Lesson 1Evidence limits and uncertainty: interpreting low-quality/biased studies and clinician communication with patientsTalks anabolic study weaknesses like pick bias, under-report, mix-ups. Teaches reading poor data, sharing doubts, backing patient choices on values.
Common biases in anabolic researchInterpreting observational and case dataHandling conflicting or absent evidenceExplaining uncertainty to patientsShared decision-making under ambiguityDocumenting risk discussions clearlyLesson 2Acute and subacute adverse effects: polycythemia, hypertension, acne, mood/behavior changes, hepatic injury (oral agents), injection complicationsLists early side effects like thick blood, high pressure, spots, mood swings, liver hurt from pills, jab issues. Gives steps for spot, grade, handle.
Polycythemia detection and managementBlood pressure elevation and treatmentDermatologic effects and acne careHepatic injury from oral agentsInjection-site and infectious issuesWhen acute effects require cessationLesson 3Cardiovascular risks: dyslipidemia, myocardial hypertrophy, thrombosis, arrhythmia risk and available evidenceSees anabolic hits on fats, pressure, heart muscle, clotting. Checks human/animal data on artery block, heart rhythm issues, sudden death, risk sort and cut.
Mechanisms of dyslipidemia and hypertensionMyocardial hypertrophy and remodelingThrombosis and coagulation abnormalitiesArrhythmias and sudden cardiac death riskImaging and functional cardiac assessmentRisk stratification and mitigation stepsLesson 4Psychiatric and neurobehavioral effects: aggression, mood disorders, dependence, and withdrawal syndromesCovers fight mood, grump, sad, worry, self-harm from anabolics. Details addiction, cycle urge, quit pains, checks, safety plans, mind health links.
Aggression, irritability, and violence riskMood disorders and suicidalityCognitive and impulse-control changesDependence, craving, and compulsive useWithdrawal syndromes and taperingCollaboration with mental health servicesLesson 5Harm reduction principles when non-medical use is disclosed: minimizing acute harms, infection prevention, safer dosing concepts, and when to refuse to prescribeUses harm cut on street use admit, no judge talk, safe dose ideas, germ stop, real goals. Clears law, right, doctor lines for no-script.
Nonjudgmental assessment and rapportSafer dosing and cycle design conceptsInjection hygiene and infection preventionOverdose and acute crisis planningWhen to decline prescribing or supportReferral pathways and community resourcesLesson 6Ongoing monitoring protocols: frequency and thresholds for intervention, red flags for urgent cessation and referralSets follow-up for users, visit times, test/scan gaps, levels for dose shift/stop/refer. Stress red signs, note shared calls.
Visit frequency by risk categoryRoutine lab and imaging intervalsAction thresholds for key lab changesClinical signs requiring urgent cessationCriteria for specialist referralDocumentation and follow-up planningLesson 7Reproductive and endocrine sequelae: hypogonadism, testicular atrophy, infertility, menstrual disturbances, virilization in femalesSees anabolic breaks gland axis, low hormones, shrink balls, no babies, cycle mess, man-traits in women. Plans checks, talks, recovery hopes.
HPG axis suppression mechanismsMale hypogonadism and testicular atrophyMale and female fertility impairmentMenstrual disruption in female usersVirilization signs and reversibilityEndocrine recovery and PCT limitsLesson 8Musculoskeletal and metabolic harms: tendon injury risk, insulin resistance, and body composition changes over timeChecks bone/muscle/metabolism hurts like tendon snap, sugar block, body shift long-term. Screens, training load talks, risk cut ways.
Tendon structure and rupture riskJoint stress and injury patternsInsulin resistance and glucose controlVisceral fat and body composition shiftsScreening for metabolic syndromeTraining and rehab modificationsLesson 9Screening and baseline evaluation to mitigate risk: CBC, CMP/LFTs, lipid panel, testosterone/hormone profile, PSA, ECG, blood pressure and targeted imaging when indicatedSets start history, exam, tests pre/during anabolic. How blood count, liver/kidney, fats, hormones, PSA, heart trace, pressure, scans sort risk, tailor checks.
Key history and physical exam elementsCBC and CMP/LFT interpretationLipid panel and cardiovascular markersHormone profile, PSA, and gonadal testsECG, blood pressure, and ambulatory dataWhen to order echocardiogram or imaging
