Both the proportion of substandard and counterfeit products are described to be higher in formulations for oil-based solutions used for injectables compared to tablets used for oral administration 25, 26, 36, 43. Funnel plots (Fig. 4) show the plots of the logit transformed proportions from each study (x-axis) against its standard error (y-axis) for counterfeit and substandard AAS, as a measure of precision of that study. The analysis for substandard substances comes with some challenges. In two articles, the authors analyzed mixed samples, but the proportion of AAS was above 75%, as described in the inclusion criteria published in the study protocol 34,35,36. In 17 articles we were able to extract samples that exclusively analyzed anabolic agents (WADA class S1). One study was a retrospective database analysis of the Brazilian federal police database . Most included study designs (95%) were nonclinical laboratory studies. We searched PubMed/Medline, Embase and Google Scholar for articles published before March 2022. While it might seem more convenient or cost-effective to use black market sources, the risks far outweigh any perceived benefits. The best way to safely benefit from TRT is to work with a healthcare provider. Possessing or distributing these substances without a prescription is illegal and can result in serious legal consequences. Self-medication or obtaining Testosterone without a prescription is illegal and potentially dangerous to your health. Additionally, the decision to prescribe a particular form of bioidentical Testosterone depends on various factors, including the patient’s medical history, preferences, and response to treatment. As mentioned in the previous response, bioidentical Testosterone is available in various forms, including testosterone injections, gels, patches, tablets, and pellets. For the rest of the world, the laws in regards to Testosterone for sale (and other anabolic steroids) are even more lax. Any anabolic steroid source should always have Testosterone for sale in at least its three most popular formats, whether it be a legal source in a country where sale is permitted or on the black market where it is illicitly traded. There are more variants and preparations of Testosterone than there are of any other anabolic steroid, and this is one of the biggest reasons as to why those looking for anabolic steroids will find Testosterone for sale in every place they look. First of all, Testosterone is the original anabolic steroid and is even labelled as the father of all anabolic steroids. • Levels of AI detected are not between the acceptable range defined for original productsa (quantitative) • Levels of active pharmaceutical ingredients (AI) detected are between the defined range of the declared formulation defined by the individual studya (quantitative) Classification of prohibited substances coded according to the WADA prohibited list (updated version as of 01 January 2021) • articles where the exact composition of analyzed IPEDs is not provided by the author Historically, the majority of AAS users were professional or competitive athletes, but nowadays survey data has revealed that over 75% of AAS users are non-competitive bodybuilders or athletes, who are mostly motivated by cosmetic benefits over performance enhancement from AAS use 4, 6, 8–13.
