Side Effects & Health Risks

The heart is a muscle. Steroids cause it to grow, but unlike skeletal muscle this growth is pathological — the heart walls thicken, reducing its efficiency.

LVH is a major risk factor for heart failure and sudden cardiac death. It can develop within months of use.

An echocardiogram (heart ultrasound) can detect LVH. If you have used steroids for more than one cycle, consider getting one.

Steroids accelerate the buildup of plaque in arteries, particularly through their effect on cholesterol (lowering HDL, raising LDL).

This process is largely irreversible. Plaque does not disappear when you stop using. Young men are having heart attacks in their 30s from steroid use.

Monitor your lipid panel regularly. If your HDL drops below 1.0 mmol/L, this is a significant concern.

Most steroids raise blood pressure through water retention, increased red blood cell mass, or direct vascular effects.

Chronic high blood pressure damages blood vessels, the heart, kidneys, and brain. It is called 'the silent killer' for a reason.

Buy a home blood pressure monitor. Check regularly. Anything consistently above 140/90 needs addressing.

Steroids stimulate red blood cell production. Too many red blood cells make the blood thicker and more likely to clot.

This increases risk of stroke, deep vein thrombosis, and pulmonary embolism.

Haematocrit should be checked on blood work. Above 54% is concerning. Therapeutic blood donation can help manage this.

These enzymes leak into the blood when liver cells are damaged. Oral steroids routinely elevate them.

Mildly elevated enzymes are expected with oral use, but significantly elevated levels (3x+ normal) indicate meaningful liver stress.

Get liver function tests as part of your blood work. Avoid combining oral steroids with alcohol or paracetamol. Keep oral cycles short (6–8 weeks maximum).

A condition where bile flow from the liver is impaired. More common with oral steroids, particularly at higher doses.

Symptoms include jaundice (yellowing skin/eyes), dark urine, pale stools, and severe itching.

If you notice any of these symptoms, stop the oral compound and see a doctor. This is not something to push through.

Rare but documented conditions associated with long-term oral steroid use. Peliosis involves blood-filled cysts in the liver.

These are rare with typical recreational use but the risk increases with prolonged oral cycles.

Another reason to keep oral cycles short and to get blood work done.

Exogenous steroids shut down the hypothalamic-pituitary-testicular axis. Your body stops producing its own testosterone, LH, and FSH.

Recovery after a single moderate cycle is usually possible with proper PCT. After years of use, recovery may be partial or impossible.

Always have PCT medications on hand before starting a cycle. Get blood work to confirm recovery.

Steroids suppress sperm production. Many users become effectively infertile while on cycle, and some remain so for months or years after stopping.

If you want children in the future, this is a serious consideration. HCG during cycle can help maintain some testicular function, but it is not guaranteed.

Consider a semen analysis before your first cycle if fertility matters to you. Consider sperm banking.

Without stimulation from LH, the testes shrink during steroid use.

Usually reversible with PCT, but prolonged use can lead to permanent reduction in testicular size and function.

HCG during cycle can help maintain testicular size and function, making PCT recovery easier.

Testosterone and other steroids can convert (aromatise) to oestrogen. Elevated oestrogen stimulates breast tissue growth.

Early signs include nipple sensitivity, itching, and small lumps behind the nipple. If caught early, it may be reversible with SERMs. If tissue has solidified, surgery is the only option.

Monitor nipple sensitivity. Have an aromatase inhibitor (AI) on hand. Do not let it progress — early intervention is key. But also do not crash your oestrogen with excessive AI use, as low oestrogen carries its own serious side effects.

Steroids can cause irritability, aggression, anxiety, and mood swings. These are not just anecdotal — they are documented hormonal effects.

The people around you will notice before you do. Relationship damage, workplace issues, and social isolation are common.

Ask someone you trust to be honest with you about changes in your behaviour. If multiple people are telling you something has changed, listen.

The crash in testosterone after a cycle, combined with elevated oestrogen, frequently causes depression. This is biochemical, not weakness.

Post-cycle depression is one of the most dangerous periods. It drives many users back onto steroids and is associated with suicidal ideation.

