What common anabolic steroids and peptides are, whether they're approved, how strong the evidence is, and what side effects and risks have been reported.
Educational only. This guide doesn't list doses for non-medical use, including bodybuilding cycles, and it isn't medical advice. For prescribed medicines like testosterone (TRT), it shows the range from medical guidelines, which is only used with a clinician's monitoring and bloodwork.
Anabolic steroids are controlled substances in the US, and products sold as “research use only” are not approved medicines. Their purity, sterility and labeled amount are not verified.
Also known as Testosterone cypionate (Depo-Testosterone), Testosterone enanthate (Xyosted), Testosterone undecanoate (Aveed, Jatenzo), Testosterone propionate, AndroGel, TRT, Test
The main male sex hormone. Prescribed as testosterone replacement therapy (TRT) for diagnosed low testosterone, and the most widely used anabolic steroid outside medicine.
Why it's used: Medically, it restores normal levels in men with diagnosed low testosterone, improving sex drive, energy, bone density and muscle mass. Outside medicine, it's the base of most steroid use, for muscle and strength.
Example: A man whose pituitary gland was damaged by a tumor stops making testosterone. After two morning blood tests confirm low levels, his doctor starts TRT and rechecks his testosterone and hematocrit after a few months.
Large human trialsHalf-life: Depends on the ester: about 8 days for cypionate (per its label), roughly 4–5 days for enanthate
Details about Testosterone
Approval status
FDA-approved for men with low testosterone caused by a diagnosed medical condition (hypogonadism). Not approved for age-related decline alone, or for performance or bodybuilding.
Prescribed testosterone replacement (TRT)
For men with confirmed low testosterone, the Endocrine Society guideline lists testosterone cypionate or enanthate at 75–100 mg a week, or 150–200 mg every 2 weeks, by injection. Gels, patches, pellets and oral testosterone undecanoate are alternatives. The dose is adjusted to keep blood levels in the mid-normal range, with testosterone and hematocrit checked before starting and during treatment.
Only under a prescriber's care, with bloodwork. Source: Bhasin S et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2018.
How it works
Binds the androgen receptor to build muscle and drive male traits. Some is converted to estradiol (by aromatase) and to DHT (by 5α-reductase), which explains several side effects. An attached ester (cypionate, enanthate, propionate) slows its release from the injection site.
Main targets
Agonist: Androgen receptor
Converted by: Aromatase (converts some to estradiol)
Converted by: 5α-reductase (converts some to DHT)
Evidence
Studied extensively in men with hypogonadism, including the T Trials and the TRAVERSE trial, which found no increase in major heart events at replacement doses in men at higher heart risk. Doses above replacement are far less studied.
Half-life
Depends on the ester: about 8 days for cypionate (per its label), roughly 4–5 days for enanthate
Reported side effects
Acne and oily skin
Higher red blood cell count (hematocrit)
Breast tissue growth (gynecomastia) from conversion to estradiol
Fluid retention
Testicular shrinkage and lower sperm count
Hair loss in people prone to male-pattern baldness
Risks and warnings
Thicker blood from a high hematocrit raises clot and stroke risk, which is why it's monitored on TRT
Lowers sperm production, so testosterone therapy isn't used in men trying to conceive
In the TRAVERSE trial, more atrial fibrillation, acute kidney injury and pulmonary embolism than with placebo
Above replacement levels: higher blood pressure, worse cholesterol and a higher risk of heart muscle damage
Can worsen untreated sleep apnea
Gels carry a boxed warning: skin contact can pass testosterone to children and women
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Bhasin S et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2018.
Lincoff AM et al. Cardiovascular safety of testosterone-replacement therapy. N Engl J Med 2023 (TRAVERSE).
FDA prescribing information for Depo-Testosterone and AndroGel.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
Also known as Deca-Durabolin, Deca, Nandrolone decanoate, Nandrolone phenylpropionate (NPP)
An injectable steroid closely related to testosterone (a “19-nor” steroid), once used medically to treat anemia and muscle wasting.
Why it's used: Medically, it raised red blood cell counts in kidney failure and helped people regain lean mass in wasting illnesses. Bodybuilders use it for size and weight gain.
