Anabolic steroids are synthetic derivatives of the male hormone testosterone. These derivatives of testosterone promote the growth of skeletal muscle and increase lean body mass. They were first abused by elite athletes seeking to improve performance. Today, athletes and non-athletes use steroids to enhance performance and also to change physical appearance. As you will see there are many ways on which anabolic steroids can be taken into the body. However, when steroids are abused for non-medical purposes they are usually injected or taken orally. In this article we examine the differences between oral and injectable anabolic steroids in order to see which one is worse. However, you should know in advance that choosing between oral or injectable steroids is like choosing between two evils.
How are anabolic steroids used?
Anabolic steroids dispensed for legitimate medical purposes are administered several ways including intramuscular or subcutaneous injection, by mouth, pellet implantation under the skin and by application to the skin (e.g. gels or patches). However, doses taken by abusers can be 10 to 100 times higher than the doses used for medical conditions.
- By mouth, orally
- By intramuscular or subcutaneous injection
- Pellet implantation under the skin
- Application to the skin via patches or gels
These same routes are used for purposes of abusing steroids, with injection and oral administration being the most common. Abusers rarely use the last two methods.
Oral anabolic steroids are usually in a pill form, tablet, and liquid suspensions or emulsions.
One benefit of taking steroids orally is that swallowing is generally more pleasant than injections. Injections are painful and may not be bearable for some. Many abusers will spend hours staring at the needles and bottles before working up the courage to give themselves that first shot. And this is all under the assumption that they have the knowledge to carry out the work.
Although oral steroids require less effort and are much more pleasant to take, they do have their dark side. They are considered as the most hepatotoxic. In other words, most anabolic steroid tablets present definite risks of permanent liver damage and liver cancer.
The main reason for such a negative effect on the liver is very easy to understand. Oral steroids cannot avoid the first-pass effect of the liver. The first-pass effect refers to the fact that ingested drugs must pass from the intestines through the liver in order to reach the bloodstream. The liver metabolizes a major part of the oral dose in this process.
It didn’t take long for chemists to tackle this problem. These substances have been 17-alpha-alkylated – a carbon atom was added at the 17th position to survive the first pass through the liver. Once through the liver and into the blood stream it can work its magic. The changes made to C-17 to inhibit hepatic degradation make nearly all oral preparations hepatotoxic.
In other words, a non 17aa steroid (17-alpha-alkylated) will be largely broken down by your liver if ingested orally. So 17aa steroids are basically steroids with a bit stuck onto them that allows you to take them orally. This, of course, increases hepatoxicity (liver toxicity) because it’s something the liver can’t metabolize.
Once injected into a muscle (buttock, thigh and shoulder muscles as the most common injection sites) they travel though the bloodstream to muscle cells to make them grow. Therefore, injectable steroids are absorbed directly into the bloodstream (they do not have to be digested), thereby avoiding the first-pass effect of the liver. By avoiding the first-pass effect, injectable steroids are less toxic to the liver than the oral ones.
Most steroid injections take a few days to start working and usually last up to one or two months before you need to take another steroid shot.
People that consider taking steroids generally have the problem that they will not be able to inject the drug into themselves. This is quite expected. It is not easy to give yourself an injection, even if you really know how to do it correctly. Many will often depend on the help of others. That’s why you will often see needles in locker rooms.
The biggest risk here lies in the fact that it’s easy to miss the target area and inadvertently inject the drug directly into a tendon. This can lead to a clot, that will lead to death provided it is not caught by a surgeon in time. An even worse scenario than this would be injecting into a vein. You will also have to rotate injection sites to prevent muscle pain, tissue damage and abscesses.
Examples of oral and injectable steroids
This is a list of the most used oral steroids: Anadrol (oxymetholone), Oxandrin (oxandrolone), Dianabol (methandrostenolone), Winstrol (stanozolol), Proviron, Primobolan.
This is a list of the most used injectable steroids: Deca durabolin (nandrolone-decanoate), Durabolin (nandrolone-phenpropionate), Depo testosterone (testosterone-cypionate), Testosterone-propionate, Equipoise (boldenone undecylenate).
Closing thoughts: Oral vs injectable steroids
Some anabolic steroids are taken orally, others are injected intramuscularly, and still others are provided in gels or creams that are rubbed on the skin. Because oral steroids have a shorter “half-life” (how long a steroid stays in your system) than injectable steroids, abusers are taking them several times a day, putting immense strain on the liver. In general, injectable steroids are more potent, safer and remain in the system longer than oral steroids. There are, however, a few exceptions. However, missing the right injection site could be fatal.