Oxandrolone vs Turinabol: What to Choose and for Whom

In sports folklore, oxandrolone and turinabol are called «light» oral steroids that supposedly can be «chosen» by beginners or women. The editorial team decided to check this logic from a medical point of view: to whom doctors actually prescribed oxandrolone, why there is no such category of patients for turinabol and whom both substances put under the greatest strain.

To whom medicine prescribed oxandrolone

Oxandrolone is one of the few anabolic substances with a serious clinical history. In the USA, under the name Oxandrin, it was used as an adjunct for restoring body weight after major surgical interventions, severe injuries and infections, as well as with weight loss without a clear pathophysiological cause. A separate indication was relieving bone pain in osteoporosis.

The most convincing data were obtained in patients with severe burns. After a major burn the body enters a state of deep catabolism, and muscles break down faster than they can recover. Randomized studies by Hart et al. (2001) and Wolf et al. (2006) showed that oxandrolone reduces protein loss and accelerates recovery in this group.

Oxandrolone was also studied in HIV-associated wasting, alcoholic hepatitis, chronic obstructive pulmonary disease and in children with certain growth disorders. The review by Orr and Fiatarone Singh (2004) concluded that there is an effect on body weight, but the evidence base is heterogeneous, and the decision must be made taking the risks into account.

It is important that even in medical settings oxandrolone was prescribed in short courses, in doses per the instructions (2.5–20 mg per day for adults), with monitoring of liver tests, lipids and calcium levels. In 2023 the FDA announced the withdrawal of approval for oxandrolone drugs in the USA, which further narrowed its medical niche.

Why turinabol has no «patient of its own»

Turinabol (4-chlorodehydromethyltestosterone) appeared in the GDR in the 1960s and formally had the status of a medicine. However, its history is inseparable from the state doping program described in detail by Franke and Berendonk (1997). It was precisely in sport, and not in the clinic, that turinabol became widely used.

In modern medicine turinabol is not registered in the leading regulatory systems, and there are no randomized studies that would determine its effectiveness or safety for any group of patients. Therefore it is impossible to say «for whom it is suitable» in the medical sense: such a category of people simply does not exist.

The products sold under the name turinabol come from underground laboratories. Analyses of such products published in the scientific literature have repeatedly found discrepancies in content, substitution of the active substance or impurities. Thus, a person who «chooses turinabol» actually does not know what exactly they are taking.

The comparison with oxandrolone here is instructive: even a drug with a long medical history was prescribed by doctors cautiously and under supervision. A substance without clinical data cannot be considered a «lighter» alternative by definition.

The myth of the «female» and «safe» steroid

Oxandrolone is often called a «female steroid», and turinabol — «mild». The basis for this is the relatively high anabolic and low androgenic activity in classic animal tests. However, the ratios obtained in rats poorly predict side effects in humans, especially with prolonged use.

Virilization in women — coarsening of the voice, facial hair growth, clitoral enlargement, menstrual cycle disorders — has been described for both substances. The documents of the GDR program analyzed by Franke and Berendonk contain descriptions of such changes in female athletes who received turinabol, and some of them turned out to be irreversible.

Another aspect of the myth is «liver safety». Both substances are 17α-alkylated; the instructions for oxandrolone contained a boxed warning regarding hepatic peliosis, liver tumors and changes in the lipid profile. The fact that in some people liver tests remain normal does not cancel these risks.

Finally, «mildness» does not apply to the hormonal axis and lipids. Oral 17α-alkylated androgens noticeably reduce HDL, and suppression of one's own testosterone develops with the use of any anabolic steroid.

Who is in the highest-risk group

When it comes to «whom» these substances threaten most, the editorial team identifies several groups. For them the risks are disproportionately high, while the benefit — in a non-medical context — is absent.

• People with liver diseasesor elevated transaminases, as well as those who regularly consume alcohol.
• People with dyslipidemia, high blood pressure, a family history of early heart attack or stroke.
• Women— because of the risk of irreversible virilization.
• Adolescents— because of the possible effect on the closure of growth zones and the formation of hormonal regulation.
• Men who are planning to have children— because of suppression of spermatogenesis.
• Athletes under doping control— both substances are in class S1 of the WADA Prohibited List.

Separately, let us mention athletes: the long-lived metabolites of turinabol described by Sobolevsky and Rodchenkov (2012) made it possible to detect violations in samples submitted many years before the reanalysis. Consequently, the risk to a career is not limited to the period of competitions.

For people who already have experience of use and feel symptoms after discontinuation — fatigue, decreased libido, depressed mood — the correct step is to consult an endocrinologist or andrologist. The review by Rahnema et al. (2014) describes approaches to diagnosing anabolic hypogonadism.

Real alternatives for athletes

If the goal is to preserve muscle mass during weight loss or to improve body composition, the most important things are a moderate calorie deficit, sufficient protein intake and the continuation of strength training. The meta-analysis by Morton et al. (2018) showed that the benefit of additional protein for lean mass gain plateaus at around 1.6 g per kilogram of body weight per day.

Creatine monohydrate remains the most researched supplement for strength sports. The ISSN position stand (Kreider et al., 2017) confirms its effectiveness and safety for healthy people at the recommended doses.

For women interested in «definition» and strength, the same principles are effective: progressive loading, protein, sleep, patience. Their effect is slower, but it is not accompanied by the risk of irreversible changes in voice or appearance.

Finally, the real «choice» should be made in favor of medical examination: a basic lipid panel, liver tests and hormonal profile give an objective picture of health and help plan training without unnecessary risks.

Editorial conclusions

Oxandrolone has a medical history: it was prescribed to patients with burns, wasting and after severe injuries — in short courses and under monitoring. Turinabol has no defined group of patients and no modern evidence base.

The notion of a «female» or «safe» steroid is not confirmed: both substances load the liver, worsen the lipid profile, suppress the hormonal axis and can cause virilization.

For people without medical indications, the justified choice is not one of these substances, but training, nutrition, proven supplements and examination.

We also recommend reading our materials «Oxandrolone or Turinabol: What's the Difference», on the risks of anabolic steroids for women and on creatine for strength sports.

References

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2. Hart DW, Wolf SE, Ramzy PI, et al. Anabolic effects of oxandrolone after severe burn. Ann Surg. 2001;233(4):556–564.
3. Wolf SE, Edelman LS, Kemalyan N, et al. Effects of oxandrolone on outcome measures in the severely burned: a multicenter prospective randomized double-blind trial. J Burn Care Res. 2006;27(2):131–139.
4. Franke WW, Berendonk B. Hormonal doping and androgenization of athletes: a secret program of the German Democratic Republic government. Clin Chem. 1997;43(7):1262–1279.
5. Sobolevsky T, Rodchenkov G. Detection and mass spectrometric characterization of novel long-term dehydrochloromethyltestosterone metabolites in human urine. J Steroid Biochem Mol Biol. 2012;128(3–5):121–127.
6. Rahnema CD, Lipshultz LI, Crosnoe LE, et al. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril. 2014;101(5):1271–1279.
7. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18.
8. Morton RW, Murphy KT, McKellar SR, et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med. 2018;52(6):376–384.