OXANDROLONE and LEAN MUSCLE GROWTH

Oxandrolone is an anabolic steroid often associated with its Mexican registration name of Anavar ™ which has been highly successful in generating the growth of lean muscle in patients.  Oxandrolone has been studied across diverse patient populations with quantified success in the generation of lean muscle mass.  Oxandrolone has proven particularly effective in HIV wasting disease populations and with patients at risk for significant muscle loss consequent to corticosteroid therapy and/or patients undergoing long term recovery from trauma or chronic infection.

Oxandrolone is known by a number of recognized brand names Anavar ™ , Lonavar ™ , Oxandrin ™, Protivar ™, Provitar ™, Oxavar ™, Vasorome ™, and others.  Oxandrolone has been shown to have great efficacy in the treatment of osteoporosis.   Oxandrolone has an interesting history among anabolic steroids, at one point being orphaned by its U.S. manufacturer in 1989 only to find an orphan drug patent issued to another manufacturer in 1995, permitting U.S. oxandrolone patients to be victimized by expensive prices all over again.

Oxandrolone is useful in helping to increase body weight after extensive surgery or long term hospitalization.  Oxandrolone is particularly useful in helping to fight muscle loss common in trauma and chronic infection patients during long-term recoveries.  For patients receiving corticosteroids such as cortisol, hydrocortisone, methylprednisolone, and dexamethasone, significant muscle loss is common.   Oxandrolone is useful to counter muscle losses consequent to corticosteroid therapies and in reducing bone pain associated with osteoporosis.   Oxandrolone can be used to treat alcohol liver damage, extend the life span of patients with HIV wasting disease, help anemic patients, combat geriatric weight loss, and in very low doses can be used to treat Turner’s Syndrome in pediatric patients.   The medical applications of oxandrolone are quite broad and the future will no doubt find scores of on-label usages as research interests in anabolic steroids continue to grow.

One mainstream application of oxandrolone is in the treatment of osteoporosis.  In osteoporosis, the density of bone minerals reduces and the microstructure of bones and proteins about the bone are altered in a manner which increases the risks of bone fracture.  Osteoporosis is thus a bone disease, generally defined as 2.5 sigma (standard deviations) below the bone mineral density for the normal range (20-year old females in study).  Subject to this standard, DEXA scanners have emerged as an inexpensive manner of measuring bone density.

It is well established that men suffering from long-term hypogonadism (low testosterone) generally exhibit signs of osteoporosis.   Similarly, women who take Aromatase Inhibitors such as anastrozole (aka Arimozole ™ aka Arimidex ™) and letrozole (aka Femara ™) generally as part of a cancer treatment, often develop osteoporosis and are often treated with SERM’s such as tamoxifen ( aka Tamoxidex ™ aka Nolvadex ™ ) and raloxifene later to treat the osteoporosis.    Many women also begin estrogen replacement therapy in part to treat their osteoporosis.  In a far more limited scope, bodybuilders who utilize aromatase inhibitors and titrate their estrogens too low long-term often present with osteoporosis later.   There is a definitive connection between osteoporosis, estrogen, and testosterone.  Osteoporosis is useful not only in limiting the effects of osteoporosis but also in reducing the bone pain associated with osteoporosis.

Oxandrolone dosages associated most medical indications outside of a research environment is limited to a maximum of 20mg per day generally in 2.5mg – 10mg doses 2 to 4 times per day.   At these lower dosages, there is a reduced risk of liver enzymes elevating to the extent that continued oxandrolone therapy is contraindicated.   Lower dosage treatments are associated with a lesser extent of side effects, making long term oxandrolone therapy more reasonable for the patients.

Oxandrolone should be used under medical supervision only, particularly in the instance of long term therapy.   Practitioners should monitor serum hemoglobin and hematocrit, liver enzymes, and lipids.  Oxandrolone and most anabolic steroids change the patient’s lipid profile increasing LDLs and reducing HDL’s.  These changes are reversible upon discontinuation of oxandrolone treatment.   Oxandrolone patients on hypoglycemic agents, diabetics, and those on anticoagulants, particularly warfarin, must be monitored with increased care.  Oxandrolone is known to alter several clotting factors (common with oral 17-alpha steroids) and PT, PTT, and INR should be expected to change during therapy particularly when oxandrolone is first started or stopped.  Female oxandrolone patients must always be screened for signs of virilization: voice changes, new hair growth, menstrual changes, etc.   Special care must also be given to oxandrolone patients with compromised adrenal function as androgen therapies can increase the risk of adrenal fatigue.  Male oxandrolone patients should be monitored for signs of HPTA suppression and total and bioavailable testosterone monitored for long term therapies.  In patients with edema, administration of oxandrolone concomitant with adrenal corticosteroids or ACTH may result in increased edema.

When reviewing thyroid functions of patients on oxandrolone and most oral anabolic steroid therapies, practitioners are encouraged to order Free-T3 and Free-T4 panels to measure the unbound serum levels as thyroxine-binding globulin levels are generally suppressed in oxandrolone patients leading to decreased bound-T4 in serum and increased uptake of T3 and T4.  The Free T3 and Free T4 panels will not be changed.   Diagnostic procedures involved radioisotopes of iodine may exhibit deviations consequent to the decreased uptake in oxandrolone patients.

Oxandrolone patients should show greater vigilance in seeking medical attention for abdominal pain, dark colored urine, light colored stools, and yellowing of the eyes as these may be early signs of liver problems.  Some rare but serious side effects include allergic reactions (difficulty breathing, swelling lips, hives), edema of the arms or legs, persistent erections, and breast tenderness or enlargement (male).  Lesser side effects include insomnia, acne, headaches, and libido changes.

Oxandrolone contraindications include carcinoma of the prostate or male or female breast, whether suspected or known, hypercalcemia, nephrosis, or patients who are pregnant or may become pregnant because of masculinization risks to the fetus.  Animal studies have demonstrated embryotoxicity and fetotoxicity associated with oxandrolone.  Potential oxandrolone patients should discuss any prior heart or blood vessel disease, heart attacks, prostate issues, testosterone treatments, high cholesterol, clotting problems, diabetes, use of blood thinners, and prior or current kidney and liver problems with their physician.

Compared to other oral anabolics, oxandrolone is extremely well tolerated and side effects are substantially diminished.  Oxandrolone is among the safest of anabolic steroids when used under medical supervision.  The risks associated with oxymetholone (Anadrol), methandienone (Dianabol), and other common oral steroids are substantially greater accounting for their ever reducing use in medical applications and isolation almost exclusively to bodybuilding.   Oxymetholone was once used heavily in the treatment of HIV wasting diseases and anemia, however the substantial hepatoxicity and side effect profiled was seen to outweigh its value and many former oxymetholone patients have moved to oxandrolone therapies under supervision.

Oxandrolone and Nandrolone remain the two most promising mainstream anabolics for use in a broad array of medical uses.

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