Turinabol and oxandrolone: the differences

Turinabol and oxandrolone are often mentioned together as "soft" oral anabolic steroids. Both do not convert to oestrogen and have a reputation for being “safe,” but have completely different histories, medical statuses, and chemical makeups. The editors tell how these substances differ and why the idea of ​​their "softness" is misleading.

Two substances with different fates

Turinabol is the trade name of 4-chlorodehydromethyltestosterone. It was developed by the East German pharmaceutical company Jenapharm in the 1960s. The drug did not have medical use for a long time, but gained world fame as the basis of the state doping program of the German Democratic Republic.

Oxandrolone was synthesised in the USA in the early 1960s. Unlike turinabol, it has had official medical indications for decades and was studied in clinical trials: to restore body weight after severe injuries, burns, surgical interventions, and exhaustion against the background of chronic diseases.

So, the main difference in the "biography": oxandrolone is a drug with a rich clinical literature, turinabol is a substance known almost exclusively from the history of doping. Hence the difference in the amount of reliable knowledge: much more is known about oxandrolone, in particular thanks to controlled studies.

Both substances are synthetic androgen derivatives and belong to the class of anabolic-androgenic steroids (AAS). Both are listed in Section S1 of the WADA Prohibited List and are prohibited in sport at any time, both in-competition and out-of-competition.

Chemical structure: common and different

A common feature of both molecules is a methyl group in position 17α. It is she who allows the substance to survive the first passage through the liver and act upon ingestion. At the same time, this modification is responsible for the main drawback of all 17α-alkylated steroids — hepatotoxicity.

Turinabol is built on the basis of metandienone (dianabol), to which a chlorine atom has been added in position 4. Chlorine blocks aromatization, that is, conversion to oestrogens. Oxandrolone is a derivative of dihydrotestosterone in which the carbon atom in the A ring is replaced by an oxygen atom. DHT derivatives are also not aromatized.

The absence of aromatization means that these substances do not cause oestrogenic side effects, such as gynaecomastia or severe fluid retention. This is what their "soft" reputation is based on. However, this is only one class of side effects, and far from the most dangerous.

Regarding anabolic activity, old pharmacological sources cite the ratio of anabolic and androgenic activity obtained in animal models. For oxandrolone, these indicators are significantly shifted in the direction of anabolic action. However, such indices determined in rats are poor predictors of effects in humans, so we do not present them as exact numbers.

Medical and legal status

Oxandrolone has long been FDA approved under the name Oxandrin. In the guidelines, it was recommended as an adjunctive therapy for weight gain after surgical interventions, severe injuries, chronic infections, as well as to counteract protein catabolism during long-term corticosteroid use. The best-known clinical data were obtained in patients with severe burns (Hart et al., 2001).

The package insert for Oxandrin contained a “black box”—the FDA's most severe warning—for peliosis hepatis, liver tumours, and adverse lipid profile changes. In 2023, the FDA withdrew approval of oxandrolone drugs in the US, citing that their benefits no longer outweighed the risks. In other countries, the status may vary.

Turinabol as a medicine has not been produced for a long time. Everything currently sold under this name comes from illegal production, without any quality control, dosage or sterility.

In many countries, in particular in Ukraine, anabolic steroids are under the control of legislation on medicinal products, and their circulation without a prescription can have legal consequences. For athletes, any detection of these substances means a violation of anti-doping rules with a long-term disqualification.

The myth of "soft" steroids

The editors consider the idea that turinabol and oxandrolone are "soft" and therefore almost safe to be one of the most harmful myths in the sports environment. It is based on the absence of oestrogenic effects, but ignores other, no less serious risks.

First, both substances are 17α-alkylated, and therefore potentially toxic to the liver: from cholestasis to peliosis and tumours. Second, oral ASAs are particularly effective in lowering the level of "good" HDL cholesterol, which increases cardiovascular risk. Third, any anabolic steroid suppresses your own testosterone production.

For women, to whom these substances are often presented as "female steroids", the risk of virilisation is very real. The history of the GDR, where turinabol was given to young female athletes, documented hoarseness of the voice, hirsutism, menstrual cycle disorders and other changes, some of which are irreversible.

Finally, products from the illegal market often contain the wrong substance listed on the label. A cheaper metandienone or an unknown mixture may be sold under the name "oxandrolone".

Turinabol in the history of sports

Systematic use of turinabol in the GDR was described in detail by Franke and Berendonk (1997) based on declassified documents. The program involved thousands of athletes, including minors, and many did not know they were receiving hormonal drugs — they were passed off as "vitamins."

The consequences for the health of former sportsmen of the GDR, in particular women, have become the subject of legal proceedings and research. This story clearly shows that the "softness" of the substance does not protect against severe long-term consequences, especially when young people take it.

In the 2010s, turinabol came back into the spotlight. The development of analytical methods made it possible to re-examine the preserved samples from the Olympic Games, and turinabol appeared especially often among the detected substances. This led to many athletes being stripped of their medals years after the competition.

For today's athletes, the conclusion is simple: sample storage and advances in analytics mean that a doping violation can be detected many years later. Any calculations on the "invisibility" of the substance have no basis.

Editorial conclusions

Turinabol and oxandrolone are oral 17α-alkylated, non-aromatizing anabolic steroids. Their similarities mostly end there.

Oxandrolone is a former drug with a clinical history and official liver and lipid warnings that was withdrawn in 2023 in the US. Turinabol is a substance known mainly from the GDR's doping program and is currently only available from illegal sources.

The reputation of "soft" steroids is not true: hepatotoxicity, lowering of HDL, suppression of the hormonal system and virilisation in women are real risks of both substances.

We also advise you to read our materials on the hepatotoxicity of oral steroids, on the lipid profile in the use of AAS, and on the history of state doping.

List of used literature

1. Franke WW, Berendonk B. Hormonal doping and androgenization of athletes: a secret program of the German Democratic Republic government. Clin Chem. 1997;43(7):1262–1279.
2. Hart DW, Wolf SE, Ramzy PI, et al. Anabolic effects of oxandrolone after severe burn. Ann Surg. 2001;233(4):556–564.
3. Orr R, Fiatarone Singh M. The anabolic androgenic steroid oxandrolone in the treatment of wasting and catabolic disorders: review of efficacy and safety. Drugs. 2004;64(7):725–750.
4. Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol. 2008;154(3):502–521.
5. Pope HG Jr, Wood RI, Rogol A, et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev. 2014;35(3):341–375.
6. Oxandrin (oxandrolone tablets). Prescribing information. U.S. Food and Drug Administration.
7. World Anti-Doping Agency. The World Anti-Doping Code International Standard: Prohibited List. Montreal: WADA; актуальна редакція.