Copied and pasted from a smart mother fucker I know who has been in the AAS game longer than me:
I want to start off by saying this: milk thistle is garbage. TUDCA (Tauroursodeoxycholic acid) is quite literally the primary and ONLY liver protectant people should be using if they are taking C17 Alpha Alkylated oral anabolic steroids. I think that Liv 52 is okay to use as well. But, if you could only pick ONE product and throw the rest away, I would say TAKE THE TUDCA!!!! Research has shown that it is the ONLY thing that is effective at treating anabolic steroid SPECIFIC induced cholestasis of the liver. Off the top of my head, one company that makes a product with TUDCA in it is Thermolife in their Liver Longer supplement, but they have seemed to be out of stock for a long while now. I know it is possible to pick up generic TUDCA if you look hard enough online. Just google it!
If you can find TUDCA elsewhere, get it as soon as you can.
As a matter of fact, using a liver support supplement such as TUDCA may even INCREASE the oral absorption and bioavailability of the steroid because it prevents cholestasis of the liver. You have to understand what happens in the liver when you use C17 alkylated orals. Cholestasis is defined as an impairment of bile flow in the liver. I don't know if you remember your highschool biology class, but bile is an extremely important component of the liver and of our body, because bile serves dual purposes:
1. In a way, it acts as a waste removal sewage fluid for the liver. All of the byproducts (not all necessarily bad, but stuff that your liver needs to remove on a regular basis or else it will harm the liver from an unhealthy buildup) that your liver creates from all the work it does in metabolizing a bazillion billion different things every day, gets collected as bile. In turn, bile salts really 'clean' the liver out.
2. Bile and the bile salts within it are very important to our digestion, especially of fats. It's stored in the gall bladder and then pumped into your duodenum (upper section of your small intestine) when you eat food to aid in digestion, as it assists in the breakdown of fats and such.
Now, in a nutshell, what happens when your liver gets 'damaged' from oral steroids is: (and i'm not going to get into the specific chemistry of it for ease of explanation to the layman) the liver is overloaded from processing the C17 alkylation on the anabolic steroid you are ingesting. What happens as a result is that it causes a slow down of bile flow in the liver, because the liver is getting so overloaded with the processes it is trying to undergo. The impairment of bile flow in the liver is known as cholestasis, and is a direct result of C17 alkylated steroid use . When bile flow is slowed down too much (or has outright STOPPED), the bile salts, which are very toxic to the liver cells, will start to damage those liver cells. The key idea here is BILE FLOW, and you'll see this repeated a lot in this post! The liver needs to keep churning bile through itself in all of its cells in order to clean out the metabolites resulting from all of the biochemical processes it's doing every second!
I don't have much time on me, so for further explanation I am going to quote a couple articles I found that explain in more detail what TUDCA does and how it literally is the ONLY liver support compound that is useful, to a much larger degree than anything else, at combating cholestasis:
A few words on the hepatotoxicity of 17a-methylated androgens/anabolics
1. 17a-methylated androgens/anabolics are hepatotoxic.
The liver toxicity of steroids is an under-researched field, but there seems to be a strong correlation between how easily the body can metabolize a steroid & its toxicity. Metribolone -- a truly excessively toxic compound -- is often referred to in the literature as a 'non-metabolizable androgen'. (1, 2, 3, etc.) Mibolerone , another deadly-toxic anabolic steroid, is also effectively 'non-metabolizable': The main metabolite of mibolerone in humans is... unchanged mibolerone. And by a very wide margin.
Methylstenbolone, which is resistant to 17b-HSD and 3b-HSD, is obviously difficult for the body to clear. It should therefore be no safer, no less toxic, than Superdrol or M1T -- compounds which share very similar traits.
2. Liver injury due to oral anabolic use typically manifests itself as cholestasis.
Hepatotoxicity induced by oral anabolic compounds tends to be characterized by enlargement of periportal hepatocytes, impairment of bile flow & dramatically increased serum levels of AST, ALT and GGT. In other words, cholestasis... but let's examine this a little bit further.
The word "cholestasis" gets thrown around a lot, but it can mean two very different things: The physical obstruction of hepatic bile flow -or- the impairment of bile secretion. In the former case, there is a mechanical block in the bile duct system; in the latter, bile is held in hepatocytes or cholangiocytes as it cannot be secreted. In both cases, what happens thereafter is that the retained hydrophobic bile salts -- which are strongly cytotoxic -- lead to cellular injury, then apoptosis, then necrosis, often followed by an inflammatory reaction and tissue fibrosis. This tissue damage, if advanced enough, can physically destroy bile ducts, worsening the condition.