Example: In a randomized trial of people on dialysis, those given nandrolone decanoate for six months gained more lean body mass, and walked and climbed stairs faster, than those on placebo (Johansen et al., JAMA 1999).
Early or small human studiesHalf-life: About 6–12 days (decanoate ester)
Details about Nandrolone
Approval status
Was FDA-approved for anemia of kidney disease, but hasn't been marketed in the US since 2002; still a prescription medicine in some other countries.
How it works
Binds the androgen receptor strongly, but is converted to a weaker androgen in skin and scalp than testosterone is. It also acts on progesterone receptors, which is linked to some of its side effects.
Main targets
Agonist: Androgen receptor
Acts on: Progesterone receptor
Converted by: 5α-reductase (makes a weaker androgen)
Evidence
Older clinical trials in anemia, HIV-related wasting and kidney disease showed gains in lean mass and red blood cells. Bodybuilding use hasn't been studied in safety trials.
Half-life
About 6–12 days (decanoate ester)
Reported side effects
Water retention
Lower libido and erectile problems
Breast tissue growth (gynecomastia)
Higher red blood cell count
Acne
Risks and warnings
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Irritability and aggression while using, and depression after stopping; dependence can develop.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
In teenagers, can close growth plates early and stunt final height.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Johansen KL et al. Anabolic effects of nandrolone decanoate in patients receiving dialysis: a randomized controlled trial. JAMA 1999.
Federal Register, 2010: Deca-Durabolin was not withdrawn from sale for reasons of safety or effectiveness.
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
Also known as Tren, Trenbolone acetate (Tren A), Trenbolone enanthate (Tren E), Finaplix, Revalor (cattle implants)
A veterinary steroid made for cattle, known for strong effects on muscle and fat and for frequent, severe side effects.
Why it's used: In cattle, it speeds weight gain and improves feed efficiency. Bodybuilders use it for fast gains in muscle and strength and for fat loss, despite frequent, severe side effects.
Example: Beef cattle in US feedlots get trenbolone acetate ear implants (such as Revalor) so they grow faster on less feed. The implant labels state they are not for use in humans.
Mostly animal & lab studies
Details about Trenbolone
Approval status
Approved only as an implant to speed weight gain in beef cattle; never approved for use in humans. The cattle implant labels state “not for use in humans.”
How it works
Binds the androgen receptor very strongly and doesn't convert to estrogen; it also acts on progesterone receptors. In cattle it increases muscle growth and feed efficiency.
Main targets
Agonist: Androgen receptor (binds very strongly)
Acts on: Progesterone receptor
Evidence
No controlled human studies. Information comes from veterinary research and case reports of harm in people.
Reported side effects
Insomnia and night sweats
Aggression, anxiety and mood swings
Coughing fits right after injection (often called “tren cough”)
Acne and oily skin
Lower libido and erectile problems
Risks and warnings
Raises blood pressure and sharply lowers HDL (“good”) cholesterol
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
Irritability and aggression while using, and depression after stopping; dependence can develop.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Human products are made by underground labs, often from cattle implant powder; quality is unknown
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
FDA animal drug labeling for Revalor and Finaplix implants (“not for use in humans”).
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
Also known as Equipoise, EQ, Boldenone undecylenate
A long-acting veterinary injectable related to testosterone, known among users for raising appetite and red blood cell counts.
Why it's used: In horses, it improves appetite, weight and condition. Bodybuilders use it for gradual muscle gains and a bigger appetite.
Example: Its US veterinary label is for horses that are run down after illness or overwork, when better weight, coat and overall condition are wanted.
Mostly animal & lab studies
Details about Boldenone
Approval status
Developed and sold as a veterinary steroid for horses; not approved for use in humans.
How it works
A testosterone derivative with an extra double bond, which reduces its conversion to estradiol. Binds the androgen receptor and stimulates red blood cell production.
Main targets
Agonist: Androgen receptor
Converted by: Aromatase (reduced conversion to estradiol)
Stimulates: Red blood cell production
Evidence
Veterinary data in horses; no controlled human trials.
Reported side effects
Higher red blood cell count (hematocrit)
Increased appetite
Anxiety
Acne
Risks and warnings
Thicker blood from a high hematocrit raises clot and stroke risk
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
One of the first oral steroids, known for fast weight gain, much of it water.
