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Orals VS Injectable Steroids: Pros and Cons

01dragonslayer

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Novice bodybuilders often contemplate whether to choose oral or injectable anabolic steroids.
We find many beginners are reluctant to utilize injectable steroids due to a fear of needles, injecting incorrectly, or just being inconvenient.

Are injectable steroids really safer for users?
Are orals really as toxic as their reputation suggests?
In this article, we analyse the pros and cons of oral vs. injectable steroids, so you know what to expect and which method of administration is optimal for you.

Oral Steroids

Examples:

Oral Steroids Pros

Convenient
Oral steroids (pills0 are very convenient to take; users simply swallow a tablet with water.

Users also don’t have to worry about the liver breaking down the substance and making it ineffective, as the most popular orals are c17-alpha alkylated, meaning a large percentage of the compound will survive liver metabolism.
Fast Results
Oral steroids, on average, have shorter half-lives compared to injectables, so we see them kick in faster, giving users results in a matter of days. For example, with Testosterone Undecanoate, serum testosterone levels peak in the bloodstream 5 hours after administration. Consequently, orals require more frequent doses to maintain high levels of sustained exogenous testosterone in the body.
Shorter Detection Time
We have found oral steroids’ detection time to be less than injectables (on average), so for users trying to avoid being flagged in a drug test and want all compounds to leave their system as soon as possible, orals are more suitable.
Below is a table comparing the detection time of oral vs. injectable steroids.


[th]
Oral Steroids​
[/th][th]
Detection Time​
[/th][th]
Injectable Steroids​
[/th][th]
Detection Time​
[/th]​
[td]Winstrol[/td][td]3 weeks[/td][td]Winstrol depot[/td][td]9 weeks[/td] [td]Anavar[/td][td]3 weeks[/td][td]Testosterone Enanthate[/td][td]3 months[/td] [td]Primobolan[/td][td]5 weeks[/td][td]Testosterone cypionate[/td][td]3 months[/td] [td]Andriol[/td][td]5 weeks[/td][td]Sustanon 250[/td][td]3-4 months[/td] [td]Dianabol[/td][td]6 weeks[/td][td]Trenbolone acetate[/td][td]5 months[/td] [td]Anadrol[/td][td]8 weeks[/td][td]Deca durabolin[/td][td]18 months[/td]
[COLOR=rgba(0, 0, 0, 0.3)]
1[COLOR=rgba(0, 0, 0, 0.3)][/COLOR]
[/COLOR]


There are, however, exceptions to this rule, with injectable steroids such as Testosterone suspension having a detection time of just 1-2 days.

Oral Steroid Cons

Bad for the Heart
In our testing, oral steroids are generally worse for the heart, lowering HDL cholesterol levels more than injectables. HDL is the beneficial cholesterol score that, when high, can lower blood pressure, and when low, can spike blood pressure.
Many orals stimulate hepatic lipase, an enzyme present in the liver that lowers HDL cholesterol.
Anadrol, Dianabol, and Winstrol are among the worst steroids for heart health in our experience, demonstrating detrimental effects on HDL and LDL cholesterol levels.
Thus, if users’ main concern is protecting their cardiovascular health when taking steroids and keeping blood pressure levels stable, injectable steroids (particularly Testosterone) are a superior option.
However, this isn’t to say injectable steroids cannot spike blood pressure to high levels, because they can, especially if the compound is powerful enough (such as Trenbolone).
Liver Toxic
Orals are also hepatotoxic, meaning they will stress the liver, as indicated by ALT and AST liver enzymes shooting up (1). Some bodybuilders aren’t overly worried about this side effect, considering the liver often repairs itself post-cycle and has powerful self-healing properties.

As a precaution, our patients often take TUDCA for liver support when taking orals. Alcohol should also be avoided, and stacking hepatotoxic steroids together, such as Dianabol and Anadrol, is not recommended.
There are exceptions to this rule, however, with some orals not causing significant liver stress, such as Anavar or Testosterone Undecanoate (2).

We have found Anavar’s hepatic effects to be mild due to the kidneys working to process Oxandrolone, taking stress off the liver. Equally, Testosterone Undecanoate poses little hepatic risk, bypassing the liver and being absorbed by the lymphatic system.
Biological Value
We have seen the biological availability of orals be significantly less compared to injectable steroids if used incorrectly.
For example, oral steroids are not to be consumed with dietary fat because many tablets are fat-soluble. Thus, most oral steroids should be taken without food for maximum results.
The only exception to this is Testosterone Undecanoate (otherwise known as Testocaps or Andriol), which should be taken with a high-fat meal (19+ grams).

Injectable Steroids

injectable steroids
Examples:

  • Trenbolone
  • Winstrol Depot
  • Deca Durabolin
  • Testosterone
  • Equipoise
  • Primobolan (Methenolone Enanthate)
Injectable steroids are administered deep into the muscle, known as intramuscular injections. These are typically performed in the buttocks or the outer thigh.

Pros

Less Liver Toxic
It’s a myth that injectable steroids do not stress the liver. Injectables do pose some toxicity, and we have even seen them cause liver failure in rare cases of steroid abuse (3).

