Did Brian Johnson (Liver King) confirm using steroids?

Yes. In a December 2022 YouTube video, Johnson admitted to using testosterone, trenbolone, growth hormone, and hCG after leaked emails to a bodybuilding coach detailed his protocol. This is confirmed, not speculated.

What is trenbolone, and is it approved for human use?

Trenbolone is a synthetic 19-nortestosterone anabolic steroid originally developed for use in cattle. It is not FDA-approved for human use. It has extremely high androgen receptor binding affinity and is associated with significant cardiovascular, hepatic, and neuropsychiatric side effects.

Can the body recover natural testosterone production after long-term steroid use?

Recovery is possible but not guaranteed. The HPG axis can take months to years to resume normal function after prolonged supraphysiological androgen use. Some men, particularly those who used 19-nor compounds like trenbolone or nandrolone for extended periods, may not fully recover and may require lifelong TRT at replacement doses.

What is post-cycle therapy (PCT)?

PCT typically involves SERMs like clomiphene citrate or tamoxifen, which block estrogen's negative feedback on the pituitary, stimulating LH and FSH release. While widely used in bodybuilding, no large RCTs have validated specific PCT protocols for recovery after supraphysiological steroid cycles. Medical supervision during this period is strongly recommended.

What are the cardiovascular risks of long-term anabolic steroid use?

Long-term supraphysiological androgen use is associated with accelerated coronary atherosclerosis, reduced HDL cholesterol, left ventricular hypertrophy, diastolic dysfunction, and increased thrombotic risk from polycythemia. These effects are dose-dependent and partially reversible with cessation, though structural cardiac changes may persist.

Brian Johnson (Liver King), Maintenance, and What Happens If You Stop

By HealthRX Medical Team

Published May 25, 2026Updated May 25, 2026Last reviewed May 25, 2026

The Public Record: From Denial to Disclosure

For roughly two years, Brian Johnson built the Liver King brand around a claim that raw organ meats, ancestral living, and nine "ancestral tenets" produced his heavily muscled, sub-10% body fat physique. He repeatedly denied steroid use in interviews and on social media.

In late November 2022, leaked emails between Johnson and a bodybuilding coach revealed a detailed pharmaceutical protocol. The leaked documents listed testosterone, trenbolone, growth hormone, hCG, and other compounds, with monthly costs reportedly exceeding $11,000.

On December 1, 2022, Johnson posted a video apology on YouTube confirming the use of anabolic steroids and hormones. He stated he had used testosterone and other agents and acknowledged misleading his audience. This was a confirmed, on-camera admission, not speculation.

At a glance

Status: Confirmed user of testosterone, trenbolone, growth hormone, and hCG (admitted December 2022)
Duration of known use: At least two years based on leaked coaching correspondence
Public claim before disclosure: Physique attributed entirely to diet and lifestyle
Significance: One of the highest-profile cases of influencer hormone-use denial followed by forced disclosure

What Was in the Protocol: A Clinical Breakdown

The leaked emails described a multi-compound regimen. Each drug carries distinct pharmacological profiles and discontinuation risks.

Testosterone (exogenous). The foundation of most anabolic protocols. Supraphysiological doses (often 300 to 600 mg/week, well above the 100 to 200 mg/week range typical of TRT for hypogonadism) suppress the hypothalamic-pituitary-gonadal (HPG) axis through negative feedback on GnRH and LH secretion.

Trenbolone. A 19-nortestosterone derivative roughly five times as androgenic as testosterone. Trenbolone is not FDA-approved for human use. It is veterinary-grade, originally developed as trenbolone acetate (Finaplix) for cattle. Its binding affinity for the androgen receptor is among the highest of any synthetic anabolic. Trenbolone also binds progesterone and mineralocorticoid receptors, contributing to side effects including night sweats, insomnia, cardiovascular strain, and mood disturbance.

Human growth hormone (hGH). Recombinant hGH at supraphysiological doses promotes lipolysis, connective tissue growth, and fluid retention. Long-term use at high doses is associated with insulin resistance, joint pain, carpal tunnel syndrome, and potential increased cancer risk.

Human chorionic gonadotropin (hCG). An LH analog that stimulates testicular Leydig cells. In anabolic steroid cycles, hCG is often used to maintain testicular size and some degree of intratesticular testosterone production. Clinical guidelines from the American Urological Association note hCG's role in fertility preservation during testosterone therapy.

What Happens When You Stop: The Discontinuation Problem

Discontinuation of long-term supraphysiological androgens triggers a well-documented clinical cascade. The HealthRX Medical Team considers this the most underreported risk in influencer hormone culture.

HPG Axis Suppression and Recovery

Exogenous testosterone, particularly when combined with 19-nor compounds like trenbolone, profoundly suppresses LH and FSH production. After cessation, the pituitary must resume gonadotropin secretion, and the testes must respond. Recovery timelines vary widely.

