Research shows that taking 25–50 mg of clomiphene per day, or every other day, is effective at restoring natural testosterone production (21). SERMs are medications that interfere with estrogen receptors via the hypothalamus in the brain, decreasing the production of the female sex hormone and thus increasing testosterone. Once endogenous testosterone has been restored, if a user wants to continue taking AAS, we have found hCG to be effective at maintaining fertility in doses of 500 IU every other day. High doses and longer cycles will cause a more severe suppressing effect. Also, milk thistle is generally considered to be safe when taken orally (16), with only a small percentage of people experiencing any side effects. Some studies have shown milk thistle to be effective at reducing inflammation and lowering liver enzymes, especially in those suffering from acute hepatitis. However, its potential for water retention can't be overlooked. It's a common concern for those exploring the world of anabolic steroids. The finding of increased body nitrogen suggested that the weight gain was not only intracellular fluid. However, this study could imply that briefly taking steroids may help someone maximize their natural potential with more permanent results. A solid post-cycle therapy protocol, as outlined in the PCT section, will help minimize your catabolic state post-cycle and help retain more of your gains. Thus, a significant proportion of the results are permanent should users continue lifting weights. Much of the raw material required to make steroids in these labs comes from sources in Eastern Europe and China. If you are eating in a calorie surplus for bulking, you likely won’t notice much or any fat loss with this steroid. Dianabol can burn fat and build muscle if only maintenance-level calories are consumed. This is more of a bonus result with Dianabol as it is not a true fat-burning steroid. But the muscle you build is yours to keep—if you earn it, support it, and don’t abandon your routine the second the cycle ends. But not all gains are water. Being in a surplus is important—but the size and quality of that surplus will determine if you gain slabs of muscle or just puff out like a water balloon. If you want to keep your gains, protect your hormones, and not feel like a puddle of sadness post-cycle, a PCT is non-negotiable. Tell that to your suppressed testosterone and estrogen-drenched mood swings two weeks after your last tab. The body’s testosterone levels will rise when first taking Dianabol, due to it essentially being exogenous testosterone. However, liver failure remains a possibility with Dianabol and other hepatotoxic steroids. Every time you eat food, the liver has to digest it; thus, when taking hepatotoxic steroids and eating large quantities of food, the liver is becoming increasingly taxed. If you begin treatment early (in the first 2 years), it’s possible to reverse it using AIs (aromatase inhibitors), which essentially reduce estrogen levels and increase testosterone. This is relatively common in AAS (anabolic-androgenic steroids) use, particularly Dianabol, due to its estrogenic nature. However, we have seen such protocols decrease strength gains due to the removal of intracellular fluid (inside the muscle cell). Milk thistle is part of the daisy family and has been used in medicine by ancient herbalists and physicians to treat those with liver disease. Anecdotally, we have found that such supplementation stabilizes rising ALT and AST levels. To combat hepatotoxicity, our patients regularly take liver support supplements, such as milk thistle (Silybum marianum). Androgenic side effects such as oily skin, acne, seborrhea, increased facial/body hair growth, scalp hair loss, and virilization may occur. Metandienone, also known as methandienone or methandrostenolone and sold under the brand name Dianabol (D-Bol) among others, is an androgen and anabolic steroid (AAS) medication which is mostly no longer prescribed. When used responsibly for short cycles, Dianabol builds muscle faster than any legal alternative. This is because liver and cholesterol values can rise to high levels when both are taken in tandem. Thus, Dianabol is actually the more potent steroid mg for mg, but because Anadrol is typically taken in higher quantities, side effects can be a little more troublesome in our experience.