Nandrolone decanoate is an injectable anabolic androgenic steroid. It is indicated for the management of the anemia of renal insufficiency and has been shown to increase hemoglobin and red cell mass. Nandrolone cannot be reduced by 5-alpha reductase into DHT and therefore does not have an adverse reaction on the prostate. Instead of DHT, nandrolone metabolizes into dihydro nandrolone. Nandrolone does not convert into estrogens. Nandrolone binds well to androgen receptors and also possesses non-receptor mediated stimulation on muscle growth. Nandrolone decanoate is one of the most potent anabolic steroids for muscle growth with an excellent myotropic activity index 3.29-4.92. Nandrolone up-regulates androgen receptor AR expression in skeletal muscle, thus potentiating the actions of other steroids. Nandrolone does not have alkylation on the 17a-carbon and therefore is not toxic for the liver.