Nandrolone

Nandrolone is a drug related to the male sex hormone testosterone. It is used in diseases associated with severe loss of muscle mass (cachexia).

Use and indications

Nandrolone is structurally very similar to the sex hormone testosterone. This allows it to exert similar effects on muscles and typically male characteristics. Because the effect on muscle is much more pronounced, nandrolone is used primarily to stimulate muscle growth in diseases associated with muscle wasting. These include AIDS, kidney disease, and severe lung disease such as COPD. In addition, nandrolone can build bone mass, which is why it is used in the treatment of osteoporosis.
Nandrolone is usually given as an injection under the skin (subcutaneous injection). This creates a depot effect that increases the interval between doses. As a result, nandrolone usually only needs to be injected every 3 weeks.

History

Nandrolone was first synthesized in 1950 and used therapeutically from the 1960s.

Pharmacodynamics and mechanism of action

Nandrolone, like testosterone, is an agonist at the androgen receptor. By binding to this receptor, it can produce the same effects as testosterone, but to a different extent. Nandrolone is much more anabolic and less androgenic than testosterone. This is because Nandrolone is not converted to the very strongly androgenic Dihydrotestosterone (DHT), but to the much weaker Dihydronandrolone (DHN). This gives it a milder side effect profile and makes it particularly suitable for use in women and children.

Pharmacokinetics

The potency of nandrolone is approximately ten times lower when taken orally than when injected subcutaneously. Therefore, it is administered subcutaneously in the form of an extended-release formulation, usually as a decanoate. Nandrolone has a very low affinity for the serum protein sex hormone-binding globulin (SHBG) and is therefore largely unbound. It is mainly metabolized by the enzyme 5-α-reductase. The duration of action is approximately 3-4 weeks when administered as a decanoate.

Contraindications

In some cases the use of nandrolone is strictly contraindicated:

• Prostate cancer or breast cancer in men
• porphyria (a rare metabolic disease)
• in cases of known pregnancy

Side effects

The possible side effects depend on the dosage and frequency of use:

• fluid retention (edema)
• muscle pain
• Increased blood lipid levels
• Nausea
• high blood pressure (hypertension)
• increased or decreased libido
• restlessness and nervousness
• Liver damage
• skin rash
• changes in voice

Side effects that may occur, especially in women

• hoarseness
• increased body hair
• acne
• hair loss
• enlargement of the clitoris
• absence or changes in the interval of menstrual bleeding

Side effects that may occur specifically in men:

• Promoting the growth of prostate cancer (which may have been pre-existing).
• Breast augmentation
• testicle reduction
• painful erections
• benign prostate enlargement
• reduced sperm count and consequent reduced fertility

Pregnancy and breastfeeding

Use during pregnancy or while breastfeeding is strictly contraindicated due to possible hormonal effects on the child.

Use as a doping substance

Nandrolone is often used as a doping substance because of its positive effect on muscle growth with comparatively low androgenic effects. Especially in weight training and competitive sports, nandrolone is used to stimulate muscle growth and reduce recovery time.