How Anabolic-Androgenic Steroid Dosage Shapes Physical and Psychosocial Harms

Anabolic-androgenic steroid (AAS) use is associated with physical and psychological harms, yet the extent to which these outcomes vary by dosage remains unclear. Using data from Wave 3 of the World’s First Steroid Checking Trial, this study examined associations between weekly AAS dose and self-reported harms among 121 AAS consumers. Of 105 analysed products, 50% were underdosed, 32% correctly dosed, 8% overdosed, and 25% contained unexpected compounds. Participants reported typical weekly dosage and side effects after dissemination of laboratory testing results. Dosage was examined descriptively across six brackets and inferentially as <500 mg versus ≥500 mg per week. Higher weekly doses were associated with increased reporting of liver issues, sleep disturbances, skin conditions, injection-site redness/swelling, and breast changes among women. No dose-related associations emerged for psychological harms. Findings suggest increased AAS dosage may drive physical harms, while psychological harms may be more compound-specific, informing tailored harm-reduction responses.