If you are going to use anabolic steroids, or any type of performance enhancing compounds, it is important to run blood work at least 3-4 times per year. It's like getting your pool water checked to make sure there is the right amount of chemicals for it to stay clear and problem free, or checking the air pressure in your car's tires.
What's more, it would be a good idea to get blood work before your cycle, so you can know where your baseline is, and flag any problems ahead of time. For example, you might have elevated liver values, and if you know about them it will be easier to prevent even bigger issues when running a harsh oral steroid. Or you may have high estrogen going into a cycle, so you may avoid using aromatizing compounds.
In this article we will do what no other article has done - simplify everything and examine how compounds affect your blood work from A to Z.
Table of Contents
How do I get blood work?
There are two ways to get blood work done. The most common way to do so is requesting blood work from your doctor, give him a list of things you want to get done, and he will send you to the lab. Another popular mode of getting blood work is ordering it online, where you independently pay for what you want done, and then take the forms to the lab.
How do steroids affect blood work?
Many people will parrot information on forums without even being aware that their claims can be easily disputed with simple blood work; blood work doesn't lie, and blood work doesn't care about 'bro science forum parroting.'
When you use anabolic steroids, the pituitary glands react to the exogenous hormones by going dormant. As a result, your LH and FSH will quickly drop to near 0, and your body will no longer produce testosterone on its own. It is true that certain steroids will suppress you faster and harder than others, but what is also true, is that all anabolic steroids are suppressive and will 'shut you down,' with proviron being the only exception due to its unique properties.
Therefore, depending on what compounds you use (testosterone, dianabol, deca durabolin), your estrogen may rise significantly, while other compounds (such DHT derivatives as masteron, proviron, winstrol) will actually inhibit estrogen.
A compound like trenbolone can quickly strain many of your lipids, and EQ (equipoise) is known to cause RBC rise, making blood donations imperative. Furthermore, trenbolone can also give false positives for estrogen with some blood work labs, so be aware of this.
HPTA blood work
The most important aspect of blood work, and anabolic steroid use, is understanding how the HPTA (hypothalamic pituitary testicular axis) works. A properly functioning HPTA features pituitary glands that are producing LH (luteinizing hormone), and it signals the leydig cells in the testes to produce testosterone, which later converts into estrogen. In natural conditions, this cycle continuously repeats itself. However, when you use anabolic steroids, SERM's, or other drugs, your HPTA functions will be altered, and it will be reflected in blood work.
Unfortunately, many people fail to understand this, and make the mistake of paying attention only to what their total testosterone shows. Nonetheless, if there is a number that should be paid most attention to, it is LH, not testosterone levels.
Lets now take a look at the numbers you will need to understand when you run blood work on your HPTA, and the normal ranges that I feel they should be at (for a healthy adult male), and what they mean:
LH (luteinizing hormone)
LH - 3-8mIU/ml. This is luteinizing hormone, and it is produced by the gonadotropic cells in the pituitary glands. It's main function is signaling the body to produce testosterone, and it is the most important number to know if your HPTA is functioning well. A low level of LH when you are off cycle means your HPTA is not functioning well, and it is not producing enough testosterone. Nevertheless, there is no need to panic, as this is the recovery phase, and you should just wait until your LH has fully recovered before starting your next cycle. Obviously, on cycle your LH will drop to near 0, as your pituitary glands go dormant, which is completely is normal.
FSH (follicle stimulating hormone)
FSH - 2.5-12mIU/ml. FSH stands for follicle stimulating hormone, and it is also produced by the gonadotrophs of the pituitary glands. As a matter of fact, FSH works in synergy with LH and regulates pubertal maturation, growth, development, and reproductive processes in the body. Like with LH on cycle, it will drop to near 0, and off cycle a low number is not a good sign. Therefore, once you start abusing steroids you will notice your FSH never returns to its original levels. Even though low levels of FSH can be attributed to getting older, steroid abuse will prevent a healthy number in long term, and it might possibly impact and reduce your chances to have children later in life.
Total testosterone - 350-950ng/dl. Testosterone is a male hormone (androgen) in the blood that affects sexual features and development. Unlike LH and FSH, testosterone is produced by our testes (leydig cells). However, you must keep in mind that this number fluctuates, being the highest in the morning and the lowest in the evening. Naturally, as men age, this number will start dropping. In fact, men who have low testosterone typically have problems with increased fat gains, inability to build muscle, low libido, and other issues. On the flip side, if you abuse steroids and your testosterone is too high for long periods of time, it can strain your heart and cause spikes in estrogen levels, causing estrogenic side effects.
Free testosterone - 32-150pg/ml. This is going to be a ratio of your total testosterone and is considered your actual 'free' testosterone, not bound. Typically, it is not worth the extra money to check, because it will be a % of your total testosterone. In other words, if your total testosterone is in range, then free testosterone will be as well in almost all cases. Moreover, the same goes for the cases when it is high or low.
Estradiol 15-50pg/ml. Testosterone aromatizes into estrogen in the body. It is important to outline that males need estrogen to function, so I disagree with people who say estradiol can be below 15, which is too low. I would like to see levels over 15pg/ml. However, with levels higher than 50pg/ml you can expect water retention, and even puffy nips or sore breasts associated with gynecomastia symptoms. In such case, an aromatase inhibitor (AI) like Aromasin is necessary to keep this number in check, but you shouldn't abuse it either and drop your estrogen too low – it is essential to maintain a balance.
