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High ALT and AST: review of hepatoprotectors

Quite a few articles and even quite a few books have been written on this topic. However, it is very rare to find truly intelligible articles on this topic.

It all starts out banally simple: a young man who has been taking steroids (or antibiotics) for some time decides to go and take liver tests.
After receiving the test results, he discovers that his AST and ALT are overestimated - and not just overestimated, but several times!

Since the young man was embarrassed to tell the doctors that he took steroids (otherwise, you never know, they’ll register him with a narcologist), the doctors unanimously claim that he most likely has hepatitis. A frightened young man runs to take a bunch of tests for markers of hepatitis (including ultrasound of the liver, etc.) and discovers that everything is essentially normal for him. So what then is the true reason for the increase in AST and ALT and what is it even and how to deal with it?

Alanine aminotransferase (ALT) is an endogenous enzyme from the group of transferases, widely used in medical practice for laboratory diagnosis of liver damage. When the liver is damaged as a result of cell destruction, this enzyme enters the blood, which is detected by laboratory methods.

Aspartate aminotransferase (AST, AsAt) is an endogenous enzyme from the group of transferases, which is synthesized intracellularly, and normally only a small part of this enzyme enters the blood.

In case of myocardial infarction, hepatitis, primary or metastatic liver cancer, as a result of cytolysis (cell destruction), this enzyme enters the blood, which is detected by laboratory methods.

An increase in AST that exceeds an increase in ALT is characteristic of damage to the heart muscle; if the ALT level is higher than AST, then this usually indicates the destruction of liver cells.

In the case of taking anabolic drugs, the increase in ALT and/or AST activity is caused precisely by taking these drugs.

Hepatoprotectors

What to do if ALT and AST are slightly elevated?
The answer is simple: do nothing. The liver is perhaps the only human organ that can heal itself on its own. As a rule, a monthly course of oral methandrostenolone will lead to only minor deviations in AST and ALT levels. Considering the ability of the liver to regenerate, it is not worth taking any medications at all. All that is needed at this stage is to follow a diet. You need to monitor your bowel movements every morning, consume more raw (mostly green) fruits and vegetables, and it is advisable to completely eliminate fried foods (preferably reserved for steamed foods) and fatty foods (even exclude mayonnaise). In this case, water consumption should be increased to three liters.

We are talking about clean water, and not about the total intake of fluid per day. If, after a light course, there are problems with stagnation of bile, then it would not be superfluous to drink a decoction of dandelion and agrimony every day instead of tea (these herbs together are excellent at driving bile). Meanwhile, the liver never hurts and cannot hurt. It cannot for an objective anatomical reason: it (like the brain) has no pain receptors. Only the membrane in which it is dressed can hurt (like the brain!), any surrounding organs can hurt (for example, the gallbladder), but the liver tissue itself does not hurt.

What to do if the liver tests of ALT and AST are several times higher? Here hepatoprotectors can come to our aid (from the Latin hepar - liver and protecto - to protect) - a collective name for medications that have a positive effect on liver function. However, you should know that at the moment there is not a single medicine for the liver, the effect of which has been proven in clinical studies with one hundred percent accuracy. According to the author, those purchased clinical studies that are conducted in Russia and the CIS countries cannot be considered scientific since they are pursuing commercial interests.

The class of drugs hepatoprotectors exists only in Russia and the CIS countries, neither in Europe nor in North America, nor in Australia, most of them are not registered. They are not included in the list of tablets for the treatment of liver diseases due to the fact that their therapeutic effectiveness has not been proven and clinical significance has not been confirmed. Very rarely, some of them are used in the USA and Europe for narrow indications, used as dietary supplements (that is, their use does not guarantee effect).

