Current Hepatology Reports

, Volume 18, Issue 4, pp 417–424 | Cite as

Spectrum of Drug Induced Liver Injury Caused by Anabolic Androgenic Steroids Abuse

  • Varun Takyar
  • Andrew StolzEmail author
Drug-Induced Liver Injury (P Hayashi, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Drug-Induced Liver Injury


Purpose of Review

Potent anabolic androgenic steroids (AAS) are often illegally present in commercially available body building supplements (BBS) and may cause drug induced liver injury (DILI) with different phenotypes.

Recent Findings

AAS induced DILI typically presents with a prolonged cholestatic liver injury with pruritus and a typical enzyme pattern of elevated transaminases that rapidly fall as alkaline phosphatase slowly increases. Liver biopsy reveals bland cholestasis that usually does not have chronic sequalae. Pathophysiology is unknown and genetic variants in genes associated with cholestatic syndromes were observed in a minority of patients. Chemical analysis of BBS have identified controlled AAS, which were not documented on the label.


More frequent use of BBS in males to enhance physical performance is predicted to increase the incidence of cholestatic DILI. The typical presentation of AAS induced liver injury in an at risk populations should prompt careful assessment of BBS exposure.


Herbal Dietary Supplement Bodybuilding Hepatotoxicity Jaundice 



Anabolic Androgenic Steroids


Alkaline Phosphatase


Alanine aminotransferase


Aspartate aminotransferase


Body building supplements


Drug Enforcement Agency


Drug induced liver injury


Drug induced liver injury network


Food and Drug Administration


gamma glutamyl transpeptidase


Herbal and Dietary supplements


National Institutes of Health


Nodular regenerative hyperplasia


Roussel Uclaf Causality Assessment Method

T Bili

Total Bilirubin


Upper limit of normal


Compliance with Ethical Standards

Conflict of Interest

Varun Takyar and Andrew Stolz each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Gastrointestinal and Liver DiseasesKeck School of Medicine of the University of Southern CaliforniaLos AngelesUSA
  2. 2.Keck School of Medicine of USCLos AngelesUSA

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