How to protect the liver during a course of steroids. Why do we need hepatoprotectors on a course of steroids? Functions of total protein in the blood

The answer to this question has been of interest to all professional sports for several decades. During the practice of pharmacology, sports doctors managed to accumulate some experience in the rehabilitation of the athlete's body after intensive courses of steroid and other "not very useful" drugs. Some experts have experience in mitigating the negative effects of anabolic steroids directly during the course, but how effective they are is unknown, because. no official research has been done. And this is understandable, because hardly anyone will sponsor semi-legal programs.

In medical unsportsmanlike practice, harmful effects it is not customary to stop anabolic steroids directly during the course of taking these drugs. Differ in the direction of reduction and dosage, and, consequently, the likelihood of negative consequences for the body is reduced.

In sports practice, especially among amateur bodybuilding, often information about drugs that help achieve best results passed from mouth to mouth. Often "unfortunate athletes" prescribe one or another hepatoprotector for themselves, in the hope that it will mitigate the toxic effect of anabolic steroids. This suggests that they do not understand the mechanism of action of hepatoprotectors, which is not surprising. However, a professional or amateur who decides to take steroids should not only be aware that these are hormonal drugs that can make adjustments to the body's work, but also know exactly how the drug works. Mistakes here are disproportionately more expensive than the services of a qualified sports doctor.

Let's make it clear

The vast majority of anabolic steroids used in bodybuilding have the prefix "17-alpha" in the pharmacological formula. In the language of specialists, this means that one carbon atom is built into the 17th position of the steroid chain. Due to this, this modification becomes dozens of times more stable compared to its 17-alpha non-alkylated counterpart.

Once in the body, oral anabolic drugs of the conditional group 17-alpha are not immediately neutralized by the liver and penetrate into the blood. Neutralizing such modified hormones for the liver is hard work, which she is forced to perform in a state of toxic stress. For the liver, 17-alpha drugs are, in fact, poisons.

The effectiveness of anabolic steroids is directly proportional to their harmful effects on the body. If the liver did not have a colossal regenerative resource, these drugs, as well as many others, would not be on the list of medicines. Meanwhile, all hepatoprotectors have a restorative effect on heppatocytes. The mechanism of stimulation of regenerating processes can be different, but many of them cannot be started at the stage of inflammation. Depending on the characteristics of the body, such a well-known drug as methandrostenolone, may be conditionally safe, risky or unacceptable for use. Parallel use of hepatoprotectors such as Liv-52, Essentiale, Legalon and others leads to the opposite effect. Pain in the right hypochondrium testifies to the obstructed duct of the liver cell membranes, which has developed as a result of their hypertrophy. Taking the above hepatoprotectors further enhances this effect. Their work should take place under conditions of normal patency of cell membranes. By itself, the liver does not hurt, because it does not have nerve endings. Pain can only occur as a result of excessive stretching of the capsule surrounding the liver.

The described phenomenon is called steroid hepatitis, but it is not such, since in this case we are not talking about inflammatory processes. After the abolition of anabolic drugs, the work of liver cells gradually returns to normal, provided there are no irreversible consequences. At this time, you can proceed to restorative treatment with hepatoprotectors. At the same time, dosages cannot be forced, since in this case more does not mean better. Although Liv-52, Essentiale and other hepatoprotectors have rather high overdose levels, it is necessary to take them at the optimal doses indicated in the annotation. It should be noted that for athletes with a large body weight, adult doses can be increased by 40-50%, since they are designed for people weighing 70-80 kg.

With high doses of anabolic steroids (particularly oral 17-alpha alkylated steroids), testosterone is often aromatized in the liver by conversion to estrogen. Staying on a steroid course, the athlete's liver is additionally "bombarded" with protein breakdown products. Physical exercise high intensity also increase the load on the liver. Bile, being "locked" in the cells, thickens, as a result of which its deficiency is felt in the digestive system. That is why fatty foods that provoke the outflow of bile are, figuratively speaking, a knife for a liver loaded with steroids.

In some cases, hepatoprotectors and choleretic agents can be taken in parallel with steroids, but for this you need to be 100% sure that there are no signs of cholestasis. At the same time, control tests must be taken at least twice a week, which makes parallel administration inconvenient.