The French company Sanofi, one of the producers of Essentiale, sends 99% of its production to Russia and the CIS countries. It should be said that the Essentiale Forte we mentioned is nothing more than a dummy, which is pressed cheap soy lecithin (which the manufacturer, by the way, does not hide). Many may argue with this statement, but the facts speak for themselves. As already mentioned, after the course the levels of AST and ALT are usually too high. But after a couple of months, the liver, due to its self-healing property, brings these indicators back to normal. A person, without knowing this, has been drinking some Essentiale Forte (or its analogues Esliver, etc.) for these two months and thinks that it was the drug that helped him. However, we have a placebo effect.

Preparations for cleaning the liver after the course

In view of the above, we will consider the most popular medications for the liver and, referring to clinical studies, we will try to confirm or refute their benefits.

1. Essential phospholipids- simply put, soy lecithin (Essentiale, Esliver, Rezalut and many other similar preparations based on phospholipids). Essential phospholipids were initially thought to be effective as a drug shield for hepatotoxic drugs, alcoholic and viral hepatitis, and hepatic steatosis of various origins.

What do the studies say?

A 2003 study of veteran medical services conducted in the United States. centers, did not reveal any positive effect of these drugs on liver function. In addition, it was found that against the background of viral hepatitis, both acute and chronic, taking essential phospholipids contributed to the activation of inflammation, since it provoked stagnation of bile.

Based on these studies, their use in the treatment of viral hepatitis is not advisable. According to some sources, liver tablets like Essentiale hardly reach the liver, but are distributed and metabolized throughout the body, which calls into question their effectiveness. But the cost of treatment with these drugs is very high - just for a month’s course of treatment (in capsules) an adult needs more than 3,000 rubles.

Conclusion: a dummy.

2. Tablets for the liver of animal origin ( Sirepar, Gepotasan) - there is no evidence base confirming their clinical effectiveness and safety. Moreover, taking these drugs is potentially dangerous.

Conclusion: a dummy.

3. Ademethionine - Heptral, Heptor. Amino acids.
For example, ademetionine takes part in the synthesis of biologically active substances and phospholipids, and has regenerating and detoxifying properties. According to the manufacturer, by the end of 1 week of use, Heptral also exhibits a pronounced antidepressant effect, breaks down fats and promotes their removal from the liver.

Heptral is registered as a medicine in Germany, Italy, and Russia.

In Australia it is registered as a drug for animals (veterinary), in other countries as a dietary supplement, since studies have shown a dubious effect. Practicing doctors - gastroenterologists, infectious disease specialists, hepatologists know that this drug is very effective, but only with intravenous infusions, since only a small part of the drug is absorbed when taken orally. Therefore, Heptral in tablets for serious liver pathology is an almost useless waste of money, in contrast to intravenous use (or at least injections into the buttock area).

Conclusion: Heptral really works, but only in part side effects after alcohol, taking medications (including steroids). In case of severe liver diseases, there is no point in taking it.

4. Ornithine aspartate - Hepa-Merz- helps reduce high level ammonia, is used for disorders of brain function associated with impaired liver function, as well as for fatty degeneration and toxic hepatitis. Ornithine was previously popular among athletes as a growth hormone supplement.

Conclusion: overall a dummy, but it makes sense to take it in case of hepatic coma.

5. Medicines for the liver with milk thistle - Legalon, Karsil, Gepabene, Silimar- these drugs are widely used as recommended by both Russian doctors and pseudo-specialists on the Internet. To the question which medicine is best for the liver, the answer is milk thistle preparations. Silymarin is the collective name for the biologically active substances in the fruits of milk thistle and is a strong antioxidant (and the only antidote for poisoning with toadstool).

According to indications, it is prescribed for hepatitis and other liver diseases for a course of at least 3 months, helps reduce the intensity of progression of liver cirrhosis. According to the author, the best method of consuming milk thistle is to purchase crushed milk thistle powder (meal).

Mentions on the Internet regarding the fact that milk thistle supposedly has healing properties only when extracted using a special method are groundless and unscientific. There is no point in overpaying for the same karsil, which is essentially pressed meal.

