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Introduction Most men would not believe that estradiol is a male hormone, as they are unaware of the role that estradiol (E2) plays in the maintenance of men's health. E2 is important for many things, including the quality and quantity of sperm [1,] controlling the GH-IGF-1 axis [3,] bone growth and keeping bones healthy [4,] body composition and glucose metabolism [5,] vasomotor stability [6,] and brain function [8]. Estradiol is a hormone more abundant in women than men that is produced by the aromatization of testosterone in the liver, fat, and other cells [1]. It has been shown to be responsible for healthy bone density [2], but its role in men's sex drive, body composition, and other variables is debated [3]. High estradiol blood levels can cause gynecomastia in the presence of low testosterone [4]. Anastrozole, a blocker of estradiol production, is prescribed to men who start testosterone replacement therapy (TRT) [5]. However, there is no data on how high is too high when it comes to estradiol in men [6].   Table of Contents Introduction The Essential Role of Aromatase in the Production of E2 E2 and the Function of the Male Reproductive System The Effect of E2 on the Growth Hormone-IGF-1 Axis The Effects of E2 on the Development and Health of Bones and Skeletons The Influence of E2 on the Composition of the Body as well as Glucose Metabolism Regulation of Vasomotor Stability by E2 and Its Effects The Role of Nitric Oxide in Vasodilation The Effects of Estrogen on NO Production and Vasodilation The Need for Further Research Potential Side Effects of Testosterone Therapy and the Role of Aromatase Inhibitors A Critical Review of Current Evidence Potential Risks of Overuse of Aromatase Inhibitors The Case for Individualized Treatment Approach Estradiol: Overview and Effects Impact of High Estradiol Levels Low Estradiol: Risks and Treatment Testosterone and Estradiol: A Complex Relationship Estradiol's Role in Physiology Estradiol in Hypogonadism Studies and Findings Estradiol and Chronic Heart Failure Estradiol's Impact on Bone Density Estrogen in Men: Studies Conclusion References: The Essential Role of Aromatase in the Production of E2 Aromatase is an enzyme that converts androstenedione and testosterone into E2 in males [3]. According to the research that has been done, the hormone E2 is critically important in the control of a variety of different elements of male health [6]. E2 and the Function of the Male Reproductive System The modulation of spermatogenesis is one of the key functions that E2 performs in the male reproductive system. Working as a paracrine factor, it does its job in the Sertoli cells of the testis, where it helps germ cells mature and divide [1]. It also changes the hypothalamic-pituitary-gonadal axis, which controls the production of testosterone and the making of sperm [1, 7]. The Effect of E2 on the Growth Hormone-IGF-1 Axis It has been proven that E2 plays a significant role in the regulation of the GH-IGF-1 axis in men [3]. In healthy men, there is a positive correlation between the levels of E2 and the levels of serum IGF-1. It is possible that E2 uses negative feedback to limit GH secretion. The Effects of E2 on the Development and Health of Bones and Skeletons E2 is a crucial hormone for the growth and upkeep of men's bones, as well as their overall skeletal health. It does so by promoting osteoblast differentiation and activity and suppressing osteoclast differentiation and activity [4] [11]. In this way, it exerts an indirect influence on these features. The Influence of E2 on the Composition of the Body as well as Glucose Metabolism E2 has an effect on both the makeup of a man's physique as well as his glucose metabolism. It appears to selectively accelerate the accumulation of body fat in subcutaneous regions while at the same time limiting the accumulation in visceral regions [5]. Additionally, it has been demonstrated that E2 can improve glucose metabolism in hypogonadal men [5]. Regulation of Vasomotor Stability by E2 and Its Effects Additionally, E2 contributes to the regulation of vasomotor stability in males. People think that the production of nitric oxide (NO) plays a role in how ethyl ester affects blood vessels. The Role of Nitric Oxide in Vasodilation Nitric oxide, often known as NO, is an important physiological mediator that plays a role in a wide variety of biological activities, some of which are associated with the cardiovascular system. In the setting of the vascular system, NO plays an important function in vasodilation, controlling blood pressure, preventing blood clots, and stimulating angiogenesis [1, 2, 5]. The Effects of Estrogen on NO Production and Vasodilation It has been demonstrated that estrogens, in general, can have an effect on the generation of NO and, as a result, can mediate vasodilation. They can use both direct and indirect processes to achieve the desired vasodilatory effects. There are direct mechanisms that involve