Last updated: March 2026
Oxymetholone (Anadrol) is the most potent oral anabolic steroid available. FDA-approved for aplastic anemia and HIV-related muscle wasting, it produces rapid, dramatic mass gains — paired with significant hepatotoxicity and water retention that demands careful monitoring and harm-reduction protocols.
Oxymetholone's unique pharmacology sets it apart from other oral steroids. It activates androgen receptors directly and appears to activate estrogen receptors independently of aromatization — a mechanism not fully elucidated in the literature.
The 17α-methyl group prevents first-pass hepatic breakdown, allowing oral bioavailability. This same modification is responsible for Anadrol's severe hepatotoxicity. ALT and AST enzymes typically rise 3-5× baseline within weeks of use. This is a direct chemical consequence of the modification, not reversible through timing or dose.
Unlike most androgens, oxymetholone does not aromatize to estradiol, yet produces profound estrogenic effects: water retention, bloating, gynecomastia risk. Research suggests oxymetholone acts as a partial agonist at the estrogen receptor directly. Standard AIs may not fully suppress these effects since serum E2 may remain normal.
Anadrol's clinical approval rests on its ability to stimulate erythropoiesis (red blood cell production). It increases EPO sensitivity, raises hematocrit and hemoglobin, and improves oxygen delivery. This is why it remains FDA-approved for aplastic anemia, Fanconi anemia, and HIV-associated wasting. Hematocrit monitoring is essential — elevated levels raise stroke risk.
Oxymetholone dramatically improves nitrogen retention and upregulates protein synthesis pathways. Clinical studies in HIV patients show 8kg lean mass gains over 16 weeks at therapeutic doses. Community-reported gains of 5-10kg in 4-6 week cycles are consistent with this data, though most gains include substantial water (which reverses post-cycle).
Clinical data from HIV-wasting and anemia trials, supplemented with community-reported outcomes (labeled).
If researching Anadrol, liver protection and bloodwork monitoring are non-negotiable harm-reduction practices.
Dosing schedules, interaction warnings, and cycle protocols for 50+ compounds — all in one place.
This page is for educational and harm-reduction purposes only. Oxymetholone (Anadrol) is a Schedule III controlled substance under the Anabolic Steroid Control Act. Possession without a valid prescription is illegal in the United States and many other countries. This content does not constitute medical advice and is not a recommendation to use this substance. Always consult a licensed physician before using any anabolic agent. Misuse of anabolic steroids carries serious legal and health consequences.