Nandrolone vs Testosterone: Clinical Differences and Applications

Bodybuilder Posing With a Strong Muscular Body

Nandrolone and Testosterone are both anabolic androgenic steroids, where Nandrolone is a derivative of Testosterone. Owing to their difference in chemical structure, both have slightly different functions, making them useful in clinical treatment.

In clinical medicine, anabolic steroids are used to treat muscle loss, anemia, osteoporosis, and certain forms of cancer. To address this, two of the most popular anabolic steroids are Testosterone and Nandrolone, both of which have high efficacy.

Let’s take a look at how Nandrolone compares to Testosterone when it comes to clinical applications and associated side effects.

What is Nandrolone?

Also called 19-nortestosterone or 19-norandrostenolone, Nandrolone is a synthetic injectable anabolic androgenic steroid (AAS) derived from testosterone. Two of the most common Nandrolone esters available include Nandrolone Decanoate (Deca-Durabolin) and Nandrolone Phenylpropionate.

Although the structure of Nandrolone is similar to that of Testosterone, the slight difference enhances its anabolic effects while reducing its androgenic ones. 

This compound was originally developed to treat medical conditions such as breast cancer, muscle wasting, osteoporosis, and anemia. However, its high anabolic profile also makes it popular as a performance enhancement compound, sought after by bodybuilders.

In the human body, Nandrolone benefits the system by triggering the following response:

  • Significant amount of nitrogen retention.
  • Notable increase in protein synthesis.
  • Faster muscle tissue repair and regeneration.
  • Increase in erythropoiesis (red blood cell production).

Thus, people are able to recover much faster after their training sessions, improve their overall performance, and increase their muscle mass.

What is Testosterone?

Testosterone is the natural male hormone, and synthetically replicated esters are often administered to those suffering from low Testosterone levels. It is available as oral pills, gels, patches, implants, and injectable compounds, the common ester forms being Enanthate, Cypionate, Propionate, etc.

Testosterone is clinically used for TRT (Testosterone Replacement Therapy) and to treat low testosterone symptoms like delayed puberty and hypogonadism. Alternatively, bodybuilders also use Testosterone to increase muscle mass and improve muscle tone, performance, and recovery. 

Whether you opt for Testosterone tablets or injections, you will get the following:

  • Androgen receptors are activated to increase muscle mass, strength, and recovery.
  • Aromatises to estradiol, improving joint health and libido.
  • Increases RBC count, which increases oxygen delivery, endurance, and recovery.
  • Improves mood and focus by increasing the level of dopamine, serotonin, and GABA

As a result, people enjoy an increase in muscle mass, less impact of DOMS, and faster muscle repair. Further, Testosterone works synergistically with other compounds, which is why it finds a place in most steroid stacks.

Nandrolone vs Testosterone: Pharmacological Profile Comparison Table

The key features of Nandrolone and Testosterone can be compared as follows:

FeatureNandroloneTestosterone
Androgenic RatingLow (~37)High (~100)
Anabolic RatingHigh (~125)Moderate (~100)
Estrogen ConversionMinimal (via DHN)Moderate to High (via Aromatase)
DHT ConversionConverts to DHNConverts to DHT
Half-life (Decanoate)~6–12 days~4–10 days (Enanthate/Cypionate)
Water Retention RiskLowerHigher
Liver ToxicityNon-ToxicNon-Toxic

Table 1: Pharmacology of Nandrolone and Testosterone

Key Clinical Applications and Differences

The differences between Testosterone and Nandrolone’s benefits and impacts can be explained as follows:

1. Hormone Replacement Therapy (HRT/TRT)

Testosterone serves as the gold standard for TRT and is the most commonly prescribed medication for those suffering from low testosterone levels. 

Nandrolone is not typically used for HRT due to suppression of natural Testosterone production, which can have an adverse effect on those already suffering from hypogonadism.

With both, there is a certain level of risk associated with suppressing endogenous testosterone. Thus, PCT is essential, and people need to stick to their prescribed dose.

2. Muscle Wasting and Cachexia

Nandrolone is often preferred due to its higher anabolic effects and less androgenic activity (less than half) when compared to Testosterone. Thus, it is prescribed to people suffering from HIV/AIDS, cancer, and chronic illness.

3. Bone Density and Osteoporosis

In clinical tests and trials, Nandrolone has shown promising results in improving bone mineral density and reducing the risk of bone fractures. Due to this, it is often prescribed to postmenopausal women to treat osteoporosis and chronic bone loss.

Testosterone acts directly on the osteoblasts, prompting bone formation. It also affects the cytokines and growth factors, leading to stronger bones.

Thus, both are effective when it comes to increasing bone density.

