Fake Natty

Read This First

Danger now?

Stop reading and call your local emergency number (999 in the UK, 911 in the US, 112 across the EU) if you or someone with you has:

• Chest pain, pressure or tightness, fainting, or a racing or irregular heartbeat
• Face drooping, an arm going weak, or slurred speech
• An injection site that is red, hot and spreading, with fever or feeling very unwell

The full list is on the Go Now card at the back of this book. Print it. Screenshot it. Put it on the fridge.

You might be reading this in the car after a session, pump still fading. Or in bed, at 1 a.m., with a forum thread open in the other tab. Maybe your training partner just told you he's "starting a cycle". Maybe you started months ago. Maybe you stopped and something hasn't come back.

Wherever you are with it, this book is for you.

Why this book exists

People are using anabolic steroids, SARMs, growth hormone and the drugs that come with them. Not just competitive bodybuilders: men and women who lift, work the door, model, make content, or are tired of looking the same after five years of honest training. Telling them "don't" hasn't worked. Most of them have already decided.

What's missing is the other half of the story. The gym tells you about the gains. The forum tells you about the "protocol". Almost nobody tells you plainly what happens to your heart, liver, kidneys, testicles and mood, which of those changes go away and which don't, and what it looks like when something is going badly wrong.

That's this book. Two promises run through every chapter:

1. No judgment. The pressure is real, the results are real, and we say so.
2. No softened consequences. If something can kill you, we say it can kill you, and how often when anyone has counted.

What this book won't give you

You will not find doses, cycles, cycle lengths, stacks, "PCT" protocols, compound recommendations, injection sites or technique, sources, lab names, or ways to beat a drug test. Not anywhere.

That isn't squeamishness. Any number we printed would be copied by someone it doesn't fit, from a bottle that may not contain what the label says. And the honest answer to "what's the safe dose?" is that nobody has worked one out for using these drugs this way. Medicine gives these drugs to people who need them, at levels designed to bring the body back to normal. Using them to go past normal is a different drug in practice, and its safe dose has never been studied.

What you will find is everything around that: what the drugs do in your body, how they hurt people, what the warning signs look like, which tests catch damage early, how to get a doctor on your side, and how to come off with help.

If you're already using: read these first

You don't have to read in order. Pick the row that fits you today.

• Thinking about starting — Ch. 1 Why People Use, Ch. 2 What Anabolic Steroids Do — Ch. 3 The Heart, Ch. 5 Fertility, Ch. 8 SARMs
• Using now — Ch. 3 The Heart, Ch. 10 Needles, Ch. 11 Bloodwork and Doctors — Ch. 4 Liver and Kidneys, Ch. 9 The Bodybuilder Pharmacy, Ch. 7 Mood
• Using SARMs or "legal steroids" — Ch. 8 SARMs — Ch. 4 Liver and Kidneys, Ch. 5 Fertility
• A woman using or considering — Ch. 6 The Body Changes Nobody Posts — Ch. 3 The Heart, Ch. 7 Mood
• Coming off, or already off — Ch. 12 Getting Off, Ch. 7 Mood — Ch. 5 Fertility, Ch. 11 Bloodwork and Doctors
• Worried about someone else — Ch. 7 Mood (partners and family) — Ch. 1, then the Go Now card

Your move: circle your row. If you're using now, read Chapter 3 tonight, before anything else.

How to use this book

Every chapter opens with a person and a moment you may recognise. Then it explains what is going on in the body, ranks the risks (common and annoying, uncommon and serious, rare and fatal) and ends with something to do.

Look for these boxes:

• Go Now: signs that mean emergency care immediately.
• Ask This: the exact words to say to a doctor, nurse or pharmacist, with what a good and a bad answer sound like.
• Myth / What the evidence says: one thing you've heard, and what's actually known.
• If You're Doing It Anyway: the harm-reduction version, the one public-health services use.
• More Isn't Better: what to know before you reach for "more" when something stops working.

At the back are two pages to print: the Go Now card and your Juice Risk and Monitoring Card, which you fill in as you read.

Stories and sources

Some stories are composites; names and details are changed. Composites are labelled as such, and they never carry a statistic or a quote from a real person. Where a story is a documented case (a published case report, a court or coroner record), we say so and cite it.

Every number in this book comes from a source listed in the References. Where the evidence is thin (a single small study, case reports only, research in animals), the text says so.

This book is general information, not medical advice. It can't examine you, read your blood results or know your history. It is written to get you into a better conversation with a clinician, not to replace one.

Over to you. Start with your row.

About this book

This book is educational. It is not medical advice, and it is not a substitute for a clinician who knows your history. If you have warning signs now, use the Go Now card or call your local emergency number. For everything else, take the questions in this book to a doctor, nurse or pharmacist.

Why People Use

A composite story

Jordan is a composite, built from patterns in the surveys and studies in this chapter. His name and details are invented.

Jordan is 24 and has been training properly for five years. Food logged, sleep mostly sorted, a programme he actually sticks to. He looks good. He looks like someone who trains. He does not look like the people on his feed.

Tuesday evening, changing room. His training partner, Kyle, pulls his shirt off and Jordan clocks it straight away: shoulders that weren't there in March, veins down the forearms, a fullness that doesn't come from chicken and rice. Kyle sees him looking and grins. "I'm on, mate. Started in the spring. Best decision I ever made."

On the drive home Jordan does the maths he's done a hundred times. Five years for what he's got. Kyle, a few months. He thinks about the guys he follows, the ones who swear they're natural and look like comic-book drawings. He thinks: everyone at the top is on something anyway. By midnight he has three forum tabs open and a WhatsApp message to Kyle half-typed: "What are you running?"

Here's what neither of them knows. In Denmark, researchers followed 1,189 men caught using anabolic steroids in gyms. Their average age was 27. Over about eleven years, 2.8% of them died, against 1.0% of more than 59,000 men their age who weren't caught. That is almost three times the death rate, in young men who were, on paper, fit.