We searched PubMed/Medline, Embase and Google Scholar for studies published before March 29, 2022 that analyzed the quality and quantity of AAS to determine the proportions of substandard and counterfeit products found on the black market. Besides the well-known side effects of anabolic steroids, new individual and public health threats arise due to fake drugs from the black market. With this systematic review and meta-analysis on black-market AAS, we have demonstrated that substantial mean proportions may be of substandard quality or counterfeit. This also may have led either to over or under estimation of certain proportions of the estimates of "substandard" or "counterfeit" anabolic androgenic steroids and their subclassifications and sub-analyses.
Different non-scientific and anecdotal patterns and duration of use are described in literature with the goal of minimizing side effects or maximizing the drug effects of AAS 1, 15. As an example, 17α-alkylation of steroids which is used for oral administration is described to result in increased liver toxicity compared to injectable AAS, because of first-pass metabolism and increased duration time in the liver due to slow metabolization . We further show a limited geographical scope of included studies, with all studies being from countries in Europe or Brazil.
It is our endeavor at LA Pharma to manufacture the purest most potent steroid formulations and make our products available to athletes across the globe. LA Pharma S.r.l. produces the full range finished products of anabolic hormone under Good Manufacturing Practice. This allows sufficient time for the user to experience the full benefits of the steroid while minimizing the risk of adverse effects. This is attributed to the steroid’s ability to enhance nitrogen retention, which is crucial for muscle growth. One of the most notable effects is rapid muscle mass gain.
The very wide range in the proportions of counterfeit or substandard AAS from the black market shows the uncertainty about quality, thus leaving users with unpredictable risks. Rather than caused by study design issues, the differing proportions of counterfeit or substandard AAS reflect the selection of the tested AAS samples, with real differences in the quality of AAS found on the black market. With this systematic review and meta-analysis, we demonstrate that substantial mean proportions of black-market AAS are counterfeit and of substandard quality. The very wide range in proportions of counterfeit or substandard black market AAS puts the user in a situation of unpredictable uncertainty. ‘Drug checking’ allows people who consume illegal and legal drugs acquired from unregulated drug markets to submit samples for chemical analysis and receive feedback on the quantity, quality, and purity of those substances.
Most samples (74%) originated from seized compounds by the police, custom authorities, or justice departments and a minority of samples were bought directly from the black market or provided by gyms and users themselves. Most included study designs (95%) were nonclinical laboratory studies. In addition, other countries from this region (Switzerland, France, Italy, United Kingdom, Czech Republic and Slovakia, Austria, and Belgium) are represented in our list of included studies.
As with other 17α-alkylated steroids, methandienone poses a risk of hepatotoxicity and use over extended periods of time can result in liver damage without appropriate precautions. As the CIBA product Dianabol, metandienone quickly became the first widely used AAS among professional and amateur athletes, and remains the most common orally active AAS for non-medical use. Side effects of metandienone include symptoms of masculinization like acne, increased hair growth, voice changes, and increased sexual desire, estrogenic effects like fluid retention and breast enlargement, and liver damage. Metandienone, also known as methandienone or methandrostenolone and sold under the brand name Dianabol (D-Bol) among others, is an androgen and anabolic steroid (AAS) medication which is mostly no longer prescribed.
LA Pharma is one of the leading companies in the production of high-end performance-enhancing drugs to build better physiques. Commonly used to increase muscle mass and strength Increased muscle mass, enhanced athletic performance When considering the purchase of Dianabol 10 La Pharma, it is vital to source the product from verified suppliers to ensure quality and safety. Following a cycle, a post-cycle therapy (PCT) is crucial to help restore natural testosterone production and minimize the risk of hormonal imbalances. More advanced users may increase the dosage to 40 to 50 mg per day, but it’s essential to approach higher dosages with caution to mitigate potential side effects.
In addition to promoting hypertrophy, Dianabol also enhances muscle strength, allowing athletes to lift heavier weights and perform at higher intensities. Users often report significant increases in body weight and muscle size within weeks of starting a cycle. In addition to its anabolic properties, Dianabol also boosts glycogenolysis, helping the body to utilize carbohydrates more effectively. The use of such substances may carry legal, health, and ethical implications.
We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA) statement . To our knowledge, this is the first systematic literature review analyzing fake black-market AAS within the published literature. Counterfeit products can potentially lead to negative health outcomes and are considered an individual and public health threat . Injectable testosterone, synthetic AAS, other hormones and adjunctive therapies can easily be purchased over the internet and are delivered to a consumer’s home without prescription 4, 6, 8. Due to lack of reporting, precise prevalence and demographic information on the use of these substances is challenging . AAS belong to the broader group of image and performance enhancing drugs (IPEDs) and are widely used as a convenient and easy method to improve body image and sport performance goals .
With this systematic review and meta-analysis, we present significant findings for fake AAS on the black market. Underground laboratories emerged both locally and in countries with lax legal regulations and it is described that an 'anabolic steroid tourism' and large networks of online resellers emerged, simplifying the illegal acquisition of anabolic steroids . We demonstrate that substantial proportions of AAS found on the black market are fake.