Numerous studies would suggest as above that not only is oxandrolone (anavar) not a serious concern to the liver but has been used in studies to treat alcohol related liver disease and a number of other liver dysfunctions.
There may of course be the potential for damage but I have not experienced it.
One study below on oxandrolone, 1000s more out there.
Objective
To explore the hypothesis that oxandrolone may reverse muscle catabolism in cachectic, critically ill pediatric burn patients.
Summary Background Data
Severe burn causes exaggerated muscle protein catabolism, contributing to weakness and delayed healing. Oxandrolone is an anabolic steroid that has been used in cachectic hepatitis and AIDS patients.
Methods
Fourteen severely burned children were enrolled during a 5-month period in a prospective cohort analytic study. There was a prolonged delay in the arrival of these patients to the burn unit for definitive care. This neglect of skin grafting and nutritional support resulted in critically ill children with significant malnutrition. On arrival, all patients underwent excision and skin grafting and received similar clinical care. Subjects were studied 5 to 7 days after admission, and again after 1 week of oxandrolone treatment at 0.1 mg/kg by mouth twice daily or no pharmacologic treatment. Muscle protein kinetics were derived from femoral arterial and venous blood samples and vastus lateralis muscle biopsies during a stable isotope infusion.
Results
Control and oxandrolone subjects were similar in age, weight, and percentage of body surface area burned. Muscle protein net balance decreased in controls and improved in the oxandrolone group. The improvement in the oxandrolone group was associated with increased protein synthesis efficiency. Muscle protein breakdown was unchanged.
Conclusions
In burn victims, oxandrolone improves muscle protein metabolism through enhanced protein synthesis efficiency. These findings suggest the efficacy of oxandrolone in impeding muscle protein catabolism in cachectic, critically injured children.
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Abstract
METHODS
RESULTS
DISCUSSION
References Severe burns induce marked physiologic derangements in addition to skin injury. These include hypermetabolism with erosion of lean body mass, generalized weakness, altered immune function with increased infectious complications, peripheral insulin resistance, and poor wound healing. 1–6 Many therapeutic strategies have been used to attenuate the hypermetabolic response, and the few notable successes have improved clinical outcome in burn care. Heating the patient environment to 88°F (30°C) to correspond with the patient’s elevated hypothalamic temperature set point has been shown to decrease the metabolic rate. 7 Early excision of burned and dead tissue to stop further inflammatory stimulation has decreased length of stay, incidence of sepsis, and blood loss associated with skin grafting. 8,9 However, even with these improvements, survivors of severe burn are hypermetabolic for a prolonged period (up to 8 months after burn), 10 with profound muscle wasting, decreased bone mineral density, and (in children) retarded linear growth as negative clinical consequences. 11–13
To avert hypermetabolism, pharmacologic agents have been used to stimulate growth and increase strength after burn. Recombinant human growth hormone has shown efficacy in improving muscle protein kinetics 14–17 and wound healing, 18–20 and also in lowering the death rate in severely burned patients. 21 However, it requires a daily subcutaneous injection and can cause hyperglycemia. 14,18 Recently, questions have been raised about its safety in adult patients in the intensive care unit setting. 22,23 Insulin has beneficial results on protein metabolism. At low doses, its action is directed at attenuating protein breakdown, but at higher doses it primarily affects protein synthesis. 24–26 The potential for precipitating hypoglycemia must be carefully weighed before beginning exogenous insulin treatment in the face of clinical euglycemia. Testosterone can increase protein synthesis, 27 but its use entails risks of virilism and hepatotoxicity.
Oxandrolone, an oral synthetic testosterone analog, has been used in acute and rehabilitating adult burn patients with promising results in terms of weight gain and urinary nitrogen balance. 28,29 It also has been used successfully in children with Turner syndrome and other constitutional delays in growth, in cachectic alcoholic hepatitis patients, and in patients with AIDS wasting myopathy. 30–32 Compared with testosterone, it has minimal virilizing activity and little hepatotoxicity. 33,34
The purpose of our study was to determine whether oxandrolone would affect burn-induced catabolism—in other words, would it improve the net balance of muscle protein synthesis and breakdown—and if so, by what mechanism. As an international tertiary referral center for children with severe burns, we receive many patients who are weeks removed from their injury. These patients arrive without definitive surgical treatment or adequate nutritional support. Burn wound sepsis or chronic eschar colonization is frequent. These children with large (20–95% total body surface area [TBSA]) burns, chronic infection, and nutritional depletion are critically ill and extremely catabolic on arrival to our burn unit. We chose to study this subpopulation of burn victims because they shared a similar therapeutic indication (depleted nutritional status) with patients who had received oxandrolone in previous studies. 31,32
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