Muscle Sport Magazine


 By Leigh Penman

If you have used oral steroids you will no doubt be familiar with the term c-17-alpha alkylated. This refers to the chemical alteration that enables the steroid to survive the first pass through the liver – allowing nearly all of the drug to enter the bloodstream. Now, while this is good on paper, the fact is that prolonged exposure to c-17-alpha alkylated drugs (which most orals are) can put a serious strain on the liver. It is for this reason that oral cycles should be restricted in length (usually less than 8 weeks) and liver enzyme values should be kept in check via blood work.

The first visible sign of an agitated liver is jaundice (bile duct obstruction), which produces an unusual yellowing of the skin. In addition to this, the whites of the eyes may also take on a yellow hue. If this occurs, the use of the oral compound should be terminated and a doctor consulted before some serious damage is done. Now before you all panic and rush to the mirror to examine your eyeballs, it has to be said that most oral steroids are generally safe just as long as they are not abused (i.e. taken in excessive dosages) or taken for extended periods of time. However, if you are planning to use, or are already using, oral compounds it is important to at least posses a layman’s knowledge of monitoring and maintaining liver health. So, with this in mind let me introduce you to ….


When having your blood work done it is important to have a full liver panel conducted. This is extremely important since it will reflect any level of hepatic strain. With this in mind, it is a good idea to have this done before you begin any steroid cycle. The reason for this is to give you a baseline reading which is important for obvious reasons – how do you know if your liver enzymes are elevated if you don’t know what they were before you started your cycle. The markers that we are most interested in when it comes to assessing liver health are ALT, AST, ALP, GGT and Bilirubin. That being said, let’s take a closer look at these important indicators, starting with:


These two enzymes are necessary to the metabolism of amino acids and protein in the liver and, should the liver be subject to any damage, they will leak into the blood stream. ALT (alanine aminotransferase) and AST (aspartate aminotransferese) are considered to be important indicators of liver toxicity due to steroid use. Should they be significantly elevated during a cycle then it is definitely time to stop that cycle!

Reference ranges for ALT and AST are:

  • ALT (SGPT): 0-55 iu/l
  • AST (SGOT): 0-40 iu/l

It should also be noted that cases of liver damage have been recorded independent of elevation of these enzymes. So, whilst they are important, you should not make them your sole indicator of liver stress/damage.


Elevations in ALP( alkaline phosphatase) and GGT (gamma-glutamyl-transpeptidase) can be indicative of bile duct obstruction. This is an indicator of serious steroid induced liver toxicity and should never be dismissed. Levels of a substance known as Bilirubin should also be measured. Bilirubin is a yellow fluid found in bile and is responsible for the yellowing of the skin and eyes associated with bile duct obstruction.

Reference ranges for ALP, GGT and Bilirubin are:

  • ALP: 25-150 iu/l
  • GGT: <50 mol/l
  • Bilirubin: 0.1-1.2 mg/dl


It is important to note that slight elevations of ALT and AST can be the result of exercise induced muscle damage rather than liver toxicity. This is why it is important to obtain a pre steroid use baseline reading. Elevations following steroid use would then be an accurate reflection of the effect the steroids are having on the liver and an indication that steroid use should be terminated in order to avoid further liver damage.


There are a number of natural compounds which are reputed to have protective effects on the liver and, if considering the use of or already using oral steroids, it is wise to employ them. The most popular natural liver protector is Silymarin (milk thistle) although NAC (N-acetylcysteine) and gluthionine may also be of value. You can find these products in any health store or go to where you will find a powerful liver support product called LEGALON.

N.B. Coming up…more of your questions answered plus a comprehensive look at interpreting blood test results.

Leigh Penman, in addition to be a staff writer at MuscleSport Mag, has been writing for bodybuilding magazines, websites and nutritional supplement companies since 1985. Whilst residing in the UK, she earned the reputation of being one of the top female writers in bodybuilding-related media. Her credits included being a contributing editor on all the magazines in production as well as filling the shoes of Ladies Editor and Showbiz Editor on two publications (the later being on Arnold’s sanctioned magazine, ‘Bodypower’). During this time she also competed successfully on four occasions (placing in the top four in all contests).

Relocating to New York in the late 1990s she focused her writing attention to crystal healing techniques and metaphysics – however, she still maintained a five day workout schedule during this time and gained her personal training certificate.

Having also studied pharmacology in relation to sports performance, her writing began taking her in that direction until the present day which sees her embarking on a return to the magazine world, as well as extending her web-related work in the bodybuilding and fitness field.

Leigh has been working out for close to thirty years so she is clearly a writer who ‘walks her talk.’
She can be contacted personally at

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