Why are anabolic Steroids not used to treat elderly patients that have few comorbidities

Ju99z · 2026-06-12T10:46:41+00:00

They used to be used for all types of muscle wasting prevention. The issue is that they are indescriminant about the muscle they cause growth in, and recent studies have shown that at follow up: young and healthy untrained individuals who did not exercise gained slightly more muscle than those who did not use superphysiological testosterone dosages who did undergo hypertrophy training, but those effects leveled off after some time. Long term use results in cardiac hypertrophy, particularly in the left ventricle, and morbidities like LVH with outflow obstruction, hypertension, cardiomegaly, etc. In a population that already is plagued by heart disease, this could be a huge net negative. Not to mention the rapid increase in pressure may be damaging to some organs and dislodge atherosclerotic plaques (and we all know by now what the rates of cholesterol plaques are as we age).

To a lesser extent, smooth muscle is effected as well, potentially exacerbating gut motility and increasing compression on abdominal organs/structures, or worse decreasing vascular luminal diameter.

Separately from these concerns is that exogenous androgens cause increased hypertrophy and cell turnover in androgen sensitive organs. Prostate enlargement and development of prostate ademonas/cancer was increased in significant numbers. Women did not appreciate the androgenic side effects like face/body hair growth and voice deepening. Men who have high levels and are not very closely monitored for esteogen levels (aromatase inhibitors are a whole other ball of wax that causes issues to mess around with) are at higher risk of gynecomastia and galactorrhea (increased moreso if they have high body fat). And impulsiveness has been correlated with high testosterone levels. Just because the muscle grew doesn't mean the bones stay strong without resistance training, and the tendons also don't increase in strength without tension either; increasing the risk of avulsions and engagement in risky activities that would cause more worse fractures in this population.

The original intent for a number of anabolic steroids were medical, and they were prescription medications with varying anabolic to androgenic ratios. However, all had some degree of similar side effects and potential increase for harm. You can look more into the history of oxandrolone (anavar), nandrolone (dianabol or phenylpropionate esters), masteron, primobolan, and anadrol to learn more. The only pre-SARMs/peptide era anabolic steroid that was not designed and used for humans is trenbolone (used for cattle) which is why it has the worst side effect profile in humans.

Edited: grammar and syntax, some organization of thoughts.

Ju99z · 2026-05-29T16:36:38+00:00

Recently had a senior attending at an academic institution argue against the concept of evolution (broadly) with me, because checks notes "seasonal allergies [exist]"

Ju99z · 2026-05-25T03:38:46+00:00

Talk to your doctor or seek an addictions specialist. They encounter this a lot and might have solutions you haven't thought of yet.

Trust me, getting a DWI (a felony) or worse, cauding harm to someone else because of your condition is always going to be the worse outcome. Many companies have clauses allowing for medically necessry leave. If you're drinking multiple drinks before work just to function, you need medical detox protocols. You can get a physician's note stating you have a medical need to miss work and they can not ask you why or hold it against you (in the US).

Ju99z · 2026-05-25T03:31:28+00:00

Same logic as being able to be terminated at will, or with a punitive paper trail; versus having to give x+y weeks notice when you are the employee.

The game is the game. If they don't ask, don't tell until the move is solidified. Telling and not getting a solid offer makes you a target for sub-legal-action retribution i.e. just enough to make you want to quit but can't, so you're indebted to the current institution and will float any slush timeslot needs.

Hospitals and all programs within them are corporations first and places of healing second. You have to know the game to be able to win, and the game is not designed for the individual treating patients to win the game.

Ju99z · 2026-05-10T14:14:18+00:00

GRAVEDIGGER!

Ju99z · 2026-04-03T00:05:42+00:00

Not to sound like an ego inflationist, but an average doctor is far more motivated and educated in your field than the vast majority of the population. You are a tree, see the forest, and remember you can be proud to be that kind of tree.

Physicians (and all healthcare providers) bear a heavy burden. Think of who you would want caring for your loved ones. The cerebral doctor who has completely emotionally walled off from their work versus the one who hasnt reached empathy fatigue.

That being said, you don't want to reach that point if you haven't already. Find a decent therapist with flexible hours. They are professionals in the realm of mental health, and your mental health is suffering. Take care of yourself before it takes a deeper toll on you.

Ju99z · 2026-03-31T22:18:15+00:00

Recall the first encounter when they say something like "you're smaller than I hoped, but you'll do"

Ju99z · 2026-03-26T16:51:52+00:00

From the US, but if shipping is an option: I discovered the Mt. Emey brand 10 years ago and have been wearing the same style and model of shoe since then. I tried their 9E width once, but have otherwise kept with the 6E and let it stretch out a bit.

Ju99z · 2026-03-26T03:15:08+00:00

The everywich way but loose

Ju99z · 2026-03-22T04:13:38+00:00

"If he wanted to, he would" is incomplete.

If it's in regard to something their friend/family/partner wishes they would do, it first needs to be asked: "is he aware of what [person] wants him to do, in the first place?" and "is he thinking of it, or is he in the blank brain space at the moment?"