attaching to estrogen receptors on endothelial cells and making more NO. This, in turn, causes the blood vessels to become more dilated. One of the indirect ways that could be at work is by changing the production and release of other vasoactive chemicals, like prostaglandins, which could have an effect on NO production. The Need for Further Research Please be aware that despite the fact that the idea that NO synthesis mediates the vasodilation effects of E2 is reasonable based on the known actions of estrogens and NO, further research is required to determine the particular role that E2 plays in this process. Because of this, to get a better understanding, it would be important to look at the original research papers or more recent studies that focus on the part that E2 plays in changing NO production and vasodilation. Potential Side Effects of Testosterone Therapy and the Role of Aromatase Inhibitors When men undertake testosterone therapy (TTh), their estrogen levels may increase, and this may, in some instances, result in the development of nipple or breast soreness or even gynecomastia (the formation of male breast tissue in males). This can be a clear indicator that aromatase inhibitors should be used to reduce the amount of estrogen in the body. A Critical Review of Current Evidence Even so, there is not enough proof to support the regular use of aromatase inhibitors along with TTH when there are not any signs of estrogen overload. Although testosterone levels returned to normal after therapy with an aromatase inhibitor, the symptoms of low testosterone did not improve, according to the findings of one randomized controlled trial. Potential Risks of Overuse of Aromatase Inhibitors In addition, decreasing estrogen levels below a key threshold may raise the likelihood of developing osteoporotic changes and decrease insulin sensitivity, particularly in people who are receiving TTH. These risks may be increased in people who are already at higher risk for developing osteoporosis. The Case for Individualized Treatment Approach The study did not find any evidence to support the claim that taking TTH with aromatase inhibitors or other medicines would lead to lower levels of estrogen that would be better than taking TTH by itself. On the other hand, it was shown that certain TTH-treated men who had elevated estrogen levels but did not experience any clinical improvements from TTH did respond to actions taken to lower estrogen levels. These efforts included either a reduction in the amount of testosterone or the use of aromatase inhibitors. When this occurs, DXA monitoring is an option that should be examined. Estradiol: Overview and Effects Estradiol is a hormone more abundant in women than men that is produced by the aromatization of testosterone in liver, fat and other cells [1]. It has been shown to be responsible for healthy bone density [2], but its role in men's sex drive, body composition, and other variables is debated [3]. Impact of High Estradiol Levels High estradiol blood levels can cause gynecomastia in the presence of low testosterone [4]. Anastrozole, a blocker of estradiol production, is prescribed to men who start testosterone replacement therapy (TRT) [5]. However, there is no data on how high is too high when it comes to estradiol in men [6]. Low Estradiol: Risks and Treatment Low estradiol can be associated with higher fat mass and lower sexual function in men [7], so it is important to be careful when a clinic wants to put you on this drug without first justifying its use [8]. The most important details are that many clinics may be using the wrong estradiol test [9], and that most men on testosterone replacement therapy (TRT) do not develop gynecomastia even without using anastrozole [10]. Testosterone and Estradiol: A Complex Relationship Some physicians monitor estradiol blood levels after 6-8 weeks of TRT initiation using the sensitive estradiol test to determine if anastrozole use is warranted [11]. After 4-6 weeks on anastrozole, its dose can be adjusted to ensure that estradiol is not under 20 pg/ml [12]. The body of evidence suggests that after aromatase P450 inhibitors biotransform testosterone in the tissues, the ERs (estrogen receptors) in men mediate its effects [13]. Estradiol's Role in Physiology Some of the things that estrogen does are control LH feedback, skeletal homeostasis, lipid metabolism, cardiovascular physiology, brain development, and spermatogenesis [14]. Estradiol in Hypogonadism Estradiol serum concentration in adult males is around 20-30 pg/ml, with a production rate of 45 g/d [15]. Low levels of estradiol are associated with increased fat and decrease in sexual desire and erectile function compared to higher levels [16]. Studies and Findings This study found that estradiol levels of 21.80 pg/ml and > 30.11 pg/ml resulted in greater mortality in men with hypogonadism, suggesting that estrogen deficiency is largely responsible for some of the key consequences of male hypogonadism [17]. Estrogens have a