Did Liver King confirm steroid use?

Yes. In a December 2022 video posted to his social media channels, Brian Johnson confirmed using testosterone, trenbolone, growth hormone, and hCG. This followed the publication of leaked emails detailing his pharmaceutical protocol.

What side effects did Liver King publicly describe?

In various interviews and his apology video, Johnson described elevated blood pressure, night sweats, disrupted sleep, increased aggression, joint pain, water retention, fatigue during post-cycle recovery, reduced libido, and mood instability. Each of these aligns with the known adverse-event profiles of the compounds he confirmed using.

Is trenbolone approved for human use?

No. Trenbolone has never received FDA approval for use in humans. It is approved only as a veterinary growth promotant in cattle. There are no human clinical trials establishing safe dosing, and all human safety data comes from case reports and observational studies.

Can HPG axis function recover after steroid use?

In most cases, yes, but the timeline varies. Published data suggest median recovery of spermatogenesis takes approximately 6 months, with some individuals requiring over a year. Recovery depends on the duration and dose of use, the specific compounds, and individual physiology.

What monitoring should someone on TRT receive?

Standard TRT monitoring per Endocrine Society guidelines includes hematocrit (to screen for polycythemia), lipid panel, liver function tests, PSA (in age-appropriate men), and testosterone levels at 3- to 6-month intervals. Supraphysiologic use would require more intensive surveillance including cardiac imaging.

Side Effects Brian Johnson (Liver King) Publicly Discussed (and What They Match in the Clinical Literature)

By HealthRX Medical Team

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

The Public Record: From Denial to Confirmation

For roughly two years, Brian Johnson built a massive following (over 4 million across platforms at peak) by claiming his muscular physique at age 45+ came entirely from eating raw organ meats, sleeping on the ground, and following nine "ancestral tenets." He repeatedly denied steroid use in interviews and social posts.

In late November 2022, leaked emails between Johnson and a bodybuilding coach were published by fitness YouTuber Derek of More Plates More Dates, revealing a detailed pharmaceutical protocol. The leaked documents listed monthly spending exceeding $11,000 on compounds including testosterone, trenbolone, growth hormone (multiple IUs daily), hCG, deca-durabolin, and several ancillary drugs.

Johnson posted a video apology in December 2022 confirming the use. "Yes, I've done steroids," he stated. He described experiencing specific physical and psychological effects during and after his cycles. This confirmation is the factual basis for the clinical analysis below.

At a glance

Status: Confirmed. Johnson admitted on camera in December 2022 to using testosterone, trenbolone, growth hormone, and hCG.
Duration of confirmed use: The leaked protocol documents suggest use spanning at least several months; Johnson has not disclosed exact timelines publicly.
Context: He was simultaneously promoting a supplement brand (Ancestral Supplements) while denying any pharmaceutical assistance.
Relevance: His case illustrates how supraphysiologic doses of multiple anabolic agents produce predictable adverse events that match the published clinical literature.

Testosterone at Supraphysiologic Doses: Expected Side Effects

Standard testosterone replacement therapy (TRT) targets physiologic levels, typically 300 to 1 to 000 ng/dL. The leaked protocol suggested Johnson was using doses far above replacement. At supraphysiologic levels, the adverse-event profile shifts substantially.

The FDA prescribing information for testosterone cypionate lists polycythemia (elevated red blood cell count) as the most common adverse reaction in clinical trials, occurring in up to 24% of patients on replacement doses. A 2010 study in the New England Journal of Medicine found that testosterone supplementation in older men with mobility limitations was associated with increased cardiovascular adverse events, prompting early termination of the trial.

Johnson has publicly described cardiovascular strain. In his apology video and subsequent podcast appearances, he referenced elevated blood pressure and concerns about heart health. These align with the well-documented effects of exogenous testosterone on erythropoiesis and blood viscosity, which increase cardiovascular load.

Hypothalamic-pituitary-gonadal (HPG) axis suppression is another expected consequence. Exogenous testosterone signals the hypothalamus to reduce GnRH output, which suppresses endogenous LH and FSH. The result: testicular atrophy and azoospermia. Johnson's use of hCG, an LH analog, is consistent with attempting to mitigate this effect. A 2005 study in the Journal of Clinical Endocrinology & Metabolism demonstrated that concurrent hCG administration during testosterone use preserved intratesticular testosterone levels and spermatogenesis in a majority of study participants.

Trenbolone: The Compound With the Harshest Profile

Trenbolone is a 19-nortestosterone derivative that was never approved for human use by the FDA. It exists in veterinary medicine as an implant pellet (Revalor) for cattle. There are no controlled human clinical trials, which means the adverse-event data comes from case reports, animal pharmacology, and observational data from self-reporting users.