A 2021 study in the Journal of Clinical Endocrinology & Metabolism found that former anabolic steroid users showed persistent hypogonadal symptoms (low testosterone, reduced sperm counts, sexual dysfunction) months to years after discontinuation. Some men never fully recovered baseline testosterone production. The 19-nortestosterone derivatives appear to cause particularly prolonged suppression, with nandrolone metabolites detectable for 12 to 18 months after last use, suggesting sustained receptor-level activity.

The Symptomatic Valley

During the weeks to months between cessation and HPG axis recovery, users commonly experience:

Fatigue and low energy
Loss of muscle mass and increased fat deposition
Depressed mood, irritability, or frank depression
Reduced libido and erectile dysfunction
Joint pain (particularly if growth hormone is also discontinued)

These symptoms are not trivial. Research published in Drug and Alcohol Dependence documents clinically significant depressive episodes during anabolic steroid withdrawal, with a subset of users meeting criteria for major depressive disorder.

Post-Cycle Therapy: What the Evidence Actually Shows

In bodybuilding circles, "post-cycle therapy" (PCT) with selective estrogen receptor modulators (SERMs) like clomiphene or tamoxifen is standard practice. Clomiphene citrate at 25 to 50 mg daily has been shown to raise LH and FSH in hypogonadal men, and it is used off-label to stimulate endogenous testosterone recovery.

The HealthRX Medical Team notes a critical gap: no large randomized controlled trial has evaluated PCT protocols specifically for recovery after supraphysiological steroid cycles. Most evidence is extrapolated from studies of clomiphene for secondary hypogonadism or from small case series. Recovery is not guaranteed, and the combination of trenbolone's prolonged suppressive effects with years of exogenous testosterone may create a scenario where full HPG recovery is unlikely without ongoing medical management.

Long-Term Considerations If Use Continues

Whether Johnson continued, reduced, or stopped his protocol after disclosure remains publicly unclear. He has made subsequent social media posts suggesting lifestyle changes, but has not provided a detailed public update on his current pharmaceutical status. The following clinical considerations apply to anyone on a similar long-term protocol.

Cardiovascular risk. Supraphysiological androgens reduce HDL cholesterol and increase LDL. Trenbolone is particularly cardiotoxic. A 2017 study in Circulation reported that anabolic steroid users had significantly impaired coronary artery plaque volume compared to non-users, even after adjustment for traditional risk factors. Long-term users face accelerated atherosclerosis.

Left ventricular hypertrophy. Echocardiographic studies of long-term anabolic steroid users show concentric left ventricular hypertrophy and diastolic dysfunction. These changes are dose-dependent and duration-dependent.

Hepatic effects. While injectable testosterone and trenbolone are not 17-alpha-alkylated (the modification most associated with liver toxicity), chronic use combined with other oral agents or the sheer metabolic load of multiple compounds warrants periodic hepatic monitoring. The FDA's prescribing guidance for testosterone recommends liver function testing.

Hematologic changes. Testosterone stimulates erythropoiesis. Polycythemia (hematocrit above 54%) increases thrombotic risk. The Endocrine Society's 2018 guidelines recommend monitoring hematocrit every 6 to 12 months during testosterone therapy, with dose reduction or phlebotomy if levels become dangerous.

Fertility. Prolonged supraphysiological testosterone use can cause azoospermia. Recovery of spermatogenesis after cessation is variable. A meta-analysis in Fertility and Sterility reported that most men recover sperm production within 12 months of stopping testosterone, but a subset do not, particularly after years of use or when 19-nor compounds are involved.

The HealthRX Medical Team Take

Brian Johnson's case is clinically instructive for three reasons.

First, the magnitude of the protocol matters. This was not standard TRT at replacement doses. The combination of supraphysiological testosterone, trenbolone (a veterinary compound with no human safety data from controlled trials), growth hormone, and hCG represents a polypharmacy approach with compounding risk. Each compound's side effect profile interacts with the others in ways that have never been studied in a clinical trial setting.

Second, duration amplifies risk. Two or more years of sustained supraphysiological androgen exposure creates cardiovascular, endocrine, and hematologic changes that may be only partially reversible. The longer someone is on these compounds, the less likely complete HPG axis recovery becomes, and the more entrenched cardiac remodeling may be.

Third, the disclosure gap is a public health problem. Johnson's extended denial period meant that followers attempting to replicate his physique through diet alone were set up for failure. When influencers conceal pharmaceutical assistance, they create unrealistic body composition expectations. The clinical consequence is that some followers then seek out the same compounds without medical supervision, compounding population-level risk.

For anyone in a similar situation, considering stopping a multi-compound hormone protocol, the HealthRX Medical Team's recommendation is unambiguous: do it under the supervision of an endocrinologist who can monitor gonadotropins, total and free testosterone, estradiol, hematocrit, lipids, cardiac biomarkers, and mood throughout the process. Discontinuation without clinical oversight is where the most serious adverse events occur.

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