All anabolic steroids have a tendency to reduce HDL (good) cholesterol and increase LDL (bad) cholesterol. The relative impact of an anabolic/androgenic steroid on serum lipids is dependant on the dose, route of administration (oral vs. injectable) type of steroid (aromatizable or non-aromatizable) and level of resistance to hepatic metabolism. With regards to nandrolone at a dose of 600mg per week over 10 weeks demonstrated 26% reduction in HDL cholesterol levels. This suppression is slightly greater than an equal dose of testosterone over an equal period. In other words it shows a slightly more negative impact on HDL/LDL ratio with nandrolone than with testosterone cypionate. It’s always recommended to accompany the use of this product with a low saturated fat diet and a cardiovascular exercise program.
Clinical practice guidelines recommend > 3400 anti-factor Xa International Units of LMWH subcutaneous daily (equivalent to > 34 mg subcutaneous daily of enoxaparin). For most patients, continue prophylaxis until hospital discharge; however, in patients that are considered to be at high risk (., > 60 years of age or a history of VTE), continue prophylaxis through hospitalization and for 2—4 weeks after discharge. Previous guidelines have suggested a dose of enoxaparin 40 mg subcutaneous 1—2 hours before surgery then daily or 30 mg subcutaneous every 12 hours starting 8—12 hours before surgery.
There are possible estrogenic side effects of Nandrolone despite it not being a very estrogenic hormone, at least not directly. Nandrolone does aromatize slightly. Aromatization refers to the conversion of testosterone to estrogen . This takes place when the testosterone hormone interacts with the aromatase enzyme. When the conversion takes place this can cause estrogen levels to go up, which can promote gynecomastia and water retention. High blood pressure can also become an issue if water retention becomes severe. Along with the low level of aromatase activity Nandrolone is also a progestin and has a strong binding affinity for the progesterone receptor. This may stimulate the mammary tissue and enhance the risk of gynecomastia in sensitive individuals.
Combating the estrogenic side effects of Nandrolone can be achieved by the use of anti-estrogen medications, specifically Aromatase Inhibitors (AI’s) such as Anastrozole ( Arimidex ). Selective Estrogen Receptor Modulators (SERM’s) are also sometimes used, such as Tamoxifen ( Nolvadex ). However, AI’s are the proper choice as they will directly reduce serum estrogen levels and SERM’s will not. An AI should be enough to reduce and avoid gynecomastia unless the individual already has existing gynecomastia that could potentially be exasperated.
Important Note: It’s often been said that Nandrolone based gynecomastia is based on increases in prolactin. It is true that 19-nor steroids can increase prolactin, which can also negatively affect libido and erection function. Some men may need to use a dopamine agonist to combat this. However, it is not prolactin that causes 19-nor based gynecomastia but rather the imbalance between estrogen and progesterone. If you merely combat prolactin you may find yourself with the very gynecomastia you tried to avoid.