Nandrolone, also known as 19-nortestosterone, is an endogenous androgen. It is also an anabolic steroid (AAS) which is medically used in the form of esters such as nandrolone decanoate (brand name Deca-Durabolin) and nandrolone phenylpropionate (brand name Durabolin). Nandrolone esters are used in the treatment of anemias, cachexia (muscle wasting syndrome), osteoporosis, breast cancer, and for other indications. They are now used by oral administration or instead are given by injection into muscle or fat. Side effects of nandrolone esters include symptoms of masculinization like acne, increased hair growth, and voice changes. They are synthetic androgens and anabolic steroids and hence are agonists of the androgen receptor (AR), the biological target of androgens like testosterone and dihydrotestosterone (DHT). Nandrolone has strong anabolic effects and weak androgenic effects, which give them a mild side effect profile and make them especially suitable for use in women and children. There are metabolites of Nandrolone that act as long-lasting prodrugs in the body, such as 5α-Dihydronandrolone. Nandrolone esters were first described and introduced for medical use in the late 1950s. They are among the most widely used anabolic steroid worldwide. In addition to their medical use, nandrolone esters are used to improve physique and performance, and are said to be the most widely used anabolic steroid for such purposes. The drugs are controlled substances in many countries and so non-medical use is generally illicit.
Medical uses Nandrolone esters are used clinically, although increasingly rarely, for people in catabolic states with major burns, cancer, and AIDS, and an ophthalmological formulation was available to support cornea healing. The positive effects of nandrolone esters include muscle growth, appetite stimulation and increased red blood cell production, and bone density. Clinical studies have shown them to be effective in treating anemia, osteoporosis, and breast cancer. Nandrolone sulfate has been used in an eye drop formulation as an ophthalmic medication.
Non-medical uses Nandrolone esters are used for physique- and performance-enhancing purposes by competitive athletes, bodybuilders, and powerlifters.
Side effects
Side effects of nandrolone esters include masculinization among others. In women, nandrolone and nandrolone esters have been reported to produce increased libido, acne, facial and body hair growth, voice changes, and clitoral enlargement. However, the masculinizing effects of nandrolone and its esters are reported to be slighter than those of testosterone. Nandrolone has also been found to produce penile growth in prepubertal boys. Amenorrhea and menorrhagia have been reported as side effects of nandrolone cypionate. Side effects of high doses of nandrolone may include cardiovascular toxicity as well as hypogonadism and infertility. Nandrolone may produce scalp hair loss, although this is also theoretical.
Pharmacology
Pharmacodynamics
Nandrolone is an agonist of the AR, the biological target of androgens like testosterone and DHTTooltip dihydrotestosterone. Unlike testosterone and certain other anabolic steroids, nandrolone is not potentiated in androgenic tissues like the scalp, skin, and prostate, hence deleterious effects in these tissues are lessened. This is because nandrolone is metabolized by 5α-reductase to the much weaker AR ligand 5α-dihydronandrolone (DHN), which has both reduced affinity for the androgen receptor (AR) relative to nandrolone in vitro and weaker AR agonistic potency in vivo. The lack of alkylation on the 17α-carbon drastically reduces the hepatotoxic potential of nandrolone. Estrogen effects resulting from reaction with aromatase are also reduced due to lessened enzyme interaction, but effects such as gynecomastia and reduced libido may still occur at sufficiently high doses. In addition to its AR agonistic activity, unlike many other anabolic steroids, nandrolone is also a potent progestogen. It binds to the progesterone receptor with approximately 22% of the affinity of progesterone. The progestogenic activity of nandrolone serves to augment its antigonadotropic effects, as antigonadotropic action is a known property of progestogens.
Anabolic and androgenic activity Nandrolone has a very high ratio of anabolic to androgenic activity. In fact, many nandrolone-like anabolic steroids and even nandrolone itself are said to have among the highest ratio of anabolic to androgenic effects of all anabolic steroids. This is attributed to the fact that whereas testosterone is potentiated via conversion into dihydrotestosterone (DHT) in androgenic tissues, the opposite is true with nandrolone and similar anabolic steroids (i.e., other 19-nortestosterone derivatives). As such, nandrolone-like anabolic steroids, namely nandrolone esters, are the most frequently used anabolic steroids in clinical settings in which anabolic effects are desired; for instance, in the treatment of AIDS-associated cachexia, severe burns, and chronic obstructive pulmonary disease. However, anabolic steroids with a very high ratio of anabolic to androgenic action like nandrolone still have significant androgenic effects and can produce symptoms of masculinization like hirsutism and voice deepening in women and children with extended use.
Pharmacokinetics The oral activity of nandrolone has been studied. With oral administration of nandrolone in rodents, it had about one-tenth of the potency of subcutaneous injection of nandrolone. Nandrolone has very low affinity for human serum sex hormone-binding globulin (SHBG), about 5% of that of testosterone and 1% of that of DHT. It is metabolized by the enzyme 5α-reductase, among others. Nandrolone is less susceptible to metabolism by 5α-reductase and 17β-hydroxysteroid dehydrogenase than testosterone. This results in it being transformed less in so-called "androgenic" tissues like the skin, hair follicles, and prostate gland and in the kidneys, respectively. Metabolites of nandrolone include 5α-dihydronandrolone, 19-norandrosterone, and 19-noretiocholanolone, and these metabolites may be detected in urine. Single intramuscular injections of 100 mg nandrolone phenylpropionate or nandrolone decanoate have been found to produce an anabolic effect for 10 to 14 days and 20 to 25 days, respectively. Conversely, unesterified nandrolone has been used by intramuscular injection once daily.
Chemistry
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