Steroids vs Prohormones: Are Prohormones Worse Than Steroids?

Steroids and prohormones are often sold to lifters as two different things: one an illegal, dangerous drug, the other a legal supplement. The chemistry says otherwise. Anabolic steroids are active hormones, meaning testosterone and its synthetic derivatives. Prohormones are precursors that the body converts into an active androgen. Once that conversion happens, the result acts on the same androgen receptor and carries the same kinds of risks.

So are prohormones worse than steroids? Not in every way, but they are not the safer option many buyers assume. Most are oral, many of the best known were 17-alpha-methylated and hard on the liver, they have far less research behind them, and they tend to be used by younger lifters who treat them as supplements rather than drugs. Many of the prohormones once sold in supplement shops are now controlled substances in the United States.

This guide covers how steroids and prohormones differ, how US law has treated prohormones since 2004, what the research shows about their side effects, and where each carries more risk. Nothing here is a recommendation to use either.

Steroids vs Prohormones: What Is the Difference?

Anabolic-androgenic steroids (AAS) are testosterone and synthetic compounds built on its structure, such as nandrolone, trenbolone and oxandrolone. They are already active when they enter the body and bind directly to the androgen receptor, which raises muscle protein synthesis. Testosterone itself is an FDA-approved prescription medicine for men with clinically low testosterone.

Prohormones sit one step back in the chain. They are precursors that enzymes in the body convert into an active androgen. A few examples:

• Androstenedione (“andro”): converted partly to testosterone and partly to estrogens.
• 1-androstenediol (1-AD): converted to 1-testosterone, a potent androgen.
• Halodrol (chlorodehydromethylandrostenediol): converted to chlorodehydromethyltestosterone, the active steroid in Turinabol.
• 19-nor prohormones (such as 19-norandrostenedione): converted to nandrolone.

Two common beliefs about prohormones are wrong. First, they do not “boost natural production.” They supply extra androgen from outside, and the body responds as it does to steroids: it makes less of its own testosterone. Second, not every product sold as a prohormone was one. Superdrol (methasterone) and M1T (methyl-1-testosterone) were sold as prohormones in the 2000s, but both are active steroids in their own right. In practice, “prohormone” became a marketing and legal label more than a chemical one.

Side-by-Side Comparison

How US Law Caught Up With Prohormones

The Andro Years

Prohormones became a supplement category in the years after the Dietary Supplement Health and Education Act of 1994, which lets supplements go on sale without FDA approval. DHEA and androstenedione were the first big sellers. Patrick Arnold, the chemist credited with bringing androstenedione and later 1-AD to the supplement market, went on to become known as the chemist behind THG, the designer steroid at the center of the BALCO doping scandal.

Andro became famous in 1998, when baseball player Mark McGwire was reported to be using it during his record-setting home run season. Sales boomed, but the research did not back the hype. In a randomized controlled trial published in JAMA in 1999, young men who took 300mg of androstenedione a day over eight weeks of weight training gained no more strength or muscle than men on placebo. Their testosterone did not rise. Their estrogen levels did, and their HDL (“good”) cholesterol fell.

The Anabolic Steroid Control Act of 2004

In March 2004 the FDA warned companies selling androstenedione to stop. Congress then passed the Anabolic Steroid Control Act of 2004, signed in October 2004 and in force from January 2005. It added androstenedione, 1-AD, 4-androstenediol, the 19-nor precursors of nandrolone, 1-testosterone and M1T to the legal definition of anabolic steroids, making them Schedule III controlled substances alongside testosterone. DHEA was specifically left out, which is why it is still sold as a supplement in the US.

Designer Prohormones and the 2014 Act

The 2004 law named specific compounds, so the industry moved to ones it did not name. The years after 2005 were the era of designer prohormones such as Superdrol, Halodrol, Epistane (sold as Havoc), methylstenbolone and prostanozol. Some came from old pharmaceutical research: Superdrol, for example, was described by researchers in the 1950s but never sold as a medicine, so it had never been through clinical safety trials. Many of these products were 17-alpha-methylated oral compounds, and reports of liver injury followed.

