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It isnt always easy to spot the signs of GHB use

Salvianolic acid B protects against acetaminophen hepatotoxicity by inducing Nrf2 and phase II detoxification gene expression via activation of the PI3K and PKC signaling pathways

Sources B vitamins and folic acid (2017) NHS [accessed 18 June 2020] Vitamin B12 Deficiency and Pernicious Anaemia (2016) Patient Info [accessed 18 June 2020] Vitamin B12 or folate deficiency anaemia (2019) NHS [accessed 18 June 2020]

Maybe its an irritation of the biceps tendon

In these older cells, there was a noticeable increase in muscle hypertrophy, reflected by an enlarged muscle cell size

But when this many patients are injecting themselves with compounds they found on Reddit as part of their rehab, we cant just ignore it