Stanozolol vs Turinabol: What to Choose and for Whom

On forums, stanozolol and turinabol are often contrasted as options «for cutting» or «for quality». The editorial team suggests looking at this comparison through a doctor's eyes: which people risk the most from each substance, how these risks manifest in tests and why for the vast majority of readers the justified decision will be to give up both.

Where the illusion of choice comes from

The illusion of choice arises when two substances are described through their «advantages»: one supposedly provides «dryness», the other — a «quality gain without water». Such an approach is borrowed from marketing and says nothing about safety. In medicine, comparison always begins with contraindications and risks, and only then — with possible benefit.

Neither of the two substances today has registered indications for a healthy person who wants to improve their figure or athletic results. Stanozolol had limited medical use (in particular for hereditary angioedema), turinabol — only a formal status of a medicine in the GDR. No clinical safety studies were conducted for sports purposes.

Another cause of the illusion is the «survivor» effect. People for whom use passed without noticeable problems readily talk about their experience; those who developed complications keep silent or learn about the connection between their problems and steroids much later.

Therefore the editorial team translates the question «what to choose» into the language of health: which particular systems of the body are under threat in a specific person and whether they are ready to accept these risks without any medical necessity.

Whom stanozolol threatens most

Stanozolol is a DHT derivative with a pyrazole ring and a 17α-methyl group. Its best-known effects in laboratory indicators are a pronounced decrease in HDL and sex hormone-binding globulin (SHBG). Therefore it is primarily dangerous for people with an unfavorable cardiovascular profile.

• People with already reduced HDL, elevated LDL or familial hypercholesterolemia.
• People with arterial hypertension and a family history of early cardiovascular events.
• Athletes with a history of tendon and ligament injuries: complaints about joints and the risk of tendon ruptures against the background of anabolic steroids are discussed in the literature.
• People with liver diseases — as for any 17α-alkylated steroid.

A separate risk is associated with the aqueous suspension for injection, which often has a veterinary or underground origin. A violation of sterility can lead to abscesses, and the injection of such a suspension itself is, by description, painful.

For women, stanozolol, like other androgens, carries the risk of virilization. The notion that it can be used in «small doses without consequences» is not confirmed by the data: a change of voice can be irreversible.

The review by Baggish et al. (2017) summarizes that long-term use of anabolic steroids is associated with a decrease in myocardial contractile function and accelerated coronary atherosclerosis. For people with baseline risk factors, these consequences develop against a worse «background».

Whom turinabol threatens most

Turinabol (4-chlorodehydromethyltestosterone) is also 17α-alkylated and therefore poses a threat primarily to the liver. People with non-alcoholic fatty liver disease, hepatitis, as well as those who regularly consume alcohol or hepatotoxic drugs, have an increased risk of damage.

The historical experience of the GDR program, documented by Franke and Berendonk (1997), shows that the most vulnerable groups were women and adolescents. Female athletes received turinabol from a young age, and among the consequences described are virilization, menstrual cycle disorders and other long-term health problems.

The risks of turinabol are compounded by the fact that in modern conditions no pharmaceutical company produces it. A person who buys a product under this name cannot be sure of either the composition, the dosage or the purity.

Like stanozolol, turinabol suppresses the hormonal axis. For men who are planning parenthood in the near future, this is a weighty argument: recovery of spermatogenesis after anabolic steroids can last for months, and in some people persistent hypogonadism develops (Rahnema et al., 2014).

Finally, turinabol is most often detected in retrospective analyses of samples. For athletes who are counting on a career, the risk of late disqualification is a separate factor that makes the «choice» of turinabol especially unpromising.

What the tests show

The harm from oral anabolic steroids is often not felt subjectively but is clearly visible in laboratory indicators. That is why doctors who encounter patients who have used such substances first of all order tests.

It is worth remembering that an increase in AST and ALT after intense training may be associated with muscle damage, so a doctor evaluates these indicators together with GGT, bilirubin and the clinical picture.

Normalization of tests after discontinuation does not mean that «nothing happened». Structural changes in the vessels and myocardium described in studies of long-term users may persist.

Sport, law and alternatives

For athletes subject to testing, the question is settled by the rules: stanozolol and turinabol belong to class S1 of the WADA Prohibited List. The story of Ben Johnson (1988) and the mass reanalyses of samples from the 2008 and 2012 Olympics shows that both substances are reliably detected, including years later.

From a legal standpoint in Ukraine, as in many countries, the circulation of prescription and unregistered medicines is regulated by legislation, and their sale without permits is an offense. Buying products «off hand» also gives no guarantees regarding the content.

If the goal is to reduce body fat percentage and preserve muscle, a moderate calorie deficit, high protein intake and the continuation of strength training are proven to be effective. The meta-analysis by Morton et al. (2018) shows the benefit of protein for gaining muscle mass during strength training.

Creatine monohydrate is the supplement with the most powerful evidence base for strength and muscle mass (Kreider et al., 2017). It is permitted by WADA and safe for healthy people at the recommended doses. Athletes should choose products with independent certification of the absence of doping impurities.

Editorial conclusions

Between stanozolol and turinabol there is no safe option. Stanozolol is especially dangerous for people with cardiovascular risk factors and tendon problems, turinabol — for people with liver damage, women and adolescents. Both suppress fertility.

The harm from both substances is clearly visible in tests — liver tests, the lipid panel, the hormonal profile — even when a person feels well.

For athletes and amateurs, the justified choice is training, nutrition, creatine and medical examination.

We also recommend reading our materials «Stanozolol or Turinabol: What's the Difference», on the lipid panel for athletes and on recovery of the hormonal system after steroids.

References

1. Pope HG Jr, Wood RI, Rogol A, et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev. 2014;35(3):341–375.
2. Baggish AL, Weiner RB, Kanayama G, et al. Cardiovascular toxicity of illicit anabolic-androgenic steroid use. Circulation. 2017;135(21):1991–2002.
3. Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol. 2008;154(3):502–521.
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. Rahnema CD, Lipshultz LI, Crosnoe LE, et al. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril. 2014;101(5):1271–1279.
6. 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.
7. 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.