Other blood work numbers
When you get blood work done, you will see a bunch of things that were tested, and for the most part they should not be impacted by anabolic steroid use. Without a doubt, anything out of range should be investigated, but there are some values that are going to be off. However, these aspects of blood work can be solved, so they should not alarm you. They are as follows:
Red blood cell count (RBC)
RBC - 4.15-5.8. Red blood cell count (RBC) may rise on anabolic steroids. Nonetheless, if this number gets too high it can strain your heart health. Hence, it is important to give blood in order to thin out your blood. For instance, I recommend giving blood every 6 weeks and take support supplements.
Glucose, Serum- 65-99. If you did not fast prior to your test, this number may come in high, so to get an accurate number you should fast for 8-12 hours. Anything over 100 is a red flag, and figures over 120 are a sign of serious issues. Therefore, if you ate a chocolate cake before getting bloods and your number came in over, there it is nothing to be alarmed about.
Blood Urea Nitrogen
BUN- 6-20mg/dl. Blood Urea Nitrogen is a waste product derived from protein breakdown in the liver. A lot of weightlifters will have high BUN levels because of their diets, and the fact that they are constantly breaking down muscle and repairing it on a daily basis. Thus, to get an accurate BUN number you should stop working out for at least a week prior to blood work, otherwise this number means little. Interestingly, most doctors will be confused when they see this, because the ranges they use are for the typical couch potato male, not a lifter who is pounding away everyday.
Creatinine - .76-1.27mg/dl. If you are holding a lot of muscle mass this number will come in hotter than the ranges. Same as BUN, the values that are used by doctors are for the normal couch potatoes, not a weightlifter/bodybuilder. Therefore, in order to get an accurate figure you would probably have to stop lifting weight for months and lose muscle mass, so disregard this number and consider a high level of creatinine as something to be proud of, since it means that you are holding more muscle than the normal male out there.
Cholesterol - total cholesterol levels under 200 mg/dl. HDL and LDL stand for high and low density lipoprotein respectively. LDL is mostly known as the bad cholesterol, whilst HDL is the good cholesterol. Unfortunately, it is normal on anabolic steroids for your good cholesterol to drop and bad cholesterol to rise. This is why it is important to cycle off and not abuse AAS (anabolic androgenic steroids). Hence, if your cholesterol levels are poor before using steroids, then you should fix your lifestyle first. Such factors as stress, lack of exercise, and poor diet can lead to cholesterol problems.
AST 0-40IU/L. It is an enzyme found in liver, heart, and muscle cells. AST can become strained on cycle, so it is important to run support supplements such as N2guard.
ALT 0-44IU/L. Yet another enzyme, which is a signal of liver strain if this number is high. It is normal for it to rise when taking most oral anabolic steroids and a support supplement like N2guard should be used. Furthermore, it is important to know that this number can get worse if you are taking other drugs and drinking alcohol. If it does not normalize after stopping your oral steroids, then liver disease may be present.
Using support supplements
Support supplements have been used by athletes and bodybuilders for years to help normalize blood work, and prevent organ and lipid strain.
The vitamins, minerals, and herbs like Hawthorn, taurine, dandelion, uva ursi, milk thistle, and indole 3 carbinol are used by almost all bodybuilders. All of these supplements are meant to be beneficial for such health aspects as cholesterol balance, blood pressure, water weight, cell repair, liver and kidney protection, and an overall protection of major organs. However, there is one supplement that contains all of these, and many ingredients more, making it the most complete support supplemental stack, and it is called N2guard.
As mentioned earlier, giving blood is not only healthy for yourself, but also saves lives. You can look at it as changing the oil in your car.
How ancillaries influence blood work
HCG will increase estrogen and testosterone, while dropping LH and FSH. Remember, HCG mimics LH in the body, which signals the pituitary glands to stop producing LH - after all, why would your body produce LH when it thinks you have too much already? Once you stop using HCG, testosterone and estrogen will drop, and LH and FSH will slowly rise back up.
SERM's (selective estrogen receptor modulators), such as clomid and nolvadex, are popular in post cycle therapy (PCT), and when blood work is done while they are still active in the body, misgivings can occur. The reason is when you take a SERM, estrogen becomes blocked from cycling back into your pituitary glands, causing a sharp rise in LH and testosterone while the drug is active in the body. Those who run blood work during this time will think they are recovered. However, to get an accurate idea of where you are at during PCT, you must stop all drugs for 2-3 weeks, since the drugs are temporarily manipulating your results. Too many guys run blood work while the SERM's are still active, and think they are recovered. Nevertheless, this is a major error, which tells you nothing about where you are.
Aromatase inhibitors, of course, will affect estrogen levels. Letrozole is the strongest AI, and it can drop your estrogen levels by more than 70% very quickly. This is why people complain about the negative side effects of this compound. On the other hand, aromasin and arimidex are more mild, and for this reason more popular.
How SARMs affect blood work
SARMS are far less suppressive than anabolic steroids. Ostarine, for example, is not suppressive when used for less than 4 weeks at 25 milligrams (mg) per day, or less. Other SARMS like Andarine (S4) and Anabolicum (LGD) are very slightly suppressive, where LH and FSH will drop by 15-20%, making recovery after cycle much easier. All in all, they also have very minimal impact on your overall blood work and lipids.
Cardarine isn't a SARM (it is a PPAR inhibitor), and in no way will it have any influence on your hormones whatsoever. As a matter of fact, it may improve your cholesterol levels and other heart related blood work.
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