4 years on and off, you shouldn't worry. If you feel worried or something sparked your anxiety go to your general practitioneer or look one up and ask for a physical -
ALL insurance companies cover it at
NO cost so you won't be paying a dime for it only the doctor's visit, you can even tell him you want a full workup on the blood tests, leave nothing out.
Most cases of experienceing the bad androgenic effects are from oral use and people that use recreational drugs.
Case 1. Cholestasis due to anabolic steroid use.[Modified from: Singh C, Bishop P, Wilson R. Extreme hyperbilirubinemia associated with the use of anabolic steroids, health/nutritional supplements and ethanol: response to ursodeoxycholic acid treatment. Am J Gastroenterol 1996; 91: 783-5. PubMed Citation]
A 24 year old body builder
developed pruritus and jaundice having taken various anabolic steroids for one and a half years. He was also taking several herbal products and dietary supplements including Ma Huang (6% ephedrine), carnitine and chromium. He also drank alcohol, estimating his average intake as one case of beer per day for the last year. He developed dark urine and jaundice and stopped all medications and his alcohol intake promptly. Despite this, he remained jaundiced for a month and had worsening nausea and weight loss and eventually sought medical care. He had no history of liver disease or risk factors for viral hepatitis and took no other medications. On examination, he was muscular and physically fit but deeply jaundiced. He had an enlarged liver but no rash, fever or splenomegaly. Laboratory testing showed a total serum bilirubin of 53 mg/dL, but only modest elevations in serum aminotransferase and a normal alkaline phosphatase level (Table). His prothrombin time was normal. Tests for hepatitis A, B and C were negative. Abdominal ultrasound showed no evidence of biliary obstruction. Liver biopsy was not done. He was treated symptomatically for pruritus with antihistamines, cholestryamine and ursodiol. His jaundice gradually improved and pruritus waned. Six months after the onset of jaundice, he was asymptomatic, had regained most of his weight loss (40 pounds), serum bilirubin was 1.5 mg/dL and serum enzymes were normal.
Key Points
Medication: Anabolic steroids (nandrolone, stanozolol)
Pattern: Bland cholestasis
Severity: 3+ (jaundice, hospitalization)
Latency: 16 months
Recovery: 0.6 months
Other medications: Various herbal products and dietary supplements
Laboratory Values
Time After Stopping
ALT
(U/L)
Alk P
(U/L)
Bilirubin
(mg/dL)
Other
Anabolic agent use for ~1.5 years6 weeks 237 129 21
8 weeks 90 121 53
10 weeks 203 91 51 Ursodiol started
12 weeks 119 81 22
14 weeks 116 67 8
4 months 58 50 4
5 months 33 75 1.5 Asymptomatic
Normal Values <56 <139 <1.2
Comment
A very typical case of severe cholestasis due to anabolic steroid use. Because the steroids were being used without medical supervision, the dose and actual duration of use of each preparation was unclear, but cholestasis usually arises within 4 to 12 weeks of starting a C-17 alkylated androgenic steroid. The jaundice can be severe and prolonged and accompanied by severe pruritus and marked weight loss. The serum enzymes are typically minimally elevated except for a short period immediately after stopping therapy. The pattern of enzyme elevations can be hepatocellular, cholestatic or mixed. Liver biopsy shows a “bland” cholestasis with minimal inflammation and hepatocellular necrosis. Ma Huang has also been implicated in cases of drug induced liver injury, but is associated with an acute hepatocellular pattern of injury.
http://livertox.nlm.nih.gov/AndrogenicSteroids.htmI'm sure DOC could chime in on here and shed some good information.