4. Joint Health and Collagen Synthesis

Nandrolone promotes the synthesis of collagen and synovial fluid, helping cushion the joints. This, along with its anti-inflammatory properties, provides joint pain relief and enhances mobility.

Testosterone, on the other hand, aromatises to estradiol, which can improve bone and joint health, alongside increasing bone strength. It also prompts cartilage synthesis and reduces inflammation. 

Studies on Testosterone have shown that only 1% of patients have joint pain on conclusion of clinical trials, speaking to the efficacy of this treatment route.

Side Effects and Safety Profile

The general side effects of Nandrolone include:

  • Headaches
  • Acne
  • Diarrhea
  • Nausea and vomiting
  • High blood pressure
  • Elevated cholesterol
  • Swelling in the extremities
  • Changes in the sex drive
  • Insomnia
  • Depression
  • Irritability
  • Aggression

In males, it can lead to:

  • Testicular atrophy
  • Low sperm count
  • Chronic priapism
  • ED
  • Gynecomastia (growth in breast tissue)

In women, Nandrolone’s side effects include:

  • Menstrual irregularity
  • Clitoral enlargement
  • Hirsutism (excessive body and facial hair growth)
  • Male pattern baldness

When taking Testosterone injections or tablets, one may experience the following side effects:

  • Acne
  • Swelling in the extremities
  • Mood swings and irritability
  • Sleep apnea
  • Altered sex drive
  • Elevated blood pressure
  • Liver stress

Among men, it can also cause:

  • Gynecomastia
  • Chronic priapism

Additionally, women may also face:

  •  Menstrual irregularity
  • Clitoral enlargement
  • Hirsutism
  • Male pattern baldness

Side Effects Comparison Table

The severity of the common side effects of Nandrolone and Testosterone can be compared as follows:

Side EffectNandroloneTestosterone
GynecomastiaLow (less aromatization)Moderate to High
Hair LossLower riskHigher (via DHT)
AcneMildModerate to High
Libido ChangesMay suppress libidoUsually enhances libido
Cardiovascular RiskSome risk (lipid impact – high LDL)Known risk (lowers HDL), increases blood pressure
Suppression of Natural TestosteroneSignificantSignificant

Table 2: Comparison Between the Side Effects of Testosterone

Legal Status and Medical Accessibility

Both Nandrolone and Testosterone are available with a prescription in most countries. In the UK, both are listed as a Class C medication and are thus illegal to procure without a prescription 

Additionally, both have to be procured from reputable sources such as a trusted online pharmacy. It is also important to watch out for counterfeits and buy genuine products from trusted brands.

Which One is Better? It Depends on the Use Case

Choosing between Nandrolone and Testosterone needs to be a careful, judicious decision made after a thorough medical evaluation and consultation. For TRT, Testosterone is the best treatment route. For muscle preservation during chronic illnesses, Nandrolone can be more effective.

Similarly, for improving libido and mood, Testosterone is the better option since it stimulates the production of dopamine and serotonin. To reduce joint pain, Nandrolone’s effect on collagen synthesis and synovial fluid generation is beneficial.

Thus, it is important to always consult a physician to learn which is the better option and get a tailored treatment plan.

Final Thoughts 

Choosing between Nandrolone and Testosterone injections is based on an individualised approach that accounts for the patient’s health, fitness goals, and requirements. Further, a risk/benefit assessment during your medical consultation is key to determining the best treatment route.

Choosing Between Nandrolone and Testosterone

Considering hormone therapy or need to improve bone health? Speak with a licensed endocrinologist and learn whether testosterone, nandrolone, or other options are better suited for you.

Frequently Asked Questions

What is the Diet to Maintain When Taking Steroids?

Opt for a protein-rich diet that has complex carbs and healthy fats. Be sure to avoid excessively processed foods and those containing high amounts of salt, and incorporate leafy greens, fibres, vitamins, and micronutrients in your diet.

Can I Stack Nandrolone and Testosterone Together for Bodybuilding?

Nandrolone and Testosterone Enanthate can be stacked together in short 8-week cycles to gain lean bulk.

What is the Dosage of Testosterone and Nandrolone for Bodybuilding?

For men, Nandrolone dosage ranges between 200 and 400 mg per week. Women, on the other hand, are prescribed a much lower dose of 50 to 100 mg per week.

For male bodybuilders, usually 300 to 500 mg/week of Testosterone is prescribed. Women have a much lower recommended dose of 15 to 70 ng/dL for Testosterone.

Is It Better to Take Nandrolone or Testosterone for Muscle Loss in Wasting Disease?

Owing to its higher anabolic effect and low androgenic impact, Nandrolone is the better option when you have to treat muscle loss.

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