GP Proviron by Geneza Pharmaceuticals

Originally developed as a drug for treating depression in men, Proviron or Mesterolone is an orally applicable androgen and derivative of Dihydrotestosterone (DHT). Proviron is 1 alpha-methyl-17 beta-hydroxy-5 alpha-androstan-3-one and the molecular mass of this prescription drug is 304.467 g/mol at the base. One of the biggest advantages associated with use of GP Proviron is its unique ability to promote the count and quality of sperm and is also indicated to treat serious wellness problems such as low libido and erectile malfunction. The drug is even recommended to male patients struggling with impotency or lack of testosterone. In addition to these advantages, use of Mesterolone (GP Proviron) is also associated with improved release of luteinizing hormone and follicle-stimulating hormone for stimulating testes so that more testosterone can be produced.

Since it is not a 17 alpha alkylated compound, it can be used for a long period of time. The drug can even enhance potency of testosterone when used in an anabolic steroid cycle with it. The fact that GP Proviron can attach itself to SHBG (sex hormone-binding globulin) and albumin means that a large percentage of testosterone (free) is made available to conduct anabolic actions. Furthermore, the performance enhancing drug can also be used as an anti-aromatase and this characteristic proves to be beneficial when the drug is stacked with other anabolic steroids and performance enhancing drugs that may convert to estrogen to some extent. Since this steroid can bind to the aromatase enzyme, it does not allow steroids that are made a part of the cycle (with GP Proviron) to interact with enzymes and lead to formation of estrogens. Some sportsmen even use Mesterolone in an anabolic steroid cycle in place of testosterone that can have a negative effect on the libido since Proviron can enhance the level of libido to some extent because of the dihydrotestosterone effects of Mesterolone. A combined therapy with gonadotrophic hormone exhibiting follicle-stimulating hormone activity may be advised for initiating treatment and treatment with GP Proviron may be repeated after an interval of several weeks. It is important to note that use of Proviron is meant only for male patients though a medical practitioner may recommend its use to some female patients. When advised, individuals administered with it should undergo regular prostate examinations prophylactic-ally.

The increased level of free testosterone can then be utilized by the body for promoting protein synthesis that in turn stimulates muscle gain. Moreover, the steroid also has the ability to reduce the amount of free estrogen in the body by minimizing estrogen receptors’ ability to bind to estrogen. The drug is medically recommended to individuals suffering with potency disturbances due to androgen-deficiency, easy fatigability, lack of concentration, weak memory, disturbances of libido, depressive moods, general vegetative complaints, irritability, and declining physical activity and mental alertness in middle- and old-aged men. It may even be indicated for promoting the development of secondary male sex characteristics in cases of prepuberal hypogonadism and increasing fructose concentration up to normal values to enhance the chances of procreation.

The ideal dose of Mesterolone (GP Proviron) is 25-100 mg per day for men and 25 mg every day for women though some sportsmen, male as well as female, increase the doses to 50-125 mg every day and 40-60 mg per day, respectively.  Tablets of Proviron should not be chewed and must always be swallowed with a full glass of water. Overdosing or abuse of this drug can lead to health complications such as oily skin, acne, exacerbation of male pattern baldness, growth of body/facial hair, deepening of the voice, and menstrual irregularities. The use of Mesterolone is not recommended to patients with carcinoma of the prostate or those who are undergoing androgen therapy of any kind, including the use of GP Proviron. In case a dose of this drug has been missed and it is almost time for the next dose, the first dose should be ignored and the next dose should be taken at the designated time. Under no circumstances, two doses of the drug should be taken together for the dose that was missed. Medical advice should be sought without any delay and use of GP Proviron should be stopped immediately if side effects such as pain in liver area, headache, loss of appetite, depression, unexplained weight loss, aggression, symptoms of an enlarged prostate (change in urination), acne or hirsutism are experienced.

Womens and effective anabolic steroid Oxandrolone

If you want a highly effective yet safe and affordable anabolic steroid for cutting cycles, lean muscle building cycles, or fat loss, Anavar or Oxandrolone would be an ideal choice for you. This derivative of dihydrotestosterone increases nitrogen retention which leads to higher retention of protein, making it an excellent choice for muscle building and maintenance during a cutting steroid cycle as this steroid can easily hold onto muscles while the users are on a low calorie diet. Steroid use among women can be traced back to the 1960s with the German Democratic Republic doping program. This government funded program supplied performance enhancing drugs to thousands of male and female athletes over the span of several decades. During this time period there seemed to be little regard to the side effects of these drugs that were given to female athletes to increase performance. This resulted in irreversible side effects that have been well documented. Anabolic steroids such as Oral Turinabol, Mestanolone, and Testosterone were given to women just as they were given to men during the GDR doping program. These steroids all have an androgenic rating much too high to be considered safe for women to use. Although many records were broken and medals were won during this time period, there were heavy prices paid by many of the female athletes in the long run such as facial hair growth, deepening of the voice, hardening of facial features, and liver damage.

It is five times as anabolic as testosterone, but only a fifth as androgenic. These properties make this compound a great choice for women because it can be taken at a low dose without the side effects that accompany other highly androgenic steroids that cause masculinity effects in women. This drug was first marketed under the trade name Anavar. Oxandrolone was primarily designed for use in women and children for treating disorders that cause involuntary muscle loss while promoting muscle growth. This anabolic steroid is extremely popular among those participating in weight-based sports and body building as Anavar is second to none when it comes to possessing lean muscle building qualities and promoting huge strength gains and fat loss effects. This performance enhancing drug is also commonly used for achieving mass, fat loss, lean muscle, and strength gains and is often stacked with testosterone enanthate, injectable Winstrol, Oral Winstrol, and Sustanon 250. Some of the other legal anabolic steroids and performance enhancing drugs with which it can be stacked are Trenbolone and Primbolan.

Oxandrolone is a synthetic anabolic steroid that is a dihydrotestosterone derivative with an oxygen atom replacing the 2 carbon and methylation in the 17 position. Unlike most 17-alpha alkylated steroids, this drug’s toxicity level is, relatively speaking, mild. This tends to be a major factor contributing to Oxandrolone’s popularity. Since this oral steroid is a DHT derivative it will not convert to estrogen. There is little to no water retention with the use of Oxandrolone, and this has made this a drug of choice with athletes that compete in weight classes.

Oxandrolone was surprisingly discontinued in 1989 due to bad publicity after a report of being abused by bodybuilders. This drug seemed to be the safest being used for burn victims and HIV/AIDS patients to slow muscle wasting. It would have seemed more logical to stop the production of more dangerous steroids that were being abused instead of Oxandrolone, but that was not the case. Oxandrolone was later picked up by Savient Pharmaceuticals in 1995 under the trade name Oxandrin.

Oxandrolone has remained popular but has been a highly counterfeited drug due to the high price of raw materials. Stanozolol (Winstrol) has often been the drug used to replace Oxandrolone when it is counterfeited due to much cheaper prices, and similarities in gains. People will generally experience more side effects with Winstrol, especially with women. Raw material prices have dropped dramatically with China and India becoming such a large part of the steroid market and this has resulted in less counterfeits than ever before with this drug.

Oxandrolone is not known for packing on as much muscle mass as some other more androgenic steroids, but it will increase muscle density, hardness, and strength that is very noticeable in women, especially if they have never used anabolic steroids in the past. As with all anabolic steroids, dosage is key with maximizing gains and minimizing side effects. Oxandrolone can be dosed pretty low for women to see noticeable changes.

When starting Oxandrolone for the first time, a woman would generally start out with about 5mg per day split up into to 2, 2.5mg doses with about 8 hours in between each dose. If there are no side effects such as moodiness or acne with this dose, then the dose can probably be increased to 10mg per day. When taking 10mg per day, it will be split into 2 even doses with 8 hours in between as well.
Women seem to be much more sensitive to anabolic steroids than men, and they will often experience the most side effects, especially with highly androgenic compounds. With that being said, I feel that Oxandrolone would be the best choice if a woman decides to step over the line and turn to anabolic steroids. There are many other drugs out there that women do take to increase performance, and in doing so they often sacrifice femininity.

Methenolone (Primobolan) and athletes with chronic immune disorders

Methenolone (Primobolan) is generally advised in case of men suffering from the deficiency of a hormone known as androgen in men. In some rare instances this drug has also been advised to treat a condition known as aplastic anaemia which is mainly characterized by the deficiency of blood cells.

In some other instances it has been advised to counter the abnormal weight loss associated with certain disorders or following major trauma. It is illegal to obtain and use Primobolan without being prescribed by the doctor.

Effects on the body:
Primobolan has been advised for women suffering with breast cancer in some instances as it has been believed to aid in the reduction of the tumour size. The anabolic steroids such as Primobolan reduce the excretion of nitrogen from the tissue.

This retention of nitrogen within the muscle tissues aids in the building of muscle mass to a certain extent. The muscle building effect may be present to a certain extent while no clear evidence about enhancement in athletic performance has been observed with the use of Primobolan.