Why it's used: Bodybuilders use it for fast gains in size and strength, much of it water weight. It has no current approved medical use in the US.
Example: In the late 1950s, US weightlifting team doctor John Ziegler worked with the drug company Ciba on Dianabol and gave it to American lifters, making it the first widely used performance steroid. He later said he regretted it.
Early or small human studiesHalf-life: About 3–6 hours
Details about Methandrostenolone
Approval status
Sold in the US as Dianabol from the late 1950s; no longer an approved medicine in the US.
How it works
A testosterone derivative modified to survive the liver, so it works as a tablet. It converts to a potent estrogen, which drives water retention and breast tissue growth.
Main targets
Agonist: Androgen receptor
Converted by: Aromatase (converts it to a potent estrogen)
Evidence
Small studies from the 1960s and 1970s showed strength and weight gains; no modern safety trials.
Half-life
About 3–6 hours
Reported side effects
Water retention and bloating
Breast tissue growth (gynecomastia)
Raised blood pressure
Acne
Risks and warnings
Oral 17α-alkylated steroid: can injure the liver, including cholestatic jaundice, blood-filled cysts (peliosis hepatis) and liver tumors.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
Irritability and aggression while using, and depression after stopping; dependence can develop.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
In teenagers, can close growth plates early and stunt final height.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
LiverTox (NIH): Androgenic steroids.
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
An oral steroid often described as “mild”, though its US approval was pulled in 2023 and it still strains the liver and cholesterol.
Why it's used: Medically, it helped people regain weight and muscle after burns, surgery or severe illness. Bodybuilders, and many women, use it for strength and lean muscle with little water gain, especially while dieting.
Example: In a small study at a Galveston burn unit, severely burned, malnourished children given oxandrolone for a week built muscle protein more efficiently than untreated children (Hart et al., Ann Surg 2001).
Early or small human studies
Details about Oxandrolone
Approval status
Was FDA-approved (Oxandrin) to help regain weight after surgery, trauma or illness. The FDA withdrew approval in June 2023 and later determined it had been withdrawn for reasons of safety or effectiveness.
How it works
A DHT-derived steroid that doesn't convert to estrogen, modified to survive the liver so it works as a tablet.
Main targets
Agonist: Androgen receptor
Evidence
Clinical trials in burns, HIV-related wasting and other conditions showed lean mass gains. In 2023 the FDA determined it had been withdrawn from sale for reasons of safety or effectiveness.
Reported side effects
Lower HDL (“good”) cholesterol
Raised liver enzymes
Acne
Lower libido
Risks and warnings
Its label carried boxed warnings for peliosis hepatis (blood-filled liver cysts), liver tumors and blood lipid changes
Oral 17α-alkylated steroid: can injure the liver, including cholestatic jaundice, blood-filled cysts (peliosis hepatis) and liver tumors.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
In teenagers, can close growth plates early and stunt final height.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Hart DW et al. Anabolic effects of oxandrolone after severe burn. Ann Surg 2001.
Federal Register, June 28, 2023: withdrawal of approval of Oxandrin and generic oxandrolone tablets.
Federal Register, September 13, 2023: Oxandrin was withdrawn from sale for reasons of safety or effectiveness.
A strong oral steroid used medically for certain anemias, known in bodybuilding for rapid weight and water gain.
Why it's used: Medically, it boosts red blood cell production in certain anemias. Bodybuilders use it for rapid weight and strength gains.
Example: A patient with aplastic anemia, where the bone marrow stops making enough blood cells, may be prescribed Anadrol-50 to raise red blood cell production, with regular liver tests.
Early or small human studies
Details about Oxymetholone
Approval status
FDA-approved (Anadrol-50) for anemias caused by deficient red blood cell production, such as aplastic anemia.
How it works
A DHT-derived steroid modified to survive the liver. It stimulates red blood cell production; it doesn't convert to estrogen, yet water retention is commonly reported.
Main targets
Agonist: Androgen receptor
Stimulates: Red blood cell production
Evidence
Approved on older clinical data in anemia; also studied in small trials for HIV-related wasting.
Oral 17α-alkylated steroid: can injure the liver, including cholestatic jaundice, blood-filled cysts (peliosis hepatis) and liver tumors.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
In teenagers, can close growth plates early and stunt final height.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
FDA prescribing information for Anadrol-50.
