Side effects of anabolic steroids used by athletes at Unaizah Gyms, Saudi Arabia: a pilot study

J Sports Med Phys Fitness. 2019 Mar;59(3):489-495. doi: 10.23736/S0022-4707.18.08366-4. Epub 2018 Apr 20.


Background: A large number of Saudi athletes are recently shown to use androgenic anabolic steroid (AAS) products to achieve rapid muscle growth without realizing the serious health risks of these drugs. Aim of this study was to elucidate the side effects encountered with prolonged use of AAS products by Saudi athletes.

Methods: A cross-sectional study was conducted, in which 16 regular gym members, 12 of them used AAS, were asked to answer a questionnaire and provide blood samples following current AAS course completion. Hemoglobin, serum proteins, lipid profile and hematological parameters were measured. Meanwhile, the parameters of kidneys, liver, heart, and immune system function were monitored.

Results: The subjects reported taking a 3-month course of an AAS comprising three compounds (testosterone enanthate, nandrolone decanoate and methandienone). A two-week gap separated every two courses, during which tamoxifen citrate (40 mg per day) and clomiphene citrate (10 mg per day) were taken to control serum testosterone levels. The intake of AAS one course had remarkable effects on some parameters related to kidney function. However, AAS three courses or more treatments showed abnormal liver and heart enzymes. Moreover, endogenous testosterone levels decreased dramatically with prolonged use of AAS (more than 10 courses). Alpha 2 protein increased by taking more than 10 courses, which might cause acute phase reactant of liver infection or inflammation.

Conclusions: AAS products must be controlled by Saudi ministry of health and should not be taken randomly without the supervision of the healthcare professional.

MeSH terms

  • Adult
  • Anabolic Agents / adverse effects*
  • Athletes
  • Cross-Sectional Studies
  • Humans
  • Male
  • Methandrostenolone / adverse effects*
  • Nandrolone Decanoate / adverse effects*
  • Pilot Projects
  • Saudi Arabia
  • Surveys and Questionnaires
  • Testosterone / adverse effects
  • Testosterone / analogs & derivatives*


  • Anabolic Agents
  • Testosterone
  • testosterone enanthate
  • Methandrostenolone
  • Nandrolone Decanoate