Despite the safety of this drug, the clinical effectiveness of silymarin in alcoholic liver damage and acute hepatitis has not been confirmed due to a lack of adequate research. In acute hepatitis B, there was no improvement in liver function tests between the placebo and silymarin groups. Data on the effectiveness of its use in acute hepatitis C have not yet been obtained; there are only descriptions of individual cases where milk thistle extract reduced the activity of aminotransferases in chronic hepatitis C.

Summarizing today's evidence-based medicine data on its effectiveness, we can state that today a lot of experimental data has been accumulated to recommend further study of the effectiveness of silymarin in chronic liver diseases (including fatty hepatosis).
Conclusion: the hepatoprotective effect of milk thistle does not currently have one hundred percent scientific justification. However, practical medical experience has been accumulated according to which milk thistle extract can have a positive effect on liver cells. This is a budget option, so to speak, but at the same time the longest path (up to 3 months or more) to heal the liver.

6. Artichoke is a plant used to treat the liver. Artichoke is a plant that has been used since ancient times in folk medicine to reduce joint pain and treat jaundice, as it improves metabolism, helps reduce bad cholesterol, and has a diuretic, choleretic and hepatoprotective effect. In artichoke preparations, the main active ingredient is cymarin, which has properties similar to silibinin. Among the preparations with artichoke, one can highlight Hofitol, among the dietary supplements - Cynarix, Artichoke Extract.

As a hepatoprotector, artichoke leaf extract is widely used, but no evidence-based studies of its effectiveness have been carried out, and it is not recommended for use in acute hepatitis, cholelithiasis and cholestasis syndrome.

Conclusion: there is no point in talking about any treatment without an evidence base. On the other hand, artichoke has been used since ancient times in folk medicine to treat the liver. If we talk about its use, the author would advise using it together with milk thistle powder as a cycle of low-cost treatment for the liver.

7. Medicine for the liver - Liv 52, as well as dietary supplements - the manufacturer Liv 52 claims that the herbal extracts included in the drug protect the liver parenchyma in case of toxic damage (drugs, alcohol), normalizes the protein-synthetic function of the liver, has a choleretic effect, stimulates cell restoration liver.

According to the results of various US studies, there are no reported effects of Liv 52. For example, in case of viral hepatitis, taking Liv 52 did not lead to a reduction in treatment time, but there was a decrease in bilirubin in the blood and a reduction in severe weight loss in patients. In the treatment of alcoholic hepatitis, neither antitoxic nor restorative effects were found.
Moreover, the results of one of the clinical studies conducted in the USA led to the withdrawal of this drug from the country's market.

In the treatment of alcoholic hepatitis when taking Liv 52, the survival rate in the placebo group was 86%, and in the group taking Liv 52 - 74%. In acute liver pathologies, the use of these liver tablets aggravated the severity of the inflammatory syndrome. As for the use of dietary supplements intended for the treatment of liver diseases, cleansing it, normalizing digestion - this remains the patient’s choice, whether he believes the manufacturer’s assurances or not.

Since the safety and quality of each series of food additives can only be confirmed by the manufacturer - a piece of paper (quality certificate), and what will be written there and whether it corresponds to reality is on his conscience. However, there are dietary supplements whose manufacturers, taking care of product promotion, confirm their medicinal properties and positive effects on health through various laboratory and clinical studies, but there are only a few such manufacturers.
Conclusion: a dummy. However, some herbs such as agrimony and dandelion can actually help disperse bile and thereby make the work easier for the liver. After all, the less load placed on the liver, the faster it is able to restore itself.

8. Pumpkin seed oil(such as the one praised by Dr. Luber Tykveol). The composition of pumpkin seed oil preparations includes polyunsaturated and unsaturated fatty acids with a high percentage of oleic, linoleic acids - phytosterols, vitamins C and group B, which, according to the manufacturer, has a hepatoprotective effect

There is no evidence base regarding the clinical effectiveness of pumpkin seed oil preparations. To judge the real hepatoprotective activity of this drug, additional research is required.
Conclusion: a dummy. However, according to some athletes, it may have a synergistic effect along with its use with milk thistle and artichoke. According to the author, the most budget option in in this case There will be pumpkin seeds crushed in a coffee grinder, taken together with milk thistle powder and artichoke (chophytol, or herbal decoction). This budget option can really be beneficial with minor increases in ALT and AST.

