What performance-enhancing drugs (PEDs) and stack are recommended for a 19-year-old, 220-pound individual seeking to gain muscle mass while maintaining leanness, with a history of anabolic steroid use, planning to obtain them legally over-the-counter (OTC) in another country?

From the Guidelines

I strongly advise against using performance-enhancing drugs (PEDs) or steroid stacks for bodybuilding, as they pose significant risks to your health and wellbeing, including potential damage to your endocrine system, cardiovascular health, liver, and psychological wellbeing. At 19 years old, your body is still developing naturally, and introducing synthetic hormones now could have long-lasting and potentially irreversible consequences. The evidence base for the safety and efficacy of PEDs is limited and often observational, with few randomized clinical trials to support their use 1.

Key Considerations

• The use of PEDs and supplements should be prohibited due to the potential for harm and the lack of scientifically reliable support for their benefits 1.
• Athletes should have their nutritional needs met through a healthy, balanced diet without dietary supplements, and should focus on natural bodybuilding methods such as proper nutrition, progressive resistance training, sufficient recovery, and patience 1.
• The principle of “unreasonable risk” should be the standard for banning or recommending avoidance of substances being evaluated for use by athletes, due to the potential for harm in the absence of defined benefit 1.

Recommendations

• Focus on natural bodybuilding methods, including proper nutrition (caloric surplus with adequate protein), progressive resistance training, sufficient recovery, and patience, to achieve sustainable results without the serious health risks associated with PEDs.
• Consider consulting with a sports medicine physician who can provide medically appropriate guidance based on your specific health status, if you are determined to pursue bodybuilding seriously.
• Be aware of the potential dangers of recreational drugs and performance-enhancing substances, including the risk of sudden death and myocardial infarction, and seek education and counseling from physicians and athletic department staff 1.

From the Research

Performance-Enhancing Drugs (PEDs) and Stacks

There are no research papers that recommend specific PEDs and stacks for a 19-year-old, 220-pound individual seeking to gain muscle mass while maintaining leanness, with a history of anabolic steroid use, planning to obtain them legally over-the-counter (OTC) in another country.

Health Risks Associated with PEDs

• The use of anabolic-androgenic steroids can improve muscular performance, but it is associated with serious health risks, including hepatotoxicity and acute cardiac events 2, 3.
• Polydrug abuse, restrictive diets, and dehydrating practices may potentiate the health risks associated with weight training and steroid use 2.
• Anabolic-androgenic steroids can cause behavioral and psychiatric symptoms, including myocardial infarct, suicide, and cancer, although the evidence to support a cause and effect relationship is lacking 4.

Alternatives to PEDs

• Nutritional and training alternatives to anabolic-androgenic steroids are promising and may help athletes achieve their goals without the risks associated with PEDs 2.
• Sports medicine physicians should educate themselves and their patients about the physiology, performance benefits, adverse effects, and testing methods of PEDs to prevent their use 5.

Prevalence of PED Use

• The use of appearance- and performance-enhancing drugs (APEDs) is increasing, with up to 5% of male and 2% of female college athletes using anabolic-androgenic steroids, and reports of a more than 20% usage rate among teenagers 3.
• The use of PEDs is not limited to athletes, and users range from professional athletes and bodybuilders to amateurs and adolescents 3.