Primobolan supposedly burns fat thereby reducing its amount in the body. This effect of Primobolan has increased its popularity among athletes who look at building a lean mass with less fat in their body. Further it has been stated that Primobolan prevents wasting of muscles and reverses the effects of anaemia. Anabolic steroids may enhance the formation of blood cells in some instances. In case of individuals suffering from chronic immune disorders such as AIDS, Primobolan has been advised as immune booster drug. Being described as Arnold Schwarzenegger’s favourite steroid, Primobolan is widely abused in sports and bodybuilding. It is considered that it Primobolan builds strength with adding bulk to the muscles. Primobolan is generally more favored by athletes as it helps them to maintain a lean body mass while improving the ability of the muscles to contract. Also it has been proposed that it is not associated with the common side-effects of other steroids such as acne, water retention, infertility and others. In case of body builders, it is used during the bulking or cutting cycles.

Primobolan is considered a fairly weak steroid. Its anabolic/androgenic ratings are low and it’s one of the weakest steroids on paper; though, it is stronger than masteron. Since Masteron is always related to cutting cycles, on paper primo should gain credibility as a cutting steroid.

Primo has a huge advantage over most steroids, as it’s stronger than testosterone at binding to the androgen receptor. As with most dihydrotestosterone (DHT) related AAS, it’s a good aid for fat loss. In addition, Primo doesn’t aromatize, so you won’t need an aromatase inhibitor (AI) or SERM with it. Interesting fact, Primobolan was tested by old-school bodybuilders as gynecomastia (gyno) treatment back in the 70s and 80s. As strange as it sounds, it has been medically proven to reduce breast tumors in women (which are mainly estrogen related).

Since primobolan increases nitrogen retention, it’s been touted as anti-catabolic and somewhat anabolic (which can be disputed). In simple terms, it helps you keep your muscle mass while you’re dieting. That’s one of the biggest reasons it’s used on cutting cycles. Anecdotally, evidence shows that by using primobolan during low-calorie diets (even 20-30% below your BMR), you can keep your current lean muscle while gaining new muscle tissue. While this seems to be against basic understanding of nutrition, we’ll chuck this one to the magic of steroids. Primobolan can be used alone for a first cycle at doses of 300-400mg/wk injected of the preparation Primobolan Depot or Enanthate. However, Methenolone will lower natural testosterone levels and may then impact sex drive and erectile function, so this is not optimal.
Primobolan can be used alone, but you must realise this is not optimal. Yes, you may experience gains in strength and lean body mass, but the effects will not be as pronounced if the anabolic steroid is not combined even with a low dose of Testosterone. Let’s assume you’re going to run it alone and discuss the doses to suit. Primobolan Enathate is one of the more common forms of Primbolan on the black market. Schering is dosed at 100mg/ml, meaning an effective dose and amount is 300-400mg/wk, which is 3-4ml injected intramuscular. The same dose can be used whether cutting or bulking or used alone or in combination with other steroids. A dose of 50mg every day or 100mg every other day is advised for Primobolan Acetate or 100mg every day in pill form orally.

Cycle and dosing info for Primo:
Although Primo is a quality steroid, as said it is rather week. Also due to the fact that it contains (in injectable form) an enanthate ester, anything under 400mg per week is rather a pointless use of Primo and a waste of money. Generally with AS, more does not always mean better (due to side-effects and other issues), however in the case of Primo more does definitely equal better. If stacking Primo with testosterone, 400-800mg per week will be an effective dose, with obviously the higher doses being the most effective. Primo will have two main effects in such a stack. Firstly it will seem to amplify the effects of test, so 500mg of Test Enanthate may seem like 750mg or more. Secondly, Primo is very forgiving with one's diet. Quality muscle can still be obtained at a steady rate even with one's diet being off from time to time. However, with a spot-on diet, Primo and test will work wonders.

For those who would want to use Primo on its own or without test, you would really need to use a minimum of 600-800mg per week. If you can afford it, 1000mg per week of Primo will highly reward the user. Some people often ask about using Primo with Trenbolone. This can be done, however without test one must realise that you are likely to be quite shut down, and it is likely you would need some sex medicines as well as HCG. Despite this, for those that want a test-less cycle, Primo and Tren is a great cutting cycle. My ultimate cutting cycle however is one that incorporates Primo, Test Prop and Tren Acetate. Another very good cutting cycle that is test-free would be Primo (600-1000mg per week) with Anavar (60-80mg per day).

Due to the enanthate ester that is attached to the Methenolone base in Primo, it really should not be run for less than 8 weeks. Primo is also useful at a high dose for those who use higher doses of test and experience appetite loss from this. Primo doesn't cause such appetite loss, thus when bulking this can give a chance for diet to be spot-on. Primo does suppress and shut you down as said, however it is roughly about half as suppressive as test, so a 12 week Primo cycle would shut you down similar to a 6 week test cycle. For this reason, Primo alone can be run up to 20 weeks without fear of a very difficult recovery in PCT.

Female Primobolan Doses:
Primobolan is widely used by females due to its low anabolic and androgenic rating. This means that it will be an excellent choice for women due to the low incidence of temporary and permanent side effects. These include virilisation and are common place with the more anabolic and androgenic steroids. Symptoms, such as, deepening of vocal chords, acne, hair growth and hair loss, jaw growth and enlargement of sexual organs can occur. This can happen even when steroid doses are not considered abuse. Primobolan, generally, is a safe anabolic steroid for women to use – in the right doses. For both bulking and cutting cycle, it’s advised that more than 100mg/wk of legit pharmaceutical grade Primobolan should be used. If any side effects do occur, stop Primobolan use immediately or risk the fact of permanent sides.

Benefits of the thyroid hormone T4

Synthetic forms of the thyroid hormone T4 are generally called levothyroxine, and they are considered the standard treatment for hypothyroidism. Though they are man-made, synthetic T4 hormones are exactly the same as the T4 that is produced and released by the thyroid gland.

Synthroid is the most commonly-prescribed brand of T4 for hypothyroidism. It delivers a steady, prolonged dose of T4. There is also a generic form of T4 available, which is more cost-effective than brand-name medications. Fortunately, it's also equally as effective. Synthroid (levothyroxine) is a replacement for a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism. Levothyroxine is given when the thyroid does not produce enough of this hormone on its own.

Synthroid treats hypothyroidism (low thyroid hormone). Synthroid is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer.

All the approved brands of T4 are bio equivalent. In other words, there is no significant difference in their composition. However, that does not mean that these brands are exactly the same. The bio availability of a given brand at a given time after ingestion might be different. That's why much of the endocrinology community—the American Association of Clinical Endocrinologists, The Endocrine Society, and the American Thyroid Association—believe that once you start with a brand, you should stick with it. If you change brands during treatment, you risk altering your hormone levels. That means your symptoms may return and you may need to adjust your dose. Changing brands may change the dose slightly, which in turn may change how you feel. Thyroid hormone controls the rate of metabolism. When the thyroid is under active, all body processes slow down and symptoms such as weight gain, fatigue, and decreased body temperature are experienced. Through supplementation of thyroid hormones, basal metabolic rate will be increased.

Thyroid hormones are essential to proper development of all cells in body. These hormones allow for the body to become more sensitive to all other hormones, in turn making them more effective. Thyroid hormones also regulate macronutrient (protein, fat and carbohydrate) metabolism, therefore increasing protein synthesis and ultimately energy. This allows for the body to burn more calories and use them more sufficiently. For this reason, thyroid hormones are commonly used as fat-loss drugs.

This medicine does not typically cause side effects as long as proper dosages are administered. However some drawbacks of Thyroid drug use are cardiac stress and possible loss of lean body mass. Negative feedback in the thyroid can decrease natural production of thyroid hormone, causing short term decrease of metabolic rate after use is discontinued.

Determining Dosage:
Finding your ideal T4 dosage is essential. The right dosage keeps hypothyroidism from interfering with your life. The wrong dosage can make it an even bigger problem than it was before you sought treatment.

Getting the right dosage is important, but don't expect the dosage you start out with to be the dosage that you eventually keep. Doctors often use weight as a guideline for determining dosage. Some use the formula of 1.6 micrograms of T4 for every 1 kilogram (or 2.2 pounds) of weight for a starting dosage. Others prefer a more conservative approach, starting patients at a very low dose (perhaps as low as 25 micrograms). Note the 1.6 micrograms is a full replacement dose. This means that if part of your thyroid still functions properly, you won't need this full dose because you will continue to make some of their own T4, in addition to the dose in the pill.

Because it's common for dosages to change at the start of treatment, your doctor will likely monitor your thyroid stimulating hormone (TSH) levels after two or three months (though some doctors check as soon as four weeks) from your first day of treatment. And since hormone replacement therapy is usually a lifelong treatment, you should get checked every year to make sure you're taking the right dose if you're on a stable dose. You should communicate with your doctor more frequently if your dose is being adjusted.

Doctors often err on the side of caution when prescribing starting dosages of T4 for a variety of reasons. For one, starting at a low dose and moving up lets your heart get used to the increased metabolism. Also, they don't want to induce hyperthyroidism—a condition caused by high levels of thyroid hormones. You can learn more about the symptoms of over-treatment below.

Even with a moderate dose of T4, some patients are susceptible to over-treatment symptoms. Elderly patients with weaker hearts and people with heart arrhythmias (irregular heartbeat) are especially sensitive to thyroid hormone. Generally, doctors like to start a slightly lower dose in these patients, in order not to cause or worsen irregular heart beats.

Be aware that when and how you take medication does influence its effectiveness. For example, thyroid medication should not be taken with calcium or iron. Both of these minerals bind with thyroid hormone and make it unavailable for your body's use.