9. Tablets - bile acids (Ursofalk and its analogues).
Ursodeoxycholic acid is a bile acid preparation. Used for the treatment of diseases of the biliary tract and liver, uncomplicated cholelithiasis. It has a hypoglycemic and choleretic effect, reduces the saturation of bile with cholesterol (until cholesterol stones are completely dissolved), causes an increase in pancreatic and gastric secretion.

In all patients, during 20 weeks of therapy with ursodeoxycholic acid, positive dynamics of clinical, biochemical and ultrasound data were noted.

The results of the study indicate the high effectiveness of ursodeoxycholic acid in superinvasive opisthorchiasis and allow us to recommend it for the treatment of cholestasis syndrome in such patients. Conclusion: Ursolfalk is perhaps the only drug that is recognized by the scientific community for the treatment of the liver.

However, ursolfalk is not so much a heparprotector as a choleretic drug.

10. Homeopathic medicines for the liver. Among homeopathic medicines, we can highlight Hepel (Germany) and Galstena (Austria).

What do the studies say? Homeopathic remedies have not undergone proper clinical studies, so there is nothing to say about the effectiveness of these drugs for the treatment of liver diseases.
Conclusion: a dummy.

Conclusions on the article

1. If we talk about cleansing the liver after long-term use of anabolic steroids (in particular their oral form), then it definitely makes sense to inject Heptral (2-3 packs, depending on test results) and drink Ursolfalk. This course will undoubtedly bring AST and ALT levels back to normal. However, it should be borne in mind that during the liver cleansing it is necessary to maintain an appropriate diet (no sweet, fatty, highly salty, fried foods), drink three liters of clean water and there should not be any other medications (including our favorite tamoxifen, gonadotropin and etc., aspirin, antibiotics).

2. If there is no money for cleaning the liver with Heptral and Ursolfalk, then you can clean the liver with milk thistle (meal), crushed pumpkin seeds and drinking tea 1-2 times a day based on a decoction of dandelion, agrimony and artichoke. Such a complex will undoubtedly bring your AST and ALT levels back to normal within three months.

What you definitely shouldn’t do is buy Essentiale and similar dummies (Liv 52, GEPA-MERZ and other dietary supplements).

IVAN VASILIEV

leading specialist of the moretesto website

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 destructive effects of steroids. The most effective of them are (list in order of decreasing effectiveness):

• Ademetionine
• Karsil, Legalon
• Alpha lipoic acid
• Ornithine

Methods of taking hepatoprotectors and dosage

Taking hepatoprotectors should begin 2 weeks after the start of the steroid course and continue 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 first half of the day)

A question of efficiency

It is worth noting that hepatoprotectors are not very common in the United States 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, their use during a course of steroids can significantly reduce the risk of liver damage, so their use in bodybuilding (using anabolic steroid) is still justified.

The answer to this question has been of interest to everyone for several decades now. professional sports. During the practice of pharmacology, sports doctors managed to accumulate some experience in the rehabilitation of an athlete’s body after intensive courses of steroids and other “not very useful” drugs. Some experts have experience in mitigating the negative effects of anabolic steroids directly during the cycle, but how effective they are is unknown, because no one has conducted official research. And this is understandable, because it is unlikely that anyone will sponsor semi-legal programs.

In medical non-sports practice, harmful effects It is not customary to stop anabolic steroids directly during a course of taking these drugs. They differ in the direction of reduction and dosage, and, therefore, the likelihood decreases negative consequences for the body.

