- Use injection routes that reduce hepatic load (subcutaneous, intramuscular).
- Maintain hydration and balanced diet to support liver function.
- Avoid concurrent hepatotoxic substances (alcohol, certain supplements). | | Create contingency plan | - If liver enzymes >3× ULN: discontinue anabolic agent; consider hepatoprotective agents (e.g., N-acetylcysteine) and re‑evaluate with a hepatologist.
- If lipid panel shows significant dyslipidemia: initiate statin therapy after consulting cardiology, adjust diet, monitor quarterly. | | Documentation & Review | Record all baseline metrics, monitoring results, interventions, and outcomes in the patient’s chart. Schedule annual review of risk stratification and update plan accordingly. |
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5. Summary
Baseline assessments are essential to quantify each patient's hepatic and cardiovascular status before initiating anabolic therapy.
Risk stratification should integrate all baseline data to guide dosing, monitoring frequency, and necessary preventive measures.
Monitoring schedules must be individualized but generally include quarterly labs for liver function and lipids, with additional imaging or specialist referrals as warranted by any abnormalities.
Intervention thresholds are clearly defined; exceeding them mandates prompt action—ranging from dosage adjustments to discontinuation of therapy—to prevent serious complications.
By adhering to this structured protocol, clinicians can optimize patient safety while enabling the therapeutic benefits of anabolic steroids.
