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The concurrent use of a 5-alpha reductase inhibitor such as finasteride will interfere with site-specific reduction of nandrolone action, considerably increasing the tendency of nandrolone to produce androgenic side effects. Reductase inhibitors should be avoided with nandrolone if low androgenicity is desired. Side Effects (Hepatotoxicity): Nandrolone is not c-17 alpha alkylated, and not known to have hapatotoxic effects in healthy subjects. Liver toxicity is unlikely. Side Effects (Cardiovascular): Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendancy to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favors greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. Studies administering 600mg of nandrolone decanoate per week for 10 weeks demonstrated a 26% reduction in HDL cholesterol levels. This suppression is slightly greater than that reported with an equal dose of testosterone enanthate, and is in agreement with earlier studies showing a slightly stronger negative impact on HDL/LDL ratio with nandrolone decanoate as compared to testosterone cypionate. Nandrolone decanoate should still have a significantly weaker impact on serum lipids than c-17 alpha alkylated agents. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction. 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