LiverTox (NIH): Androgenic steroids.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
An oral and injectable steroid known for a lean, “dry” look, and for sharply lowering HDL (“good”) cholesterol.
Why it's used: Medically, it prevented swelling attacks in hereditary angioedema. Athletes and bodybuilders use it for strength and a leaner look without water gain.
Example: Sprinter Ben Johnson tested positive for stanozolol at the 1988 Seoul Olympics and was stripped of his 100-meter gold medal.
Early or small human studies
Details about Stanozolol
Approval status
Approved in the US in 1962 to prevent attacks of hereditary angioedema; approval was withdrawn in 2010 and it's no longer sold for people in the US.
How it works
A DHT-derived steroid that doesn't convert to estrogen. The tablet form is modified to survive the liver.
Main targets
Agonist: Androgen receptor
Evidence
Older clinical studies in hereditary angioedema; no modern trials of performance use.
Reported side effects
Joint aches
Acne
Hair loss in people prone to it
Lower HDL (“good”) cholesterol
Risks and warnings
Oral 17α-alkylated steroid: can injure the liver, including cholestatic jaundice, blood-filled cysts (peliosis hepatis) and liver tumors.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
In teenagers, can close growth plates early and stunt final height.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
LiverTox (NIH): Androgenic steroids.
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
Also known as Masteron, Mast, Drostanolone propionate, Drolban
An injectable DHT-derived steroid, used in bodybuilding mostly during cutting phases.
Why it's used: Medically, it was used to treat advanced breast cancer. Bodybuilders use it mostly while dieting, for a harder look and to hold on to strength.
Example: In the 1960s and 1970s, women with advanced breast cancer were treated with drostanolone (sold as Masteron and Drolban) as a hormonal therapy.
Early or small human studies
Details about Drostanolone
Approval status
Once used to treat advanced breast cancer in women; no longer marketed in the US.
How it works
A modified form of DHT that binds the androgen receptor and doesn't convert to estrogen.
Main targets
Agonist: Androgen receptor
Evidence
Studied decades ago as a breast cancer treatment; no modern trials.
Reported side effects
Hair loss in people prone to it
Acne and oily skin
Lower HDL (“good”) cholesterol
Risks and warnings
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
Also known as Primobolan, Primo, Methenolone enanthate, Methenolone acetate
A DHT-derived steroid, injected or taken as a tablet, often described by users as mild, though it still shuts down natural testosterone and worsens cholesterol.
Why it's used: Medically, it was used in some countries for muscle wasting and anemia. Bodybuilders use it for slow, lean gains without estrogen-related side effects such as water retention.
Example: Outside the US, it was prescribed for conditions such as anemia caused by bone marrow failure.
Early or small human studies
Details about Methenolone
Approval status
Never approved in the US; sold as a prescription medicine in some other countries in the past.
How it works
A DHT derivative that doesn't convert to estrogen. Unlike most oral steroids, the tablet form isn't 17α-alkylated.
Main targets
Agonist: Androgen receptor
Evidence
Older clinical use and studies outside the US; no modern trials.
Reported side effects
Hair loss in people prone to it
Acne
Lower HDL (“good”) cholesterol
Risks and warnings
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
Also known as Oral-Turinabol, Tbol, Chlorodehydromethyltestosterone (CDMT)
An oral steroid derived from Dianabol, with a chlorine atom that stops it converting to estrogen.
Why it's used: Used for strength and lean muscle without water retention, mainly by athletes.
Example: East Germany's state doping program gave androgens, mainly Oral-Turinabol, to several thousand athletes a year, including minors, and recorded damaging side effects (Franke and Berendonk, Clin Chem 1997).
Early or small human studies
Details about Turinabol
Approval status
Never approved in the US. Made in East Germany, where it was the main steroid of the state doping program in the 1970s and 1980s.
How it works
A chlorinated form of methandrostenolone (Dianabol) that doesn't convert to estrogen and is modified to survive the liver.
Main targets
Agonist: Androgen receptor
Evidence
No modern controlled trials. Much of the human information comes from records of the East German doping program, including later health problems in former athletes.
