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Tests included: Hematocrit, Lipid panel (LDL, HDL, triglycerides), Cystatin C kidney test, eGFR kidney test, GGT liver test, Total Testosterone (LC/MS), Free Testosterone (Equilibrium Ultrafiltration), Ultrasensitive Estradiol, Prolactin, DHT test (LC/MS), IGF-1 test (LC/MS), and ferritin.

A Smart Bodybuilder Monitors His Lab Tests for Long Term Gains

If you are a bodybuilder using anabolic androgenic steroids (AAS), it's vital to be aware of the potential side effects. However, many athletes overlook the necessity of lab tests to maximize benefits and to detect these damaging effects early on to minimize potential risks. To guarantee that you remain healthy during on-cycle phases, regular lab tests are recommended to monitor your body's response to AAS. The importance of lab tests lies in their ability to identify potential side effects in the early stages. Early detection is essential in minimizing the risks and avoiding long-term health problems. Blood pressure tests can detect high blood pressure, a common side effect of AAS usage.

Another crucial test is the liver function test; the liver is crucial for breaking down and eliminating AAS from your body, potentially causing damage to the liver through AAS usage. The liver enzyme test measures the liver's function to ensure it's working adequately. Kidney function tests are also recommended since AAS may affect the kidneys, leading to kidney damage. The creatinine levels in the blood and urine determine how well the kidneys are functioning. Lastly, lipid profile testing measures cholesterol and triglyceride levels. AAS usage may lead to imbalanced lipid levels, putting bodybuilders at risk of heart disease. These crucial tests help detect potential risks to your health effectively. Regular monitoring through blood pressure, liver, kidney, and lipid profile tests is fundamental to minimizing the potential health risks associated with AAS usage. It is advisable to prioritize regular lab tests to ensure you remain healthy even during on-cycle phases. Take care of your health, and always stay informed. Keep reading for more details.

What Bodybuilder Blood Tests are Included and Why?

Bodybuilders using testosterone and anabolic androgenic steroids (AAS) have to be smart about maximizing benefits and minimizing short- and long-term side effects while exercising and eating effectively for good muscle gain, fat loss, and quality of life.  Harm reduction is essential, especially when medical professionals' judgment and stigma create barriers to care. Here is a list of 14 carefully selected lab tests and panels that are essential in maintaining proper health while improving body composition and strength:

Complete Blood Count (CBC)

A complete blood count (CBC) test panel measures several components of your blood, including red blood cells, which carry oxygen; white blood cells, which fight infection; hemoglobin, the oxygen-carrying protein in red blood cells; hematocrit, the proportion of red blood cells to the fluid component in your blood (which is correlated with blood thickness); and platelets, which help with blood clotting.

All androgens, including testosterone and AAS, can raise the number of red blood cells and their percentage in the blood (hematocrit), which makes the blood thicker (erythrocytosis).High hematocrit can cause high blood pressure, headaches, and cardiovascular risks. This panel is essential since it determines when you reach a hematocrit of 53, indicating that blood donation or therapeutic phlebotomy is needed.

Comprehensive Metabolic Panel (CMP)

The comprehensive metabolic panel, or CMP, consists of 14 blood tests that are an initial medical screening tool to review overall health. The CMP blood test panel checks for glucose, kidney function, liver function, electrolyte, and fluid balance. FASTING IS REQUIRED.

Lipid Test Panel

This panel includes LDL (bad cholesterol), HDL (good cholesterol), and triglycerides (fatty acids dissolved in the blood).  Higher doses of T and AAS can increase LDL and decrease HDL and triglycerides. Severely decreased HDL may cause cardiovascular issues in the long term. FASTING IS REQUIRED.

Cystatin C with EGFR Kidney Test

Cystatin C is a more accurate way to determine kidney function in people with higher muscle mass since using creatinine as the primary variable can be affected by higher muscle mass, protein intake, and creatine supplementation. Another one of the measures of kidney function is the estimated glomerular filtration rate (eGFR). The glomerular filtration rate describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCR_Cr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit of time and is a useful measure for approximating the GFR. eGFR under 60 may indicate issues that are affecting kidney function.

