Wow...that is ripped!
Some ripped models and bodybuilders take growth hormone, oxandrolone (Anavar), stanozonol (Winstrol), thyroid meds and diuretics while also being on a low carb diet and cardio. Lots of work but it surely works. Liver enzyme elevations, dehydration, and HPTA (testicular and thyroid axis) dysregulation are some of the side effects.