Lesson 1Evidence limits and uncertainty: interpreting low-quality/biased studies and clinician communication with patientsE talk limits of anabolic research, like pick bias, under-report, mix-up. E teach doctors to read weak or clash data, talk uncertainty, support patient choices based 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 complicationsE list common early bad effects like too much blood cells, high blood pressure, pimples, mood change, liver damage from oral, injection wahala. E give steps for find, 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 evidenceE check how anabolic affect fats, pressure, heart muscle, clotting. E review human animal data on artery block, heart rhythm wahala, sudden death, how to group and cut heart risk.
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 syndromesE cover anger, bad mood, low mood, worry, suicide link to anabolic. E detail addiction, must-cycle, stop wahala, assessment, safety plan, send to mind health.
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 prescribeE use harm cut when non-med use come out, no judge talk, safe dose ideas, infection stop, real goals. E clear legal, good, clinic lines for no prescribe.
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 referralE define follow-up for anabolic users, visit times, lab scan gaps, levels for dose change, stop, send. E stress see red flags, write shared choices.
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 femalesE review how anabolic mess brain-gonad line, cause low hormone, small balls, no seed, period wahala. E talk female man-like, check, counsel, recovery hope.
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 timeE check muscle bone and energy harms like tendon hurt, sugar resist, blood sugar wahala, long body change. E talk screen, train load counsel, risk cut.
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 indicatedE detail start history, body check, tests before or for anabolic. E explain blood count, liver kidney, fats, hormones, PSA, heart trace, pressure, scans for risk group and plans.
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