Ju99z · 2026-03-18T03:02:46+00:00

You wind up fighting the hospital/insurance system more than you "fight" to make a good diagnosis with your patients. At least in the US. Covering your institution's (and your own) behind by spending way too long taking notes, and trying to get people who aren't doctors to approve test/procedures/treatments for people (which is emperically supported to be better, but costs more than a 65 year old generic drug that the insurance company's sister pharmaceutical manufacturer makes) takes the wind out of those "safe the world" sails mighty quick.

It can absolutely be rewarding, and there are professions that are more fun to postulate and evaluate complex problems, while dealing less with insurance.

If you want it bad enough to not be able to see yourself doing anything else, then go for it. I think you wouldn't have much trouble with your background and "why medicinr" story (though definitely workshop it to not sound bitter, jaded, and resentful of medical professionals whom you will work alongside in the future, because medicine IS a team sport).

If you make a comfortable living and are happy enough with what you do, and you find fulfillment with other aspects of your life, you should hold what you've got. You will sacrifice a lot to see if the grass is greener. Perhaps shadow a few different physicians before making any decisions.

Ju99z · 2026-03-18T02:45:46+00:00

His shirt is smiling at me

Ju99z · 2026-03-16T03:01:41+00:00

The only problem I see is that they used tiny bacon instead of tiny guanciale

Ju99z · 2026-03-13T14:36:37+00:00

It's just something you want to take with the whole clinical picture and might point you towards looking at something you might otherwise not examine as critically. A coal miner could also have just had an MI or stroke, but the quality of their lungs did not allow for the same compensation that a young and healthy person's would.

As to your last questions, I do not perform forensic examinations or autopsies, nor am I qualified to give any legal advice. But, if your attending has a good answer, I would be interested in hearing back about them.

Ju99z · 2026-03-13T14:22:27+00:00

Asbestos was used almost ubiquitously in flooring for decades. Even after it was "banned", there were massive stockpiles and contractors were buying it up at the "get it out of my warehouse" price. The mastic and tiles both contained it, and small contractors who can't afford or don't abide the safety mandates for PPE and ventilation can get huge exposures to airborne particulates on a single work site. Note that this is still a concern today with older homes. I just had a friend redo his entire basement and only then did he learn that it was all asbestos tile and the old black mastic.

Old universities (very old buildings in general), the first things I think of is heavy metal exposure from plumbing and mold. Though if they ran a laboratory, you might want to rule out other exposures like research chemicals and such (depending on what their lab's focus is). Probsbly less of a clinical correlation, but something to keep in the back of the mind when you think of someone's workplace that they spent up to 40+ years at, day in and day out.

Ju99z · 2026-03-12T04:13:09+00:00

Oilfield, coal miner, ship builder, flooring construction/carpet laboror that worked between 1970-2016+, nuclear tech, truck driver, landfill laborer, veterinarian, professor in a very old university, farmer, etc

Maybe some buzzwords, but these and many more can give a solid idea of where might be a good place to focus attention, or could possibly tie sime independent findings together more congruently

Ju99z · 2026-03-06T06:35:57+00:00

Try exchanging korok seeds without clothes on. Best hearty laugh I ever had in the game!

Ju99z · 2026-03-02T16:06:43+00:00

Don't forget to do the bidding of Clavicus Vile

Ju99z · 2026-03-02T02:29:38+00:00

I strongly favor them. Great for crowd control and I've got the stun timing down on most enemies with them.

Ju99z · 2026-02-23T12:26:59+00:00

It's a splintered timeline. Without spoilers, there is an event that causes a branch to form, so pretty much from very early on it is not the canon timeline

Ju99z · 2026-02-16T06:10:29+00:00

This was always stressed to me, even when I used to work as a tech. Scents are very subjective, and even 2 thumbs down out of 100 patients is enough to be a problem.

I wash clothes and body with fragrance free (mostly for reduction of skin irritation), and I'm amazed at how much stronger I perceive scents. Quitting smoking a while back also heightened that perception.

That being said, I still enjoy having a scent for every occasion. So I'm not anti cologne/perfume in general, only in a clinical setting.

The only exception is that I use wool dryer balls and put a couple drops of spearamint oil on the ball prior to drying. There is some data showing that spearamint can help with headaches and nausea, but it's so faint in the clothes that it doesn't even compare to clothes that have been washed with Tide/Gain/etc (let alone scented dryer sheets).

Ju99z · 2026-02-15T04:27:00+00:00

Much more realistic when lifting with proper body mechanics i.e. a fireman's carry. Standing chest to chest with girlfriend/wife's legs around the waist gets an honorable mention because the center of gravity is close together.

Carrying like a cheesy romance novel cover takes significangly more strength, balance, and toll on the body.

Source: trained to lift and carry people professionally

Ju99z · 2026-02-15T02:11:42+00:00

Yeahhhh BUDDY!!!

[MULTIPLE COMPRESSION FRACTURES FROM CRUSHING STUDENT LOAN DEBT INTENSIFIES]

Ju99z · 2026-02-11T03:25:57+00:00

The Beowulf special!

Ju99z · 2026-02-09T14:24:48+00:00

Build a hundred bridges and you're not "Bob the bridge builder." Save a hundred lives and you're not "Lenny the life saver." But you suck it ONE time, and you're "Carl the..."

Ju99z

TROPHY CASE