Reported side effects
Lower HDL (“good”) cholesterol
Raised liver enzymes
Acne
Risks and warnings
Oral 17α-alkylated steroid: can injure the liver, including cholestatic jaundice, blood-filled cysts (peliosis hepatis) and liver tumors.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Long-term use is linked to high blood pressure, heart muscle damage (cardiomyopathy), heart attacks and early death.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Underground-lab products are often mislabeled or contaminated, and non-sterile injections can cause abscesses and infections.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Franke WW, Berendonk B. Hormonal doping and androgenization of athletes: a secret program of the German Democratic Republic government. Clin Chem 1997.
LiverTox (NIH): Androgenic steroids.
Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008.
Pope HG et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014.
A potent oral “designer” steroid once sold as a supplement, and linked to serious liver injury.
Why it's used: Sold as a supplement for fast gains in size and strength, before it became a controlled substance.
Example: Doctors described five previously healthy people who used methasterone supplements and developed jaundice from severe liver injury; all recovered over about three months with supportive care (Shah et al., Clin Gastroenterol Hepatol 2008).
Mostly animal & lab studies
Details about Methasterone
Approval status
Never approved as a medicine. Sold in the mid-2000s as a “prohormone” supplement; the DEA made it a Schedule III controlled substance in 2012.
How it works
A 17α-methylated form of drostanolone, so it works as a tablet and is hard on the liver.
Main targets
Agonist: Androgen receptor
Evidence
Never tested in proper human trials; human information comes from case reports, many describing severe liver injury.
Reported side effects
Lower HDL (“good”) cholesterol
Raised blood pressure
Fatigue and loss of appetite
Lower libido
Risks and warnings
Case reports of severe cholestatic liver injury with jaundice, some needing hospital care
Oral 17α-alkylated steroid: can injure the liver, including cholestatic jaundice, blood-filled cysts (peliosis hepatis) and liver tumors.
Lowers HDL (“good”) cholesterol and raises LDL, adding to heart disease risk.
Shuts down the body's own testosterone production: testicles shrink and sperm counts fall, and recovery after stopping can take months or be incomplete.
In women: masculinizing effects (deeper voice, facial and body hair, clitoral enlargement) that can be permanent.
Schedule III controlled substance in the US: illegal to possess without a prescription.
Prohibited in sport by the World Anti-Doping Agency (WADA).
Sources
Shah NL et al. Methasteron-associated cholestatic liver injury: clinicopathologic findings in 5 cases. Clin Gastroenterol Hepatol 2008.
DEA, 2012: placement of methasterone and prostanozol into Schedule III.
A long-acting GLP-1 receptor agonist that lowers blood sugar, slows stomach emptying and reduces appetite.
Why it's used: Lowers blood sugar in type 2 diabetes, helps with substantial weight loss, and lowers heart attack and stroke risk in people with heart disease and excess weight.
Example: An adult with obesity who has had a heart attack is prescribed Wegovy. In the SELECT trial, people like this had about a 20% lower risk of heart attack, stroke or heart-related death.
Large human trialsHalf-life: About 1 week
Details about Semaglutide
Approval status
FDA-approved for type 2 diabetes (Ozempic, Rybelsus) and for chronic weight management and cardiovascular risk reduction (Wegovy).
How it works
Mimics the gut hormone GLP-1. A fatty-acid side chain lets it bind to albumin in the blood, which is why a single injection lasts about a week.
Main targets
Agonist: GLP-1 receptor
Evidence
Studied in tens of thousands of people across the SUSTAIN (diabetes), STEP (weight) and SELECT (heart outcomes) trial programs.
Half-life
About 1 week
Reported side effects
Nausea, vomiting, diarrhea or constipation
Abdominal pain
Headache and fatigue
Risks and warnings
Pancreatitis and gallbladder problems, including gallstones
Low blood sugar when combined with insulin or sulfonylureas
Dehydration from stomach side effects can harm the kidneys
Boxed warning: thyroid C-cell tumors in rodents; not for people with a personal or family history of medullary thyroid cancer or MEN 2
Sources
Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021 (STEP 1).
Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023 (SELECT).
FDA prescribing information for Ozempic and Wegovy.
A once-weekly dual agonist of the GIP and GLP-1 receptors used for type 2 diabetes and weight management.
