The danger taxonomy

#The shape of every entry here

What it is, what it was believed to do, and the documented cost — in that order, every time. No doses. Case reports and cohort data, not warnings with nothing behind them.

#Diuretics (furosemide, spironolactone)

Prescription drugs for fluid overload, used off-label in the final 24–48 hours to strip subcutaneous water. Loop diuretics dump both sodium and potassium; potassium-sparing diuretics do the reverse. Stacking either — especially on top of a week of water restriction — produces electrolyte swings large enough to destabilise cardiac rhythm. Spironolactone's own mechanism carries a documented risk of severe hyperkalaemia; a published case describes ventricular standstill as a direct consequence.

#DNP (2,4-dinitrophenol)

An industrial chemical repurposed as an extreme fat-loss aid. It uncouples the process that would normally turn burned fuel into usable energy, releasing the energy as heat instead — which is the fat-loss effect and the mechanism of harm at the same time. There is no dose that produces meaningful fat loss without meaningful heat generation, because they are the same physical process. Published case reports document fatal outcomes, including in a 17-year-old.

#Clenbuterol

A veterinary bronchodilator (and, in some places, a low-dose human asthma drug) used off-label for its thermogenic effect. Reported bodybuilding doses run several times higher than therapeutic ones — but published case reports document cardiac toxicity, including myocardial ischaemia, at doses within the nominal therapeutic range in people without tolerance built up. There is no reversal agent.

#Insulin

A prescription hormone for diabetes, used off-label for its anabolic signalling. Its therapeutic and lethal effects are separated by physiology that self-administration without an actual diabetes-management infrastructure cannot safely track. A published case describes a bodybuilder found in a coma from covert insulin use he had not disclosed to his own doctors. There is no home substitute for continuous glucose monitoring and rescue glucagon.

#Growth hormone, insulin, and abdominal distension

The visibly distended "gut" seen in some advanced competitors is not simple bloating. It's a compound of three things happening at once from the same drugs: growth hormone driving real organ enlargement, insulin driving visceral fat, and both together driving hypertrophy of the abdominal wall muscles themselves. That's why, unlike bloating, it doesn't resolve with a water cut.

#Synthol and site-enhancement oils

An oil/alcohol/lidocaine mixture injected directly into a muscle to fake localised size. This is direct tissue damage, not a systemic risk in the same sense as the rest of this list: documented complications include fibrosis, nerve damage, pulmonary embolism and reported stroke. What it produces is oil sitting inside fibrotic tissue — not muscle — which is why it doesn't respond to training or time, and undoing it generally means surgery.

#Anabolic-androgenic steroids — the chronic condition underneath all of it

Long-term steroid use is what makes every acute manipulation above more dangerous, and it carries its own separately measured cost. A cohort of over 20,000 male IFBB competitors followed for an average of 8+ years found sudden cardiac death was the single leading cause of death — 38% of all deaths recorded — with professional competitors carrying five times the risk of amateurs, and elite "Open" competitors specifically showing a death rate over the study period in the single-digit percent range. Autopsies consistently found cardiac enlargement; toxicology found steroids present in the majority of cases tested. A five-fold relative risk and a measured percentage-point absolute death rate at the top of a sport are not small print.

#Retrieve

Full citations for every claim above, including the study details and publication years: /protocol/showprep § The danger taxonomy.