GGT Liver Test

The GGT blood test looks for an enzyme, or protein, called gamma-glutamyl transpeptidase (GGT) in your blood. GGT is found in liver cells. This test helps your doctor look for damage to your liver or its ducts. It can also help tell the difference between liver and bone disease if your results from a different blood test called alkaline phosphatase are abnormal. Higher-than-average test results could indicate liver damage from diseases such as hepatitis, cirrhosis, tumors, or pancreatic cancer. The good thing about GGT (unlike liver enzymes included in the CMP like AST and ALT) is that resistance exercise does not affect its value, so it is a more accurate way to detect liver disease in bodybuilders.

Total Testosterone by Liquid Chromatography/Mass Spectrometry, plus Free Testosterone by Equilibrium Ultrafiltration.

Men with high testosterone cannot use the regular total testosterone test based on immunoassays since it has an upper limit of 1,500 ng/dL. The LC/MS testosterone test does not have an upper limit.  Also, some labs offer calculated free testosterone instead of the equilibrium ultrafiltration-based one, which is more accurate for this critical variable.

Ultra-Sensitive Estradiol (E2) Test

The commonly used estradiol test may overestimate estradiol. That test uses immunoassay technology that cannot differentiate C-Reactive Protein (involved in inflammation) from estradiol, so it reads the combination of the two as estradiol. This ultrasensitive estradiol test is based on liquid chromatography/mass spectrometry (LC/MS), an assay technology that does not have that limitation. Furthermore, DHT analogs like oxandrolone may dramatically decrease estradiol, causing joint aches and other low-estradiol issues. Note: 0.4 percent of total testosterone aromatizes to estradiol.  This is the body's way of balancing testosterone's negative effect on lipids with estradiol's beneficial effect. If your total testosterone is high, so will your estradiol. Be very careful when assuming that an aromatase inhibitor is needed.  For more information, click on the effect of high and low estradiol on men's health. How to predict estradiol for different testosterone doses.

Prolactin Test

Many bodybuilders worry about increased prolactin since it has been associated with erectile dysfunction.

DHT Test

This test measures the amount of dihydrotestosterone (DHT) in the blood. Low DHT has been associated with low libido, and high DHT has been linked to acne, hair loss, and benign prostatic inflammation in a minority of men.

IGF-1 Test

Insulin-like Growth Factor 1, also known as IGF-1, is used as a biomarker for blood levels of human growth hormone. It is a hormone that the liver and other tissues produce that affects glucose metabolism and growth-promoting activities. Low IGF-1 may impede muscle growth.

Ferritin Test

Ferritin is a protein that stores iron. Red blood cells need iron to form and carry oxygen around your body. Low levels of ferritin lead to anemia.  TRT and anabolics make the body make more red blood cells (erythrocytosis).  This increased production decreases iron stores and ferritin.

Testosterone has been shown to decrease ferritin. Men on TRT and anabolics with high hematocrit (increased blood thickness caused by TRT or anabolics) usually donate blood or get a therapeutic phlebotomy to decrease hematocrit. There is a loss of around 30 points of ferritin during every donation.  Low ferritin can cause fatigue, restless leg syndrome, muscle aches, and other issues.

What Other Bodybuilder Blood Tests Can Be Considered?

 LH + FSH if off-cycle. 

We also provide a Post PCT Panel for people to find out if their hypothalamic-pituitary-testicular axis has recovered after a few weeks of PCT. The recovery of LH and FSH in an off-cycle period correlates to the normalization of the hormone axis responsible for proper testosterone and sperm production by your body.

Other tests that may be of interest:

PSA

Although studies published in the last 10 years do not show a link between the use of androgens and an increased risk of prostate cancer, some bodybuilders may have benign prostatic enlargement (BPH) that may require PSA follow-up.

Thyroid Panel

Some bodybuilders may experience fatigue issues due to pre-existing low thyroid function (hypothyroidism), so it would be a good idea for them to check their thyroid function to ensure that it is working properly for not only energy production but also effective fat loss.

Free Resources for Educated Bodybuilders:

Suggested Reading: Testosterone Replacement Blood Test Targets

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