Why it's used: Lowers blood sugar in type 2 diabetes and produces some of the largest weight loss of any approved medicine; also approved for obesity-related sleep apnea.
Example: In the SURMOUNT-1 trial, adults with obesity on the highest dose lost about a fifth of their body weight on average over 72 weeks.
Large human trialsHalf-life: About 5 days
Details about Tirzepatide
Approval status
FDA-approved for type 2 diabetes (Mounjaro) and for chronic weight management and obesity-related obstructive sleep apnea (Zepbound).
How it works
Activates the receptors for two gut hormones, GIP and GLP-1, which together affect insulin release, appetite and how quickly the stomach empties.
Main targets
Agonist: GIP receptor
Agonist: GLP-1 receptor
Evidence
Studied in thousands of people in the SURPASS (diabetes) and SURMOUNT (weight) trial programs.
Half-life
About 5 days
Reported side effects
Nausea, vomiting, diarrhea or constipation
Reduced appetite
Indigestion and abdominal pain
Risks and warnings
Pancreatitis and gallbladder problems
Low blood sugar when combined with insulin or sulfonylureas
Can make birth-control pills less effective, especially when starting or increasing the medication
Boxed warning: thyroid C-cell tumors in rodents; not for people with a personal or family history of medullary thyroid cancer or MEN 2
Sources
Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med 2022 (SURMOUNT-1).
FDA prescribing information for Mounjaro and Zepbound.
An investigational once-weekly “triple agonist” that acts on the GIP, GLP-1 and glucagon receptors.
Why it's used: Being developed for obesity and type 2 diabetes, and studied in related conditions such as knee osteoarthritis pain, sleep apnea and fatty liver disease.
Example: In the 80-week Phase 3 TRIUMPH-1 trial, adults with obesity on the highest dose lost 25% of their body weight on average, compared with about 4% on placebo (N Engl J Med 2026).
Large human trialsHalf-life: About 6 days (early trials)
Details about Retatrutide
Approval status
Not approved. Phase 3 trials have reported results, and Eli Lilly has said it plans to apply for FDA approval in early 2027.
How it works
Adds glucagon-receptor activity to GIP and GLP-1 effects; glucagon activity is thought to raise energy use and reduce liver fat.
Main targets
Agonist: GLP-1 receptor
Agonist: GIP receptor
Agonist: Glucagon receptor
Evidence
Phase 3 trials in thousands of adults with obesity, with or without type 2 diabetes, reported large weight loss and better blood sugar control, building on Phase 1 and 2 studies. A heart and kidney outcomes trial is still running.
Half-life
About 6 days (early trials)
Reported side effects
Nausea, vomiting, diarrhea and constipation, mostly during the step-up phase of treatment
Higher heart rate at higher doses
Dysesthesia (unusual skin sensations such as tingling or burning), more common than with placebo in Phase 3
Low blood pressure, more common than with placebo in Phase 3
Risks and warnings
Long-term safety is not yet established
Products sold as “research use only” are not quality-controlled medicines; purity, sterility and labeled amount are not verified.
Sources
Jastreboff AM et al. Retatrutide, a triple hormone receptor agonist, for treatment of obesity (TRIUMPH-1). N Engl J Med 2026.
Bellido V et al. Retatrutide in adults with obesity and type 2 diabetes (TRIUMPH-2). Lancet 2026.
Bajaj HS et al. Retatrutide in type 2 diabetes (TRANSCEND-T2D-1). Lancet 2026.
Jastreboff AM et al. Triple–hormone-receptor agonist retatrutide for obesity: a phase 2 trial. N Engl J Med 2023.
Sanyal AJ et al. Retatrutide for metabolic dysfunction-associated steatotic liver disease: a randomized phase 2a trial. Nat Med 2024.
Coskun T et al. LY3437943 from discovery to clinical proof of concept. Cell Metab 2022.
Wen Y et al. ANGPTL3/8 and serum lipids with retatrutide. Diabetes Obes Metab 2025.
Also known as CagriSema (combined with semaglutide)
An investigational long-acting analogue of amylin, a hormone released with insulin that helps you feel full.
Why it's used: Being developed for weight loss, mainly in combination with semaglutide.
Example: In the REDEFINE 1 trial, adults with obesity taking CagriSema (cagrilintide with semaglutide) lost about 23% of their body weight on average over 68 weeks.
