Maximus Clinical Study Review: Is Oral Testosterone Safe for Your Liver?

Summary

Oral testosterone hasn’t always had the best reputation. Older versions caused liver problems, which led many doctors to avoid using them.

But new types of oral testosterone are different. This study looked at a newer form called oral native testosterone—a cleaner, simpler version of the hormone your body already makes.

Over 90 days, 100 men took this form of testosterone. Their liver health was tracked through blood tests before and after treatment. The results? No signs of liver damage. In fact, liver health improved for men who started out with higher-than-normal liver markers.

This suggests oral native testosterone is not only effective—it’s safe for the liver, too.

Why This Matters

Older testosterone pills had a major flaw—they had to be chemically modified to survive digestion and liver breakdown. That made them harder on the liver. Some men developed jaundice, others saw dangerously high liver enzymes. Because of those risks, oral testosterone fell out of favor for decades.

Then came a breakthrough: testosterone undecanoate. It uses the lymphatic system to bypass the liver entirely, entering the bloodstream directly. Studies showed it didn’t cause liver problems—a major step forward.

Now we have an even simpler option: oral native testosterone. It doesn’t require any chemical modification. It’s just pure testosterone, taken by mouth. Like undecanoate, it also uses the lymphatic system for absorption.

That’s important because it avoids something called first-pass metabolism— the process where a drug is broken down by the liver before it ever reaches your bloodstream. Skipping this step means the testosterone stays intact and doesn’t stress the liver.

But until now, we didn’t know how safe this newer form was over the long term. That’s exactly what our study set out to answer.

What are ALT and GGT?

ALT and GGT are enzymes—proteins your body uses to help carry out certain functions. Both are commonly measured in blood tests to check how well your liver is working.

ALT (Alanine Aminotransferase)

• Found mostly in your liver
• When liver cells are damaged, ALT leaks into your blood
• High ALT = a possible sign of liver injury or stress
• Normal range: 0–55 U/L (varies slightly by lab)

Think of ALT as a "smoke alarm" — if it's high, your liver might be irritated or inflamed.

GGT (Gamma-Glutamyl Transferase)

• Found in the liver and bile ducts
• Helps process toxins and transport substances
• Less affected by exercise or muscle damage than ALT
• High GGT can mean liver stress, especially from alcohol or certain medications
• Normal range: 0–51 U/L

GGT adds context to ALT. If both are high, it usually points to a liver-specific problem.

What the Study Did

• 100 men took oral native testosterone for at least 90 days.
• They did at-home blood tests before and after treatment.
• The focus was on two key markers of liver health: ALT and GGT.
• The goal was to see if liver stress or damage occurred over time.

The study also measured testosterone levels to make sure the treatment was working.

What the Study Found

Liver Health

• On average, liver enzyme levels stayed the same or even slightly improved.
• There were no signs of liver damage in any of the 100 men.

Subgroup Findings

Some men had elevated liver markers at the start of the study. In these men:

• ALT levels dropped by 29%
• GGT levels dropped by 17%

That means their liver health got better during treatment.

Testosterone Levels

The treatment worked well:

• Testosterone levels rose by an average of 505 ng/dL.
• 1 in 4 men reached levels above 1123 ng/dL, which is high and often associated with noticeable improvements in mood, energy, and performance.

The Takeaway

This study shows that oral native testosterone is safe for your liver, even over several months of use.

For men who want the benefits of testosterone but prefer the convenience of a pill — without liver risks — this may be a great option.

Key Points

• Older oral testosterone = risky for the liver
• Newer version (native testosterone) = no liver problems found
• Works well: most men saw big increases in testosterone
• May actually improve liver health in some cases

Maximus Oral Testosterone

Maximus Oral Testosterone Protocol is an excellent option if you are looking to have minimal effect on your fertility markers while raising your testosterone levels. Our protocol works with your body's natural production of testosterone to boost levels, minimizing the shutdown of that natural production system.

We use native testosterone, which is bioidentical to the testosterone made by your testes. The absorption of this is better, and regular monitoring of key blood markers, including liver enzymes, has shown minimal to no changes typically associated with liver damage. Our tablets are absorbed via the lymphatic system as well, avoiding any additional stress on the liver.

With this option, our study participants and current clients experienced a 2-5x increase in their total testosterone, on average, and a 3-7x increase in their free testosterone levels, on average. Top choice if you want to stay away from injectables.

For best results, we have found through our studies that taking the Oral Testosterone tablet with 30+ grams of fat creates the optimal environment for absorption.

Want to review our white paper further? Click here.

​​Reviewed by Gabriel Alizaidy, MD, MS

Disclaimer: The contents of this article, including, but not limited to, text, graphics, images, and other information, is for information purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. The content is not meant to be complete or exhaustive or to be applicable to any specific individual's medical condition. You should consult a licensed healthcare professional before starting any health protocol and seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition. Always talk to your doctor about the risks and benefits of any treatment. Never disregard or delay seeking professional medical advice or treatment because of something you have read on this site. Maximus does not recommend, endorse, or make any representation about the efficacy, appropriateness, or suitability of any specific test, products, procedures, treatments, services, opinions, healthcare providers or other information contained herein. Maximus is not responsible for, nor will they bear any liability for, the content provided herein or any actions or outcomes resulting from or related to its use.

References

1. Amneal Pharmaceuticals. Methyl Testosterone Capsules, USP, CIII (10 mg) [Prescribing Information]. Bridgewater, NJ: Amneal Pharmaceuticals; May 2019.
2. Goldstein I, Chidambaram N, Dobs A, et al. Newer formulations of oral testosterone undecanoate: development and liver side effects. Sex Med Rev. 2024;qeae062. doi:10.1093/sxmrev/qeae062
3. Newell-Price J, Huatan H, Quirke J, et al. An oral lipidic native testosterone formulation that is absorbed independent of food. Eur J Endocrinol. 2021;185(5):607–615. doi:10.1530/EJE-21-0606
4. Lala V, Zubair M, Minter DA. Liver Function Tests. [Updated 2023 Jul 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482489/
5. Tiller NB, Stringer WW. Exercise-induced increases in "liver function tests" in a healthy adult male: Is there a knowledge gap in primary care? J Family Med Prim Care. 2023;12(1):177–180. doi:10.4103/jfmpc.jfmpc_1923_22
6. Mayo Clinic. Liver function tests. Published 2023. Accessed May 4, 2025. https://www.mayoclinic.org/tests-procedures/liver-function-tests/about/pac-20394595