fundamental role in the regulation of body fat and sexual function, and this suggests that measuring estradiol might be helpful in assessing the risk of sexual dysfunction, bone loss, or fat accumulation in men with hypogonadism [18]. Estradiol and Chronic Heart Failure A study examined the relationship between serum concentration of estradiol and mortality in men with chronic heart failure and reduced left ventricular ejection fraction (LVEF) [19]. Results showed that men in the lowest and highest estradiol quintiles had increased mortality, while those in the highest quintile had increased survival rates [19]. Estradiol's Impact on Bone Density Estradiol below 11 pg/ml was associated with increased bone loss [20]. Estrogen deficiency is common in men with chronic HF and is associated with increased morbidity and mortality [21]. Estrogen appears to play an important role in determining bone mineral density in men, but it is unclear if it also affects bone   Estrogen in Men: Studies Estradiol is a hormone more abundant in women than men that is produced by the aromatization of testosterone in liver, fat and other cells [1]. It has been shown to be responsible for healthy bone density [2], but its role in men's sex drive, body composition and other variables is debated [3]. High estradiol blood levels can cause gynecomastia in the presence of low testosterone [4]. Anastrozole, a blocker of estradiol production, is prescribed to men who start testosterone replacement (TRT) [5]. However, there is no data on how high is too high when it comes to estradiol in men [6]. Low estradiol can be associated with higher fat mass and lower sexual function in men [7], so it is important to be careful when a clinic wants to put you on this drug without first justifying its use [8]. The most important details are that many clinics may be using the wrong estradiol test [9], and that most men on testosterone replacement therapy (TRT) do not develop gynecomastia even without using anastrozole [10]. Some physicians monitor estradiol blood levels after 6-8 weeks of TRT initiation using the sensitive estradiol test to determine if anastrozole use is warranted [11]. After 4-6 weeks on anastrozole, its dose can be adjusted to ensure that estradiol is not under 20 pg/ml [12]. The body of evidence suggests that testosterone in men is mediated by the ERs (estrogen receptors) after its biotransformation by the aromatase P450 inhibitors in the tissues [13]. These estrogen-mediated actions include feedback regulation of LH, regulation of skeletal homeostasis, lipid metabolism, cardiovascular physiology, and brain and spermatogenesis [14]. Estradiol serum concentration in adult males is around 20-30 pg/ml, with a production rate of 45 g/d [15]. Low levels of estradiol are associated with increased fat and decrease in sexual desire and erectile function compared to higher levels [16]. This study found that estradiol levels of 21.80 pg/ml and > 30.11 pg/ml resulted in greater mortality in men with hypogonadism, suggesting that estrogen deficiency is largely responsible for some of the key consequences of male hypogonadism [17]. Estrogens have a fundamental role in the regulation of body fat and sexual function, and this suggests that measuring estradiol might be helpful in assessing the risk of sexual dysfunction, bone loss, or fat accumulation in men with hypogonadism [18]. A study examined the relationship between serum concentration of estradiol and mortality in men with chronic heart failure and reduced left ventricular ejection fraction (LVEF) [19]. Results showed that men in the lowest and highest estradiol quintiles had increased mortality, while those in the highest quintile had increased survival rates [19]. Estradiol below 11 pg/ml was associated with increased bone loss [20]. Estrogen deficiency is common in men with chronic HF and is associated with increased morbidity and mortality [21]. Estrogen appears to play an important role in determining bone mineral density in men, but it is unclear if it also affects bone loss in elderly men [22]. Another study assessed longitudinal rates of change in bone mineral density in young and elderly men and related these to circulating total and bioavailable estrogen and testosterone levels [23]. The rate of increase in bone mineral density at the forearm sites in the young men was significantly correlated to serum total and bioavailable estradiol and estrone levels, but not with total or bioavailable testosterone levels [23].  