Dr. Alex Tatem, a fellowship-trained urologist specializing in men’s health, recently released his comprehensive ranking of PEDs. He provided medical insight into compounds commonly used in bodybuilding and strength sports. The tier list evaluates each substance based on effectiveness, safety profile, and practical application rather than raw potency alone.
S-TierÂ
Leading Dr. Tatem’s rankings are several standout compounds. MK-677, a growth hormone secretagogue, earned S-tier status specifically for hard gainers struggling with calorie consumption.
“If you’re someone who really struggles to put on size, MK-677 is S-tier,” Tatem explained, praising its appetite stimulation and growth hormone release without testosterone suppression concerns.
Testosterone cypionate claimed its rightful place as the foundation of all anabolic compounds. As the “building block off of everything else,” Tatem emphasized its historical significance and fundamental role in hormone replacement therapy.
Nandrolone decanoate (Deca) also achieved S-tier status, with Tatem noting his personal research contribution studying its joint pain relief properties.
Two oral compounds made the elite tier: Anavar (oxandrolone) and Primobolan. Anavar impressed with its minimal liver toxicity compared to other orals, while Primobolan excelled as a cutting compound for achieving a “shredded, granular look” without excessive water retention.
A Tier
On his A-tier, Tatem placed Turinabol (commonly known as T-Bol). It holds a unique place in the history of performance enhancement, and was originally developed in the 1960s as part of East Germany’s state-sponsored doping program for Olympic athletes. It provides strong, lean strength gains with minimal water retention but stresses the liver.
B-Tier
Several compounds earned solid B-tier rankings for their effectiveness despite notable drawbacks. Equipoise received recognition as “more anabolic than testosterone” but was marked down for causing anxiety and significantly raising hematocrit levels.
Winstrol, despite being a “fantastic favorite” with impressive strength gains and vascularity, lost points for devastating lipid profiles and joint discomfort.
Growth hormone, while capable of true muscle hyperplasia (new muscle cell formation), landed in B-tier due to complexity of use. “Growth hormone requires a strategy,” Tatem warned, citing insulin sensitivity issues and potential carpal tunnel syndrome from fluid accumulation.
C and F Tiers
Halotestin fell to C-tier primarily for its limited application, providing aggression and muscle hardness without meaningful hypertrophy. Anadrol received similar treatment despite acute strength benefits, with Tatem noting it as “the only anabolic truly linked to cancer” through case reports of liver cancer.
Superdrol, once sold at GNC as a supplement, received C-tier status due to extreme liver toxicity. “There have been multiple case reports of guys going into liver failure,” Tatem cautioned, describing cases requiring liver transplants.
The bottom tier saw two compounds completely dismissed. Trenbolone, despite being incredibly potent, earned F-tier due to extensive toxicity. “If you can think of a way that Tren can poison you, Tren can poison you,” Tatem stated, citing kidney damage, liver toxicity, and brain amyloid plaques linked to Alzheimer’s disease.
Proviron also received F-tier ranking as merely a “supporting character” with minimal anabolic properties, typically added to complex stacks without clear benefit.
Medical Perspective on Risk vs. Reward
Throughout his analysis, Dr. Tatem emphasized the importance of risk-benefit analysis from a medical standpoint. He consistently highlighted safer alternatives and warned against compounds with severe health consequences.
The doctor concluded with a strong safety disclaimer, emphasizing that no aesthetic or athletic achievement justifies compromising long-term health.
