Updated: Jan 5
In October 2015 a paper was published titled "Neuroregenerative Effect of Oxandrolone: A Case Report" which studied the impact of the medication oxandrolone on a 25 year old male patient who had CMT-1A. The medication was dosed at 20mg a day for 3 months, with the patient regularly engaging with strength training three times a week.
The results of the study were remarkable: the patient showed an increase in lean body mass, muscular strength and improved nerve conduction velocity. The recommendation stemming from this paper was that more testing should be done to see if oxandrolone is a viable medication to help treat people with CMT.
The problem is, since the paper was released, no neurologist has done any further research on this drug, and many are unwilling to even acknowledge the findings in the paper, dismissing it is as a one-person trial, rather than seeing it as a potentially promising first-step in finding a usable medication for people with CMT.
Why would this be the case? Because oxandrolone is an androgenic anabolic steroid, and there is a strong negative public view of steroids that carries over into the world of medicine. Even though oxandrolone is an FDA-approved drug, used in men, women and children, for a wide range of issues such as treating burns, osteoporosis and to counteract HIV/AIDS-induced muscle wasting, people hear the word "steroid" and jump to the false conclusion that they are dangerous.
To quote Professor Mary Reilly, a Professor of Clinical Neurology at UCLH and regarded as an expert in CMT: "Because of the serious side effects of anabolic steroids we would never recommend anabolic steroids to be given [for the treatment of CMT]."
Is Oxandrolone Safe?
When used at the approved medical dosage, under the guidance of a medical professional, oxandrolone is completely safe to use, and the quote above shows an inexcusable ignorance when it comes to androgen therapy. There are well over 50 different types of anabolic steroid, and claiming that they all have serious side-effects shows a complete misunderstanding of anabolic steroids as a whole; you wouldn't compare paracetamol to fentanyl even though both are pain-killers, and as such oxandrolone shouldn't be lumped together with over 50 other, vastly different drugs to determine its safety.
When assessing the history of oxandrolone, when used in a medical setting, it has been studied and used for decades with very little side effects for long periods of time in all genders and ages. So why then do so many neurologists make this claim that it is unsafe?
Steroids: a Complex History
The first steroids were synthesized back in the 1930's, and have become a staple drug in many medical treatments over the following decades, but the majority of people will know them for two things:
Their performance enhancing capabilities
Their legal status
Several high-profile athletes have been fined or banned from competing in sports due to the use of steroids, and others arrested and charged for possession of steroids without a prescription. Using steroids is seen as giving an athlete an unfair advantage, and is labelled as a drug-class dangerous enough to warrant legal enforcement. However, the legal classification of steroids is a contentious point. The Anabolic Steroid Act of 1990 was passed by the US Congress as an apparent response to the increasing levels of illicit traffic of steroids, yet during deliberations of this law, the American Medical Association (AMA), Drug Enforcement Administration (DEA), Food and Drug Administration (FDA) as well as the National Institute on Drug Abuse (NIDA) all opposed listing anabolic steroids as controlled substances, citing the fact that use of these drugs does not lead to the physical or psychological dependence required for such scheduling under the Controlled Substance Act. The widely accepted reason for why steroids were made illegal was because of the Canadian sprinter Ben Johnson winning the 100m sprint in the 1988 Summer Olympics, beating the US favourite to win, Carl Lewis, and testing positive for a steroid in subsequent drug tests. Congress therefore wanted to make steroids seem "un-American" by making them illegal without prescription.
Following the legal classification of steroids, seeing them banned by organisations such as WADA, as well as a few high-profile cases of steroid abuse leading to death, many people, including doctors, assume all steroids are dangerous and have no place in medicine, when the opposite is true. There is also the notion that steroids-use will leave men looking like the Hulk, and women looking like men. While this can happen when certain steroids are abused, this does not happen at appropriate medical doses of oxandrolone, with many years of academic papers and medical use backing this up.
The results in the paper "Neuroregenerative Effect of Oxandrolone: A Case Report" are simply far too positive to ignore, and there is no legitimate reason why this drug has not been explored further for people with CMT. Neurologists need to learn more about this drug through research, or discussing the treatment with endocrinologists, rather than remaining steadfast with their outdated notions of oxandrolone.
Anecdotally, I've spoken to a few people with CMT who have doctors who have prescribed them oxandrolone, and have reported positive results, therefore I would encourage people to discuss this paper with their neurologists and, if appropriate, challenge the notion that the drug is either unsafe, or the paper is invalid. While this drug is never going to cure CMT, it may significantly help with other aspects, such as nerve conduction, muscle wasting and limb weakness. Ultimately, we as people with CMT are the ones living with the disease, and cannot afford to ignore a potentially positive treatment, whereas the neurologists are afforded the luxury of ignorance as time is not against them as it is against people with CMT.