Elderly men with bioavailable estradiol levels below the median had significantly higher rates of bone loss and levels of bone resorption markers than men with bioavailable estradiol levels above 40 pmol/liter [23]. Ranjith Ramasamy and Larry Lipshultz conducted a study of 423 men on TRT and found that those with high testosterone and estradiol levels had significantly greater libido than those with low levels [24]. The results are expected to be presented at the American Urological Association annual meeting in Orlando [24]. Hyperestrogenism is believed to be harmful to male sexuality [25]. A study screening 34,016 men in Low T Centers revealed that 7,215 (20.2%) had high estradiol levels [26]. The age distribution of those with high estradiol levels was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years, 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years [26]. The correlation coefficient of serum estradiol to age was .53 [26]. Low blood levels of estradiol (E2) are associated with brittle bones in old men, according to a new study [27]. Age-adjusted models showed that E2 and free E2 but not testosterone (T) associated significantly inversely with cortical porosity [28]. Free E2 also associated significantly with trabecular bone volume fraction, but this association did not remain significant after further adjustment [28]. Low serum E2 may reduce cortical bone strength and increase fracture risk in older men [29]. Conclusion The hormone estradiol, also known as E2, has emerged as a key player in a myriad of biological functions in males. It is involved in the regulation of sperm health, the growth hormone-insulin-like growth factor-1 axis, bone health, body composition, glucose metabolism, vasomotor stability, and brain function. The key enzyme aromatase, which facilitates the conversion of androstenedione and testosterone to E2, is integral to these processes. Understanding the role of E2 in male physiology helps shape our approach to health issues like low testosterone and the potential side effects of testosterone therapy. While the use of aromatase inhibitors can sometimes be beneficial in managing the effects of elevated estrogen levels, more evidence is needed before they can be recommended for routine use alongside testosterone therapy. It is also crucial to consider the balance between testosterone and E2 in the male body, as overly suppressing estrogen levels might lead to unintended consequences such as osteoporotic changes and decreased insulin sensitivity. As we deepen our understanding of E2's role in the body, it becomes clear that a nuanced, individualized approach to treatment is needed to balance the benefits and risks. Finally, there are still many open questions about the specific mechanisms through which E2 influences different aspects of male health. For example, the relationship between E2 and nitric oxide in mediating vasodilation remains to be fully elucidated. Therefore, more research is required to continue building a comprehensive understanding of E2's role in men's health. As we continue to learn, our approach to male hormonal health will evolve, bringing about new strategies for maintaining and improving men's health.   Buy the best-priced  gold standard ultrasensitive estradiol test on DiscountedLabs.com.   References:   1 https://www.healthline.com/health/estrogen-in-men 2 https://www.medicalnewstoday.com/articles/estrogen-in-men 3  https://academic.oup.com/ejendo/article/181/1/R23/6654090 4 https://tctmed.com/estrogen-in-men/ 5 https://www.news-medical.net/health/The-Role-of-Estrogen-in-Mene28099s-Health.aspx 6 https://my.clevelandclinic.org/health/body/22353-estrogen 7 https://eje.bioscientifica.com/downloadpdf/journals/eje/181/1/EJE-18-1000.pdf 9 https://www.testosteronewisdom.com/role-of-estradiol-in-men-and-its-management-2/ 10  https://www.news-medical.net/health/What-does-Estradiol-do.aspx 11  https://eje.bioscientifica.com/view/journals/eje/181/1/EJE-18-1000.xml  

Although testosterone frequently overshadows estradiol, a hormone more commonly associated with women, estradiol plays a significant role in men's health. Derived from testosterone through a process known as aromatization, estradiol contributes to various physiological aspects in men. Although it's crucial for maintaining bone density, its role in sexual health, body composition, and other health parameters is subject to ongoing discourse. Here, we delve into the dynamics of estradiol in men, its implications, and the importance of accurate measurement. Understanding Estradiol in Men The hormone estradiol, although present in smaller quantities in men compared to women, is produced through the aromatization of testosterone in liver, fat, and other cells. This conversion is nature’s design, hinting at a purpose behind it. Besides promoting bone health, estradiol’s influence on men's libido, body composition, and other factors is a hot topic among researchers. Excessive levels of estradiol, especially alongside low testosterone levels, could lead to conditions like gynecomastia (enlarged breasts in men). Hormonal Balance: The HPT Axis The Hypothalamic-Pituitary-Testicular (HPT) axis is a hormonal cascade that adjusts testosterone production based on the levels of testosterone and estradiol in the body. When either hormone level goes up too high, the HPT axis responds by decreasing the production of testosterone to keep hormone levels in balance. Aromatase Inhibitors: Boon or Bane? Aromatase inhibitors (AIs) stop the production of estradiol