5 Unexpected Dianabol Side Effects You Should Know About

dianabol sideffects article 1

Everything You should know about Dianabol side effects (Methandrostenolone), stands among the most powerful anabolic steroids available, earning the moniker ‘granddaddy of anabolic steroids.’

Famous figures like Arnold Schwarzenegger and other iconic bodybuilders of the 70s are testaments to Dianabol’s ability to massively increase size and strength.

Even half a century later, the appeal of Dianabol endures due to its significant muscle-building effects, recognized within the fitness and bodybuilding circles. Yet, it’s crucial to note that its adverse effects are often underplayed—especially to beginners, who may opt for Dianabol in their initial steroid cycle.

Here, we outline the primary adverse effects linked to Dianabol use, helping you weigh the potential risks against the gains.

Guide for Dianabol Side effects:

Dianabol Side Effects

Cholesterol and Blood Pressure

Research indicates that Dianabol can substantially worsen blood pressure and cholesterol profiles due to plaque accumulation, instigating a notable surge in LDL (bad) cholesterol and a sharp decrease in HDL (good) cholesterol (1). This elevation in blood pressure enhances the risk of a heart attack or myocardial infarction.

From a cardiovascular standpoint, Dianabol is particularly taxing since it is taken orally and must be processed by the liver.

The liver, in response, activates hepatic lipase, an enzyme that can further lower levels of HDL cholesterol.

Liver Failure FB 1

Additionally, Dianabol is notorious for causing water retention because of the aromatase enzyme, which leads to thicker blood and hampers cardiac circulation.

To mitigate cardiovascular strain from Dianabol, incorporating fish oil supplements (4 g/day) has shown benefits, aiding in blood pressure stabilization, particularly for those with hypertension (2).

Regular cardio or aerobic workouts also appear to moderate blood pressure rises attributed to Dianabol (3), thanks to a boost in nitric oxide production by endothelial cells. This compound works to dilate blood vessels and enhance circulation.

Bodybuilders might find cardiovascular exercise especially useful since weightlifting typically has the opposite, constrictive effect on blood vessels.

Note: Dianabol should be avoided by anyone with existing high blood pressure or a family history of heart disease. 


Gynecomastia refers to the buildup of breast tissue in males due to high estrogen levels, a condition Dianabol can induce due to the presence of the aromatase enzyme (4). This may manifest as swollen nipples in mild instances, escalating to a chest resembling female breasts in severe cases.

gynecomastia vs normal breast 1

Whilst swollen nipples often revert back to normal post-cycle once hormonal levels stabilize and estrogen decreases, the expansion of breast tissue in more serious cases may require surgery to correct.

Using an aromatase inhibitor (AI) or a selective estrogen receptor modulator (SERM) can prevent gynecomastia by either halting the conversion of testosterone into estrogen, or by blocking the estrogenic effects at the receptor level, respectively.

Both Nolvadex and Clomid are commonly utilized SERMs that can be taken should swelling occur, to effectively halt the development of pronounced breast tissue.

Note: The risk for gynecomastia rises if Dianabol is used in combination with other estrogenic steroids such as Testosterone or Anadrol.

Water Retention

An increase in estrogen can lead to notable water retention, contributing to a gain of 10 pounds or more in fluid weight.

water retention 1

This results in a soft, undefined muscular appearance, marking Dianabol as a preferred choice for bulking in the off-season. Bloating can also cause swelling in the midsection and may be visible in the facial area.

For many users, water retention is a temporary and non-issue, occasionally even favorable for enhancing muscular strength. However, those aiming to decrease water retention might use a diuretic such as furosemide (6), at the cost of muscle fullness and a small strength reduction. Diuretics have also proven to improve blood pressure by decreasing blood viscosity, thus easing circulation.

Generally, to avoid water retention during muscle gain, alternatives like cycling with Trenbolone, Superdrol, or Winstrol might be more suitable than contending with Dianabol’s tendency for fluid-related side effects.