When the first pain symptoms appear, it is necessary to immediately reduce the load and cancel toxic androgenic steroids. After the disappearance of pain in the liver, you should go short course hepaprotectors of plant origin, for example, Liv-52, as well as the old, but effective drug Essentiale containing valuable polyunsaturated fatty acids. Among natural remedies good results gives olive oil and pumpkin seeds, which contain valuable omega-3 fats, which are actively involved in cellular regeneration processes.

Under the general name "hepatoprotectors" means drugs that restore liver function by regenerating its cells. However, different drugs work differently. Among hepatoprotectors of plant origin, Karsil stands out, the action of which is aimed at stabilizing cell membranes, improving metabolic processes in the liver and protecting cells from the effects of toxins.
The active ingredient in Karsil is silymarin. This complex flavonoids are also found in medicinal plant milk thistle. Both karsil and milk thistle can be used during forced and gentle cycles of anabolic steroids. Unlike the same Liv 52, they do not have a choleretic effect and therefore do not contribute to the appearance of hepatic pain syndrome.

However, after a course of rehabilitation treatment, it is better to carry out drugs Liv 52 and Essentiale due to their greater efficiency. One of side effects anabolic steroids causes changes in the liver, similar to some diseases. Accordingly, the function of enzyme systems and the structure of cell membranes in the organ are disrupted. These disorders are eliminated by taking Essentiale, but with the parallel use of this drug, its “neutralization” by the action of steroid toxins is observed. A positive effect can only be achieved during a long sparing course, when the activity of Essentiale prevails over the action of steroids.

A separate group of drugs that reduce the load on the liver during steroid cycles are choleretic agents that act on the principle of tone of the biliary tract. They stimulate the outflow of bile and facilitate its penetration into the intestines. Those choleretic drugs, the action of which is aimed only at increasing the production of bile by liver cells, but not facilitating its outflow, are not suitable for taking on an asteroid course. There are choleretic agents with a mixed effect, they also need to be treated with caution, since steroids impede the natural outflow of bile and, without additional stimulation of the membranes and biliary tract, it is difficult for it to be transported to its destination. For example, allahol contributes to the active formation of bile, but practically does not relieve spasm of the biliary tract, therefore, at the peak of the asteroid course, it is not recommended to take it.

The drug Flamin, consisting of a dry extract of immortelle sandy, can be used as a remedy with a general choleretic and tonic effect on the biliary tract, as well as a positive effect on the function of the gallbladder. This is especially true for athletes who have had cholecystitis or have a chronic form of this disease.

The general rule for all choleretic agents introduced into the course regimen, including hepatoprotectors with a clear choleretic effect, is that their action should be aimed primarily at increasing the tone of the biliary tract and relieving their spasm.

In addition to the toxic effects of anabolic steroids, the liver also experiences increased stress during the cycle, caused by a rich diet. The importance of precise control of the fat consumed on the course has been said repeatedly. In intensive courses, the less it is, the better. However, do not forget about the important function of fats in the body, so long intensive courses of steroids can indirectly harm precisely the lack of essential fatty acids for the body. In this case, it is recommended to displace all "doubtful fats" and use only olive and natural butter, as well as fish fat(in acceptable quantities).

Today, diseases of the liver and gallbladder among athletes, as well as among ordinary people, are not uncommon. This is due to the huge amount consumed modern man foreign chemicals that are found in almost any food. Cholelithiasis, inflammation of the gallbladder, cholecystitis, cholestasis - a far from complete list of diseases that are the outcome "chemical" diet.

Often, diseases of the liver and gallbladder become the reason why an athlete is forbidden to take a course of anabolic steroids aimed at growth. muscle mass and strength. During such a course, the load on the liver increases significantly, since we are talking not only about the toxic effect of steroids, but also about very large physical activity and enhanced diet. Therefore, it is first necessary to eliminate problems with the liver, and only then resort to the help of chemical hormonal drugs.

For chronic diagnoses or poor tolerance of large doses of steroids, you can undergo the so-called. gentle courses. The effect of them is incomparably less than with full-fledged steroids, but also incomparably greater than without them.

Sparing courses in their principle repeat the usual courses, with the difference that their dosage is 3-5 times less. It should be noted that this applies specifically to the dosage, and not to the more rare use of steroid drugs. For example, on a sparing course, methandrostenolone is taken one tablet 3-4 times a day, instead of 10-15 tablets during the day. Moderate doses of retabolil (deca-durabolin) intramuscularly do not have a pronounced toxic effect on the liver, so this drug is also convenient to use on a sparing course. Moreover, its duration can be up to three months. As a result, the athlete receives almost the same amount of drugs, but the course of taking them is more extended in time. At the same time, the muscles will be inferior in volume, however, there is also a smaller decline (rollback) during the period of withdrawal of steroid drugs.