and are often given to people who are getting testosterone replacement therapy (TRT) to help them look younger and stay healthy. While higher estradiol levels could potentially cause gynecomastia and water retention, there's speculation, albeit without scientific backing, linking high estradiol levels to erectile dysfunction. The use of AIs is thought to mitigate these issues by lowering estradiol levels. However, the exact threshold of estradiol levels in men, beyond which it could be detrimental, remains undefined. Unveiling the Optimal Range Recent studies have started to shed light on estradiol's optimal range. For instance, levels below 20 pg/ml have been associated with increased bone loss, higher fat mass, and diminished sexual function in men. It is very important to get a correct reading of estradiol, and it is better to use a sensitive estradiol test (LC/MS assay) instead of the more common ECLIA-based test to avoid getting wrongly high estradiol readings from things like CRP (C-reactive protein). Estradiol’s Diverse Effects: A Closer Look 1. Bone Density: A study showed that estradiol levels below 11 pg/ml were linked to increased bone loss in men, emphasizing estradiol's role in bone health (Source). 2. Libido and Erectile Function: One groundbreaking study revealed that lower estradiol levels were correlated with increased body fat and a decrease in sexual desire and erectile function (Source). 3. Mortality Rate: A study highlighted that men with estradiol levels either below 21.80 pg/ml or above 30.11 pg/ml had a higher mortality rate, indicating a potential sweet spot for estradiol levels (Source). 4. Testosterone Therapy: In men undergoing TRT, elevated estradiol levels were associated with heightened libido, suggesting a nuanced interplay between testosterone and estradiol (Source). Conclusion The journey to demystify estradiol's role in men is ongoing. While its importance in bone health is well acknowledged, the hormone's broader impact on male physiology is gradually being unraveled. Accurate estradiol measurement and a deeper understanding of its optimal range could pave the way for enhanced men's health management, particularly for those undergoing testosterone replacement therapy.     Here is a more detailed discussion on estradiol in men: Click here   How to Get a sensitive estradiol test  

Testosterone Replacement Therapy (TRT) has changed the lives of many men around the world.  Like any therapy, it can have great benefits if properly managed but negative side effects if not monitored.  This article will briefly and simply review the different TRT tests that most physicians use to monitor your progress while minimizing potential side effects.   Table of Contents How to Know if You Need TRT Follow Up Lab Tests After Starting TRT Avoiding or Lowering High Hematocrit on TRT Avoiding Low Ferritin and Iron Monitoring the PSA Test on Testosterone Monitoring Estradiol Test on Testosterone Avoiding High Blood Pressure and Water Retention on TRT Monitoring Kidney Function Avoiding High Liver Enzymes Monitoring Thyroid Tests Maintaining Good HDL Levels on TRT Prolactin in Men with Low Testosterone: The Forgotten Hormone Where to Buy Your Own TRT Tests: How to Know if You Need TRT The first thing doctors actually measure before you get on testosterone replacement is your total and free testosterone blood levels to find out if you have low testosterone. They will also ask you a few questions to see if you have low testosterone or hypogonadal symptoms. They include low sex drive, erectile dysfunction, fatigue, low mood, and issues with cognitive capacity and function. So, testosterone replacement therapy includes anything to increase testosterone levels with either injections or creams, gels, pellets, oral, nasal, and other TRT options. Follow Up Lab Tests After Starting TRT Once you get on testosterone replacement, your doctor will have you come back either at week six or eight to run another blood test to see if your dosage needs to be adjusted and/or you may require other medications to monitor or to modulate or change levels like estradiol, hematocrit, etc. The first one obviously is testosterone total and free. You come back at week six or eight, and your total testosterone is not over 500 nanograms per deciliter, your doctor will probably choose to increase your dosage or your frequency of injections in the case of injections. Free testosterone is usually around 2% of total or higher. If you have lower than 2%, your doctor will probably focus on any issues related to high sex hormone binding globulin (SHBG), which is a protein that binds to testosterone and does not free it up for action. Avoiding or Lowering High Hematocrit on TRT Hematocrit is the proportion of red blood cells in the blood. Testosterone tends to increase red blood cells.  Some men don't have that issue, but most men at least have a two to a three-point increase in hematocrit after starting TRT. Hematocrit increases a lot more in men on TRT who have sleep apnea and in smokers since these two can cause oxygen starvation.  