Is Trenbolone (Tren) a peptide? Chemical structure, scientific studies, mechanisms of action, and safety

Trenbolone, often called „Tren”, belongs to the group of anabolic-androgenic steroids rather than peptides. Its basic molecule has a specific steroid structure, while terms such as trenbolone acetate refer to chemically modified forms of this compound. Veterinary approvals, laboratory test results, and reports from people using anabolic steroids address different issues. They should not be used to make general claims about proven benefits for humans. 1 2

The available literature covers many different areas, including laboratory models, animal husbandry regulations, surveys involving humans, and individual case reports related to safety. None of these types of evidence, alone or in combination with the others, provides a verified protocol for the use of trenbolone in bodybuilding or confirms a beneficial long-term safety profile.

Experimental studies confirm that trenbolone causes biological reactions. However, this is not equivalent to demonstrating a beneficial benefit-risk ratio in bodybuilding, in the context of healthy aging or any other proposed use in humans. The chemical identity of trenbolone is much better established than the claims about its safety and effectiveness that often appear online.

What is Trenbolone? Names, synonyms and identity

Chemically speaking, trenbolone is a synthetic androgen. Its basic structure is described by the name 17β-hydroxyestra-4,9,11-trien-3-one. „Tren” is an informal abbreviation useful when searching for information, but insufficient for identifying the research material or the finished product. 1

The names of esters should be written exactly as given by the authors of the publication. The parent steroid and its esters have a similar chemical structure but differ in molecular mass and physicochemical properties. These differences are important when evaluating the research material, even if the biological discussion focuses on the androgenic activity associated with trenbolone.

Identification of a specific ester is necessary for proper chemical description. Trenbolone acetate and trenbolone enanthate are not the same molecular entities as unesterified trenbolone, although all these forms are related by a common steroid structure. Publications regarding one form should cite the actual name of the form rather than substituting it with another.

The wide range of research on trenbolone makes the selection of evidence particularly important. Studies on the residues of the substance in food, products of environmental metabolism, and direct experimental administration should be treated as separate categories. Similarity of search terms does not eliminate differences in exposure or in the objectives of the studies.

This is important because the publications cover veterinary medicine, experimental endocrinology, environmental exposure, analytical chemistry, and off-label use by humans. An article on an environmental metabolite does not have to examine the substance listed on the label of a product intended for bodybuilders. The search term itself does not confirm the connection between the publication in question and the analyzed issue.

Chemical databases provide reference structures, not laboratory confirmation of the authenticity of the purchased product. This distinction is particularly important when the published description of the adverse event is based on the exposure reported by the patient, rather than on a full analysis of the preserved sample of the product.

The reference molecular identity is not the same as the verified identity of a commercial sample. A bottle labeled „Tren” may, according to the declaration, contain a specific ester, but the label itself does not confirm the composition, the content of substances, impurities, or the equivalence with the test material. The chemical database describes the intended molecular unit, but does not confirm the authenticity of products labeled with its name.

How is trenbolone classified? Peptide, protein, mixture, or another substance?

Due to its molecular structure, trenbolone is a small-molecule anabolic-androgenic steroid. It is not an amino acid chain, a protein, or a peptide hormone. Its steroid ring system chemically distinguishes it from peptide substances. 1

Anabolic and androgenic responses can occur in different tissues and with varying intensity, depending on the research model. The apparent separation of these effects for a single experimental endpoint does not prove that a similar relationship occurs for cardiovascular, reproductive, neurological or other outcomes.

In pharmacological terminology, anabolic action refers to processes related to tissue building, while androgenic action encompasses effects resulting from androgen signaling. These are related biological properties, rather than completely independent categories of action.

The demonstration of an anabolic effect does not confirm the absence of androgenic activity in other tissues. Definitions such as „action similar to SARMs” should therefore be understood as comparisons of specific response patterns. They do not change the established steroid classification of trenbolone nor do they prove selective action limited to one tissue or a mild profile of adverse effects.

Some studies describe the responses to trenbolone as tissue-selective or „SARM-like”. However, this does not mean that trenbolone becomes a non-steroidal selective androgen receptor modulator or a peptide. Such a designation describes the pattern of responses in a specific model, not a change in molecular structure. The study conditions and endpoints defining selectivity remain key. 3

The purpose of allowing a product intended for livestock is closely linked to the approved species, product, conditions of use, and the safety assessment of the food. It does not answer the clinical question regarding direct human exposure. Regulatory evidence must remain linked to the product and the population for which it was developed.

