Short answer: The serious liver problems in testosterone labels are tied mainly to long-term, high-dose oral 17-alpha-alkyl androgens such as methyltestosterone. The AndroGel, Xyosted and Aveed labels say those products are not known to cause them, and Kyzatrex says it is not that type of androgen. Labels still list abnormal liver tests among reported reactions and ask users to report signs such as yellow skin.
The modern labels share one paragraph (AndroGel 1.62% section 5.9, Xyosted 5.8, Aveed 5.10, Kyzatrex 5.8). It says that long-term use of high doses of oral 17-alpha-alkyl androgens, such as methyltestosterone, has been linked to serious liver problems: peliosis hepatis (blood-filled spaces in the liver, which can be fatal), liver tumors, cholestatic hepatitis and jaundice. It also says long-term shots of testosterone enanthate have produced multiple liver adenomas, a kind of benign tumor.
| Product | What the label says about its liver risk |
|---|---|
| AndroGel 1.62% (gel) | Not known to cause these effects |
| Xyosted (enanthate auto-injector) | Not known to produce these effects; report signs of liver problems |
| Aveed (undecanoate shot) | Not known to produce these effects; report signs of liver problems |
| Kyzatrex (oral undecanoate) | Not a 17-alpha-alkyl androgen; stop and check the cause if signs such as jaundice appear |
| Depo-Testosterone (cypionate) | Warns that prolonged high doses (mainly 17-alpha-alkyl) are linked to adenomas, liver cancer and peliosis; lists cholestatic jaundice and changed liver tests |
The older Depo-Testosterone label lists nausea, cholestatic jaundice, alterations in liver function tests and, rarely, liver tumors and peliosis hepatis among reactions seen with some androgens. Under human data, it notes rare reports of liver cancer in people on long-term, high-dose androgens, and that stopping did not always make the tumors go away. It also lists serious liver disease as a reason not to use the product.
After approval, AndroGel 1.62% (section 6.2) lists abnormal liver function tests, and Aveed lists raised ALT, AST and bilirubin among reports. These show that changes happened, not how often or whether testosterone caused them. The labels separately note liver toxicity among serious problems in people who misuse anabolic steroids.
LiverTox, the NIH (NIDDK) database on drug-related liver injury, says many synthetic androgenic steroids can cause cholestatic liver injury, and that long-term androgen use is linked to liver tumors including hepatocellular carcinoma, adenomas and peliosis hepatis. It notes these steroids are used for hormone replacement and also, illicitly, for exercise and athletic performance.
Put together, the labels draw the line between modern replacement products used at usual doses and the oral 17-alpha-alkyl androgens and high-dose use behind most of the serious reports.
The AndroGel 1.62% label lists liver function tests among the blood tests to check periodically, next to testosterone, PSA, hemoglobin, hematocrit and lipids. The ALT and AST entry explains the two main liver enzymes.
The labels ask users to report signs of liver trouble, with jaundice (yellowing of the skin or eyes) as the example. Keeping lab results next to your dose history, as Dose Track does, shows whether a change in liver tests followed a change in product or dose.
Read more on Dose Track: ALT and AST (liver enzymes) · Depo-Testosterone side effects · Kyzatrex side effects · Jatenzo vs Kyzatrex vs Tlando