Johnson, in a January 2023 appearance on the Mark Bell Power Project podcast, described night sweats, disrupted sleep, and increased aggression while on his protocol. All three are among the most frequently self-reported effects of trenbolone in user surveys and case literature.

The mechanism behind trenbolone-associated night sweats and insomnia is not fully established in peer-reviewed literature, but the compound's strong progestogenic activity and its effects on central thermoregulation are suspected contributors. A case series published in the Journal of Medical Case Reports documented tachycardia, hypertension, and hepatotoxicity in trenbolone users presenting to emergency departments.

The HealthRX Medical Team's assessment: Trenbolone is the single most concerning compound in Johnson's disclosed protocol. Without FDA approval for human use, there are no established safe dosing ranges, no long-term safety data, and no standardized monitoring guidelines. Any clinician encountering a patient using trenbolone is effectively managing an uncharted pharmacologic exposure.

Growth Hormone: Documented Effects and Johnson's Reported Experience

The leaked protocol indicated Johnson was using several IUs of recombinant human growth hormone (rhGH) daily. FDA-approved uses of GH in adults are limited to growth hormone deficiency and specific wasting conditions.

At supraphysiologic doses, GH produces a recognizable adverse-event profile. The Endocrine Society's 2011 clinical practice guidelines note that common side effects include peripheral edema, arthralgia, carpal tunnel syndrome, and glucose intolerance. A hallmark physical sign of chronic GH excess is acromegalic-type tissue changes: soft tissue swelling in the hands and feet, jaw prominence, and visceral organ growth (including the intestines, which can produce visible abdominal distension sometimes called "GH gut" or "palumboism" in bodybuilding circles).

Media coverage and fitness commentators have noted changes in Johnson's abdominal profile consistent with these descriptions. The HealthRX Medical Team notes that while these observations are publicly documented in widely viewed media, we cannot attribute any specific physical feature to a specific drug without clinical examination. What we can say is that the pattern is consistent with what the endocrinology literature describes in cases of chronic GH excess.

Johnson has publicly mentioned joint pain and water retention in multiple podcast appearances during 2023. Both are among the most common adverse events listed in the FDA label for Genotropin, occurring at rates of 10 to 20% even at therapeutic doses.

HPG Axis Recovery: What the Science Says About Coming Off

In several 2023 interviews, Johnson discussed the difficulty of returning to baseline hormonal function after discontinuing his protocol. This experience is consistent with a substantial body of evidence on post-cycle HPG axis suppression.

A 2015 review in Fertility and Sterility found that recovery of spermatogenesis after anabolic steroid use took a median of 6 months, with some men requiring 12 months or longer. The duration of suppression correlates with the duration and dose of steroid use, as well as the specific compounds involved. 19-nortestosterone derivatives like trenbolone and nandrolone are associated with particularly prolonged suppression due to their metabolites remaining detectable (and biologically active at the androgen receptor) for months after the last dose.

Johnson's description of fatigue, reduced libido, and mood instability during the post-use period aligns with the symptom cluster of secondary hypogonadism that clinical literature consistently documents in men discontinuing supraphysiologic androgens.

The Broader Clinical Lesson: Polypharmacy Compounds Risk

The HealthRX Medical Team emphasizes that Johnson's protocol was not a single-drug exposure. It was a polypharmacy stack of at least four major hormonal agents, each with distinct receptor activity, half-lives, and organ system effects. The interaction risks of combining anabolic steroids with growth hormone are poorly studied because no ethics board would approve such a trial at these doses in healthy volunteers.

What the literature does tell us:

Cardiovascular: Testosterone and trenbolone both impair the HDL/LDL ratio. A study in Circulation found that anabolic steroid users had significantly reduced coronary artery plaque volume and systolic function compared to non-users.
Hepatic: Trenbolone's 17-alpha-alkylated oral variants (when used) are directly hepatotoxic. Even injectable forms carry documented hepatic risk in case reports.
Psychological: Supraphysiologic androgens, particularly trenbolone, are associated with mood volatility, irritability, and in some cases frank psychiatric symptoms. A 2000 JAMA study demonstrated dose-dependent mood and behavioral effects of testosterone in a controlled setting.

What This Case Tells the Public

Johnson's story is not unique in the fitness influencer space, but it is one of the most well-documented because the leaked protocol was unusually detailed and his subsequent admissions were on camera. The clinical value of this case is straightforward: the side effects he described map predictably onto the known pharmacology of the drugs he confirmed using.

The HealthRX Medical Team's position is that honest disclosure allows for honest medical management. Patients who disclose hormone use to their clinicians can be monitored with appropriate labs (hematocrit, lipid panels, hepatic function, glucose, echocardiography), and intervention can happen before adverse events become irreversible. Concealment, as Johnson practiced for years, eliminates this safety net.

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