Early or small human studies
Details about Cagrilintide
Approval status
Not approved. Studied alone and combined with semaglutide (CagriSema) in trials by Novo Nordisk at the time of review.
How it works
Activates amylin and calcitonin receptors, slowing stomach emptying and increasing fullness.
Main targets
Agonist: Amylin receptors
Agonist: Calcitonin receptor
Evidence
Phase 2 trials alone and with semaglutide; the combination is in Phase 3 trials (the REDEFINE program).
Reported side effects
Nausea, constipation and diarrhea
Injection-site reactions
Risks and warnings
Long-term safety of cagrilintide on its own is not established
Products sold as “research use only” are not quality-controlled medicines; purity, sterility and labeled amount are not verified.
Sources
Lau DCW et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a phase 2 trial. Lancet 2021.
A shortened form of growth hormone–releasing hormone made of its first 29 amino acids.
Why it's used: Was used to test and treat growth hormone deficiency in children; now used off-label at some clinics to raise growth hormone.
Example: Before it was discontinued, it was prescribed for children with short stature caused by growth hormone deficiency.
Early or small human studies
Details about Sermorelin
Approval status
Was FDA-approved (Geref) for growth hormone deficiency in children; the brand was discontinued in the US in 2008.
How it works
Stimulates the pituitary to release growth hormone in natural pulses.
Main targets
Agonist: GHRH receptor (in the pituitary)
Evidence
Older clinical studies, mainly in children with growth hormone deficiency.
Reported side effects
Injection-site reactions
Flushing
Headache
Risks and warnings
No longer available as an approved product in the US
Products sold as “research use only” are not quality-controlled medicines; purity, sterility and labeled amount are not verified.
Sources
Prakash A, Goa KL. Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency. BioDrugs 1999.
Also known as CJC-1295 with DAC, Modified GRF (1-29)
A synthetic GHRH analogue designed to last much longer than the body's own GHRH.
Why it's used: Used to raise growth hormone and IGF-1 for longer than the body's own GHRH does; sold online as a research chemical.
Example: In small early studies in healthy adults, a single injection raised growth hormone and IGF-1 levels for days; it never reached approval.
Early or small human studiesHalf-life: About 6–8 days with DAC; about 30 minutes without
Details about CJC-1295
Approval status
Not approved. Early clinical development was discontinued.
How it works
Stimulates growth hormone release. The “DAC” version binds albumin in the blood, which greatly extends how long it lasts; versions without DAC (often sold as modified GRF 1-29) are short-acting.
Main targets
Agonist: GHRH receptor (in the pituitary)
Evidence
Small early-phase studies in healthy adults showed sustained increases in growth hormone and IGF-1.
Half-life
About 6–8 days with DAC; about 30 minutes without
Reported side effects
Injection-site reactions
Flushing
Headache
Risks and warnings
Long-term safety unknown
Prohibited in sport by the World Anti-Doping Agency (WADA).
Products sold as “research use only” are not quality-controlled medicines; purity, sterility and labeled amount are not verified.
Sources
Teichman SL et al. Prolonged stimulation of growth hormone and IGF-I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. J Clin Endocrinol Metab 2006.
A synthetic five-amino-acid growth hormone secretagogue.
Why it's used: Used to raise growth hormone release, often in research-chemical blends with CJC-1295.
Example: In a Phase 2 trial of 114 patients after bowel surgery, ipamorelin didn't speed recovery of bowel function compared with placebo (Beck et al., Int J Colorectal Dis 2014).
Early or small human studiesHalf-life: About 2 hours
Details about Ipamorelin
Approval status
Not approved. Trials for recovery of bowel function after surgery did not lead to approval.
How it works
Activates the ghrelin receptor to release growth hormone; in animal studies it had little effect on cortisol or prolactin.
Main targets
Agonist: Ghrelin receptor (in the pituitary)
Evidence
Animal studies plus a small number of human trials, including mid-stage trials for postoperative ileus.
Half-life
About 2 hours
Reported side effects
Human side-effect data are limited
Risks and warnings
Long-term safety unknown
Prohibited in sport by the World Anti-Doping Agency (WADA).
Products sold as “research use only” are not quality-controlled medicines; purity, sterility and labeled amount are not verified.