Thus, you should avoid milk products two hours before and after taking thyroid medication. There are also some medications that alter T4 levels.

Aspirin, danazol and propanolol have been shown to increase T4 levels and furosemide, methadone, lithium, aluminum-containing antacids, colestipol, and rifampicin have been shown to decrease T4 levels.

There are also some unique interactions. Progesterone and estrogen are substances that can bind with T4, but also tend to increase T3 levels. Anabolic steroids tend to decrease thyroid hormone levels. Finally, thyroid hormone can suppress insulin, an important consideration for diabetics and bodybuilders using insulin.

Finally, if diagnosed with hypothyroidism, you will be taking medication for the rest of your life.

Below are some of the symptoms of over-treatment:
    Feeling hot and sweating more than normal
    Shaking (hand tremors)
    Heart palpitations
    Having difficulty falling asleep
    Having mood swings
    Experiencing mental "fuzziness" (forgetfulness, loss of concentration)
    Experiencing muscle weakness
    Losing weight
    Menstrual irregularities

If you experience any of these symptoms throughout the duration of your hypothyroidism treatment, talk to your doctor immediately. He or she will first check your blood tests, before deciding on a dose.

Anabolic steroid and HIV therapy

Sometimes, athletes who use anabolic steroids may share the needles, syringes or other equipment they use to inject these drugs. By sharing needles, syringes or other equipment, a person becomes a high risk for HIV transmission. HIV is the virus that causes AIDS. If a person shares needles, syringes and other equipment to inject steroids into the vein (IV), in the muscles or under the skin, small amounts of blood from the person infected with HIV may be injected into the bloodstream of the next person to use the equipment.

HIV attacks the body's defense system, making the body less able to fight off infections and cancers. There's no vaccine or cure for HIV or AIDS. People who may have been exposed to HIV should be tested. If they find out they have the virus, they can start treatment early. You can't tell just be looking at someone if he or she has HIV. And, since someone can be infected with HIV for many years without having any symptoms, some people may not know they have HIV. Anyone who has ever shared a needle to shoot any drugs even once could become infected with HIV and should be tested.

These have shown some benefit in a variety of human disorders, including HIV-related muscle wasting and other catabolic conditions such as chronic obstructive pulmonary disease, severe burn injuries, and alcoholic hepatitis. Because of their diverse biological actions, anabolic steroids have been used to treat a variety of other conditions, including bone marrow failure syndromes, constitutional growth retardation in children, and hereditary angioedema.

Anabolic steroid side effect, safety, risks and danger:
Anabolic steroid therapy is associated with various side effects that are generally dose related, therefore, illicit use of mega doses for the purpose of bodybuilding and enhancement of athletic performance can lead to serious and irreversible organ damage. The most common side effects of anabolic steroids are some degree of masculinization in women and children, behavioral changes (eg, aggression), liver damage, and alteration of blood lipid levels and coagulation factors. Anabolic steroids could also raise levels of homo cysteine. Bodybuilders who used the muscle-building anabolic steroids have increased levels of homo cysteine, an amino acid tied to increased mortality, heart disease risk and blood vessel damage.

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). The HIV retrovirus may be passed from one person to another when infected blood, semen, vaginal secretions or other bodily fluids come in contact with an uninfected person's broken skin or mucous membranes. People with HIV have what is called HIV infection and are fit and well. Some of these people will develop AIDS as a result of their HIV infection. Growth hormone is a popular bodybuilding and performance enhancing aid, and the use of recombinant human growth hormone (rHGH, or simply GH) to treat various conditions in HIV infection has been debated with excitement for years. Indeed it is licensed for the treatment of wasting syndrome in advanced stages of AIDS. GH is also a commonly used bodybuilding and performance enhancing drug, which can be purchased on the black market; used to help both muscle anabolism / strength and reduction in body fat levels. Both of these applications have possible significance in the treatment of HIV.

Other than in the treatment of wasting disease, results from the studies using rHGH to treat body changes associated with HIV and/or drugs used to treat HIV have been very favourable. One which has been studied extensively is the use of rHGH in reducing HIV-associated adipose redistribution syndrome (HARS). However, the positive effects of HGH treatment in HIV may be more direct. Several studies have proposed that rHGH may bolster the immune system in ways that might improve clinical outcomes in HIV. HIV-associated adipose redistribution syndrome (HARS)
HARS is a type of lipodystrophy (abnormal distribution of body fat), where there is accumulation of excess truncal fat and visceral adipose tissue, as opposed to regular gynoid (glutes and hips) or android (abdomen) deposition. This is observed in HIV infected people, moreso as virus load increases. Although not a debilitating condition in itself (indeed extra body fat can prolong life if followed by wasting), HARS is unpleasant for the individual, giving reduced confidence in body image; another negative aspect of the disease.

rHGH therapy has been shown to significantly reduce HARS, leading to an improved body image, and significant improvement in psychological well-being. Numerous studies have demonstrated the benefits of this, leading to rHGH being licesenced for the treatment of HARS in some countries. It should also be noted that improvement in psychological well-being could also contribute to a positive clinical outcome, in that it reduces the effects of wasting.

Immune system:
Of most interest in HIV therapy are the possible benefits of rHGH use on the immune system, since HIV's primary adverse effect is reduction in the immune system. It has been clearly demonstrated that rHGH does benefit the immune system, but the method by which it helps is still under debate. One theory is that rHGH may stimulate renewal of the thymus gland, an important organ in the immune system. This may, in turn, lead to improved immune health in people with HIV. Studies are now examining whether or not renewing thymus tissue leads to better health and longer survival.

The thymus is necessary for developing new T-lymphocytes, which are key immune cells in the defense against disease, and numbers of which steadily reduce in HIV as infection progresses. In particular the thymus gland is involved in the development of CD4+ and CD8+ cells, and it is the CD4+ level which is a very critical marker in HIV outcome. Without some thymus activity, immune reconstitution that produces a wide range of functional CD4+ cells is not believed to be possible. Thus, the state of the thymus in HIV disease and how therapies affect it are of great interest to those researching ways to restore the immune system.

Napolitano et al (2002) researched rHGH and its impact on the thymus in HIV. Doses ranged from 1.5 (4.5IU) to 3.0mg (9IU) per day for 6–12 months in healthy HIV volunteers. After six months, marked increases in thymus mass were noted, beyond what has been seen using anti-HIV therapy alone. This increase was sustained during the course of rHGH therapy and correlated with a higher CD4+ count, suggesting that the thymus is functioning properly and helping make new T-cells, further suggesting a stronger immune system. When rHGH was stopped, there was a loss of thymus mass; however, CD4+ cell count increases seen over the course of therapy were sustained despite this loss of mass.

Napolitano later (2003) did a twenty-person study using 3mg (9IU) rHGH a day injected under the skin (subcutaneous injection). This was followed by 1.5mg (4.5IU) rHGH a day for another six months, for a total of one year of daily therapy. Of the 20 volunteers (all of whom stayed on anti-HIV therapy during the study), ten took one year of rHGH according to the schedule described above while the other ten were merely observed. After one year, the group on rHGH stopped therapy and were observed for a second year, while the group who hadn't taken rHGH therapy then started one year of it. The size of the thymus increased in those on rHGH during the first year, but not among the second group. Those on rHGH had a significant increase in thymus mass while those only on anti-HIV therapy actually had a slight decrease. Interestingly the most pronounced increase in both naïve and total CD4+ cell counts were seen among those on rHGH with a rise in the hormone IGF-1 (insulin-like growth factor-1) which is also associated with immune function. In subjects with pronounced increase in IGF-1 levels due to rHGH use, naïve cells increased by 95% and CD4+ increased by 25%.

The anabolic steroids and Hepatitis C

The anabolic steroids have been studied as a treatment for wasting caused by HIV and have been shown to be safe and effective, helping the formation of lean muscle mass. To be most effective, anabolic steroid treatment should be combined with an exercise program of resistance (weight) training. Studies have mostly been restricted to men because of concerns about the side-effects of steroid treatment for women. It is estimated that as many as 40% of HIV-positive men who are ill because of HIV have low levels of testosterone (hypogonadism). Low testosterone can result in decreased appetite, depression, poor metabolism of food, and sexual problems, including the inability to obtain and maintain an erection.

A blood test can show if you have low levels of testosterone and your doctor may prescribe either a short course of oral testosterone replacement therapy, testosterone patches or testosterone gel. Although testosterone is usually considered to be the male sexual hormone, it also occurs naturally in women. Testosterone patches have been examined as a treatment for wasting caused by HIV in women. It was found that weight and quality of life improved for some of the women, and the development of male characteristics was not reported. Side-effects from testosterone replacement therapy are rare, but can include the shutting down of natural testosterone production, shrinking of the testicles, hair loss, increased sexual desire, and aggression. In women, male characteristics, such as the deepening of the voice, and facial hair may develop. Hepatitis C is usually transmitted through blood-to-blood contact. Needles, syringes and other equipment used to inject drugs, and equipment used to sniff drugs such as straws or banknotes, should never be shared.