The obstruction of bile flow is typically not something you'd experience after exposure to any toxin; it is the almost exclusive domain of inherited or autoimmune diseases which leave fibrotic lesions or scar-tissue in the liver, such as cystic fibrosis, primary biliary cirrhosis, and so on. Exposure to oral anabolic compounds can, however, result in the second form of cholestasis -- bile retention in hepatocytes -- thus the enlarged hepatocytes observed after their use.
3. There are three fundamental ways of preventing/treating cholestasis:
1. Metabolic induction of hydrophobic bile acid detoxification
2. Stimulation of impaired bile secretion
3. Protection of hepatocytes from the toxic effects of hydrophobic bile acids and/or inhibition of hepatocyte apoptosis.
Cholestatic liver damage is caused by bile acid accumulation... But not all bile acids are toxic. Generally speaking, the fewer hydroxyl groups they bear, the more hydrophobic and cytotoxic they are. Hence lithocholic acid is markedly cytotoxic, deoxycholic acid is very slightly cytotoxic, and cholic acid is essentially non-cytotoxic. Treatment #1 would involve hastening the metabolic conversion of the more toxic bile acids to hydrophilic, less toxic compounds --- or increasing the synthesis of hydrophilic bile acids from cholesterol, which would decrease the cytotoxicity of the entire bile pool as a whole. This can seemingly be achieved with the oral administration of ursodeoxycholic acid (UDCA), which has been reported to activate the PXR/SXR nuclear receptor in hepatocytes, which then activates bile acid–metabolizing enzymes. It is reasonable to assume that Tauroursodeoxycholic acid (TUDCA), the taurine conjugate of UDCA, should have the same effect.
As for #2... Bile secretion at the level of the hepatocyte is carried out by a group of transporter proteins: The bile salt export pump (BSEP), the phospholipid export pump (MDR3), the canalicular bilirubin conjugate export pump (MRP2), and a chloride-bicarbonate anion exchanger (AE2) for bicarbonate excretion. BSEP is the driving factor behind bile-acid dependent secretion, and MRP2/AE2 are the major forces behind bile-acid-independent bile secretion. Hydrophilic bile acids such as UDCA & TUDCA (and even, partially, cholic acid) have been shown to increase expression of BSEP mRNA; they activate BSEP coactivators by binding to the Farnesoid X Receptor (the "bile acid receptor"); they phosphorylate the BSEP protein via a Ca+/PKCa-mediated mechanism; lastly, they stimulate Cl -/HCO3 - exchange via this same PKCa induction, thus increasing AE2 levels.
Taken together, the above effects drastically enhance secretion of potentially toxic bile acids.
I want to start off by saying this: milk thistle is garbage. TUDCA (Tauroursodeoxycholic acid) is quite literally the primary and ONLY liver protectant people should be using if they are taking C17 Alpha Alkylated oral anabolic steroids. I think that Liv 52 is okay to use as well. But, if you could only pick ONE product and throw the rest away, I would say TAKE THE TUDCA!!!! Research has shown that it is the ONLY thing that is effective at treating anabolic steroid SPECIFIC induced cholestasis of the liver. Off the top of my head, one company that makes a product with TUDCA in it is Thermolife in their Liver Longer supplement, but they have seemed to be out of stock for a long while now. I know it is possible to pick up generic TUDCA if you look hard enough online. Just google it!
If you can find TUDCA elsewhere, get it as soon as you can.
As a matter of fact, using a liver support supplement such as TUDCA may even INCREASE the oral absorption and bioavailability of the steroid because it prevents cholestasis of the liver. You have to understand what happens in the liver when you use C17 alkylated orals. Cholestasis is defined as an impairment of bile flow in the liver. I don't know if you remember your highschool biology class, but bile is an extremely important component of the liver and of our body, because bile serves dual purposes:
1. In a way, it acts as a waste removal sewage fluid for the liver. All of the byproducts (not all necessarily bad, but stuff that your liver needs to remove on a regular basis or else it will harm the liver from an unhealthy buildup) that your liver creates from all the work it does in metabolizing a bazillion billion different things every day, gets collected as bile. In turn, bile salts really 'clean' the liver out.
2. Bile and the bile salts within it are very important to our digestion, especially of fats. It's stored in the gall bladder and then pumped into your duodenum (upper section of your small intestine) when you eat food to aid in digestion, as it assists in the breakdown of fats and such.
Now, in a nutshell, what happens when your liver gets 'damaged' from oral steroids is: (and i'm not going to get into the specific chemistry of it for ease of explanation to the layman) the liver is overloaded from processing the C17 alkylation on the anabolic steroid you are ingesting. What happens as a result is that it causes a slow down of bile flow in the liver, because the liver is getting so overloaded with the processes it is trying to undergo. The impairment of bile flow in the liver is known as cholestasis, and is a direct result of C17 alkylated steroid use . When bile flow is slowed down too much (or has outright STOPPED), the bile salts, which are very toxic to the liver cells, will start to damage those liver cells. The key idea here is BILE FLOW, and you'll see this repeated a lot in this post! The liver needs to keep churning bile through itself in all of its cells in order to clean out the metabolites resulting from all of the biochemical processes it's doing every second!