Regulatory approval is a separate issue from chemical classification. The FDA describes approved steroid implants containing trenbolone acetate intended for specific uses in food-producing animals. These approvals pertain to veterinary products and their permitted conditions of use, not to preparations intended for bodybuilders. The safety assessments of residues in food do not prove that direct administration of trenbolone to humans is safe. 2

The structure and composition of trenbolone – what has been established?

For unesterified trenbolone, the sumary formula is C18H22O2, and the molecular mass is approximately 270.4 g/mol. The octanoate of trenbolone has a separate sumary formula C20H24O3 and a molecular mass of approximately 312.4 g/mol. These values refer to different chemical units and should not be used interchangeably. 1 4

The differences between esters also mean that the parameters given for a single chemical unit should not be attributed to another without checking the source. None of these compounds contains an amino acid chain, so both remain outside the category of peptides.

The molecular structure of trenbolone includes a steroid skeleton, a ketone group, and a hydroxyl group. Esterification changes the chemical form within the hydroxyl group. This is important for identification and formulation, but it does not form a peptide bond or convert the molecule into an amino acid polymer.

For the repeatability of experiments, the authors should identify the chemical form used and the way it is characterized. Compliance with the nominal name of the component is insufficient when delivery systems, accompanying components, or exposure conditions differ.

The summary pattern alone does not fully confirm identity. Stereochemistry and the exact chemical form are also important. When comparing studies describing the material, the report should include identification of the parent compound or ester, analytical characterization, formulation, and relevant exposure information.

A study using an implant with a specific formulation is not automatically comparable to an experiment involving another preparation. Implants containing several active substances create an additional interpretational problem: the observed changes may result from the action of multiple components or their interactions. Assigning the entire effect to trenbolone acetate requires appropriate comparison groups.

The finished veterinary product introduces another level of complexity to the composition. The implants may contain trenbolone acetate along with other active substances, therefore the result obtained using a complex preparation cannot be automatically attributed solely to trenbolone. The FDA list clearly distinguishes such combinations and the animal groups for which they are intended. 5

These distinctions show why the terms „pure Tren” or „the same active substance” are not sufficient to confirm the research equivalence. Identity, quantity, purity, formulation, and exposure require appropriate documentation.

Studies on trenbolone – evidence in humans, animals and in the laboratory

Animal studies and laboratory tests

In one controlled study in rats, the enanthate form of trenbolone was evaluated for muscle, bone, adipose tissue, hemoglobin, and prostate responses. Tissue-dependent effects were observed in the controlled experimental conditions. The androgen-sensitive muscle response is not equivalent to improvements in strength or athletic performance in trained humans, and the model included surgically altered endocrine conditions. 3

Veterinary literature should be interpreted in accordance with its actual purpose. The results examined relate to animal husbandry, and exposure conditions are subject to regulations. They cannot be considered indirect clinical research in humans.

In a separate experiment in rats, transcriptional responses in the androgen-sensitive muscle complex were analyzed. After exposure to androgen, changes in the expression of genes related to the breakdown of muscle proteins were observed. These results help investigate biological pathways, but the change in gene expression alone does not confirm improved human function or acceptable long-term safety. 6

Studies supporting veterinary applications address other questions: they relate to animal growth, product properties, and safety requirements associated with food production. The existence of an approved use in farming must be taken into account, but it should not be treated as a clinical indication for humans. Species, formulations, endpoints, and regulatory standards are different. 2

Survey studies based on participants' self-reported data are useful for identifying patterns that require further analysis. However, the method of participant selection, memory errors, the use of other anabolic steroids, and baseline behavioral differences can influence the observed relationships.

Observational studies involving humans

Evidence regarding humans goes beyond individual relationships. In a 2024 publication, a survey was conducted among 282 men using anabolic-androgenic steroids, analyzing exposure to trenbolone, psychological distress, and aggression. A link was found between the declared amount of trenbolone and verbal aggression after taking into account age and body mass index. The survey study does not allow determining that trenbolone itself caused this result. 7

Interviews can reveal experiences and the way problems are described that standardized surveys do not capture. Their goal is to understand the phenomenon qualitatively, rather than estimating the number of users who experience a specific outcome.

In a study published in 2026, responses from the Global Drug Survey were evaluated from 1146 men who declared the use of anabolic steroids. 237 respondents reporting the use of trenbolone in the previous year were compared with 909 respondents using other steroids but not trenbolone.

