Isn't there what is termed an "effective dose" that these people should be following?
Yes, you touched on an important point. I always argue that yes, there are guidelines, and people are similar even if differences obviously exist. I say you can take a look at what bodybuilders do on average, how doses differ between weight classes and get a fairly good idea wha a given level of muscularity corresponds to approximatately dosage wise.
A top light heavy will typically be between 2-3 grams. That is close to maxing out steroid effects. More can work a bit better but there's obviously diminishing returns as everyone can intuit. The craziest specimens we've seen have hit 5 grams or even more (10 grams!) You know the Nassers and freaks that came after like I believe Nick Walker. In Nassers era almost no one took blood pressure medication and I believe high BP is a large part of what causes damage in bodybuilders. Nowadays most everyone is on BP meds and it remains to be seen how it plays out in the furure. I saw where Fouad said he didn'teven understand that one could take BP meds and still be a bodybuilder. They thought those drugs are for sick people exclusively. But they can be used profylactically. One heart journal argued recently a systolic reading of 100-110 is optimal. Go beyond and you can accumulate damage over time, steroids or not. My docs always said less than 140 was fine. But I feel BP is major in preventing CV damage. Some of the BP drugs have been demonstrated to reduce the thickening of the left ventricle so it makes sense to start BP control from the first day you start steroids. And heart scans would be valublable to catch problems before they get out of control. I did none of that, mistly because docs don't go for it here, they can't legally assist drug abuse.
Now many use telmisartan, a beta blocker and metformin for insulin sensitivity (another probably important marker in the long run). Most every coach demands blood work, though you could argue most of them don't understand how to interpret it. It's also illegal for the coach, he isn't a doctor.