Today Superdrol, Halodrol, Epistane and the other big names of that era are Schedule III controlled substances, through DEA scheduling and the Designer Anabolic Steroid Control Act of 2014. That law, signed in December 2014, added 25 compounds at once, gave the DEA a faster route to schedule new ones, and created penalties for selling products that contain an anabolic steroid without saying so on the label.

This is why older lists of “legal prohormones” are unreliable. Many of the products once sold as legal alternatives to steroids are now controlled substances themselves.

Are Prohormones Worse Than Steroids?

Milligram for milligram, steroids are more potent, and a high-dose steroid cycle can do more damage than a modest prohormone. But the idea that prohormones are the safe, legal version of steroids does not hold up. On several points they carry more risk, not less.

The Liver: Mostly Oral, Often Methylated

Swallowed drugs pass through the liver before they reach the rest of the body, and the liver breaks most androgens down quickly. Adding a methyl group at the 17-alpha position slows that breakdown, which lets the drug survive and work as a pill. It is also what makes 17-alpha-methylated steroids such as Anadrol and Winstrol hard on the liver. The risks include cholestasis (bile backing up in the liver, causing jaundice) and, with long-term use, blood-filled cysts in the liver (peliosis hepatis) and liver tumors.

Many of the strongest prohormones were methylated orals, including Superdrol, Halodrol, Epistane and M1T. Published case reports describe young men with severe cholestatic jaundice after taking Superdrol, some with kidney failure as well (see our Superdrol cycle guide). In a report from the US Drug-Induced Liver Injury Network, 44 young men developed severe and prolonged cholestatic liver injury after taking bodybuilding supplements, many of which contained anabolic steroids. Injected testosterone, by contrast, avoids the first pass through the liver.

Not every oral is methylated, and not every prohormone sold today is. But a non-methylated prohormone still has to be converted by enzymes to do anything, and for most of them no liver data exists at all.

Cholesterol and the Heart

Oral androgens tend to hit cholesterol harder than injected testosterone. In a classic 1989 study published in JAMA, the oral 17-alpha-alkylated steroid stanozolol lowered HDL cholesterol far more than injected testosterone enanthate did.

Prohormone trials show the same pattern. HDL fell with androstenedione in the 1999 JAMA trial. In a small four-week trial of the prohormone 1-Andro, published in the Journal of Applied Physiology in 2014, men who took it while training gained more muscle and strength than men on placebo, but their HDL dropped sharply, their LDL rose and their kidney markers got worse. The study’s title sums it up: the prohormone “enhances resistance training gains but impairs user health.”

Low HDL and high LDL are among the main ways androgen use is thought to raise heart disease risk. Blood pressure can rise too, especially with compounds that cause water retention.

Testosterone Suppression

Any androgen strong enough to build muscle tells the brain to turn down its signal to the testes, through the hypothalamic-pituitary-gonadal (HPG) axis. Natural testosterone and sperm production fall. That happens whether the androgen came from an injection or from a capsule the body converted. Low testosterone after a cycle, known as anabolic steroid-induced hypogonadism, can cause low libido, fatigue and low mood, and recovery can take months.

There is almost no research on recovery after prohormone use specifically. Users borrow post-cycle therapy (PCT) protocols from steroid users, which have weak evidence of their own. Blood work before and after a cycle is the only way to know where recovery stands. Our PCT guide covers recovery in more depth.

Less Research, Less Quality Control

Testosterone has decades of clinical use behind it, and its effects on muscle have been tested in controlled trials at doses as high as 600mg a week. Most prohormones have been tested in a handful of small trials, and many designer compounds never in humans at all. The people taking them are, in effect, the trial.

Quality control is a second gap. In the US, the FDA does not approve supplements or review them for safety before they go on sale. Contamination is documented: in a study published in 2004, an IOC-accredited lab tested 634 non-hormonal supplements from 13 countries and found that 94 of them (14.8%) contained prohormones that were not on the label. Steroids have the opposite problem. A 2022 meta-analysis found that 36% of black-market steroid samples were counterfeit and a further 37% substandard.

