Anabolic steroids can cause many adverse effects. Most of these side effects are dose-dependent, the most common being elevated blood pressure, especially in those with pre-existing hypertension,[31] and harmful changes in cholesterol levels: some steroids cause an increase in LDL cholesterol and a decrease in HDL cholesterol.[32] Anabolic steroids have been shown to alter fasting blood sugar and glucose tolerance tests.[33] Anabolic steroids such as testosterone also increase the risk of cardiovascular disease[34] or coronary artery disease.[35][36] Acne is fairly common among anabolic steroid users, mostly due to stimulation of the sebaceous glands by increased testosterone levels.[37][38] Conversion of testosterone to dihydrotestosterone (DHT) can accelerate the rate of premature baldness for males who are genetically predisposed, but testosterone itself can produce baldness in females.[39]
High doses of oral anabolic steroid compounds can cause liver damage as the steroids are metabolized (17α-alkylated) in the digestive system to increase their bioavailability and stability.[40] When high doses of such steroids are used for long periods, serious damage to the liver may occur.[citation needed]