In sports practice, especially among amateur bodybuilding, there is often information about drugs that help achieve best results, is passed on from mouth to mouth. Often "would-be athletes" prescribe one or another hepatoprotector to 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 must not only be aware that these are hormonal drugs that can make adjustments to the functioning of the body, but also know how exactly the drug works. Errors here are disproportionately more expensive than the services of a qualified sports doctor.

Let's be clear

The overwhelming number of anabolic steroids used in bodybuilding have the prefix “17-alpha” in their pharmacological formula. In the language of specialists, this means that one carbon atom is built into the 17th position of the steroid chain. Thanks to this, this modification becomes tens of times more stable compared to its 17-alpha non-alkylated analogue.

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. Detoxifying such modified hormones is a difficult job for the liver, which it must perform under toxic stress. For the liver, 17-alpha drugs are essentially 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 medical products. Meanwhile, all hepatoprotectors have a restorative effect on hepatocytes. The mechanism for stimulating regenerative processes may 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. Painful sensations in the right hypochondrium indicate a difficult flow of liver cell membranes, which developed as a result of their hypertrophy. Taking the above-mentioned hepatoprotectors further enhances this effect. Their work must take place under conditions of normal patency of cell membranes. The liver itself does not hurt, since it has no 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 discontinuation of anabolic drugs, the function of liver cells gradually returns to normal, provided there are no irreversible consequences. At this time, you can proceed to restorative treatment with hepatoprotectors. In this case, you cannot force the dosage, since in this case more does not mean better. Although Liv-52, Essentiale and other hepatoprotectors have fairly high overdose limits, it is necessary to take them in the optimal doses indicated in the annotation. It should be noted that for athletes with large body weight, adult doses can be increased by 40-50%, since they are designed for people weighing 70-80 kg.

With large doses of anabolic steroids (particularly oral 17-alpha alkylated steroids), testosterone often aromatizes in the liver, converting it to estrogen. While on a steroid course, the athlete’s liver is additionally “bombarded” with protein breakdown products. Physical exercise high intensity also increases the load on the liver. Bile, being “locked” in the cells, thickens, resulting in its deficiency in the digestive system. That is why fatty foods, which provoke the outflow of bile, are, figuratively speaking, a knife for the 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 discontinue toxic androgenic steroids. After the pain in the liver disappears, you should take a short course of hepaprotectors of plant origin, for example, Liv-52, as well as the old but effective drug Essentiale, which contains valuable polyunsaturated fatty acids. Among natural remedies good results produces olive oil and pumpkin seeds, which contain valuable omega-3 fats that are actively involved in cellular regeneration processes.

The general name “hepatoprotectors” means drugs that restore liver function by regenerating its cells. However, different drugs work differently. Among the 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 of the drug Karsil is silymarin. This complex of flavonoids is also found in the medicinal plant milk thistle. Both karsil and milk thistle can be used during accelerated 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 the course, restorative treatment is best carried out with drugs Liv 52 and Essentiale, due to their greater efficiency. One of the side effects of 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, gentle course, when the activity of Essentiale prevails over the effect of steroids.

A separate group of drugs that reduce the load on the liver during steroid courses are choleretic drugs, which 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 drugs with mixed effects; they also need to be treated with caution, since steroids impede the natural outflow of bile and, without additional stimulation of the membranes and bile ducts, it is difficult for it to be transported to its destination. For example, Allahol promotes the active formation of bile, but practically does not relieve spasm of the biliary tract, so it is not recommended to take it at the peak of the asteroid course.

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 suffered cholecystitis or have a chronic form of this disease.

The general rule for all choleretic drugs introduced into the course regimen, including hepatoprotectors with a clear choleretic effect, is that their action should be aimed, first of all, 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 loads caused by a rich diet. The importance of precise control of the fat consumed during the course has been mentioned more than once. In intensive courses, the less it is, the better. However, we should not forget about the important function of fats in the body, so long intensive courses of steroids can indirectly cause harm precisely due to the lack of fatty acids important for the body. In this case, it is recommended to displace all “questionable fats” and consume only olive and natural butter, as well as fish fat(in acceptable quantities).