I don't have much time on me, so for further explanation I am going to quote a couple articles I found that explain in more detail what TUDCA does and how it literally is the ONLY liver support compound that is useful, to a much larger degree than anything else, at combating cholestasis:
A few words on the hepatotoxicity of 17a-methylated androgens/anabolics
1. 17a-methylated androgens/anabolics are hepatotoxic.
The liver toxicity of steroids is an under-researched field, but there seems to be a strong correlation between how easily the body can metabolize a steroid & its toxicity. Metribolone -- a truly excessively toxic compound -- is often referred to in the literature as a 'non-metabolizable androgen'. (1, 2, 3, etc.) Mibolerone , another deadly-toxic anabolic steroid, is also effectively 'non-metabolizable': The main metabolite of mibolerone in humans is... unchanged mibolerone. And by a very wide margin.
Methylstenbolone, which is resistant to 17b-HSD and 3b-HSD, is obviously difficult for the body to clear. It should therefore be no safer, no less toxic, than Superdrol or M1T -- compounds which share very similar traits.
2. Liver injury due to oral anabolic use typically manifests itself as cholestasis.
Hepatotoxicity induced by oral anabolic compounds tends to be characterized by enlargement of periportal hepatocytes, impairment of bile flow & dramatically increased serum levels of AST, ALT and GGT. In other words, cholestasis... but let's examine this a little bit further.
The word "cholestasis" gets thrown around a lot, but it can mean two very different things: The physical obstruction of hepatic bile flow -or- the impairment of bile secretion. In the former case, there is a mechanical block in the bile duct system; in the latter, bile is held in hepatocytes or cholangiocytes as it cannot be secreted. In both cases, what happens thereafter is that the retained hydrophobic bile salts -- which are strongly cytotoxic -- lead to cellular injury, then apoptosis, then necrosis, often followed by an inflammatory reaction and tissue fibrosis. This tissue damage, if advanced enough, can physically destroy bile ducts, worsening the condition.
The obstruction of bile flow is typically not something you'd experience after exposure to any toxin; it is the almost exclusive domain of inherited or autoimmune diseases which leave fibrotic lesions or scar-tissue in the liver, such as cystic fibrosis, primary biliary cirrhosis, and so on. Exposure to oral anabolic compounds can, however, result in the second form of cholestasis -- bile retention in hepatocytes -- thus the enlarged hepatocytes observed after their use.
3. There are three fundamental ways of preventing/treating cholestasis:
1. Metabolic induction of hydrophobic bile acid detoxification
2. Stimulation of impaired bile secretion
3. Protection of hepatocytes from the toxic effects of hydrophobic bile acids and/or inhibition of hepatocyte apoptosis.
Cholestatic liver damage is caused by bile acid accumulation... But not all bile acids are toxic. Generally speaking, the fewer hydroxyl groups they bear, the more hydrophobic and cytotoxic they are. Hence lithocholic acid is markedly cytotoxic, deoxycholic acid is very slightly cytotoxic, and cholic acid is essentially non-cytotoxic. Treatment #1 would involve hastening the metabolic conversion of the more toxic bile acids to hydrophilic, less toxic compounds --- or increasing the synthesis of hydrophilic bile acids from cholesterol, which would decrease the cytotoxicity of the entire bile pool as a whole. This can seemingly be achieved with the oral administration of ursodeoxycholic acid (UDCA), which has been reported to activate the PXR/SXR nuclear receptor in hepatocytes, which then activates bile acid–metabolizing enzymes. It is reasonable to assume that Tauroursodeoxycholic acid (TUDCA), the taurine conjugate of UDCA, should have the same effect.
As for #2... Bile secretion at the level of the hepatocyte is carried out by a group of transporter proteins: The bile salt export pump (BSEP), the phospholipid export pump (MDR3), the canalicular bilirubin conjugate export pump (MRP2), and a chloride-bicarbonate anion exchanger (AE2) for bicarbonate excretion. BSEP is the driving factor behind bile-acid dependent secretion, and MRP2/AE2 are the major forces behind bile-acid-independent bile secretion. Hydrophilic bile acids such as UDCA & TUDCA (and even, partially, cholic acid) have been shown to increase expression of BSEP mRNA; they activate BSEP coactivators by binding to the Farnesoid X Receptor (the "bile acid receptor"); they phosphorylate the BSEP protein via a Ca+/PKCa-mediated mechanism; lastly, they stimulate Cl -/HCO3 - exchange via this same PKCa induction, thus increasing AE2 levels.
Taken together, the above effects drastically enhance secretion of potentially toxic bile acids.