Hepatic Risk Associated with Dianabol

Like many oral anabolic steroids, Dianabol is subject to c-17 alpha-alkylation, making it potentially liver-damaging. Liver function tests often reveal elevated AST/ALT levels indicative of hepatic strain, which generally persists until the user stops taking the steroid.

liver impact 1

While liver resilience is a widely recognized trait, prompting some bodybuilders to downplay the risks of hepatotoxicity, the threat of cholestasis remains significant. Cautionary measures are therefore recommended, such as avoiding alcohol and other liver-stressing medications, including specific anti-depressants.

Liver support supplements have proven beneficial among our clinic’s bodybuilding patients, particularly the use of TUDCA. This bile acid notably lowers AST/ALT ratios (7), mitigating inflammation and decreasing the probability of cholestasis linked to steroid use.

Caution: For individuals with pre-existing liver conditions, the use of Dianabol may pose serious health risks. Additionally, it’s prudent to avoid combining Dianabol with other hepatotoxic steroids, like Winstrol or Anadrol.

The Impact of Anabolic Steroids on Testosterone Levels

Anabolic steroids, synthetic derivatives of testosterone, can cause a temporary shutdown of natural testosterone production due to their effects on the HPTA (hypothalamic-pituitary-testicular axis).

During the active steroid cycle, this might not present an immediate issue; however, post-cycle, individuals often face the consequences of low testosterone levels.

test 1

Common symptoms related to low testosterone observed include:

  • Persistent fatigue
  • General tiredness
  • Shrinkage of the testicles
  • A decrease in overall well-being
  • Reduced sex drive and function

Depending on the extent of disruption to the HPTA, these symptoms may last for weeks to months. To combat these effects, bodybuilders typically turn to a post cycle therapy (PCT) regimen with the goal of restoring natural testosterone levels more rapidly.

pct 1

Nolvadex, hCG, and Clomid are frequently used PCT medications within the bodybuilding community.

For a Dianabol-only cycle, a lighter PCT protocol might suffice:

  • Nolvadex: 40mg daily for 45 days

For more intensive PCT following a stack that includes Dianabol and other steroids:

  • hCG: 2000 IU every other day for 20 days
  • Nolvadex: 40mg daily for 45 days
  • Clomid: 100mg daily for 30 days

Dr. Khame Ayodele is recognized for using such PCT protocols to achieve a 100% success rate in restoring natural testosterone in 19 men within a 45-day period. Our clinic has adopted similar strategies with positive outcomes.

Overview of Dianabol side effects

Our experience suggests Dianabol fares better than many steroids in minimizing androgenic effects, such as severe acne or hair loss.

Nonetheless, Dianabol raises significant concerns, particularly pertaining to cardiovascular and liver health.

Thus, it is crucial for users to heed the safety measures discussed herein to minimize damage while cycling with Dianabol.

In the event of experiencing acute symptoms like high blood pressure whilst on Dianabol, one should seek emergency medical help immediately and stop using the steroid.


(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1923870/

(2) https://pubmed.ncbi.nlm.nih.gov/8339414/

(3) https://pubmed.ncbi.nlm.nih.gov/11926784/

(4) https://pubmed.ncbi.nlm.nih.gov/14182614/

(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361692/

(6) https://www.ncbi.nlm.nih.gov/books/NBK499921/

(7) https://www.sciencedirect.com/science/article/abs/pii/S0011393X05806599

General Practitioner at | Website | + posts

Dr. Grant Fourie, a specialist in male hormones, is based in Cape Town, South Africa. He provides comprehensive treatments for conditions related to low testosterone, such as erectile dysfunction, fatigue, and mood changes. His methods include hormone replacement therapy and other modern treatment options.
Contact me via email or phone to book personal appointment in my clinic: The Village Square, Cape Town - South Africa


About Dr. Grant Fourie

Dr. Grant Fourie, a specialist in male hormones, is based in Cape Town, South Africa. He provides comprehensive treatments for conditions related to low testosterone, such as erectile dysfunction, fatigue, and mood changes. His methods include hormone replacement therapy and other modern treatment options. Contact me via email or phone to book personal appointment in my clinic: The Village Square, Cape Town - South Africa

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