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

Often, diseases of the liver and gall bladder become the reason why an athlete is prohibited from taking 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 to large doses of steroids, you can undergo the so-called. gentle courses. The effect from them is incomparably less than with full use of steroids, but also incomparably greater than without them.

Gentle courses, in principle, repeat regular 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 more rare doses of steroid drugs. For example, methandrostenolone on a gentle course is taken one tablet 3-4 times a day, instead of 10-15 tablets throughout 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 gentle course. However, its duration can reach 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 over time. In this case, the muscles will be inferior in volume, but 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 action hepatoprotectors, it only begs to be one conclusion: These drugs are incompatible in sports practice rather than indicated for simultaneous use. 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, it would only be by neutralizing the 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 use may be rational in some cases, especially with previously suffered diseases of the gallbladder, but they also require an individual approach in the choice and can aggravate health problems.

Liver video

– exocrine gland, 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, in addition to the secretion of enzymes.

Main functions of the liver:

• Neutralization of foreign substances.
• Removal of excess hormones and mediators.
• Removal of metabolic end products.
• Participates in digestive processes (gluconeogenesis).
• Regulation of carbohydrate metabolism, depot.
• Regulation of lipid metabolism, synthesis
• Blood depot.
• Synthesis of bile acids and bilirubin. Production and secretion of bile.

As can be seen 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 (tablets) 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 during

Gallbladder- an organ that contains bile secreted by the liver. The gallbladder regulates the release of bile into the duodenum. Bile from the gallbladder to the duodenum passes 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 are 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.

It is possible to take anabolic steroid tablets, but to do this you should limit the dose of the drugs to 30 mg per day, the maximum permissible dose is 50 mg, which applies more to professionals. Under no circumstances should you use two tablets at the same time. And also try not to take tablet medications for longer than 4-6 weeks, and for amateurs the limit is closer to four weeks. Amateurs are generally advised to do without tableted anabolic steroids.

In addition, all anabolic steroids affect the thickness of bile, complicating its outflow. Therefore, during the course it is necessary to add choleretic drugs throughout the entire intake of steroids, tablets or injections. The most popular and effective choleretic drugs:

Allohol– orally, after meals, 1–2 tablets. 3–4 times a day.

Holosas– orally, 2–3 times a day, adults – 1 teaspoon.

Flamin– orally, 30 minutes before meals, 1 tablet. 3 times a day.

3. Liver condition tests.

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

Functions of total protein in the blood:

• Maintaining colloid osmotic pressure;
• Active participation in blood clotting;
• Maintaining a constant blood pH (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 fasting, proteins break down into amino acids, which are used for the synthesis of proteins in the brain, myocardium and other vital organs);

Demoted– decreased protein synthesis by the liver.

Promoted– a number of diseases, including those related to the liver.

Aspartate aminotransferase(AST or ASaT), norms: up to 41 U/l – endogenous enzyme located inside the cell. Most of it is found 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, located primarily in liver cells.

Promoted- destruction of liver cells.

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

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

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

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

Promotion bilirubin means toxic liver damage from steroids or other substances, and in some cases, desolation and poor bile flow.

Gamma glutamyl transferase (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.

Promotion GGT occurs extremely rarely when taking steroids, and its increase may indicate problems with the liver or kidneys.

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

4. Liver restoration.

The liver is the only organ that can regenerate from 25% tissue to 100%. The liver recovers perfectly, from almost any condition into which an athlete or non-athlete puts 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. The liver is also “loaded” by other factors that slow down its recovery. You may not need to 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 recovers well on its own, the main thing is to remove all possible stress on it:

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

If these points are observed, the liver will recover on its own, but you can also help with medication. If the tests of AST, ALT and bilirubin are higher than the reference values, then it is necessary to resort to drug treatment.