The sexual transmission of hepatitis C is now an issue of concern. It used to be thought that this was very rare. However, there have been recent reports of increasing numbers of gay men testing positive for hepatitis C. Many of these men are HIV positive and their only risk activity appears to be unprotected anal sex. Sexual activity that carries a risk of contact with blood, such as rougher anal sex, use of sex toys and fisting, seems to have a particular risk of hepatitis C transmission. Group sex, especially in the context of drug use, is also an important risk factor. Using condoms correctly, every time you have sex, not sharing sex toys or washing them between use, and not sharing pots of lubricant can reduce the risk. Mother-to-baby transmission of hepatitis C is thought to be uncommon, but the risk is increased if the mother is also HIV positive. A high hepatitis C viral load increases the risk that a mother will pass on hepatitis C to her baby and, as with HIV, a caesarean delivery reduces the risk. It’s best not to share razors, hair and nail clippers, nail scissors or toothbrushes if you have hepatitis C.

Very few people experience symptoms when they are first infected with hepatitis C. When they do occur, symptoms include jaundice, diarrhoea and feeling sick. In the longer term, about 50% of people with hepatitis C will experience some symptoms. The most common ones are feeling generally unwell, extreme tiredness, weight loss, depression and intolerance of fatty food and alcohol. Although a small proportion of people infected with hepatitis C clear the infection naturally, about 85% will go on to develop chronic hepatitis C. About a third of people will develop severe liver disease within 15 to 25 years. The severity of disease can be affected by the strain of hepatitis C you are infected with. Men, people who drink alcohol, people who are infected with hepatitis C when they are already into middle age, and people with HIV seem to experience faster hepatitis C disease progression. Hepatitis C can cause liver fibrosis (hardening) and cirrhosis (scarring). This damages the liver to such an extent that it cannot work properly, causing jaundice, internal bleeding and swelling of the abdomen. Chronic infection with hepatitis C can cause liver cancer (hepatocellular carcinoma, or HCC). HCC is especially likely to happen in people with cirrhosis, particularly if they drink heavily. There’s also some evidence that smoking can speed up the rate of cirrhosis and increase the risk of liver cancer. Surgery is the most effective form of treatment for liver cancer, but  other options include chemotherapy and treatment with drugs.

You should be tested soon after your diagnosis with HIV to see if you are also infected with hepatitis C. Unlike hepatitis B, there is no vaccine against hepatitis C. If you are in a group at high risk of infection with hepatitis C, it’s recommended that you have regular tests to see if you have been infected. A test is available to measure hepatitis C viral load. Unlike the HIV viral load test, this is not an indicator of when to start treatment. However, it is used to show how effective treatment any hepatitis C is being and how long it should continue. Liver function tests can give an indication of the extent to which hepatitis C has damaged your liver. Liver ultrasounds and biopsies may also be used. People co-infected with HIV and hepatitis C are more likely to develop liver damage than people who are only infected with hepatitis C. However, hepatitis C does not increase your risk of becoming ill due to HIV or responding less well to HIV treatment.

HIV treatment can be used safely and effectively if you are co-infected with HIV and hepatitis C. HIV treatment that suppresses viral load and increases your CD4 cell count can slow the rate of HCV-related liver damage. However, you may be at greater risk of experiencing the liver side-effects which some anti-HIV drugs can cause, and you and your doctor should have this in mind when selecting which anti-HIV drugs to take. It also seems to be the case that people co-infected with HIV and hepatitis C are at greater risk of developing some of the metabolic disorders which anti-HIV drugs can cause (particularly insulin resistance and diabetes).

Drugs are available for the treatment of hepatitis C and you should receive your treatment and care from doctors who are expert in the treatment of both HIV and hepatitis C. This may mean that, as well as seeing an HIV doctor, you also need to see a specialist liver doctor. If you have both HIV and hepatitis C, you should be assessed to see if you would benefit from starting hepatitis C treatment. If you and your doctor decide that you will start hepatitis C treatment now, and your CD4 cell count is between 350 and 500, you should start hepatitis C treatment first, then start HIV treatment. If your CD4 cell count is between 350 and 500 and you don’t yet need treatment for hepatitis C, you should start HIV treatment. If your CD4 cell count is under 350, you should start HIV treatment before starting hepatitis C treatment. A number of anti-HIV drugs have interactions with drugs used to treat hepatitis C. The choice of anti-HIV drugs you take will need to be made with these possible interactions in mind.

Before you start treatment for hepatitis C, it is important to know which strain, or genotype, of hepatitis C you have been infected with, as this can predict your response to treatment and the amount of time you will need to take treatment for. There are several hepatitis C genotypes. Type 1 is most common in the UK, and unfortunately responds least well to the currently available treatments for hepatitis C. Genotype 4 is also harder to treat. People with genotypes 2 or 3 respond better to treatment. However, there are new HCV drugs available, and more in development, which should improve the chances of a cure for people with harder-to-treat genotypes.

Factors such as your age, gender, how long you have had hepatitis C, the degree of liver damage and whether cirrhosis has developed are also important in predicting if treatment is likely to be effective. Unlike HIV treatment, treatment for hepatitis C is not lifelong. It consists of 24 or 48 weeks of treatment, and the length of treatment you receive will depend on the hepatitis C genotype you are infected with. A test after twelve weeks of treatment can predict if you are going to respond to treatment. Drugs are available for the treatment of hepatitis C. The backbone of treatment consists is pegylated interferon and ribavirin. These are taken in combination with an anti-HCV protease inhibitor. This sort of triple combination has been found to be much more effective than dual therapy with pegylated interferon and ribavirin alone. The aim of hepatitis C treatment is to eradicate infection with hepatitis C completely. Other aims of treatment include normalising liver function, reducing liver inflammation and reducing further damage to the liver. If you are ill because of HIV, then the aim of hepatitis C treatment is likely to focus on improving your tolerance of anti-HIV drugs, reducing the risk of death from liver problems and improving your overall quality of life. Hepatitis C treatment can have unpleasant side-effects, including a high temperature, joint pain, weight loss, nausea and vomiting and depression. Other side-effects include disturbances in blood chemistry.

Arthritis and HIV-infected patients

Musculoskeletal syndromes that occur in HIV-infected patients include manifestations of drug toxicity, reactive arthritis, Reiter's syndrome, infectious arthritis, and myositis. Principles to keep in mind when evaluating an HIV-infected patient with a musculoskeletal syndrome include the following:

Any musculoskeletal syndrome in non-HIV infected patients can occur in HIV-infected patients, such syndromes may not be related to the HIV infection.
HIV infection can alter clinical presentation and course. Reactive arthritis, inflammatory arthritis, or musculoskeletal infections may be more severe in presentation and course in HIV-infected persons. In some cases, musculoskeletal infections may be more insidious and subtle in onset.
Ruling out or correctly diagnosing infections is especially important to prevent the spread of infection in an immunocompromised patient.
The probability of an opportunistic infection as a cause for a musculoskeletal complaint depends on the stage of the patient's HIV disease. At early stages (CD4 count above 300), opportunistic infections are unlikely, although resistance to common bacterial pathogens may be reduced.
Generally, diagnostic tests and treatment regimens for musculoskeletal syndromes are the same as when the syndromes occur in non-HIV infected patients, except that the patient's HIV-related medications may cause side effects and interactions that impact differential diagnosis and limit therapeutic options, and there should be a very high threshold to using immunosuppressive drugs.

Some risk factors for HIV infection are also risk factors for other conditions that may present as musculoskeletal syndromes. Examples include injection drug use and arthritis associated with hepatitis B virus infection or endocarditis, sexual promiscuity and the arthritis syndromes associated with sexually transmitted infections such as gonorrhea and chlamydia, and hemophilia and hemarthrosis. Clinicians need to examine HIV-infected patients who present with acute or subacute musculoskeletal pains for evidence of infection in the joints and muscles. Careful examination of the skin may reveal a fungal infection that has spread to the joints. Septic arthritis may be difficult to differentiate from reactive arthritis, but cultures of the synovial fluid and blood will be sterile in cases of reactive arthritis. Septic arthritis in HIV-infected injection drug users (IDUs) is most commonly due to Staphylococcus aureus and usually responds well to treatment. In patients with advanced HIV disease who are not IDUs, clinicians must always consider opportunistic infections in joints, bones, and muscles. HIV-infected patients with muscle pain and weakness must be evaluated for idiopathic polymyositis, myositis secondary to zidovudine (AZT) toxicity, and infectious pyomyositis. Although many clinicians believe that HIV infection predisposes patients to musculoskeletal infections and has a negative impact on the outcome of the therapy, this hypothesis is not yet proved.
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Both Reiter's syndrome and septic bursitis can cause a monarticular arthritis in an HIV-infected patient. Evaluation of synovial fluid is necessary to rule out infection and make a diagnosis. Clues to help the clinician differentiate between infectious and reactive arthritis in patients with HIV disease include a history of urethritis, cervicitis, diarrhea, or conjunctivitis, and findings of psoriasiform lesions, nail changes and enthesopathy (inflammation of tendinous insertions), as these may accompany a reactive arthritis.

The onset of reactive arthritis in HIV-positive patients usually occurs in the foot and ankle, and the common types of inflammation are enthesopathy (involving the Achilles tendon, plantar fascia, or anterior and posterior tibial tendons) and multidigit dactylitis. Synovitis is rare but may occur in joints of the lower extremities. In the upper extremities, dactylitis and enthesopathy occur in the tendinous insertions in the lower part of the arms. Cutaneous symptoms include psoriasiform rashes, keratoderma blennorrhagicum, and onychodystrophy.