High hematocrit can increase the viscosity of the blood and may cause cardiovascular issues. So, the magic number to go for is a hematocrit of 53 or below. When you're getting close to 53, you have to basically donate blood or go for what we call a therapeutic phlebotomy to bring down the red blood cell amount in the blood. And that's very important because as hematocrit goes up, your blood becomes more and more viscous, and your cardiovascular system gets compromised.  It's also very important not to let it go too high because above 52, most blood centers would not accept you as a donor, so you would have to require a special prescription for a therapeutic phlebotomy from your doctor for the blood centers to take your blood and dispose of it later. Keep in mind that donating more frequently than every three months may decrease your ferritin and iron stores considerably, which can cause fatigue and other issues. Here are some hematocrit lab panels, or you can buy them as part of the CBC panel. Avoiding Low Ferritin and Iron When your hematocrit is over 53, and you donate blood frequently than every three months, you can deplete your iron stores which makes you tired, depressed, and with no libido. Blood donations should not be happening that frequently because you'll lose iron. Some doctors will test your iron and your ferritin, and if you have low levels, they will put you on an iron supplement. Discounted Labs sells a blood donation panel that is designed to inform you if you can safely donate blood. Monitoring the PSA Test on Testosterone High PSA, prostate-specific antigen, is the only contraindication for testosterone replacement therapy if it is 4 or above. Obviously, physicians get very concerned that a man with higher PSA may have prostatic cancer, although it could be caused by an infection of your prostate (prostatitis) that could be easily treatable with an antibiotic. So, all high PSA tests do not mean you have cancer, but it could mean that you could have a treatable prostatic infection.  Your doctor may prescribe antibiotics and retest your PSA after your antibiotic cycle is finished.  He or she may need to refer you to a urologist if your high PSA test does not come down.  But if you do have a PSA of four or higher, you are not going to be allowed to use testosterone replacement unless your doctor can actually prove that it's an infection that will eventually be treated so that your PSA can come down. Monitoring Estradiol Test on Testosterone Estradiol (E2) is a very important hormone for men. We need it because estradiol is actually linked to bone health, cognitive functioning, cardiovascular health, even sex drive, and decreased fat mass. Having very low estradiol of under 20 pg/mL is actually not good for you since it can decrease bone density and cause other issues. Having very high estradiol in relation to your testosterone blood level may also have some consequences.  Several studies have different opinions and conclusions on what high estradiol means. About 0.3 to 0.4% of testosterone gets converted into estradiol by the aromatase enzyme. So obviously, the body increases the amount of estradiol as your testosterone goes up. There's nothing wrong with that. Estradiol balances testosterone to keep a better lipid (cholesterol) profile and to keep healthy sperm counts, just to name a few benefits. But what level of estradiol in men is too high? For example, if you have a testosterone level after you start TRT of 700 nanograms per deciliter, obviously, your estradiol is going to be higher than when before you started TRT. Is that cause for concern? Most men on testosterone replacement therapy do not need to take medications to lower estradiol. Estrogen blocker medications like anastrozole (Arimidex) are being overprescribed by many TRT clinics.  Men with a history of gynecomastia or breast enlargement may have issues with gynecomastia again if your estradiol's over 50 pg/ml, but in most studies where men with gynecomastia were followed, a lot of those men had low testosterone while they had high estradiol. A large study in adolescent boys showed that most of the ones with gynecomastia also had high IGF-1.  Some studies have shown that the ratio of testosterone to estradiol is really the important factor to monitor, with ratios over 12 being needed for healthy sperm production in men. But the management of estradiol in men is a very controversial topic as there is not a lot of agreement in the field.  Some doctors insist on keeping an E2 level of 20 to 40 picograms per milliliter no matter how high testosterone levels reach. We have learned in the past three years that the old immunoassay-based estradiol test tends to overestimate estradiol in men. Two studies have shown that the real estradiol value is better tested with a liquid chromatography-mass spectrometry sensitive estradiol assay. So, make sure that if your doctor is going to check your estradiol, you're using the right LC/MS E2 test. Discounted Labs offers several lab panels that contain sensitive estradiol.  