Nandrolone decanoate relieves joint pain in hypogonadal men: a novel prospective pilot study and review of the literature

Abstract

Testosterone is an archetypal androgenic-anabolic steroid (AAS), while its exogenous administration is considered to be the gold standard for the treatment of male hypogonadism. The benefits are not due to its intrinsic nature alone but are due to the result of its interactions with the androgen receptor (AR). As the management of hypogonadism continues to advance into the modern era, it would be preferable for modern andrologists to have multiple tools at their disposal to influence AR activity. Nandrolone, or 19-nortestosterone, is one such compound. In the following review of the literature, we examine the history, pharmacology, and clinical applications of this medication. We also present the results of our novel pilot study examining the favorable effects of nandrolone on joint pain for hypogonadal men.

Detecting the abuse of 19‐norsteroids in doping controls: A new gas chromatography coupled to isotope ratio mass spectrometry method for the analysis of 19‐norandrosterone and 19‐noretiocholanolone

“…20,21 Unlike dihydrotestosterone (DHT), the 5α-dihydro 19-norderivatives possess a weak binding affinity to the androgen receptors in prostate and hair follicles, reducing the incidence of prostatic growth and alopecia and justifying the beneficial effect of nandrolone in male hypogonadism therapy. [22][23][24][25] 19-Norandrosterone (19-NA; the 5α-reduced isomer) and 19-noretiocholanolone (19-NE; 5β-isomer) are the main 19-norsteroids metabolites, mostly excreted as glucurono-and sulfo-conjugates. 26,27 The 3β-hydroxy isomers (norepiandrosterone and norepietiocholanolone) have been also identified as minor enzymatic products in the sulfate fraction.…”

“…19‐Norsteroids undergo a phase I metabolism similar to that of testosterone, through the oxidation of hydroxyl group on C17 (catalyzed by 17β‐hydroxysteroid‐dehydrogenase), reduction of double bound C4–C5 (by 5α‐ and 5β‐reductase) and reduction of three keto‐function (by 3α‐ and 3β‐hydroxysteroid‐dehydrogenase) enzymatic steps 20,21 . Unlike dihydrotestosterone (DHT), the 5α‐dihydro 19‐norderivatives possess a weak binding affinity to the androgen receptors in prostate and hair follicles, reducing the incidence of prostatic growth and alopecia and justifying the beneficial effect of nandrolone in male hypogonadism therapy 22–25 . 19‐Norandrosterone (19‐NA; the 5α‐reduced isomer) and 19‐noretiocholanolone (19‐NE; 5β‐isomer) are the main 19‐norsteroids metabolites, mostly excreted as glucurono‐ and sulfo‐conjugates 26,27 .…”