In reactive arthritis, the synovial fluid is usually inflammatory, with a few thousand white blood cells and a synovial glucose level that is at least two thirds the serum glucose level. Gram stain or culture of synovial fluid is the only reliable way to make the diagnosis of a septic arthritis or bursitis. If the diagnosis is entertained, aspiration and culture should be performed immediately. If the synovial fluid is purulent, it may be prudent to initiate broad antibiotic coverage while waiting for the results of definitive synovial fluid cultures. Also, if the synovial fluid is initially unobtainable (as in axial joint infection), it is prudent to initiate antibiotic coverage. Blood cultures should be obtained during the work-up of the arthritis, as they may become positive before the synovial fluid cultures. HIV-infected patients who are at high risk for septic arthritis include IDUs and hemophiliacs. Clinicians must always consider and rule out acute infectious synovitis in these patients.

Gram-positive bacteria, such as S. aureus and Streptococcus pneumoniae, commonly found in non-HIV infected patients with septic arthritis and bursitis, are causative factors in most reported cases of septic arthritis and bursitis in HIV-infected persons. Infections with organisms not common to the skin have also been reported. One report described osteomyelitis in HIV-infected patients, but usually it results from direct extension from a septic joint. Clinicians must frequently re-examine HIV-infected patients treated for septic arthritis for evidence of worsening or unchanging symptoms and signs. If bone pain and fever continue despite antibiotic coverage, extension of the infection to the surrounding bone should be considered, surgical debridement may be necessary.

In most HIV-infected patients with acute joint or bursa infections, broad antibacterial coverage to cover common skin organisms (including staphylococcal and streptococcal infections) should be initiated. Patients with advanced HIV disease occasionally have opportunistic joint infections, such as sporotrichosis, cryptococcosis and Mycobacterium avium intracellulare. Often these patients have extraarticular features suggestive of such infections, including typical skin lesions. These opportunistic infections often present with a more indolent course than that of a bacterial septic arthritis. If extra articular features of fungal infection are present or hyphae or budding yeasts are seen on direct synovial fluid examination, the patient should receive standard doses of intravenous amphotericin B.

The HIV Wasting Syndrome

Wasting syndrome is defined as weight loss in excess of 10% from baseline that is associated with chronic diarrhea, fever, or weakness. Between 1987 and 1991, wasting was the second most common AIDS-associated condition reported to the CDC and the only AIDS-associated illness noted in 7.1% of reported cases. Unpublished data from the CDC's Adult-Adolescent Spectrum of Disease Program, which studied AIDS deaths in 10 cities, found that between 1990 and 1994, wasting occurred in 21.6% of cases. This was the fourth most common AIDS-associated condition, after PCP, MAC, and esophageal candidiasis. CDC statistics from 1995 document wasting as the third most common AIDS-indicator condition, after severe immunosuppression and PCP. Wasting is more prevalent in people of low socioeconomic status and women. For a variety of reasons, clinicians often treat wasting syndrome inadequately. They can be overwhelmed by the difficulties and competing side effects of antiretroviral regimens and OI therapies. Physicians receive very little nutrition education as part of their formal training. Additionally, effective pharmacologic intervention in wasting is just beginning to evolve.

The degree of wasting and malnutrition correlates with progression of AIDS. Data from the Multicenter AIDS Cohort Study showed that development of AIDS, fever, thrush, and a CD4 lymphocyte count of less than 100/mm3 were independently associated with continuing loss of body mass. Another study found that measurements of lean body mass, albumin, and transferring predict survival, independent of CD4 count. Starvation causes death when people reach 66% of ideal body weight or 54% of ideal body cell mass; patients with AIDS die at a similar level of weight loss. Because wasting is associated with disease progression, prevention and treatment of wasting should be an integral part of the care of patients infected with HIV. Studies are in progress to document the effect of reversing wasting on disease progression, morbidity and mortality.

Pathophysiology of Wasting:

Not all pathogenetic mechanisms of wasting in HIV have been fully elucidated, but many factors that promote progressive weight loss are understood. Wasting is a product of:  perturbations of metabolism and resting energy expenditure caused by the body's immunologic response to HIV and its secondary infections;  inadequate nutrition, secondary to poor oral intake, and malabsorption of nutrients, caused by diarrhea and alteration of levels of endogenous anabolic hormones, especially in men.

Perturbations of Metabolism: Resting energy expenditure (REE) increases with HIV infection. Even asymptomatic individuals with early infection have been shown to have an REE of 9% to 12% above seronegative controls. In HIV-associated hypermetabolism, maintenance of body weight requires an increase in caloric intake but, in the absence of OIs, most HIV-positive individuals can maintain adequate intake. Patients with AIDS have REEs of 25% to 34% above controls in some studies, and REE increases even when nutritional intake is poor. Paradoxically, in normal subjects REE decreases when caloric intake declines.

The development of an OI, with its concomitant rise in REE, usually leads to loss of weight, mostly lean body mass. Conversely, weight gain achieved through alimentation alone is mostly adipose tissue. This physiologic preference for fat over lean body mass is more acute in men than women, but all patients with AIDS face a persistent loss of lean body mass that is difficult to replace. The body, instead of reacting to a scarcity of nutrients by preserving lean body mass, combines hypermetabolism with accelerated protein breakdown and negative nitrogen balance to produce wasting.

Limited data are available on the potential role of cytokines in patients with AIDS and more research is needed. However, the mechanism of metabolic dysregulation that inappropriately increases REE and favors adipose tissue over lean body mass may in part be related to the cytokines elaborated in response to HIV and OIs. Tumor necrosis factor (TNF), interleukin (IL)  and 6 and interferon alpha, beta, and gamma have all been implicated in metabolic dysregulation. TNF induces weight loss and suppresses appetite in animal models. In addition, these various cytokines may act synergistically to cause futile cycling and inappropriate use of substrates.

Futile cycling of fat occurs in HIV infection, contributing to increased REE as well as hypertriglyceridemia. Peripheral lipolysis releases free fatty acids from adipose tissue. The free fatty acids are re-esterified into triglycerides in the liver and then packaged into very low density lipoproteins (VLDLs), which are released into circulation. The VLDLs are broken down in the periphery by lipoprotein lipase, resulting in storage of the triglycerides in peripheral adipose tissue again. Each of these steps requires adenosine triphosphate (ATP), thus wasting energy, shuttling fat between the periphery and the liver and back again. Current research concludes that TNF, IL-1, IL-6, and interferon alpha play a role in futile cycling of fat.

Inappropriate use of substrate contributes to increased REE and protein wasting seen in HIV. An example of this is the liver utilizing glucose to synthesize triglycerides, instead of protein, in individuals with negative nitrogen balance. This step consumes energy needed to maintain body cell mass. Using energy to make fat is inappropriate in a patient losing body cell mass. The body should be oxidizing fat, not synthesizing it, in this situation. Bodily energy reserves and substrate such as glucose should be employed to restore lean body mass. TNF, IL-1, IL-6, and interferon alpha appear to be involved in the transformation of glucose into triglycerides in the liver.

Malnutrition: Malnutrition occurs in HIV for many reasons. Both illness and inactivity suppress appetite. Many of the medications used to treat HIV and OIs cause anorexia and a variety of GI side effects. Candidiasis, aphthous ulcers, and CMV disease involving the mouth and esophagus make eating difficult and decrease oral intake.

Many secondary infections including MAC, CMV, cryptosporidium, microspora, protozoa, and bacterial pathogens cause diarrhea and secondary malabsorption of nutrients. HIV causes diarrhea through villous atrophy, crypt hyperplasia, lymphocyte infiltration of bowel epithelium, viral infiltration of the mucosae, and the development of an enteric autonomic neuropathy. Many of the well-known hepatic complications associated with HIV, as well as abnormalities of the pancreas caused by ddI, ddC, pentamidine, CMV, MAC, cryptococcus, toxoplasmosis, and TB contribute to diarrhea and malnutrition. Malnutrition is further exacerbated when patients decrease oral intake in an effort to reduce diarrhea.

Androgen Deficiency: One of the roles of androgenic hormones is to help generate and maintain lean body mass. More than half of men with AIDS have low or inadequate androgenic hormone levels due to HIV's interference with the hypothalamus-pituitary axis, adrenal glands, and the testes. Total and free testosterone levels are both suppressed. This lack of endogenous anabolic stimulation is particularly important in light of the metabolic shift away from preservation of lean body mass. HIV's effect on endogenous androgens in women has not been well studied. Given the high prevalence of wasting syndrome in women, both viral effects on female metabolism and the impact of hormone supplementation need further study.

Treatment of Wasting: Optimally, clinicians should try to prevent wasting syndrome as well as treat it when it occurs. Weight loss is often the first sign of a new AIDS-defining illness. Patients should be weighed at every visit and their weight trends recorded on a graph. Because lean body mass is lost in preference to fat, weight alone can be a misleading indicator of nutritional status and clinical course. Laboratory markers of nutritional status include albumin, transferrin, and cholesterol levels. Some clinicians also use bioelectric impedance analysis, which measures lean body mass, to track nutritional status.

