Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favors greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependant on the dose, route of administration (oral vs. injectable), type of steroid (aromatizable or non-aromatizable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
Non-medical users of anabolic steroids often “stack” different anabolic steroids over the course of a “cycle” of use. They also administer various ancillary drugs and substances to enhance the desired effects of anabolic steroids or to minimize adverse side effects. The most common liquid (injectable) anabolic steroids encountered in these cases are (oil-based) esters of testosterone (., testosterone cypionate, testosterone enanthate, and testosterone propionate, and a blend of testosterone esters called Sustanon 250) or nandrolone (., nandrolone decanoate). Also popular are Equipoise (boldenone undecylenate) and trenbolone acetate and trenbolone enanthate, as well as the water-based injectable Winstrol (stanozolol). Popular oral anabolic steroids include methandrostenolone (Dianbol), oxandrolone (Anavar) and oxymetholone (Anadrol 50).
Injectable steroids are injected into muscle tissue, not into the veins. They are slowly released from the muscles into the rest of the body, and may be detectable for months after last use. Injectable steroids can be oil-based or water-based. Injectable anabolic steroids which are oil-based have longer half-life than water-based steroids. Both steroid types have much longer half-lives than oral anabolic steroids. And this is proving to be a drawback for injectables as they have high probability of being detected in drug screening since their clearance times tend to be longer than orals. Athletes resolve this problem by using injectable testosterone early in the cycle then switch to orals when approaching the end of the cycle and drug testing is imminent.