The group that reported using trenbolone reported more psychosocial and physical problems. These differences between the groups are based on self-reported data and not confirmed medical diagnoses or randomized causal estimates. 8

Qualitative interviews with sixteen users presented reports on psychological and behavioral harms. Such interviews can indicate experiences and research priorities, but they do not allow determining the frequency of problems in the population or quantifying the risk associated with a specific relationship alone. 9

A single case may raise justified clinical concerns and prompt further investigation, but it does not determine the probability of a given event in the entire population. In assessing causality, the identity of the product, concomitant exposure to other substances, and additional medical factors remain important.

Clinical safety reports

The published case report documented a myocardial infarction in a young man reporting chronic use of trenbolone acetate. This is an important clinical signal, but a single report does not allow determining the frequency of such an event or ruling out all alternative explanations. The strength of the causal relationship claim should not go beyond the evidence presented in the case report. 10

The selected evidence does not support a controlled, clinically validated regimen of trenbolone use in bodybuilding. The existence of human observational studies should not be confused with clinical efficacy studies that demonstrate a favorable benefit-risk ratio.

The activity of the androgen receptor provides a reliable basis for explaining experimental effects, but receptor signaling differs between tissues and endocrine environments. One should not assume a uniform response based on a single model.

Mechanism of action studied in the context of trenbolone

The main biological explanation studied involves the effect of the androgen receptor on gene expression and tissue responses. Scientists analyzed differences between trenbolone and testosterone in terms of metabolism and effects on tissues that respond to androgens.

Initial animal studies emphasize the importance of trenbolone not undergoing conversion in the same 5α-reductase pathway as testosterone. 3

The absence of aromatization is not evidence of a lack of endocrine or systemic consequences. Similarly, differences between tissue responses in the study should not be presented as total selectivity.

The gene expression study analyzed pathways related to muscles, instead of limiting itself to measuring body weight. Genes related to atrophy and other responses in the androgen-sensitive mouse muscle were evaluated.

This allows for formulating a more precise experimental question, but at the same time it narrows down the conclusions: one muscle model does not represent all muscles, organs, or clinical situations. 6

Statistical dependence does not confirm the mechanism. Behavioral outcomes can be influenced by overlapping psychological, pharmacological, and social factors, therefore mechanistic hypotheses must be clearly separated from causal conclusions.

Evidence of diverse tissue responses should not be interpreted as an exclusive targeting of action. The difference between the muscle and prostate responses at a given experimental exposure does not prove the absence of cardiovascular, reproductive, psychological, or other effects. Also, the absence of aromatization does not confirm endocrine neutrality.

Observational studies of behavior do not establish the final molecular pathway responsible for aggression or mood changes. Declared exposure, concomitant use of other substances, baseline mental health status, and participant selection can all influence the observed relationships.

Therefore, a reliable pharmacological explanation should remain separate from the causal mechanism demonstrated in humans. 7

A consistent review of the evidence should identify the exact endpoint measured. Body weight, growth of breeding animals, reported changes in body shape, strength, cardiovascular outcomes, and psychological symptoms are not surrogate results.

Limitations of scientific evidence regarding trenbolone

One of the main evidentiary gaps concerns the transfer of results between different research environments. Tissue growth in animals, breeding results, changes in body shape in humans, and significant health outcomes are not equivalent. Each of these areas requires its own evidence and appropriate comparison groups.

The absence of the ability to calculate the reliable frequency of occurrence of a given risk should not be interpreted as proof that the event is rare. On the other hand, a particularly worrying case should not be presented as a precise prediction for every person exposed to the substance.

Another limitation concerns the uncertainty of actual exposure in non-clinical studies. Participants may take multiple substances, change products over time, or declare quantities that have not been analytically confirmed.

Even large survey studies can be burdened by confounding factors and measurement errors. Comparing with 2026 is valuable for identifying a pattern of reported problems, but it does not allow for the influence of trenbolone to be separated from all other differences between groups. 8

Sporting bans are classifications derived from regulations, not the results of clinical studies. They should be presented accurately, but not used as a substitute for the scientific evaluation of specific adverse effects.

Security threats also remain difficult to quantify. Case descriptions identify possible serious harms, while survey research expands the scope of reported experiences. None of these sources alone provides a reliable absolute risk for a specific population using validated material.