Treating Underlying Illness: A crucial first step is to provide appropriate antiretroviral therapy as well as meticulous prophylaxis and treatment of OIs. Two early studies documented clinical and biochemical improvement in individuals treated with AZT monotherapy; one documented an average 2- to 3-kg weight gain and a second demonstrated rapid, significant, and sustained declines in interferon and triglyceride levels in subjects treated with AZT. A later study documented a decrease in REE of 650 kcal/day in patients with CMV colitis who were treated with ganciclovir. Several studies have documented that patients with active, untreated secondary infections are often unable to gain weight even with hyperalimentation.

Patients with untreated secondary infections involving the mouth and GI tract tend to have poor oral intake, since they often have dysphagia and odynophagia as well as diarrhea and malabsorption. Addressing oral and esophageal complications can improve caloric intake and reduce discomfort (see ACC, March 1995 for a complete discussion of esophageal lesions in HIV).

Nutrition: Maintenance of good nutrition is essential. Lost weight can be very difficult to replace. Calorie needs are in the 25 to 60 kcal/kg/day range; 20% should be protein. Working with a nutritionist is helpful. Patients often have deficiencies of micronutrients. One study found a 31% decrease in progression to AIDS in patients taking regular multivitamins with minerals. This finding may be confounded by a bias in favor of more compliant patients with better diets.

Oral feeding is clearly the nutritional route of choice. Emphasizing intake that is high in calories, protein, and fat is important. Over-the-counter nutritional supplements can help patients who are having difficulty with meals, or while they are being treated for oral or esophageal ulcers. Enteral alimentation can be used if oral or esophageal disease or disabling systemic illness makes eating temporarily impractical. Total parenteral nutrition (TPN) has been hotly debated in AIDS. Using TPN in patients with inadequately treated, active OIs and end-stage disease is of little value. Weight gained, if any, will be primarily fat. TPN is occasionally useful as temporary "bridge" therapy for a discrete period during treatment of intercurrent illness. The clear goal should be a restoration of full oral feeding once the patient can eat again. TPN is generally inappropriate in the terminal care of patients with AIDS.

HIV-virus and making use of anabolic steroids

People who are suffering from the dreaded HIV-virus and making use of anabolic steroids to prevent AIDS wasting tend to gain modest gains in terms of muscle mass and weight, according to a new review.  Anabolic steroids are synthetic substances similar to the male sex hormone testosterone that promote growth of skeletal muscle and the development of male sexual characteristics. Although most recently in the news for their misuse by professional athletes, anabolic steroids have legitimate medical application for men with low testosterone and people with certain types of anemia. Two anabolic steroids available in the United States, Nandrolone Decanoate and Oxandrolone, have been used to help increase weight and muscle mass in small studies of people with wasting. Conversely, anabolic steroid use has been associated with increased rates of HIV in those who share needles or use non sterile needles when they inject steroids.

A synthetic anabolic steroid derived from Dihydrotestosterone, Winstrol or Stanozolol has been approved by the U.S. Food and Drug Administration for human use. This steroid with a high oral bioavailability survives first-pass liver metabolism when ingested because of a C17 a-alkylation.

Classified as a controlled substance under the Anabolic Steroids Control Act of 1990 and assigned to Schedule III, this drug has the chemical name of 17-methyl-2′ H -5(alpha)-androst-2-eno [3,2- c ]pyrazol-17(beta)-ol and the molecular weight of 344.5392 g/mol at the base.

Why Is Winstrol Used:
Winstrol is medically prescribed to treat anemia and hereditary angioedema. It is also recommended for improving muscle growth and increasing bone density. Winstrol may also be prescribed for improving the production of red blood cells in the body and stimulating the appetite of debilitated or weakened individuals. It may also be recommended to treat health conditions like urticaria, Raynaud’s phenomenon, cryptofibrinogenemia, and lipodermatosclerosis. Winstrol use can also be associated with strengthened tendons and ligaments and to increase lymphocyte count and CD8+ cell numbers and to decrease CD4+ and CD3+ in postmenopausal women who are diagnosed with autoimmune disorders or osteoporosis.

Winstrol is generally used by those into bodybuilding, athletics, and power lifting to lose fat while retaining lean muscle mass. Winstrol is commonly made a part of cutting cycles for preserving lean body mass while metabolizing adipose. Winstrol has the unique ability of reducing the level of sex hormone-binding globulin (SHBG) that binds to sex hormones for creating a positive and synergetic effect with other anabolic steroids used in an anabolic steroid cycle. This performance enhancing drug is also used by athletes to run faster and preserve muscle tissue during dieting. Winstrol is also admired in the bodybuilding circles for decreasing the level of high-density lipoproteins and increasing the level of low-density lipoproteins. This drug can even stimulate immediate-early gene expression in a manner that is independent of the androgen receptor.

In addition to these advantages, this drug is also used by athletes and bodybuilders because of its diuretic properties since Winstrol can improve the excretion of water from the body while improving body strength, without causing an increase in the level of body weight. Athletes absolutely admire this drug as it helps them utilize more amounts of testosterone for burning excess fat tissues and stimulates the production of prostaglandin E2 and the matrix metalloproteases collegenase and stromelysin in skin fibroblasts. The use of Winstrol can also be associated with the inhibition of growth factor stimulated DNA synthesis and fibroblasts.

Winstrol is ideally used by men in doses of 25-100 mg per day and 5-15 mg per day by women for a period not exceeding eight weeks at a stretch. This drug may be stacked for a bulking cycle with Testosterone, Dianabol or Anadrol or with Trenbolone or Halotestin during a dieting phase. A big majority of athletes even stack Winstrol with Equipoise, Deca Durabolin or Primobolan.

Anabolic steroids and retrospective studies of HIV

Anabolic steroids are orally-ingested, synthetic (man-made) drugs that act like testosterone. They cause growth and development of male sexual organs, secondary sex characteristics, and increases in muscle size and strength. They are used for treating delayed puberty in boys, anemia, low muscle mass due to AIDs or HIV, breast cancer, and for replacing testosterone in men with low testosterone levels. Anabolic steroids often are abused by athletes for increasing muscle mass and performance. Non-athletes and non-competitive body builders also abuse anabolic steroids for cosmetic reasons. Anabolic steroids have many side effects because testosterone, which they mimic, has many effects in the body. The long list if side effects from anabolic steroids include shrinking of testicles, breast enlargement (gynecomastia), low sperm count, increased hair growth, deeper voice and reduced breast size in women, high blood pressure, heart attack, stroke, high cholesterol, rage, violence and aggression. Liver disease and liver cancer also can occur.

Anabolic steroids increase blood levels and effects of cyclosporine by decreasing the breakdown of Cyclosporine. They also reduce the breakdown of Warfarin (Coumadin), increasing blood levels of Warfarin and the risk of bleeding from warfarin.
High-dose steroid therapy has been proven effective in AIDS-related Pneumocystis pneumonia (PCP) but not in non-AIDS-related cases. We evaluated the effects on survival of steroids in HIV-negative patients with PCP. Retrospective study patients admitted to the ICU with hypoxemic PCP.
HDS were associated with increased mortality in HIV-negative patients with PCP via a mechanism independent from an increased risk of infection. Pneumocystis jiroveci pneumonia (PCP) is a major cause of acute respiratory failure in immunocompromised patients. Malignant disease, steroid treatment, and transplantation of solid organs or bone marrow are the leading causes of T-cell suppression, which is associated with a high risk of opportunistic infections, including PCP. The number of patients with T-cell suppression has risen in recent years, resulting in an increased incidence of PCP. In recent studies, more than 8% of patients with hematological malignancies admitted to the ICU for acute respiratory failure had PCP. Mortality rates of up to 30% have been reported in cancer patients with PCP.

Studies done in the 1990s showed that adjunctive treatment with high-dose steroids (HDS) was associated with a dramatic decrease in mortality during PCP episodes in HIV-positive patients. Corresponding proof of efficacy is not available for HIV-negative patients with PCP, and findings from the three available studies, all retrospective, are conflicting. In a 1998 study in 30 patients, the 16 patients given adjunctive HDS had no difference in mortality but spent less time on mechanical ventilation compared to the 14 patients managed without steroids. The second study, reported in 1999, compared 15 patients with HDS and 8 without HDS and found no significant differences in mortality or ICU stay length. The most recent study was published in 2011 and found no significant difference in mortality between the 59 patients given HDS and the 29 other patients. More over two retrospective studies from our group could not conclude of outcome improvement with adjunctive steroid in that setting. The small sample sizes may have jeopardized the ability of these studies to detect significant differences between patients given HDS and other patients.

The pathophysiology of PCP may differ between patients with and without HIV infection. Studies have shown that HIV-negative patients with PCP were older and had a larger number of co-morbidities, longer symptom duration at diagnosis and higher neutrophil counts in bronchoalveolar lavage fluid, compared to HIV-positive patients. Conceivably, these differences between the two populations might affect the ability of steroid therapy to provide therapeutic benefits.

