In October 2018, a 47-year-old male recreational bodybuilder presented to his general practitioner in Prague, Czech Republic, with polydipsia (daily fluid intake 5-6 L), polyuria, blurred vision, malaise, and weight loss of 10 kg in the past month. He did not complain of any pain or fever and was taking no regular medication except recent (3 months) use of performance-enhancing drugs (PEDs) purchased from a fitness center, including two selective androgen receptor modulators (SARMs)-RAD140 5 mg twice daily and andarine 25 mg twice daily, 5 days per week-as well as the growth hormone (GH) secretagogue (GHS)/ghrelin analog ibutamoren 25 mg daily, 5 days per week.
He had no previous use of hormonal supplements.