Dianabol Results: With Before-and-After Pictures

## Dianabol (Methandrostenolone) – A Quick‑Reference Guide

| Topic | Key Points |
|-------|------------|
| **What is Dianabol?** | • First oral anabolic steroid introduced in 1960.
• Synthetic derivative of testosterone with a methyl group at C17α → oral bioavailability, short half‑life (~4 h).
• Classic "bodybuilder’s" steroid: rapid gains in strength & muscle size. |
| **Mechanism** | • Binds androgen receptors → ↑protein synthesis, nitrogen retention.
• Also has weak estrogenic activity (≈ 5–10 % of testosterone), may cause gynecomastia if not mitigated. |
| **Typical Dosage Regimen** | • 20 mg/day for men (up to 40 mg/day in experienced users).
• Women: 5–15 mg/day.
• Cycle length: 4–6 weeks.
• "Stack" with other steroids (e.g., testosterone, trenbolone) or with aromatase inhibitors to reduce estrogenic side‑effects. |
| **Adverse Effects** | • Liver toxicity (hepatotoxicity), especially with oral formulations.
• Cardiac strain: hypertension, left ventricular hypertrophy, arrhythmias.
• Estrogenic effects: gynecomastia, water retention, sexual dysfunction.
• Psychological: aggression, mood swings.
• Long‑term endocrine disruption: hypogonadism, infertility. |
| **Monitoring** | • Liver function tests (ALT/AST, bilirubin) before and during therapy.
• Lipid panel, blood pressure, ECG if indicated.
• Hormonal profile: testosterone, LH, FSH.
• Imaging for cardiac complications if clinically suspected.
• Follow‑up after cessation to document recovery of endocrine function. |

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## 3. Clinical Decision‑Making Algorithm (for a 40‑yr‑old male)

| Step | Action | Rationale |
|------|--------|-----------|
| **1** | Confirm clinical suspicion: "burning" chest pain lasting > 20 min, relieved by rest/oxygen, with risk factors. | Typical presentation of MI or unstable angina. |
| **2** | Perform 12‑lead ECG immediately; look for ST‑segment elevation, depression, T‑wave inversion. | ECG abnormalities are the most rapid and specific indicator of ischemia. |
| **3** | Obtain cardiac biomarkers (troponin I/T) at baseline and repeat after 3–6 h. | Elevation confirms myocardial necrosis; helps distinguish NSTEMI from unstable angina. |
| **4** | If ECG shows ST‑segment elevation → immediate reperfusion therapy (PCI or fibrinolysis). <30 min door‑to‑balloon time is target. | Reperfusion restores blood flow, limits infarct size, improves survival. |
| **5** | If ECG normal or non‑specific and troponin elevated → NSTEMI: start antiplatelet therapy (aspirin + clopidogrel), anticoagulation, beta‑blocker, ACE inhibitor, statin; consider early invasive strategy if high risk (e.g., ongoing ischemia, LBBB, hemodynamic instability). | Reduces recurrent events, improves prognosis. |
| **6** | If ECG normal and troponin negative but clinical suspicion