Here, our objective was to determine whether HDS produced therapeutic benefits in HIV-negative patients with severe PCP requiring admission to the intensive care unit (ICU). To increase the sample size for our investigation, we included patients from four different sources, namely, three previously published studies and a teaching-hospital ICU database. We analyzed data from three retrospective studies of HIV-negative patients with Pneumocystis jiroveci pneumonia. The first study included HIV-negative patients admitted to two ICUs between 1988 and 1996 for PCP and compared patients who did (n=23) and did not (n=8) receive HDS in addition to standard treatment. The second study described HIV-negative patients with PCP managed in the ICU between 1989 and 1990 and looked for predictors of mortality, 33 of the 39 patients received HDS. Finally, the third study compared 56 cancer patients with PCP to 56 cancer patients with bacterial pneumonia admitted to the ICU between 2001 and 2006 of the patients with PCP, 21 received HDS. Only patients from theses studies who were admitted in ICU were included in the present study. In addition to the data from these three studies, we included data from patients admitted for PCP to the ICU of the Saint Louis Teaching Hospital, Paris, France, between 2006 and 2011. The IRB from Clermont Ferrand approved data collection for the addition of patients from St Louis hospital in this non international study. Medical chart were reviewed by the investigators (VL or AD) for all included patients . For all four sources of patients, inclusion criteria were age over 18 years, ICU admission, and PCP. Only definite case of PCP were considered (positive IF for pneumocystis or MGG coloration in BAL). Exclusion criteria were patients with HIV infection and patients who were not admitted to the ICU. Moreover, colonized patients defined with positive P. jiroveci PCR only, without any pulmonary symptom or treatment of P. jiroveci were not included.

Testosterone and exercise help weight gain in HIV wasting

Testosterone is the androgen secreted in the male testis and in the female ovaries. It is very important hormone for the proper growth of the human body. In men, testosterone plays a very important role in development of the secondary sexual characters. The sexuality of the men is dependent considerably on the testosterone levels in his body. The men with the less level of testosterone are often found to be weak and usually fail to perform well during the sex, whereas men with high level of testosterone are always healthy and found to excellent during the sexual encounter. It is the testosterone that helps to build the sexual stamina and guides the erection mechanism. But, due to low levels of testosterone many of the men are failing to perform well during the sex.

The main reason for the reduction in the testosterone level is aging. Also few other factors like stress, tensions, injuries to testis, inadequate sleep, and too much exercising decrease the testosterone levels in the body. There are various medications available to increase the levels of testosterone, but please don’t take them as they may affect your health adversely or if at all you want to take them consult the doctor. But, guys you can increase the levels of testosterone even without taking any of these medicines. So, go through the list of the food items mentioned below and have them regularly to increase the testosterone levels:

Eggs: Daily intake of egg is found to be very good source to increase the testosterone levels. Even it has been proved through the research that egg are very good source of proteins that promote the production of the testosterone. Eggs along with the proteins also contain the Vitamin A that stimulates the production of the testosterone. If you are having very low testosterone content then you should certainly start eating egg daily and you would be able to see the difference in few months.

Meat: Non-vegetarian food items are found to be very rich in the testosterone content. You can certainly boost the testosterone levels in the body by including meat in your daily diet. Meat includes the high amount of proteins that in accordance with the minerals like zinc that promotes the production of the testosterone. White meat chicken is one of the healthiest lean meats available that is best to increase the testosterone levels. But, please make a note that keep the meat intake in control otherwise it may also increase the fats and carbohydrates in the body and make you prone to many other hazardous diseases.

Vegetables: The intake of vegetables regularly will never make you prone to the low testosterone levels. Spinach is specifically very good to boost the testosterone levels in the body. The most important benefit of vegetable intake is that it doesn’t promote any hazardous effect to your health like the non-vegetarian food items. Tomatoes also are found to prop up the testosterone levels as they are rich in Vitamin A. Vegetables intake increase the testosterone levels in the body very fast, and you can see the effects in short span of time in comparison to other food items.

Fruits: One of the best methods to increase the production of the testosterone in the body is to eat the fruits regularly. Fruits are the rich source of the vitamins and minerals that prop up the testosterone production in the body. Fruits also are found to decrease the influence of the factors that affects the testosterone production adversely. Fruit intake reduces the production of the dihydrotestosterone that is found to reduce the testosterone levels in the body. The best fruit to induce testosterone levels is Apple, which if you eat regularly for about 2 months will surely increase the testosterone levels in your body. The other fruits are Pineapple, Orange, and Mango that also increases the testosterone level in body.

Milk and Milk Products: Drinking milk daily can help you to improve the testosterone levels in the body. Milk is considered as the whole food so its intake can boost the production of testosterone. Milk contains adequate amount of minerals, vitamins, and proteins that maintains the level of the testosterone in the body and doesn’t allow it to drop below the normal level. Milk products are also rich in nutrients. So, if you having the low level of testosterone, you need to include the milk and milk products in your daily diet routine.

Further evidence that anabolic steroids or resistance exercise (weight training) can help replace lean muscle tissue lost in HIV wasting appears in a study published in this week's edition of the Journal of the American Medical Association. However, using anabolic steroids with an exercise programme did not result in any greater benefit than using one element on its own.

61 HIV-positive men whose body weight had declined by more than 5% in the previous 6 months, and who had low serum testosterone levels (< 12.1 nmol/L (349 ng/dL) were randomly assigned to receive either 100mg Testosterone Enanthate weekly as an intramuscular injection or a placebo injection. They were also randomly assigned to a programme of resistance exercise or to maintain their normal activity levels.

Daily food intake was standardized for all four groups at 1.5g of protein per kg of body weight and 40kcal per kg of body weight, a diet very high in protein and carbohydrates. The authors cannot explain why the testosterone and exercise group failed to perform better than the exercise alone or testosterone alone group, despite the expected additive effect of combining the two interventions.

After 16 weeks, muscle strength had improved by 20-30% in all groups apart from the placebo group, and this improvement was statistically significant.

Oxymetholone drug effect

Anadrol (Oxydrol) is the U.S. brand name for Oxymetholone, a very potent oral androgen. This compound was first made available in 1960, by the international drug firm Syntex. Since Oxymetholone is quite reliable in its ability to increase red blood cell production (and effect characteristic of most anabolic/androgenic steroids), it showed great promise in treating cases of severe anemia. It turned out to be well suited for this purpose, and was popular for quite some time. But recent years have brought fourth a number of new treatments, most notably the non-steroidal hormone Epogen (erythropoietin). Many Athletes feared Anadrol 50 might be on the way out for good. But new HIV/AIDS studies have shown a new light on oxymetholone. These studies are finding (big surprise) exceptional anti-wasting properties to the compound and believe it can be used safely in many such cases. Interest has been peaked and as of 1998 Anadrol 50 is again being sold in the United States.
Oxydrol is the only oral anabolic-androgenic steroid indicated in the treatment of anemias caused by deficient red cell production. Oxymetholone is contraindicated in: male patients with carcinoma of the prostate or breast, females with hyperglycemia with carcinoma of the breast, women who are or may become pregnant, ipatients with nephrosis or the nephrotic phase of nephritis, patients with hypersensitivity to the drug or with severe hepatic dysfunction.
Anadrol (Oxydrol) is considered by many to be the most powerful steroid available, with results of this compound being extremely dramatic. A steroid novice experimenting with Oxymetholone is likely to gain 20 to 30 pounds of massive bulk, and it can often be accomplished in less than 6 weeks, with only 50-100mg a day. This steroid produces a lot of trouble with water retention, so let there be little doubt that much of this gain is simply bloat. But for the user this is often little consequence, feeling bigger and stronger on Anadrol 50 than any steroid they are likely to cross. Although the smooth look that results from water retention is often not attractive, it can aid quite a bit to the level of size and strength gained. The muscle is fuller, will contract better and is provided a level of protection in the form of "lubrication" to the joints as some of this extra water is held into and around connective tissues. This will allow for more elasticity, and will hopefully decrease the chance for injury when lifting heavy. It should be noted however, that on the other hand the very rapid gain in mass might place too much stress on your connective tissues for this to compensate. The tearing of pectoral and biceps tissue is commonly associated with heavy lifting while massing up on heavy androgens. There is such a thing as gaining too fast. Pronounced estrogen trouble also puts the user at risk for developing gynecomastia. Individuals sensitive to the effects of estrogen, or looking to retain a more quality look, will therefore often add Nolvadex to each cycle.

It is important to note however, that this drug does not directly convert to estrogen in the body. Oxymetholone is a derivative of dihydrotestosterone, which gives it a structure that cannot be aromatized. As such, many have speculated as to what makes this hormone so troublesome in terms of estrogenic side effects. Some have suggested that it has progestational activity, similar to nandrolone, and is not actually estrogenic at all. Since the obvious side effects of both estrogens and progestins are very similar, this explanation might be a plausible one. However we do find medical studies looking at this possibility. One such tested the progestational activity of various steroids including nandrolone, norethandrolone, methandrostenolone, testosterone and oxymetholone. It reported no significant progestational effect inherent in oxymetholone or methandrostenolone, slight activity with testosterone and strong progestational effect inherent in nandrolone and norethandrolone. With such findings it starts to seem much more likely that Oxymetholone can intrinsically activate the estrogen receptor itself, similar to but more profoundly than the estrogenic androgen methAndriol. If this is the case we can only combat the estrogenic side effects of oxymetholone with estrogen receptor antagonists such as Nolvadex or Clomid, and not with an aromatase inhibitor. The strong anti-aromatase compounds such as Arimidex, Femara, or Aromasin would prove to be totally useless with this steroid, as aromatase is not involved.