Although injectables enter the bloodstream immediately, we see them pass through the liver upon exit. However, this level of hepatic strain is significantly less compared to orals and thus isn’t considered an issue.
Therefore, our patients may not utilize a liver support supplement (such as TUDCA or milk thistle) when cycling injectables.
Better for the Heart
All anabolic steroids will increase blood pressure as they are all variants of exogenous testosterone; thus, LDL levels will rise and HDL levels will drop (4).

However, we find injectable steroids to be less damaging to the heart because they don’t stimulate hepatic lipase, an enzyme (previously mentioned) that significantly decreases good cholesterol. Consequently, we see injectable steroids causing less plaque buildup in the arteries.

Cons

Incorrect Injections Could Prove Fatal
If a user injects in the wrong location, septic shock or nerve damage are possible outcomes. These are very serious mistakes, potentially resulting in disability or death. Thus, it’s important that users know how to inject properly if they are to take oil-based steroids.
Common intramuscular injection sites:

  • Buttocks
  • Outer thigh
Below is a diagram and demonstration of Dr. Nabil Ebraheim performing a correct intramuscular injection into the buttocks.
Below is an example of a correct intramuscular injection into the outer thigh.
Risk of HIV
One of the most prevalent causes of people contracting HIV is through sharing needles.
When a person injects themselves, some of their blood will remain in the syringe (and needle). Thus, such precautions are needed with this method of administration, compared to simply swallowing a pill.
Painful
Certain steroids can be painful to inject, such as Testosterone propionate, while other steroids are administered more smoothly. Muscle soreness is also common, which can be experienced deep within the muscle and can last for hours or days.

Coughing
A violent dry cough is common when injecting steroids, particularly when administering Trenbolone, a sensation known as ‘Tren cough’. This reaction occurs when the oil hits a blood vessel, immediately resulting in several seconds of intense coughing. This is a common reaction when injecting, occurring roughly 20% of the time in our experience. This is not a dangerous side effect, despite it being an anxious experience for beginners.
When the oil hits a vessel, foreign metabolites enter the lungs; thus, the body coughs as a self-defense mechanism to expel such substances. This results in a metallic taste in the mouth.
The reason why this is more commonly experienced when injecting Trenbolone is because it’s an irritant to the lungs, similar to how cayenne pepper is an irritant to the skin.

FAQ

Do Injectable Steroids Produce Better Gains?

In theory, injectable steroids may produce better gains as they don’t need to bypass the liver; thus, their biological availability is higher than orals.
However, in practice, we see a different outcome, with orals being just as powerful (if not more so in some examples).
Research has shown that, despite orals having less biological availability, they can alter how the compound is utilized by the body. For example, orals have the power to alter tissue selectivity and hepatic IGF-1 release, which completely changes the compound’s chemistry, and consequently, users’ results can increase.
Also, anabolic, androgen, progesterone, and estrogen scores can also change depending on the method of administration, as well as the half-lives and detection times.

What is the Safest Oral Steroid?

We have found Anavar, Primobolan (Methenolone Acetate), and Testosterone Undecanoate to be the least toxic oral steroids. However, these three compounds are also costly.
Testosterone undecanoate is the safest oral steroid when bulking and aiming to increase lean mass.
Anavar and Primobolan are the safest oral steroids when cutting and aiming to reduce body fat levels while gaining lean muscle.

Typically, blood pressure does not rise excessively when taking any of these steroids. Testosterone suppression will be mild (except in the case of Testosterone Undecanoate), and liver damage is unlikely with all three.

Can You Stack Orals With Injectables?

Yes, some of the most popular steroid cycles are a combination of orals and injectables, such as:
  • Dianabol/Deca Durabolin
  • Anadrol/Winstrol
  • Anadrol/Trenbolone
  • Anavar/Testosterone
However, some bodybuilders who are comfortable injecting may naturally steer away from using orals due to the potential hepatotoxicity.
We see orals typically becoming problematic when used in excessively high doses or when users do not allocate enough time off in-between cycles. As a general rule, the duration of a cycle should be equal to the duration off steroids. And for optimal health, the latter should exceed the former.

Orals vs Injectable Steroids

inject syringe for steroids
Are injectable steroids better than oral steroids?
Each compound must be assessed individually in terms of results and side effects to see if its pros outweigh the cons.
For example, users wanting to avoid liver problems could take Testosterone (injectable) or Andriol (oral) with no issues.
However, we do see injectable steroids being healthier for the heart and liver (on average).
Despite this, Trenbolone is one of the most toxic AAS and is injectable.
Equally, if a user’s objective is to take steroids to improve athletic performance and they are subject to drug tests, it would be advantageous to use orals, as they have a shorter detection time.
Which steroids individuals should opt for, whether oral or injectable, will depend on their personal goals.
Thus, if, after ample research, a user decides to take oral steroids, they should ensure their liver and heart are in good condition prior to a cycle. Also, taking TUDCA and fish oil are crucial precautions for maximum cardiac and hepatic protection.
We have found it generally troublesome to stack orals together, as this places additional strain on the liver.
The only exception to this is if users are in a financial position to run Anavar/Testosterone Undecanoate cycles, which are more mild orals.
 

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