Drug Co.) and Essentiale forte (Aventis) are well-known to reduce liver toxicity and are even prescribed in many countries to treat such things as hepatitis and cirrhosis of the liver. I also recently developed a product called Liver Stabil, under Molecular Nutrition, that incorporates a very wide range of proven hepatic support ingredients, and feel very comfortable recommending this to you as a first option as well. All of these products are very affordable. Regardless of which one you choose, I do think you should use one of them during all oral cycles. While nothing is for certain, a good liver supplement may very well help you avoid an unwelcome problem with liver toxicity.

 

Know Your Gear! William Llewellyn’s ANABOLICS 9th Edition (2009) is out NOW. Order your copy of this monster steroid reference guide today, by calling 888-828-8008 or visiting www.AnabolicsBook.com.

 

References:

            [1]. Anabolic steroids and fibrinolysis. Lowe GD. Wien Med Wochenschr, 1993;143(14-15):383-5.

            2. Effect of anabolic steroids on plasma antithrombin III. alpha2 macroglobulin and alpha1 antitrypsin levels. Walker ID, Davidson JF, Young P, Conkie JA. Thromb Diath Haemorrh, 1975 Sep 30;34(1):106-14.

            3. Depo-Testosterone. Pharmacia. U.S. Prescribing Information, Revised August 2002.

            4. Anabolic-androgenic steroid abuse in weight lifters: evidence for activation of the hemostatic system. Am J Hematol, Ferenchick GS, Hirokawa S, Mammen EF, Schwartz KA, 1995 Aug;49(4):282-8.

            5. Raised concentrations of C reactive protein in anabolic steroid using bodybuilders. F M Grace, B Davies et al. Br J Sports Med, 2004;38:97-98.

            6. Testosterone increases human platelet thromboxane A2 receptor density and aggregation responses. Ajayi AA, Mathur R, Halushka PV. Circulation, 1995 Jun 1;91(11):2742-7.

            7. Androgenic-anabolic steroid abuse and platelet aggregation: a pilot study in weight lifters. Ferenchick G, Schwartz D, Ball M, Schwartz K. Am J Med Sci, 1992 Feb;303(2):78-82.

            8. Pulmonary embolism associated with the use of anabolic steroids. Liljeqvist S, Helldén A, Bergman U, Söderberg M. Eur J Intern Med, 2008 May;19(3):214-5. Epub 2007 Sep 19.

            9. Coronary thrombosis and ectasia of coronary arteries after long-term use of anabolic steroids. Tischer KH, Heyny-von Haussen R, Mall G, Doenecke P. Z Kardiol, 2003 Apr;92(4):326-31.

            [1]0. Massive pulmonary embolus and anabolic steroid abuse. Gaede JT, Montine TJ. JAMA, 1992 May 6;267(17):2328-9.

            1[1]. Steroid anabolic drugs and arterial complications in an athlete— a case history. Laroche GP.  Angiology, 1990 Nov;41(11):964-9.

            [1]2. Death caused by pulmonary embolism in a body builder taking anabolic steroids (metanabol). Siekierzyńska-Czarnecka A, Polowiec Z, Kulawińska M, Rowinska-Zakrzewska E. Wiad Lek, 1990 Oct 1-15;43(19-20):972-5.

 

 

 



[i] Anabolic steroids and fibrinolysis. Lowe GD. Wien Med Wochenschr. 1993;143(14-15):383-5.

 

[ii] Effect of anabolic steroids on plasma antithrombin III. alpha2 macroglobulin and alpha1 antitrypsin levels. Walker ID, Davidson JF, Young P, Conkie JA. Thromb Diath Haemorrh. 1975 Sep 30;34(1):106-14.

 

[iii] Depo-Testosterone. Pharmacia. U.S. Prescribing Information. Revised August 2002.

 

[iv] Anabolic-androgenic steroid abuse in weight lifters: evidence for activation of the hemostatic system.

Am J Hematol. Ferenchick GS, Hirokawa S, Mammen EF, Schwartz KA. 1995 Aug;49(4):282-8.

 

[v] Raised concentrations of C reactive protein in anabolic steroid using bodybuilders. F M Grace, B Davies et al. Br J Sports Med 2004;38:97-98.

 

[vi] Testosterone increases human platelet thromboxane A2 receptor density and aggregation responses. Ajayi AA, Mathur R, Halushka PV. Circulation. 1995 Jun 1;91(11):2742-7.

 

[vii] Androgenic-anabolic steroid abuse and platelet aggregation: a pilot study in weight lifters. Ferenchick G, Schwartz D, Ball M, Schwartz K. Am J Med Sci. 1992 Feb;303(2):78-82.

 

[viii] Pulmonary embolism associated with the use of anabolic steroids. Liljeqvist S, Helldén A, Bergman U, Söderberg M. Eur J Intern Med. 2008 May;19(3):214-5. Epub 2007 Sep 19.

 

[ix] Coronary thrombosis and ectasia of coronary arteries after long-term use of anabolic steroids. Tischer KH, Heyny-von Haussen R, Mall G, Doenecke P. Z Kardiol. 2003 Apr;92(4):326-31.

 

[x] Massive pulmonary embolus and anabolic steroid abuse. Gaede JT, Montine TJ. JAMA. 1992 May 6;267(17):2328-9.

 

[xi] Steroid anabolic drugs and arterial complications in an athlete--a case history. Laroche GP.

 Angiology. 1990 Nov;41(11):964-9.

 

[xii] Death caused by pulmonary embolism in a body builder taking anabolic steroids (metanabol). Siekierzyńska-Czarnecka A, Polowiec Z, Kulawińska M, Rowinska-Zakrzewska E. Wiad Lek. 1990 Oct 1-15;43(19-20):972-5.