Anadrol (Oxydrol) is also a very potent androgen. This factor tends to produce many pronounced, unwanted androgenic side effects. Oily skin, acne and body/facial hair growth can be seen very quickly with this drug. Many individuals respond with severe acne, often requiring medication to keep it under control. Some of these individuals find that Accutaine works well, which is a strong prescription drug that acts on the sebaceous glands to reduce the release of oils. Those with a predisposition for male pattern baldness may want to stay away from Anadrol 50 completely, as this is certainly a possible side effect during therapy. And while some very adventurous female athletes do experiment with this compound, it is much too androgenic to recommend. Irreversible virilization symptoms can be the result and may occur very quickly, possibly before you have a chance to take action.

It is interesting to note that Anadrol 50 does exhibit some tendency to convert to dihydrotestosterone, although this does not occur via the 5-alpha reductase enzyme (responsible for altering testosterone to form DHT) as it is already a dihydrotestosterone based steroid. Aside from the added c-17 alpha alkylation, oxymetholone differs from DHT only by the addition of a 2-hydroxymethylene group. This grouping can be removed metabolically however, reducing oxymetholone to the potent androgen l7alpha-methyl dihydrotestosterone (mesterolone; methyldihydrotestosterone). There is little doubt that this biotransformation contributes at least at some level to the androgenic nature of this steroid, especially when we note that in its initial state Anadrol 50 has a notably low binding affinity for the androgen receptor. So although we have the option of using the reductase inhibitor finasteride (Proscar) to reduce the androgenic nature of testosterone, it would be of no benefit with Anadrol 50 as this enzyme is not involved.

The principle drawback to Anadrol 50 (Oxydrol) is that it is a 17alpha alkylated compound. Although this design gives it the ability to withstand oral administration, it can be very stressful to the liver. Anadrol (Oxydrol) is particularly dubious because we require such a high milligram amount per dosage. The difference is great when comparing it to other oral steroids like Dianabol or Winstrol, which have the same chemical alteration. Since they have a slightly higher affinity for the androgen receptor, they are effective in much smaller doses. Anadrol 50 has a lower affinity, which may be why we have a 50mg tablet dosage. When looking at the medical requirements, the recommended dosage for all ages has been 1 - 5 mg/kg of body weight. This would give a 220lb person a dosage as high as 10 Anadrol 50 tablets (500mg) per day. There should be little wonder why when liver cancer has been linked to steroid use, Anadrol 50 (Oxydrol) is generally the culprit. Athletes actually never need such a high dosage and will take in the range of only 1-3 tablets per day. Many happily find that one tablet is all they need for exceptional results, and avoid higher amounts. Cautious users will also limit the intake of this compound to no longer than 4-6 weeks and have their liver enzymes checked regularly with a doctor. Kidney functions may also need to be looked after during longer use, as water retention/high blood pressure can take a toll on the body. Before starting a cycle, one should know to give Anadrol 50 the respect it is due. It is a very powerful drug, but not always a friendly one.

When discontinuing Anadrol 50, the crash can be equally powerful. To begin with, the level of water retention will quickly diminish, dropping the user's body weight dramatically. This should be expected, and not of much concern. What is of great concern is restoring endogenous testosterone production. Anadrol 50 will quickly and effectively lower natural levels during a cycle, so HCG and Clomid/Nolvadex are a must when discontinuing a cycle.

Anabolic steroids help people with HIV put on weight and muscle mass

AIDS wasting, which leads to significant weight loss in people with HIV, causes severe loss of weight and muscle and can lead to muscle weakness, organ failure and shortened lifespan. Researchers have long sought to reverse this common, destructive effect of HIV with mixed success.

The review covered 13 studies of adults age 24 to 42 with HIV, 294 of whom received anabolic steroids for at least six weeks and 238 of whom received placebo. The average weight increase in those taking anabolic steroids was nearly three pounds.

“The magnitude of weight gain observed may be considered clinically relevant,” said lead author Karen Johns, a medical assessment officer from the agency Health Canada. “One hopes there would be greater weight gain with the long-term use of anabolic steroids however, this has not been proven to date in clinical trials.” The wasting stems from loss of the body’s ability to grow muscle and from low levels of testosterone.

Anabolic steroids are synthetic substances similar to the male sex hormone testosterone that promote growth of skeletal muscle and the development of male sexual characteristics.

Although most recently in the news for their misuse by professional athletes, anabolic steroids have legitimate medical application for men with low testosterone and people with certain types of anemia. Two anabolic steroids available in the United States, Nandrolone Decanoate and Oxandrolone, have been used to help increase weight and muscle mass in small studies of people with wasting. Conversely, anabolic steroid use has been associated with increased rates of HIV in those who share needles or use non sterile needles when they inject steroids.

In the review studies, anabolic steroids were administered to patients either orally or by injection. The main side effects were mild and included abnormal liver function tests; acne; mild increase in body hair; breast tenderness, increased libido, aggressiveness and irritability and mood swings — all common side effect of anabolic steroid use.

“The risks and side effects of taking anabolic steroids long-term are certainly of concern,” Johns said. “We were unable to assess these risks in our review due to the short duration of treatment in the studies.”

Wayne Dodge, the HIV/AIDS program director at the Group Health Cooperative in Seattle, suggests that clinicians should obtain blood testosterone levels, “if an HIV-infected individual has had significant weight loss, significant fatigue or muscle wasting, and particularly if associated with a significant decrease in libido and erections. If [testosterone] is in the low or low-normal range then a trial of [steroids] could be tried. The individual and the clinician should decide what result would constitute a successful trial: weight gain of 15 pounds, a 30 percent improvement in sense of well-being or  a successful erection once a week.”

The reviews authors conclude that further studies are needed to determine if increase in weight leads to improved physical functioning and quality of life, and ultimately increased survival, as well as the potential for serious side effects, especially with prolonged use.

Anabolic steroids and immune system

Testosterone plays a vital role in the development of male characteristics and also of the muscles in our body. Anabolic steroids are commonly consumed for these effects as it is believed to enhance the muscle growth. Athletes and other sports persons are commonly noted to abuse anabolic steroids to improve their performance and to add up muscle mass. The anabolic steroids are available as injections, patches, creams and tablets or capsules.Testosterone is commonly referred to as the male sex hormone that is mainly associated with the development of physical and sexual features in men. This is because of the ‘building’ or anabolic effect of this hormone. Anabolic steroids are generally synthetic forms of testosterone and mimic the action of testosterone. Male hormones such as testosterone is associated with muscle building, bone growth and increased production of red blood cells. Anabolic steroids work in a similar fashion to induce muscle growth. However, along with the muscle building effect, other influences on the body in general are also observed. These include changes in the physical appearance, increased oiliness in the skin and other associated effects.

Anabolic steroids were initially developed to treat a condition known as hypothyroidism wherein the production of testosterone hormone in the testes (testicles) is reduced. Further when some animal tests revealed that testosterone could build muscle mass, the abuse of anabolic steroids began. The anabolic steroids are commonly abused by body builders, weight lifters and also by other athletes involved in different kinds of sports. The steroids are commonly sold without prescription at gyms, sports events and even through mail. The anabolic steroids are generally used as oral products while some are used as injections. In both the forms, steroid abusers tend to take 10 to 100 times higher dosages of these steroids than the normally prescribed doses.

The terms "stacking", "cycling" and "pyramiding" are commonly used by the steroid abusers and these terms signify the dosage pattern of consumption of anabolic steroids. Cycling refers to the periodic use of high doses of steroids while stacking refers to mixing two or more type of steroids for a single dose. Pyramiding refers to the consumption pattern of steroids wherein they are taken initially at low doses and gradually increased over a period of few days or weeks. Steroid abusers follow different patterns for different purposes and may mix these patterns of steroid consumption to suit their specific purpose. Anabolic steroid abuse is noted in individuals of different ages. In a survey in the United States it was reported that steroid abuse was highest in the 12th grade among school children wherein almost 3.5% of the 12th graders were abusing anabolic steroids. However, the trend of steroid abuse among school children was on the decline. Among athletes it has been estimated that about one to six percent may be involved in the abuse of anabolic steroids.   

The abuse of anabolic steroids is associated with a wide number of adverse effects on the body and ranges from simple acne to severe life-threatening events. While many of these effects are reversible some of the effects may be permanent. The severity of the adverse effects is based on the dosages of steroids consumed and duration of the steroid abuse. Higher dosages and longer durations are more commonly associated with severe adverse effects. In case of men, anabolic steroid abuse is associated commonly with decreased sperm production, decrease in the size and function of the testicles, occurrence of baldness, increased development of the breast (gynecomastia), and infertility. Women commonly develop male features such as change in voice (becomes deeper), decrease in the body fat and breast size, excessive hair growth on the body, and male pattern baldness (increased hair loss in the scalp region). Many of these changes may become irreversible on prolonged abuse of anabolic steroids. In both men and women the skin changes that can be noted include oily skin and acne. Increased consumption of anabolic steroids in children results in early maturation and stunted growth.

Increased anabolic steroid abuse can often result in liver failure due to formation of tumors or cysts (fluid filled cavities) in the liver. These can often rupture leading to a significant amount of bleeding. Regular use of anabolic steroids tends to suppress the body’s immune system indirectly and thereby increases the risk of certain common conditions such as cold and flu. Athletes and sportsmen/women who use injectable forms of anabolic steroids often tend to reuse the syringes or share them. Also the syringes available with the steroid doses may not be sterile. These factors increase the risk of developing several infections such as AIDS, hepatitis and other similar infections.