The absence of such a numerical value means uncertainty, not assurance of safety.

Separating the types of evidence helps avoid both overstating and understating results. Trenbolone exhibits documented biological activity, but broad claims regarding its use in humans do not have adequate confirmation in controlled studies.

Anti-doping regulations provide for a more unambiguous classification. The WADA list for 2026 lists trenbolone among anabolic-androgenic steroids banned for all time and also includes its esters. This sporting rule is separate from national pharmaceutical law, product quality, and clinical evidence. 11

A balanced scientific assessment takes into account both established pharmacological activity and serious limitations of claims about benefits for humans. It should not create unconfirmed safe use thresholds, derive clinical usefulness from a veterinary status, or treat any reported relationship as evidence of causality.

How to interpret the evidence regarding trenbolone in humans?

Evidence regarding trenbolone in humans should be interpreted according to the study design. A cross-sectional survey may show that individuals reporting exposure to trenbolone also report certain symptoms, but it does not allow determining which event occurred first or isolating the influence of other substances.

Qualitative interviews provide detailed information about personal experiences and perceived consequences, whereas case reports can highlight potentially serious adverse events. These are valuable sources of information, but they do not constitute controlled efficacy trials. 7 8 9

A stronger assessment of causality would require reliable exposure characterization, careful documentation of concomitant use of other substances, appropriate comparison groups, and results measured at the appropriate time.

In existing survey literature, the reported amounts are not equivalent to the analytically confirmed exposure. Similarly, the differences between the groups of respondents do not prove that every observed problem was caused by trenbolone itself.

This distinction also applies to claims about benefits. Preclinical changes in muscle mass or the expression of an androgen-responsive gene cannot substitute for controlled measurements of strength, physical fitness, or general health in humans.

The cited literature regarding humans is primarily observational in nature and focuses on safety rather than on a clinically validated demonstration of benefits in bodybuilding.

What do veterinary certificates and product labels actually confirm?

The FDA documentation regarding food-producing animals describes approved implants and the conditions of their use. Such approval is relevant for veterinary regulations, but it does not mean that a comparable formulation has been evaluated or approved for direct administration to humans.

The residue levels of substances in food are related to a different question of exposure than the intended administration of a pharmacologically active substance. 2

A ready-made implant may contain more than one active substance. Consequently, the responses observed after the use of a complex preparation cannot be automatically attributed solely to trenbolone.

Before generalizing the results, the source material, the species of the animal, the comparison group, and the formulation should be documented. 5

Similar caution is necessary when interpreting labels on products intended for non-medical use. The name or declared ester does not independently confirm the identity, concentration, chemical purity, or reproducibility of the production.

The basic molecule and its esters should be described separately, and no analysis certificate should be interpreted more broadly than what the actually performed measurements allow.

Security signals and unresolved long-term questions

The cited reports regarding humans indicate questions related to psychological and physical effects, but they do not provide reliable individual risk predictions.

The dependence shown in the survey, the relationship between a specific person and a medically documented case, provide different types of information. Readers should avoid both rejecting these findings and turning them into universal statements regarding any person exposed to trenbolone. 7 10

Long-term questions are particularly difficult because exposure in non-clinical conditions can involve many substances and preparations with uncertain composition.

Appropriately designed long-term clinical trials would be needed to characterize the results over time. The lack of a well-established frequency of occurrence of a serious event does not prove that it cannot occur.

A responsible educational article should also not present doses, injection schedules, or so-called protective combinations as established methods of risk reduction.

The evidence reviewed does not support such protocols, and the history of veterinary use of trenbolone cannot replace clinical evaluation in humans.

Most frequently asked questions about trenbolone

1. Does trenbolone mean a specific substance?

The basic name identifies the defined steroid, but the informal term „Tren” often does not indicate a specific ester or formulation. The interpretation of the studies therefore requires determining the exact chemical form. A well-defined basic structure does not mean that every product using this abbreviation is equivalent or authentic. 1 Distinguishing is important when reading secondary studies: the identity of the material, the research environment, and the measured result must correspond to the claimed statement. This also prevents confusion between the results of animal studies, surveys, or regulatory documents and the controlled efficacy studies in humans.

2. What do the available studies on trenbolone confirm?

Available studies confirm androgen-related activity in experimental systems and document safety concerns in humans based on observational studies and case reports. They do not generally support safe therapy used in bodybuilding. The strongest conclusions relate to the material, population, and endpoint of a specific study, not to marketing claims. 3 8 When interpreting secondary studies, it is necessary to verify that the substance under study, the conditions and the results correspond to the claimed hypothesis. This avoids presenting animal studies, surveys or regulatory documents as controlled evidence of efficacy in humans.

