Bodybuilding is a sport that requires a lot of hard work and dedication, especially when it comes to maximizing the benefits and minimizing the side effects of testosterone and anabolic androgenic steroids (AAS). With the proper exercise and nutrition regimen, bodybuilders can achieve proper muscle gain, fat loss, and strength. However, it is important to monitor one's health through carefully selected lab tests and panels, especially in the presence of barriers to care caused by stigma and judgment from medical practitioners.

In this article, we will discuss the importance of harm reduction and list 14 essential lab tests and panels for bodybuilders to maintain proper health while improving body composition and strength.

Bodybuilders who use testosterone and anabolic androgenic steroids (AAS) need to be smart about maximizing benefits and minimizing short-term and long-term side effects while also effectively exercising and eating for good muscle gain, fat loss, and quality of life. This will allow them to get the most out of their testosterone and AAS use. It is extremely important to reduce harm, particularly when there are barriers to care, such as those induced by stigma and criticism from medical professionals.

Table of Contents

Bodybuilder Tests:

The following is a list of 14 carefully selected laboratory tests and panels that are vital in properly preserving one's health while simultaneously enhancing one's body composition and strength:

Complete blood count (CBC)


The components of your blood that are measured by a complete blood count (CBC) test panel are as follows: red blood cells, which are responsible for transporting oxygen; white blood cells, which are responsible for fighting infection; hemoglobin, which is the protein found in red blood cells that transports oxygen; hematocrit, which is the ratio of red blood cells to the fluid component in your blood (which correlates with blood thickness); and platelets, which aid in the process of blood clotting.

All androgens, including testosterone and anabolic androgenic steroids (AAS), have the ability to boost the number of red blood cells and their proportion in the blood (hematocrit), hence increasing the thickness of the blood (polycythemia). A high hematocrit level is associated with increased risks of cardiovascular disease, high blood pressure, and headaches. This panel is important because it determines when you have reached a hematocrit of 53, which indicates that you either need to donate blood or undergo therapeutic phlebotomy.

Tests included in CBC panel:

  • White blood cell count (WBC or leukocyte count)
  • WBC differential count
  • Red blood cell count (RBC or erythrocyte count)
  • Hematocrit (Hct)
  • Hemoglobin (Hbg)
  • Mean corpuscular volume (MCV)
  • Mean corpuscular hemoglobin (MCH)
  • Mean corpuscular hemoglobin concentration (MCHC)
  • Red cell distribution width (RDW)
  • Platelet count
  • Mean Platelet Volume (MPV)

Complete Metabolic Profile (CMP)


The comprehensive metabolic panel, often known as the CMP panel, is a medical screening tool that consists of 14 blood tests and is used to evaluate an individual's general health. The CMP blood test panel analyzes fluid and electrolyte balance, as well as glucose levels, kidney and liver function, and electrolyte levels. FASTING IS REQUIRED.

 Tests included:

  • Glucose
  • Sodium
  • Potassium
  • Chloride
  • Carbon Dioxide
  •  Calcium
  •  Protein
  • Albumin
  • Alanine transaminase (ALT)
  • Aspartate transaminase (AST)
  • Bilirubin
  • Alkaline phosphatase (ALP)
  • Blood urea nitrogen (BUN)
  •  Creatinine
  • eGFR

Lipid Test Panel


This panel consists of LDL, which is known as "bad cholesterol," HDL, which is known as "good cholesterol," and triglycerides (fatty acids dissolved in the blood). A higher dose of T or AAS may cause an increase in LDL cholesterol while causing a decrease in HDL cholesterol and triglycerides. A significant drop in HDL could potentially lead to cardiovascular problems in the long run. FASTING IS NEEDED.

Cystatin C and EGFR Kidney Tests


Cystatin C is a more accurate method for determining kidney function in people who have a higher muscle mass. This is due to the fact that using creatinine as the primary variable can be affected by factors such as higher muscle mass, protein intake, and creatine supplementation. Cystatin C is a more reliable method. The estimated glomerular filtration rate is yet another one of the parameters that may be used to evaluate renal function (eGFR). The pace at which fluid that has been filtered passes through the kidney is referred to as the glomerular filtration rate. The creatinine clearance rate, also known as CCRCr or CrCl, is a useful measure for approximating the glomerular filtration rate (GFR). It is the volume of blood plasma that is cleared of creatinine per unit of time. An eGFR that is lower than 60 suggests that there may be problems that are affecting renal function.