Sources
Beck DE et al. Ghrelin mimetic ipamorelin for postoperative ileus in bowel resection patients: a randomized, controlled, proof-of-concept study. Int J Colorectal Dis 2014.
Raun K et al. Ipamorelin, the first selective growth hormone secretagogue. Eur J Endocrinol 1998.
A synthetic 15-amino-acid peptide based on a sequence from a protein found in human gastric juice.
Why it's used: Used in the hope of faster healing of tendons, ligaments, muscles and the gut, based mainly on animal studies.
Example: In rat studies from a Croatian research group, it sped healing of surgically cut muscles and Achilles tendons (Staresinic et al., J Orthop Res 2006). Similar results haven't been shown in human trials.
Mostly animal & lab studies
Details about BPC-157
Approval status
Not approved for human use. The FDA lists it among bulk substances that may pose significant safety risks in compounding.
How it works
Studied in animals for effects on blood-vessel growth, tendon and ligament healing, and repair of the gut lining. How it works in people is not established.
A melanocortin receptor agonist used as needed for low sexual desire in premenopausal women.
Why it's used: Treats distressing low sexual desire in premenopausal women.
Example: A premenopausal woman with ongoing, distressing low sexual desire that isn't caused by another condition or medication is prescribed Vyleesi, used as needed before sexual activity.
Large human trialsHalf-life: About 2.7 hours
Details about Bremelanotide
Approval status
FDA-approved (Vyleesi) for low sexual desire (hypoactive sexual desire disorder) in premenopausal women.
How it works
Activates melanocortin receptors in the brain, mainly MC4R, which are involved in sexual desire.
Main targets
Agonist: Melanocortin receptors (mainly MC4R in the brain)
Evidence
Approved after two Phase 3 trials (the RECONNECT studies).
Half-life
About 2.7 hours
Reported side effects
Nausea (common)
Flushing
Headache
Injection-site reactions
Risks and warnings
Temporary rise in blood pressure and drop in heart rate; not for people with uncontrolled high blood pressure or heart disease
Darkening of patches of skin with repeated use
Sources
Kingsberg SA et al. Bremelanotide for the treatment of hypoactive sexual desire disorder: two randomized phase 3 trials. Obstet Gynecol 2019.
A synthetic analogue of α-melanocyte-stimulating hormone, sold illegally as a tanning product.
Why it's used: Used to tan without sun exposure, and sometimes for libido.
Example: Sold online as tanning injections; health regulators in several countries have warned people not to use them.
Early or small human studies
Details about Melanotan II
Approval status
Not approved anywhere. Health regulators in several countries have warned against it.
How it works
Activates several melanocortin receptors, darkening skin pigment and also affecting appetite and sexual function.
Main targets
Agonist: Melanocortin receptors (nonselective, including MC1R on pigment cells and MC4R in the brain)
Evidence
Small early human studies from the 1990s. It has no approved use.
Reported side effects
Nausea
Facial flushing
Spontaneous erections
Reduced appetite
Risks and warnings
New or darkening moles; case reports of melanoma
Rare reports of serious kidney problems and priapism
Products sold as “research use only” are not quality-controlled medicines; purity, sterility and labeled amount are not verified.
Sources
Habbema L et al. Risks of unregulated use of alpha-melanocyte-stimulating hormone analogues: a review. Int J Dermatol 2017.
Olney JJ et al. The protective effects of the melanocortin receptor (MCR) agonist, melanotan-II (MTII), against binge-like ethanol drinking are facilitated by deletion of the MC3 receptor in mice. Neuropeptides 2014.
A 16-amino-acid peptide encoded in mitochondrial DNA, first described in 2015.
Why it's used: Used in the hope of better metabolism, insulin sensitivity and exercise capacity, based on mouse studies.
Example: In mice, MOTS-c prevented insulin resistance and weight gain on a high-fat diet (Lee et al., Cell Metab 2015). It hasn't been shown to do this in people.
Mostly animal & lab studies
Details about MOTS-c
Approval status
Not approved for human use.
How it works
Studied in mice for effects on insulin sensitivity, metabolism and exercise capacity.
Main targets
Studied link: AMPK (activated through folate metabolism in cell and mouse studies)