Methandrostenolone (Dianabol)

What methandrostenolone is

Methandrostenolone is a derivative of testosterone that works as a tablet. Under the name Dianabol it was marketed as a medicine and tested in controlled studies in the 1970s and early 1980s, in training men and in osteoporosis. The authors of the first training study already described it in 1976 as an “anabolic steroid” used by athletes.

In Germany, metandienone is prescription-only; no approved product is on the market. Unlike nandrolone or testosterone, there is therefore no current summary of product characteristics with systematically recorded side effects.

How it works

Methandrostenolone acts via the androgen receptor. It is 17α-alkylated, that is, modified at carbon atom 17 so that it works when swallowed; this group of steroids is most closely associated with liver damage.

The 1981 study tried to clarify what actually increases under methandienone. Total body potassium and nitrogen were measured. Both rose sharply, but in relation to the weight gain too sharply for normal muscle or other lean tissue. The authors concluded that the substance does have an anabolic effect, but that the gain is not normal muscle. The 1976 study also showed that blood testosterone falls and cortisol rises.

What the studies show

Hervey 1976: 11 training men

In a double-blind crossover design, 11 men received methandienone and placebo for 6 weeks each during strength training. Under the active substance they gained 3.3 kg on average, exclusively in the lean component, and their muscles grew larger. Strength and performance rose in both phases, but not significantly differently. Blood testosterone fell and cortisol rose. The authors left open whether the gain was genuine tissue building or more fluid in the cells.

Hervey 1981: 7 weightlifters

The repeat study with 7 weightlifters in training followed the same design, 6 weeks each with a 6-week break in between. Weight (+2.3 kg), body potassium, body nitrogen, muscle girth, leg power and strength rose significantly only in the active phase. The rise in potassium and nitrogen was too large for the weight gain to correspond to normal muscle tissue.

Aloia 1981: osteoporosis over 24 months

In a randomized, double-blind, placebo-controlled study, body potassium rose under methandrostenolone, mainly in the first 6 months. Bone mass did not change significantly; only total body calcium was slightly higher after 6 months. The authors found no clear bone gain.

Case reports: liver, kidney, heart

A 50-year-old developed severe cholestasis with a bilirubin of 922 µmol/l after eight weeks of use, together with acute kidney failure and inflammation of the pancreas (Rosenfeld 2011). The liver database LiverTox of the US health agency NIH lists methandrostenolone several times as a cause of cholestasis, in one case in a 71-year-old woman up to liver failure and death. A 34-year-old died hours after training; the heart muscle was thickened, and methandienone, stanozolol and clenbuterol, among others, were detected (Lehmann 2019).

Where the data stop

• Small and old. The training studies include 18 men in total and are over 40 years old. Modern measurement methods, larger groups and longer follow-up are lacking.
• Strength uncertain. In the larger of the two studies, strength did not rise more than under placebo; in the smaller one it did.
• No systematic safety data. We did not find controlled long-term data on the heart, blood lipids and mental health specifically for methandrostenolone. For steroids, HDL reductions of about 25 percent are documented; the registry data on steroids as a whole can be found under Anabolic steroids.
• Combined use. Case reports usually find several substances; what is due to methandrostenolone alone can hardly be separated.
• Origin of the product. No approved product is on the market in Germany. What is traded comes from the gray market and is not the medicine from the studies.

Status, approval and legal

Metandienone and its esters are listed in Annex 1 of the German Ordinance on Prescription Medicines (AMVV) and are therefore prescription-only. No approved product is on the market in Germany; finished medicinal products may only be placed on the market with a marketing authorization (§ 21 German Medicines Act). It used to be marketed as Dianabol.

Metandienone is listed by name in the annex of the German Anti-Doping Act: acquiring, possessing and bringing into the country non-small quantities for doping in sport are prohibited, as are trading and supplying for doping purposes. In sport it is on the WADA Prohibited List under S1.1 and is prohibited at all times.

Safety

Liver: cholestasis with jaundice has been described repeatedly for methandrostenolone, up to liver failure and death; as a 17α-alkylated steroid it belongs to the group most closely associated with peliosis hepatis and liver tumors. Kidney and pancreas: in one case report, acute kidney failure and pancreatitis together with cholestasis. Hormonal: blood testosterone falls, cortisol rises. Heart: sudden death of a 34-year-old with a thickened heart muscle under combined use. Blood lipids: marked HDL reductions are documented for steroids; we did not find measurements specifically for methandrostenolone. Mental health: not specifically studied.

Every step here should be preceded by a conversation with a doctor, not as a formality, but because liver damage can progress silently for a long time and then become severe.

Sources

• Hervey et al., Lancet 1976 – methandienone in 11 training men, double-blind crossover study
• Hervey et al., Clin Sci 1981 – methandienone in 7 weightlifters: weight gain is not normal muscle tissue
• Aloia et al., Metabolism 1981 – methandrostenolone in osteoporosis, randomized over 24 months
• Rosenfeld et al., J Med Case Rep 2011 – cholestasis, kidney failure and pancreatitis after methandrostenolone (case report)
• Lehmann et al., Forensic Sci Int 2019 – death after abuse of clenbuterol, stanozolol and metandienone
• LiverTox (NIH) – Androgenic Steroids: liver damage from 17α-alkylated steroids
• German Ordinance on Prescription Medicines (AMVV), Annex 1 – metandienone and its esters
• German Medicines Act (AMG), § 21 marketing authorization requirement
• German Anti-Doping Act (AntiDopG), annex – anabolic-androgenic steroids (metandienone)
• Prohibited list in sport: anabolic-androgenic steroids, S1.1 (WADA Prohibited List)