Triple-disqualifier for this user. **(1) No clinical indication** — 20yo MMA athlete with no anemia, no CKD, normal Hb/Hct/iron panel; this drug is built to fix renal failure-driven hypo-erythropoiesis, not enhance physiology. **(2) FDA rejected on cardiovascular safety** — CRDAC 13-1/12-2 votes citing thrombosis (vascular access thrombosis RR 1.5, DVT RR 3.9 in DD-CKD; seizures, infections, MACE signal in NDD-CKD), Complete Response Letter Aug 2021, AstraZeneca walked away from US rights entirely. The endurance gain athletes seek (raising hematocrit) is exactly the mechanism that drove the thrombotic events that killed the FDA filing — combat sports already raise stroke risk via head impact, and a young athlete stacking hematocrit on top of subconcussive trauma is moving the wrong direction on the risk curve. **(3) WADA-banned in and out of competition.** Even if he were tested at the amateur MMA level today, sanctioned competition (USA Boxing, USADA-tested events, future pro license) would catch detectable metabolites for ~30+ days post-dose; multiple positive cases on record (Simona Halep 2022, several cyclists, equine doping). The legitimate altitude-adaptation analog is **actually train at altitude or use a hypoxic tent** — same HIF stabilization, no thrombosis signal, no anti-doping risk, no $300+/month gray-market exposure. Would only revisit if he developed a documented anemia of CKD (extremely unlikely at 20) AND moved to a jurisdiction with EU/Japan/China approval AND obtained legitimate prescription. None of those are imminent.