5. Liver treatment.

Liver treatment always takes place on PCT or on the bridge between courses, in order to reduce the harm of AS on the liver and give it the opportunity to recover. The main drug for treating the liver is selected based on the tests. Schemes: “Drink Karsil for a month after the course” do not work; liver treatment is always carried out with injectable drugs. In some cases, injectable drugs are used, followed by tablets.

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

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

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

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

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

• Heptral 1 bottle intravenously for 10 days.

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

The use of steroids requires great attention, caution and certain knowledge. Find out the secrets of professional athletes in taking steroids!

The content of the article:

Steroids are a very effective tool for achieving the goals set for an athlete. But beyond a certain point they can begin to cause harm to health. Today you can find a lot of information on the Internet about the use of ACC in sports. However, it is very contradictory and often novice athletes are simply lost.

Sports officials who have declared war on doping are bringing even more chaos to the issue of steroid use. Now on the list of prohibited substances you can find quite a lot of drugs that are safe for humans. At the same time, the truly harmful ones may not be there. Today we will try to talk in as much detail as possible about how not to use steroids and post-cycle therapy in bodybuilding.

What are the most common mistakes in using AAS?

Steroid use at a young age

According to the results scientific research, most people continue to grow until they are 25 years old. Bone structures increase in length due to special zones called growth zones. They consist of cartilaginous tissue, the cells of which turn into bone during the entire period of growth. After reaching the age of 25, these zones become ossified and growth stops.

All steroids have androgenic activity and for this reason contribute to the closure of the growth areas of the skeletal system. In addition, when using AAS, calcium is retained in the body. This also promotes the ossification of cartilage tissue in growth zones. If you start using steroids before the age of 25, this can lead to disruption of the normal functioning of the endocrine system, which is not yet fully formed. As a result, bone tissue growth will stop prematurely.

Use of high dosages of AAS

Many athletes, especially beginners, are confident that the higher the dosage of the steroid, the more effective the course will be. But this is a misconception that can lead to a lot of negative aspects. It should be said right away that when using anabolic steroids, and primarily tablet ones, the liver is very heavily loaded.

This organ is very susceptible to any effects of various medications, including steroids. When using recommended dosages, the liver recovers and continues to function normally after stopping steroid use. Otherwise, hepatitis-inflammation of the organ may occur.

Also, when using high dosages, the concentration of estrogen in the body sharply increases, which leads to a decrease in the effectiveness of anabolic steroids. In addition to all of the above, one can note the possibility of hypertrophy of the endocrine glands and an excessive increase in metabolism. This not only does not help accelerate the growth of muscle tissue, but can slow it down, causing harm to health.

No cyclic steroid regimens

All drugs, including anabolic ones, should be used in cycles followed by a pause to allow the body to recover. The body adapts to the effects of any medication. This leads to a decrease in its effectiveness. This is due to the body's immune response to foreign substances. When using any drug, antibodies are synthesized in the body, the task of which is to neutralize substances that come from outside. Even after long break When using any drug, after its next administration, the immune system begins to synthesize antibodies.

Ignorance of ways to protect the liver

We have already said above that the liver is subjected to severe stress when using anabolic steroids. In addition, the nutrition program that athletes use during mass-gaining cycles also contributes to an increase in load.

It is important to remember that the liver is the main chemical laboratory and natural filter in the human body. All nutrients pass through this organ. Some of them are processed here, while others are modified and only after that enter the bloodstream.

You should know that all anabolic processes occurring in the body depend on the work of the liver. If the organ functions well, then there will be an increase in muscle mass. When the functioning of an organ is impaired, anabolism is impossible in principle. It is important to remember how to protect your liver.

What drugs are used to protect the liver?

To reduce the load on the liver and restore its functionality, it is necessary to use hepatoprotectors. Now it is necessary to say a few words about the most effective medications in this group.

Essentiale

The drug contains a large amount of essential phospholipids. They are ester compounds of unsaturated fatty acids, as well as choline phosphoric acid. In addition, the drug is rich in vitamins, which, together with phospholipids, accelerate the restoration of the cellular structure of the liver.