Based on an objective assessment of the effects of anabolic steroids on the liver, and an understanding of the mechanisms of work hepatoprotectors, it only asks one conclusion: these drugs in sports practice are rather incompatible than indicated for simultaneous administration. The function of hepaprotectors is not to protect the liver, but to restore it, as their name suggests. These drugs cannot protect the liver from toxins, and if they could, then only by neutralizing steroids. And this, in turn, contradicts the very essence of the course of anabolic androgenic steroids, aimed at increasing muscle mass and strength. Concerning choleretic drugs- their intake may be rational in some cases, especially in case of previous diseases of the gallbladder, but they also require an individual approach in choosing and can exacerbate health problems.

Karsil is a natural plant-based drug that belongs to the category of hepatoprotectors and is used to eliminate toxic liver damage. The tool is actively used for chronic intoxication, in bodybuilding it is used to reduce the negative effects of the course use of anabolic steroids. Main function drug in sports - cleansing, Karsil is used for:
restoration of liver functionality;

removal of toxic substances;

stimulation of the liver;

elimination of violations of the cellular structure;

improvement of liver activity;

reducing the complications of viral and infectious diseases.

Due to the herbal basis, the drug does not provoke other pharmacological agents without causing side effects, therefore it can be used both during the course of steroids and for the prevention of liver diseases in the training process.
For the most effective application Karsil is used in combination with alpha-lipoic acid and essentiale, creating a stable hepatoprotective compound that successfully eliminates the hepatotoxicity of anabolic steroids.
The usual pharmacy form of release of the drug are tablets or dragees, differing in doses of the active substance. The allowable daily allowance for an athlete should not exceed 0.25 g. Karsil is taken with meals 2-3 times a day in equal portions for 20-30 days. Next, you need to take a break of 30-50 days and continue the course of admission. It should be remembered that medical recommendations provide for the use of the drug in a total of no more than five 20-day courses per year.
How to take Karsil, in conjunction with other hepatoprotectors or exclusively alone, is a question that does not have a convincing unambiguous answer. But you should take the advice of experienced athletes and first study the compatibility of drugs and their allergic danger to the body, which can cause serious side effects.
Side effects of carsil
The natural components of the drug, in principle, do not have an overdose and serious negative consequences, but on an individual basis they can cause:
allergic reaction;

vomiting;

loss of appetite and diarrhea;

decrease in tone;

dizziness;

rashes with a slight temporary change in skin pigmentation.

Hepatoprotectors are pharmaceutical preparations aimed at protecting the liver from the toxic effects of various substances. In bodybuilding, drugs of this type have long been one of the main ones during and after taking steroids. The need to use hepatoprotectors lies in the fact that many steroids have hepatoxicity (toxicity to the liver), and therefore the only way to reduce this effect is to take these drugs.

Meanwhile, it has been proven that not all hepatoprotectors are able to protect the liver from the damaging effects of steroids. The most effective of these are (listed in descending order of effectiveness):

Ademetionine
Karsil, Legalon
Alpha Lipoic Acid
Ornithine

Methods of taking hepatoprotectors and dosage

Reception of hepatoprotectors should be started from the 2nd week after the start of the steroid course and continued for 3 weeks after its completion.

Optimal dosages of various hepatoprotectors:

Karsil - 0.07 grams, 2-3 times a day
Essentiale - take 1-2 capsules, 2-3 times a day with meals
Alpha lipoic acid - 100-200 mg per day
Arginine - 1 gram, 2 times a day
Ademitionine - 800-1600 mg per day between meals (preferably taken in the morning)

A question of efficiency

It should be noted that hepatoprotectors are not widely used in the US and are not included in clinical guidelines. This is due to the fact that drugs of this type have a weak evidence base, and in case of serious poisoning, the effectiveness of hepatoprotectors was very doubtful. However, taking them on a course of steroids can significantly reduce the risk of liver damage, so their use in bodybuilding (using anabolic steroids) is still justified.