3. Is Tren a peptide?

No. „Tren” usually means Trenbolone, which is an anabolic-androgenic steroid. Its structure is based on a steroid skeleton rather than an amino acid chain. Placing it alongside peptides in online discussions does not change this chemical classification. 1 Distinguishing is important when reading secondary studies, because the name of the compound, the research material, and the measured result must correspond to the claimed claim. Research on animals, surveys, and regulatory documents cannot be considered substitutes for controlled human efficacy studies.

4. Are trenbolone and trenbolone acetate the same thing?

No. The trenbolone acetate is the basic molecule and has a different molecular formula and molecular weight. The chemical similarity does not justify the use of these names interchangeably in the summary of the studies. Always indicate the substance actually being studied. 4 This is also important when comparing formulations and exposure conditions. The results obtained for one ester should not be automatically attributed to another without checking the source material.

5. Does the anabolic effect prove an improvement in strength?

No. Mass of tissue and strength are different outcomes; additional factors such as training and coordination influence physical fitness. The muscle mass result in rats does not confirm the strength benefits in humans. Claims should refer to the actually measured endpoint, rather than replacing it with a more appealing result. When interpreting studies, the identity of the material, model, and experimental conditions should also be considered. The animal study result is not equivalent to a controlled human efficacy study.

6. Does an SARM-like effect mean that trenbolone is non-steroidal?

No. The pattern of tissue response does not change the molecular classification. The experimental description concerns selectivity under specific conditions, whereas trenbolone remains a steroid. Neither this designation nor the favorable result in an animal study confirm the absence of adverse effects. 3 The assessment of selectivity requires knowledge of the tissues examined, exposure conditions, and endpoints. It cannot automatically lead to conclusions about the safety of all organs in humans.

7. Does approval of the use in farm animals mean approval for humans?

No. The approval applies to a specific veterinary product and the conditions of its use, including the relevant food safety requirements. It does not authorize the use of trenbolone in bodybuilding for humans nor does it confirm the appropriate formulation intended for humans. Veterinary and human uses require separate evidence and regulatory decisions. 2 The species, the route of exposure and the intended use are fundamental factors for interpretation. The veterinary document should not be presented as a controlled study of efficacy in humans.

8. Does the safety of food residues prove the safety of direct administration?

No. The residue assessment in food concerns a different type of exposure than the administration of a pharmacologically active product. The FDA describes residue control as part of the approval process for products for farm animals. These assessments should not be used as evidence of the safety of direct human exposure. 2 The amount of substance, the method of exposure, and the population being evaluated are important factors. Without adequate clinical data, conclusions cannot be drawn between these situations.

9. Was trenbolone studied in surveys involving humans?

Yes. The literature found includes surveys of people using anabolic steroids and a study using qualitative interviews. They provide information about reported experiences and relationships, but are not randomized efficacy studies. Including them helps to avoid the incorrect claim that there are no studies involving humans. 7 9 Interpretation still requires consideration of the selection of participants, possible confounding factors, and limitations of self-reporting. Surveys may indicate problems worth further investigation, but they do not replace controlled clinical trials.

10. Do survey studies show that trenbolone causes aggression?

No. They can show relationships, but they do not allow the influence of the relationship to be completely separated from other substances, the participants' baseline characteristics, and differences in reporting. The result regarding verbal aggression from the 2024 study is significant, but it does not prove an inevitable behavioral effect in every individual. The causality language should correspond to the study design. 7 It is also important whether the exposure was confirmed analytically and whether other potential causes were taken into account. Statistical correlation forms the basis for further research, not an automatic proof of the mechanism.

11. Does the 2026 survey confirm the recognized diseases of the heart or the liver?

No. The results included reported physical problems, not systematic clinical confirmation of each diagnosis. Differences between groups constitute important research signals, but they should not be transformed into verified rates of disease frequency. The way the endpoint is formulated is just as important as the sample size. 8 Self-reporting and medical diagnosis have different evidentiary value. To determine the frequency of specific diseases, appropriate diagnostic tests and a clearly defined population would be needed.

