Section 1: Core Concepts — How Signals Work
1. What is the single most important distinction the cellular communication module asks you to make automatic?
2. Which statement correctly describes the words 'hormone' and 'peptide'?
3. A cell releases a substance that acts on its immediate neighbors rather than traveling through the blood. What type of signaling is this?
4. Raloxifene acts like estrogen in bone but blocks estrogen action in breast tissue. What principle does this illustrate?
5. In the 1997 one-leg exercise study, both legs received the same insulin infusion three hours after exercise. What happened?
6. Why can a single FSH blood test be misleading during perimenopause?
7. In the TRUST trial of 737 adults ≥65 with subclinical hypothyroidism, levothyroxine lowered TSH. What happened to symptoms after one year?
Section 2: Thyroid & Adipose Tissue as Endocrine Organs
8. Which thyroid hormone is the biologically active form that enters cell nuclei and drives gene expression?
9. Roughly how much of the body's active T3 comes directly from the thyroid gland itself?
10. Why is calcitonin relevant to midlife women?
11. What discovery in 1994 established adipose tissue as an endocrine organ?
12. How is leptin best understood?
13. Which depot drains partly into the portal vein, delivering fatty acids and inflammatory signals directly to the liver?
14. Endurance athletes carry high intramyocellular lipid yet stay highly insulin sensitive. What explains this 'athlete's paradox'?
15. The SWAN study tracked body composition across the menopause transition. What did it find?
16. According to the 2026 adiposity and cancer meta-analysis (226 prospective studies), how many cancers were positively associated with BMI?
Section 3: Peptides — Signal vs. Noise
17. Why are most peptide therapies injected rather than taken by mouth?
18. Which peptide class has verified hard-outcome data — a 12% reduction in major adverse cardiovascular events?
19. What does a 'Research use only — not for human consumption' label actually mean?
20. What is the central weakness of the BPC-157 evidence base?
21. What is the 'naming trick' with TB-500?
22. Why might chronically pushing growth hormone/IGF-1 upward for 'anti-aging' run against aging biology?
Section 4: Reading the Literature
23. What are the four questions for reading one number from one trial?
24. Per CONSORT 2025 Item 14, a properly specified outcome requires which four components?
25. The WHI reported a 26% increase in invasive breast cancer on estrogen + progestin (HR 1.26). What was that in absolute terms?
26. Look AHEAD was stopped for futility: HR 0.95, 95% CI 0.83–1.09. What is the best reading?
27. The Cell Reports Medicine urolithin A trial is titled as showing improved strength. What happened to its prespecified primary endpoint (peak power output)?
28. Women were 41% of participants in 1,079 recent cardiovascular trials. Why is that still a problem?
Section 5: Myth vs Fact
29. Myth or fact: 'IL-6 is a bad inflammatory molecule.'
30. Myth or fact: 'Peptides are natural, so injecting them is safe.'
31. Myth or fact: 'The obesity paradox shows extra fat protects health.'
32. Myth or fact: 'An adiponectin-to-leptin ratio is ready to guide individual care.'
Section 6: Application and Integration
33. A 54-year-old member has trained consistently for three months. The scale hasn't moved and she feels discouraged. What's the most evidence-aligned response?
34. A friend is buying 'research grade' BPC-157 shipped in a padded envelope, with no certificate of analysis, for a nagging tendon. Which red flags apply?
35. A 60-year-old woman has a TSH slightly above range with normal thyroid hormone levels, and a clinic promises 'optimization' to fix her fatigue. What does this month's material suggest?
36. A supplement ad claims a '40% reduction in risk,' citing one company-funded trial in men aged 25–40. Applying the four questions, what should you ask first?
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Evidence strength key
- 🟢Meta-analysis — pooled human RCT evidence
- 🔵Randomized controlled trial in humans
- 🟡Observational cohort or large-scale human study
- 🟣Expert review or consensus statement
- ⚪Mechanistic / preclinical evidence