How to protect the liver while using anabolic steroids?
Question: How can I help the liver during the anabolic cycle?
Bill Roberts: firstly, damage to the liver is caused mainly or only by oral drugs. In cases where steroids are not alkylated, and estradiol remains normal, liver damage is not caused.
An example of non-alkylated steroids: testosterone, masteron, trenbolone, boldenone, nandrolone and primobolan.
To protect the liver, a good course should be based on one or more of these drugs, or even the entire course of them.
Approximately 350-700 mg per week can be taken with alkylated drugs. The most common alkylated steroids are dianabol, anadrol, oxandrolone and winstrol.
Alkylated drugs should be limited to six weeks, but many taking longer do not feel problems. However, prolonged use of alkylated drugs can lead to the formation of scar tissue in the liver. This ailment can accumulate because the scar tissue does not heal. And an excellent exhaust can be obtained without exceeding 6 weeks.
If the course length exceeds 6 weeks, then the appropriate amount of testosterone replaces the aclylated drug. I replace Anadrol or Winstrol one for one. Dianabol - three to two, that is, 50 mg of dianabol per day is replaced by 75 mg of testosterone.
Oxandrolone is also replaced by masteron three to two, or trenbolone two to three.
After each period of use of alkyliron drugs, a rest from them should be two or more times the period of use.
Estradiol should be kept within the normal range or slightly high, because high estradiol is slightly toxic to the liver. By itself, this toxicity can be ignored, but in combination with alkylated drugs, harm can increase.
Hepatotoxic drugs and excessive alcohol consumption, overuse of NSAIDs (non-steroidal anti-inflammatory drugs), aspirin or acetaminophen (paracetamol) should be avoided. Cautious use is acceptable.
As a supplement for liver health, I can recommend 3-7 grams per day of lecithin along with B vitamins. Steroid-induced cholestasis is a consequence of a decrease in the activity of bile release, and silymarin and silibinin (components of milk thistle) can partially block the undesirable effects of steroids. However, cheap preparations based on milk thistle do not provide the required amount of these substances. Antioxidants for the liver are not very relevant.
Supplements can be omitted if the above conditions are met. Supplements do not entitle a more irresponsible use of alkylated drugs. Additives remain additives.

Liver video
- gland of external secretion, the liver secretes substances into the external environment of the gastrointestinal tract. The liver is the largest gland in the body and has a huge number of functions besides the secretion of enzymes.
The main functions of the liver:
Neutralization of foreign substances.
Removal of excess hormones, mediators.
Removal of end products of metabolism.
Participates in the processes of digestion (gluconeogenesis).
Regulation of carbohydrate metabolism, depot.
Regulation of lipid metabolism, synthesis
Depot of blood.
Synthesis of bile acids and bilirubin. Production and secretion of bile.

As you can see from the listed functions, there are a huge number of them and each of these functions can be “loaded” during the course, so you should not think that only the drug itself “loads” the liver, the biggest misconception is that only oral (pills) steroids are harmful liver. The liver is harmed by many factors, so you should always monitor the condition of the liver, both throughout the course and on

gallbladder An organ that contains bile secreted by the liver. The gallbladder regulates the secretion of bile into the duodenum. Bile from the gallbladder to the duodenum enters through the bile ducts.
2. Steroids are dangerous for the liver.

Any steroids will negatively affect the liver, there is a group of drugs that is very dangerous for the liver - 17-alkylated steroids are all tablet types of steroids. These drugs are toxic to the liver, thereby the liver ceases to fully perform its functions.

You can take tableting anabolic steroids, but for this you should limit the dose of drugs to 30 mg per day, the maximum allowable dose is 50 mg, which is more for professionals. In no case should two tablets be used at the same time. And also try not to drink tableting drugs for longer than 4-6 weeks, and for lovers, the restriction is closer to four weeks. Fans are generally recommended to do without tableted anabolic steroids.

In addition, all anabolic steroids affect the density of bile, making it difficult to drain. Therefore, on the course, it is necessary to add choleretic drugs throughout the entire intake of steroids, tableted or injectable. The most popular and effective choleretic drugs:

Allochol- inside, after eating, 1-2 tab. 3-4 times a day.

Holosas- inside, 2-3 times a day, adults - 1 teaspoon.

Flamin- inside, 30 minutes before meals, 1 tab. 3 times a day.

3. Analyzes of the state of the liver.

total protein, norms: 66-83 g / l - indicatively reflects total in blood.