GGT Liver Test


The gamma-glutamyl transpeptidase (GGT) blood test looks for an enzyme or protein by that name in your blood. GGT stands for gamma-glutamyl transpeptidase. GGT is present in the cells of the liver. Your doctor can use this test to check for damage to your liver or the ducts that drain it. If the findings of a different blood test, known as alkaline phosphatase, are abnormal, this test can also assist differentiate between diseases that affect the liver and those that affect the bones. The presence of liver damage from disorders such as hepatitis, cirrhosis, tumors, or pancreatic cancer may be indicated by test results that are higher than the average. The value of GGT is unaffected by resistance training, unlike the values of other liver enzymes that are included in the CMP, such as AST and ALT. As a result, using GGT is a more accurate method for determining whether or not a bodybuilder has liver disease.

Total Testosterone determined using Liquid Chromatography/Mass Spectrometry, and Free Testosterone determined through Equilibrium Ultrafiltration.


Due to the fact that the standard total testosterone test based on immunoassays has a ceiling of 1,500 ng/dL, men whose testosterone levels are high are unable to use the test. The LC/MS test for testosterone does not have a maximum allowable concentration. In addition, some laboratories provide computed free testosterone rather than the equilibrium ultrafiltration-based one, which is more accurate for determining this essential quantity.

Ultra-Sensitive Estradiol (E2) Test


The estradiol level may be overestimated by the test that is most usually employed. This test makes use of immunoassay technology, which is unable to distinguish between C-Reactive Protein (which is involved in inflammation) and estradiol; hence, it interprets the combination of the two as being estradiol. This ultrasensitive estradiol test utilizes an assay technology known as liquid chromatography/mass spectrometry (LC/MS), which is not constrained by the aforementioned limitation. In addition, DHT analogs like oxandrolone have the potential to significantly lower estradiol levels, which can result in joint pain and other difficulties related to low estradiol. Notice that only 0.4 percent of total testosterone is converted to estradiol during the aromatization process. The body does this to counteract the good effect that estradiol has on lipids, which is caused by testosterone's adverse effect on lipids. When your total testosterone level is high, your estradiol level will also be high. When making the assumption that an aromatase inhibitor is required, you should proceed with extreme caution. Click the link that says the effect of high and low estradiol levels on men's health for additional details. How to estimate estradiol levels given varied dosages of testosterone.

Prolactin Test


Increased prolactin levels are a source of concern for many bodybuilders because of the correlation between these levels and erectile dysfunction.

DHT Test


The amount of dihydrotestosterone (DHT) that is present in the blood is determined by this test. In some males, excessive levels of the hormone dihydrotestosterone (DHT) have been connected to acne, hair loss, and benign prostatic inflammation, whilst low levels of the hormone have been linked to low libido levels.

IGF-1 Test


Insulin-like Growth Factor 1, more commonly referred to as IGF-1, is measured to determine the amount of human growth hormone present in the blood. The growth-promoting activities and the metabolism of glucose are both influenced by this hormone, which is produced by the liver as well as other tissues. A lack of IGF-1 may prevent the growth of muscle.

Ferritin Test


Iron is stored in the body via the protein ferritin. Iron is necessary for the formation of red blood cells, which are responsible for transporting oxygen throughout the body. Anemia is caused by a lack of ferritin in the blood. TRT and anabolics stimulate the production of more red blood cells in the body (erythrocytosis). Due to the increased production, iron reserves and ferritin levels have decreased.

It has been demonstrated that testosterone causes a reduction in ferritin. Donating blood or undergoing a therapeutic phlebotomy are two common ways for men who are on testosterone replacement therapy (TRT) or anabolic steroids and have a high hematocrit (an increased blood thickness caused by TRT or anabolic steroids) to lower their hematocrit levels. Every time someone donates blood, their ferritin level drops by about 30 points on average. A low ferritin level can lead to a variety of symptoms, including tiredness, muscle aches, and restless leg syndrome.