Oxandrolone is widely used due to its extremely low androgenic effect, combined with a moderate anabolic effect. Although oxandrolone is an alpha-17-alkylated steroid, its toxicity to the liver is low. Studies have shown that taking oxandrolone at a daily dose of 20 mg for 12 weeks had little effect on increasing liver enzyme activity. Being a derivative of dihydrotestosterone, oxandrolone does not aromatize (does not convert to estrogens, which can cause gynecomastia). It also does not significantly affect the production of testosterone in the body (does not inhibit the hypothalamus-pituitary-testes axis) at doses below 20 mg. At high doses, the body responds with a natural decrease in the production of luteinizing hormone, as happens when the level of endogenous testosterone is too high. This in turn inhibits further stimulation of the Leydig cells in the testes, which can cause them to atrophy. After using the drug at a dose of 20 mg per day for 12 weeks, the production of its own testosterone was suppressed by 67%. In a randomized, double-blind study, burn patients 40% of the total body surface area were selected to receive standard burn treatment with or without oxandrolone. Oxandrolone users have shown improved tissue composition, muscle retention, and shorter hospital stays