Functions of total protein in the blood:

Maintenance of colloid osmotic pressure;
Active participation in blood coagulation;
Maintaining a constant pH of the blood (an integral part of the buffer system);
Transport function - transfer of lipids, bilirubin, steroid hormones in tissues and organs; participation in immune reactions;
Creation of a "protein reserve" (during starvation, proteins break down into amino acids, which are used to synthesize proteins in the brain, myocardium and other vital organs);

Downgraded- decreased protein synthesis by the liver.
Promoted- a number of diseases, including those associated with the liver.

Aspartate aminotransferase(AST or ASAT), norms: up to 41 U / l - endogenous enzyme, located inside the cell. Most of it is in the cells of the liver and heart, an increase in the amount of AST in the blood indicates the destruction of liver or heart cells.

Promoted- destruction of liver or heart cells.

Alanine aminotransferase(ALT or ALAT) norms: up to 45 U / l - endogenous enzyme, there is an advantage in liver cells.

Promoted- destruction of liver cells.

The ratio of AST and ALT– important for understanding the destruction of liver or heart cells. A strong increase in AST and not a high increase in ALT does not indicate problems with the liver, but with problems with the heart. Destruction of liver cells is characterized by approximately the same amount of AST and ALT in the blood or a higher content of ALT.

Bilirubin general (direct + indirect bilirubin) norms: 3.4 - 17.1 µmol / l - bile pigment, one of the components of bile, a breakdown product of hemoglobin.

Unbound bilirubin (not direct), norms: up to 16.5 µmol / l - a precursor of direct bilirubin not associated with glucuronic acid, toxic to the body.

Bilirubin bound (direct), norms: 0-5.1 µmol / l - associated with glucuronic acid, non-toxic to the body.

Raise bilirubin means toxic damage to the liver by steroids or other substances, and in some cases - desolation and poor bile flow.

Gamma-glutamyltransferase (GGT), norms: 8-61 IU / l - an enzyme involved in the metabolism of amino acids, a large amount is found in the cells of the liver and kidneys.

Raise GGT is extremely rare when taking steroids, and its increase may indicate problems with the liver or kidneys.

These are the main liver tests, they will show what condition the liver is in. From them it will be possible to understand which algorithm of action, what to restore, and what is already in order.

4. Recovery of the liver.

The liver is the only organ that can regenerate from 25% tissue to 100%. The liver recovers beautifully, from almost any state into which an athlete or non-athlete drives it. The main problem is that the liver is responsible for many functions and it will take a very long time for it to recover. Also, the liver is “loaded” with other factors that slow down its recovery. You can not resort to drug treatment of the liver if LST and ALT are below 30 U / l, and bilirubin is below 15 μmol / l.

The liver perfectly recovers itself, the main thing is to remove all possible loads on it:

Reduce or eliminate AAS (androgenic anabolic steroids).
Reduce exercise stress.
Reduce the total amount of food.
Reduce stress and increase sleep.
Limit the amount of alcohol as much as possible.

If these points are observed, the liver will recover itself, but you can also help with medication. If the analyzes of AST, ALT and bilirubin are higher than the reference values, then it is necessary to resort to a medical method of treatment.

5. Treatment of the liver.

Liver treatment always takes place at PCT or at a bridge between courses, in order to reduce the harm of AS on the liver and allow it to recover. The main drug for the treatment of the liver is selected relative to the tests. Schemes: "Drink Karsil a month after the course" - do not work, liver treatment is always carried out with injectable drugs. In some cases, there are injectable preparations, and after them tablets.

1. Treatment regimen liver with slight increases in ALT, AST and bilirubin, relative to the reference values, or if these indicators are at the highest limit of the reference values.

Glutargin 5 ml 40% intravenously for 8-10 days.
thiotriazoline 4 ml 2.5% intravenously for 8-10 days.

2. Treatment regimen liver with increases in ALT and AST more than 50 IU / l.

Essentiale 2 ampoules of 5 ml intravenously 1:1 with blood for 10 days.

3. Treatment regimen liver with an increase in ALT and AST more than 70-80 U / l.

Heptral 1 vial intravenously for 10 days.

4. Treatment regimen with an increase in ALT and AST more than 100 IU / l.

Heptral 1 bottle intravenously for 10-14 days.
After the end of the injections - Heptral 1 tablet 3 times a day for 3-8 weeks.