12. Does one description of a heart attack allow us to determine the frequency of damage?

No. The case report does not contain the denominator needed to calculate the frequency and may leave uncertainty regarding exposure and other causes. The published case of myocardial infarction warrants vigilance and further investigation, but does not provide a numerical estimate of the risk for all users. 10 A single case may be an important safety signal, but it does not allow predicting the individual probability of the event. Systematic data from an appropriately defined population are needed for this.

13. Does the change in gene expression lead to clinical benefits?

No. Gene expression is an indirect biological measure. Transcriciptional studies in mice help explain possible tissue responses, but do not confirm improvement in human health or function. The link between the molecular result and a clinical claim requires additional evidence. 6 Conclusions should be limited to the model and endpoint of the thing actually being studied. A change in gene activity does not replace measurements of strength, fitness, or safety in humans.

14. Can the results of studies on complex implants be attributed solely to trenbolone?

Not automatically. Some veterinary implants contain other active substances alongside trenbolone acetate. Without proper comparison, it is not possible to isolate the contribution of each component. Therefore, the summary of the study of a compound should include its composition. 5 Possible interactions between the components further complicate the attribution of the effect of a single substance. Valid conclusions require an appropriate experimental design and the accurate identification of the product under study.

15. Is trenbolone banned according to WADA regulations?

Yes. The WADA list for 2026 bans trenbolone both during and outside of competitions in the category of anabolic-androgenic steroids. The ban also includes the corresponding esters. The anti-doping status does not depend on how the product is advertised or whether the user calls it a research material. 11 Sporting regulations constitute a separate system of evaluation from veterinary and clinical regulations. Their content should be checked in the current list for the year in question.

16. Does the product label confirm its identity and quality?

No. The label provides the declared composition of the product, whereas verification of a specific sample requires analytical evidence. Identity, quantity, impurities, and formulation are separate questions. None of these can be resolved solely by matching the name with a chemical database. Compliance of the name is only a starting point for further evaluation. The analysis certificate should be interpreted in accordance with the scope of the measurements performed, and not as a general confirmation of safety.

17. What evidence would strengthen clinical claims regarding the use of trenbolone in humans?

Appropriately controlled human studies using validated material, clinically relevant endpoints, and systematic safety monitoring would be needed. The studies would also have to include the appropriate population, rather than relying on animal analogues. Until then, biological activity should not be presented as evidence of a beneficial clinical benefit-risk ratio. It would also be necessary to consider formulations, actual exposure, other substances used, and long-term results.

Conclusions

Trenbolone is a defined anabolic-androgenic steroid, not a peptide. Its basic molecule, esters, and finished products require separate identification.

Experimental activity and veterinary applications are well documented, whereas observations involving humans indicate safety concerns, without confirming safe use in bodybuilding or precise individual risk assessments.

Educational, medical and safety warnings

The article is purely educational in nature and does not constitute medical advice or recommendations for the use of trenbolone. It does not present safe dosages, dosing schedules, or methods for limiting adverse effects.

Laboratory, veterinary, and observational studies do not confirm the safety or effectiveness of trenbolone in bodybuilding in humans. Veterinary approvals do not mean that it can be used in humans, and product labels do not guarantee their composition or quality.

Trenbolone and its esters are banned by WADA in 2026. Individuals experiencing health problems related to anabolic steroids should consult with qualified medical personnel. Legal and regulatory status should be verified in current official sources.

References

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7. Piatkowski, T., De Andrade, D., Neumann, D., Tisdale, C., & Dunn, M. (2024). Examining the association between trenbolone, psychological distress, and aggression among males who use anabolic-androgenic steroids. International Journal of Drug Policy, 134, 104636. https://doi.org/10.1016/j.drugpo.2024.104636
8. Bonenti, B., Ahmadinejad, B., Puljević, C., Ferris, J., Winstock, A., Ganson, K. T., Nagata, J. M., Bradshaw, A., & Piatkowski, T. (2026). The Trenbolo(g)ne sandwich: An international study comparing health harms among men who use anabolic-androgenic steroids with and without trenbolone. Drug and Alcohol Review, 45(4), e70162. https://doi.org/10.1111/dar.70162
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10. Shahsavari Nia, K., Rahmani, F., Ebrahimi Bakhtavar, H., Hashemi Aghdam, Y., & Balafar, M. (2014). A young man with myocardial infarction due to trenbolone acetate; a case report. Emergency (Tehran, Iran), 2(1), 43–45. https://pubmed.ncbi.nlm.nih.gov/26495342/
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