Know that this is coming and plan for it. Tell someone you trust. Have your GP's number ready. If you experience suicidal thoughts, call Samaritans on 116 123.

Steroids can worsen or create body dysmorphic disorder. You may never feel big enough, lean enough, or good enough. This drives continued and escalating use.

This is one of the least discussed but most significant risks. Many users describe being unable to stop despite wanting to, because they cannot tolerate how they look or feel without steroids.

If you are unable to take a break from steroids, or if the thought of being smaller causes you significant distress, consider speaking to a mental health professional.

Steroids accelerate genetic hair loss through increased DHT (dihydrotestosterone) activity. If you are genetically predisposed to hair loss, steroids will speed it up — sometimes dramatically.

This is dose-dependent and compound-dependent (some compounds are worse than others). The damage is not always reversible.

If hair matters to you, research the androgenic rating of compounds before using them. Finasteride can help but carries its own side effects and does not work with all compounds.

Hormonal fluctuations from steroids cause increased sebum production, leading to acne — often severe and typically on the back, shoulders, and face.

Can be severe enough to cause scarring. Often worsens when coming off cycle due to hormonal instability.

Keep skin clean. If severe, a GP can prescribe treatments. Accutane (isotretinoin) is sometimes used but has significant side effects of its own.

Before around age 18–21, your bones are still growing. Elevated androgen levels can cause the growth plates to fuse prematurely.

This means steroids can permanently stunt your height. The irony of using steroids to look better while potentially making yourself shorter is lost on many young users.

If you have not finished growing, do not use anabolic steroids. This is one of the few genuinely irreversible consequences.

The prefrontal cortex — responsible for decision-making, impulse control, and emotional regulation — continues developing until approximately age 25.

Introducing supraphysiological hormones during this period can affect neurological development. The psychological side effects (mood, aggression, impulsivity) may be more severe in younger users.

Waiting until at least 25 is the most commonly cited harm reduction recommendation, and it exists for a reason.

Your hormonal system is still developing through your early 20s. Disrupting it during this period risks more lasting damage than disrupting it as a mature adult.

Recovery from HPTA suppression is harder when the system was never fully established in the first place.

If you are under 25, you are also at your peak natural testosterone. You have more to work with naturally than you think. Get blood work to confirm your baseline before making a decision.

Looksmaxing communities promote steroids as tools for achieving a more masculine appearance — claiming testosterone will reshape your jawline, HGH will change your facial bone structure, and a bigger body will fix your confidence. These claims are overwhelmingly exaggerated. In adults, exogenous testosterone does not cause meaningful skeletal changes. HGH abuse causes acromegaly, not attractiveness.

The blackpill ideology validates real pain — loneliness, social struggle, unhappiness with appearance — but then traps people in hopelessness while simultaneously selling them solutions. The contradiction is the business model: make people feel broken, then sell them fixes.

Content creators who make you feel worse about yourself before offering a product. Before/after transformations that do not disclose lighting, angles, or drug use. Anyone who frames disagreement as “cope” — a thought-terminating cliché designed to prevent critical thinking.

The pathway typically follows four stages: self-improvement content (fitness, grooming) → masculinity content (what it means to be a man) → grievance content (why life is unfair) → ideological content (who is to blame). Algorithms accelerate this because emotional content drives engagement.

Steroid use often sits at the intersection of self-improvement and grievance content. The same communities that normalise steroid use also promote increasingly extreme worldviews. Social disengagement, anger, and isolation are both causes and consequences.

Us-vs-them framing. Escalating anger at groups of people. Thought-terminating clichés. Conspiracy thinking. Content that isolates you from people who care about you. If you are concerned, Exit UK and ACT Early provide confidential support.

Most content creators in these spaces are running a business. Their revenue comes from views, affiliate links, supplement sales, coaching packages, and course enrolments. Your insecurity is monetised. Despair is profitable.

Ask yourself whether the content you are consuming makes you feel more capable and informed, or more hopeless and dependent. Useful information empowers you. Exploitative content traps you.