Who Uses Them

The last difference is the users. Steroids are hard to get without a black-market source, and most people who take them know they are taking a drug. Prohormones have been sold online and in supplement shops, and are often bought by teenagers and beginners who see them as just another supplement. Starting androgens young, before training and diet are in place and without blood work, makes it more likely that side effects go unnoticed until they are serious.

Where the Risks Differ

A Doctor’s View on Prohormone Safety

Dr. Khash Farzam wrote about the safety of prohormones for an earlier version of this article. He starts from the definition: a prohormone is a prodrug, an inactive substance the body converts into an active one. Given that, he argues, it is intuitive that prohormones are no safer than the steroids they become. His conclusion:

“In conclusion, it is obvious that prohormones are not any safer than anabolic steroids. They carry the same HPG axis suppressive effects, damage the internal organs and essentially induce the same side effect profile as anabolic steroids.”

Dr. Khash Farzam

His main points:

• Methylation means liver toxicity: A 17-alpha-methylated prohormone is liver toxic in the same way methylated oral steroids are, a point he says is often forgotten in prohormone discussions. He cites M1T, which he describes as having steroid-level potency and liver toxicity, and Halodrol, the precursor of the active steroid in Turinabol. Taking the precursor of a steroid makes little sense, he notes, when it is potentially more toxic than the steroid itself.
• Kidneys, heart and blood pressure: Many of these compounds can also harm the kidneys, lower HDL and raise LDL cholesterol, and raise blood pressure, especially when they cause water retention. Some of these effects may pass after stopping, but he warns that kidney damage may be permanent.
• Hormonal shutdown: Suppression of the HPG axis is a major concern, particularly given how young many prohormone users are. The long-term effects of this kind of hypogonadism have not been adequately studied.
• Misuse: Because many users see prohormones as supplements rather than potent drugs, and many are younger than typical steroid users, he expects overall outcomes to be worse. Long-term data are thin for steroids and thinner still for prohormones.

What Prohormones Are Sold Today?

After the 2004 and 2014 laws, the prohormones still sold as supplements in the US are a narrower group. Most are DHEA-related compounds, such as epiandrosterone and so-called 1-Andro, or newer branded compounds such as 3-AD. Sellers market them as falling outside the scheduled lists. That is the seller’s legal position, not FDA approval, and the lists have grown before. Many other countries regulate prohormones as medicines or controlled drugs.

DHEA is the clearest case. It was excluded from the 2004 Act and is sold over the counter in the US, but it is a prescription medicine or controlled drug in many other countries, and WADA lists it as a prohibited anabolic agent. In a controlled trial in young men, 150mg of DHEA a day did not raise testosterone or improve the strength and muscle gained from training.

For anyone comparing what is on sale, a few practical points matter more than marketing claims:

• Buy from the brand directly rather than from third-party resellers. It lowers the risk of counterfeit or relabeled stock.
• Check the full chemical name on the label, not just the product name. The same compound is often sold under several brand names.
• Get blood work before and after: total testosterone, LH, estradiol, a lipid panel, liver enzymes and kidney markers. It is the only way to see the effects you cannot feel.
• Treat it as a drug: if symptoms or blood results change, stop and see a doctor.

Our guide to the best prohormone companies compares the main brands.

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Natural Options With Real Evidence

For lifters looking at prohormones because progress has stalled, the options with strong evidence are less exciting but carry far less risk. Creatine monohydrate is one of the most studied sports supplements, with consistent evidence for gains in strength and lean mass alongside training. Enough protein, progressive training and good sleep do more for most lifters than any herbal “test booster.”

Herbs sold as testosterone boosters, such as tribulus, have mostly failed to raise testosterone in controlled trials in men. Older claims that creatine ethyl ester boosts testosterone are also unsupported. In a controlled comparison, it performed no better than plain creatine monohydrate.

Who Should Not Use Prohormones

• Teenagers and young adults, whose hormone systems are still developing
• Beginners who have not yet built a base of consistent training and diet
• Women, because of the risk of masculinizing effects, some of which can be permanent
• Athletes in any drug-tested sport
• People with heart disease, high blood pressure, high cholesterol, or liver or kidney problems
• Men trying to have children, since androgens suppress sperm production