Lesson 1Dose-response, routes of administration, pharmacokinetics and detection windows relevant to clinical decisionsCovers dose-response links, oral vs injectable methods, ester choices, liver effects, and drug movement in the body. Includes half-life, active byproducts, buildup, and detection times key for tests and patient care in Eritrea.
Dose–response curves and ceiling anabolic effectsOral versus injectable formulations and bioavailabilityEster length, depot kinetics, and dosing intervalsHepatic metabolism, active metabolites, and clearanceSteady state, accumulation, and washout timelinesDetection windows and anti-doping test strategiesLesson 2Interactions with other medications and common comorbidities affecting choice and safetyLooks at drug and illness interactions impacting anabolic safety, like effects on blood thinners, diabetes meds, blood pressure drugs, liver/kidney issues, sleep problems, heart and prostate risks relevant to local health contexts.
Interactions with anticoagulants and antiplatelet drugsEffects on insulin, oral hypoglycemics, and glycemiaBlood pressure, diuretics, and cardiovascular therapiesHepatic and renal impairment considerationsSleep apnea, obesity, and cardiometabolic riskProstate disease, breast cancer, and hormone-sensitive tumorsLesson 3Classification of anabolic agents: testosterone esters, nandrolone, oxandrolone, stanozolol, selective androgen receptor modulators (SARMs) and precursorsGroups main anabolic agents like testosterone esters, 19-nor types, DHT orals, SARMs, precursors. Discusses structure links to action, strength, tissue targeting, and common medical or non-medical uses in practice.
Testosterone esters and their clinical applicationsNandrolone and other 19-nor anabolic derivativesDHT-based orals such as stanozolol and oxandroloneSelective androgen receptor modulators in developmentProhormones and over-the-counter precursorsStructure–activity links to anabolic and androgenic effectsLesson 4Guidelines and position statements: Endocrine Society, American Thoracic Society, FDA/EMA drug labels, and specialty society recommendations for anabolic useSums up key guidelines on anabolic therapy from Endocrine Society, ATS, FDA/EMA labels. Notes diagnosis levels, no-go conditions, checks, and dosing plans useful for Eritrean clinicians.
Endocrine Society guidance on testosterone therapyATS and pulmonary society views on wasting in COPDFDA and EMA labeling for key anabolic agentsContraindications and boxed warnings in guidelinesRecommended monitoring and follow-up intervalsReconciling conflicting expert recommendationsLesson 5Alternatives to anabolic agents for wasting or performance goals: nutrition, resistance training, protein supplementation, and non-androgenic pharmacotherapiesReviews non-hormone ways to tackle wasting and performance via proper eating, weight training, protein/creatine, and extra meds that build muscle with less hormone risk, fitting community resources.
Energy and protein targets in catabolic conditionsPeriodized resistance training for lean mass gainProtein, leucine, and HMB supplementation strategiesCreatine, beta-alanine, and ergogenic nutrition aidsAppetite stimulants and anabolic non-androgen drugsChoosing alternatives when androgens are unsuitableLesson 6Off-label uses and evidence base: anabolic use in sarcopenia, frailty, anorexia nervosa-related wasting, and athletic performance claimsReviews off-label anabolic use in muscle loss, weakness, eating disorder wasting, sports claims. Stresses study results, effects, safety alerts, and why many stay unproven or not advised.
Testosterone in age-related sarcopenia and frailtyAnabolic agents in anorexia nervosa and severe dietingNandrolone and others in chronic illness–related wastingEvidence and ethics in athletic performance enhancementRisk–benefit profile of off-label anabolic regimensRegulatory and medico-legal considerationsLesson 7Monitoring parameters during therapeutic anabolic use: labs, imaging, functional outcomes, and timelines for expected benefitSets monitoring standards for anabolic therapy with initial checks, blood tests, scans, function tests. Lists timelines for gains, side effects, and rules for dose shifts or stopping.
Baseline evaluation and informed consent processLaboratory panels for safety and efficacy trackingImaging and body composition assessment toolsFunctional outcomes and quality-of-life measuresTimelines for benefit onset and plateau effectsCriteria for dose adjustment or discontinuationLesson 8Androgen physiology: endogenous testosterone synthesis, AR signaling, and metabolic effectsExplains normal male hormone workings, brain-gland-testicle control, adrenal output, receptor signals, effects on muscle, bone, blood, metabolism key for basic understanding.
Hypothalamic–pituitary–gonadal axis regulationTesticular and adrenal androgen synthesis pathwaysAndrogen receptor structure and signaling cascadesGenomic versus non-genomic androgen actionsEffects on muscle, bone, and erythropoiesisImpacts on lipids, insulin sensitivity, and fatLesson 9Approved medical indications: hypogonadism, cachexia, severe burn/trauma, HIV-associated wasting, select COPD and chronic disease contextsCovers proven uses for low hormones, wasting, major burns/trauma, HIV loss, some lung/chronic illnesses with diagnosis rules, dosing, risk-benefit for safe practice.
Diagnostic criteria for hypogonadism and treatment thresholdsAnabolic use in cancer cachexia and chronic disease wastingOxandrolone in severe burn and major trauma recoveryTestosterone and analogs in HIV-associated wastingUse in COPD and advanced cardiopulmonary diseaseBalancing benefit, contraindications, and adverse risks
