An interesting further question concerns combination of Anadrol with other anabolic steroids. For exmaple, adding Anadrol to 50 mg/day of Dianabol gives little added benefit to a steroid cycle; in contrast, adding Anadrol to 50-100 mg/day trenbolone acetate or 60-80 mg/day Wonderful Steroid powder Anavar Oxandrolone gives dramatic improvement. In this its stacking behavior is similar to that of Dianabol, but not to that of trenbolone. Likely this is because unlike trenbolone, oxymetholone does not bind strongly to the androgen receptor, and most of its anabolic effect is likely not genomically mediated via the AR.
With regard to harsh side effects sometimes perceived in bodybuilding, this principally or only occurs when estrogen levels are elevated. While oxymetholone does not itself aromatize and does not have estrogenic activity, it may be that it can interfere with estrogen metabolism. Whether that it is the cause of the problem or not, keeping estradiol levels under control keeps Anadrol similar in side effects to other oral anabolic steroids. Estradiol levels may be kept under control either by using an aromatase inhibitor such as Femara Letrozole or Arimidex Anastrozole, or by limiting use of aromatizing steroids such as testosterone.
The principal side effect of concern is liver toxicity, as is the case for all alkylated oral anabolic steroid. This may be addressed simply by limiting duration of use to 6-8 weeks, and allowing suitable time off of the drug after each period of use. Because the liver regenerates quickly, a time of even half the period of use is often sufficient. However, allowing an equal amount of time is more conservative.
Per milligram, Anadrol appears less liver toxic than any other alkylated anabolic steroid, but per amount of anabolic effect, the ratio of toxicity to anabolic effect seems similar.
Other side effects of concern are the same as with other anabolic steroids in general, including potential increase in blood pressure and/or hematocrit, worsening of blood lipid profile, prostate enlargement which may be temporary, and possible promotion of acne and/or male pattern baldness, if having the gene for male pattern baldness.