NANDROLONE DECANOATE
Long-acting injectable 19-nortestosterone anabolic steroid used clinically for osteoporosis and cachexia, widely abused for muscle growth.
A 2026 systematic review and meta-analysis of 20 RCTs found nandrolone decanoate modestly increased lean soft tissue (1.59 kg) but did not improve handgrip strength, knee extension strength, or consistently improve bone mineral density. Clinical use in osteoporosis (50 mg every 3-4 weeks) showed increased bone mineral content and reduced vertebral pain, but virilization occurred in ~50% of female patients. Animal studies demonstrate ND impairs recognition memory, alters stress hormone levels, and affects neurotransmitter systems in brain region-dependent patterns. A systematic review of 148 studies found endocrine effects (42%), cardiovascular dysfunctions (14%), skin disorders (12%), and psychiatric disorders (9%) as the most common adverse effects from abuse. The GRADE assessment displayed low certainty of evidence, and the meta-analysis concluded findings do not support routine clinical use for musculoskeletal health.