Another concern of high estradiol is that some men feel that water retention is an issue, although that has not been proven by any studies. Most men with TRT-related water retention assume that their estradiol is high but fail to get it tested. Avoiding High Blood Pressure and Water Retention on TRT Some men on testosterone replacement therapy tend to have increased blood pressure related to water retention. There are some central nervous system effects that increase blood pressure and heart rate. These men can gain considerable weight during the first weeks of TRT.  Most lose most of that weight after a few weeks of therapy.  Some studies have shown that testosterone may decrease sodium excretion by the kidneys, which makes the body retain water to keep that sodium diluted. Ways to improve blood pressure are to lose weight, take a blood pressure medication, exercise, and decrease excessive sodium intake. Many men assume that their estradiol is high when they experience water retention. That assumption has not proven to be correct. Monitoring Kidney Function The estimated glomerular filtration rate, or eGFR, is a way to measure your kidney function. It's part of what we call a CMP blood test panel, and we are aiming at an eGFR over 60. Anything below that is indicative of a slowdown in the way your kidneys are filtrating toxins from your body. TRT does not really cause a decrease in eGFR. However, a lot of men taking creatine, exercising heavily, or eating very high protein intake tend to probably have artificial increases in creatine that decrease eGFR. You can Google eGFR formula and see how that's calculated. Avoiding High Liver Enzymes Current testosterone replacement therapy options have not been shown to increase liver enzymes; only the old oral forms of TRT used to cause that problem. However, doctors obviously follow it up. A very important distinction to make is that men that are exercising heavily with weights at the gym may artificially  increase in AST and ALT that has nothing to do with toxicity to the liver. Monitoring Thyroid Tests TSH, thyroid stimulating hormone, is also something else that most doctors follow up, although some actually do not. Low thyroid function (hypothyroidism or high TSH) may have the same symptoms as low testosterone. TRT medical guidelines groups around the world recommend different schedules for monitoring men on TRT, and a few of them agree with each other. Rarely do any guidelines mention thyroid function monitoring in men on TRT. TSH levels above 2.5 may indicate that you have hypothyroidism. If you have high TSH, doctors usually tend to use a comprehensive thyroid panel that includes free T3 and free T4, along with antibodies, to see if you have an autoimmune disease like Hashimoto's that may be inducing hypothyroidism. Maintaining Good HDL Levels on TRT High-density lipoprotein or HDL is another one of the variables most affected by testosterone replacement, especially at higher doses. When I say higher doses, anybody using 200 milligrams of testosterone replacement per week — cypionate or enanthate — tend to have a lowering of HDL. Low HDL has been shown to cause cardiovascular issues, so your doctor will always follow your lipids. Testosterone replacement has not really been shown to increase LDL, and there are some studies that show that TRT improves triglyceride blood levels because testosterone tends to improve the way the body metabolizes carbohydrates. There's very little we can do to increase HDL besides aerobic exercise, losing weight, decreasing TRT dose, and taking a supplement. Niacin supplementation is one of the ways to increase HDL, but some people get flushing of the skin and face. Last but not least, the use of anastrozole, an estradiol blocker, can also decrease HDL since estradiol is known to protect HDL levels. Prolactin in Men with Low Testosterone: The Forgotten Hormone Prolactin is not a hormone that is usually measured at TRT baseline or even at follow-up unless you have severe erectile dysfunction, even with good levels of testosterone. Men that have low testosterone at baseline, and I mean low testosterone, very low — under 150 nanograms per deciliter — are probably the best candidates to get a prolactin test. It is a hormone that women and men produce – obviously, women that are lactating produce it at higher concentrations in their bodies because it helps lactation. It also has some other benefits; otherwise, men would not have it. Prolactin has some immune-enhancing benefits and some cardiovascular benefits that are starting to show up in studies. So, prolactin is not an evil hormone, but it can, at higher concentrations, cause erectile dysfunction. The reason for high prolactin could be a benign tumor called pituitary adenoma (diagnosed by MRI), which can be producing a lot of pituitary output for prolactin, and that could actually impair your testosterone replacement therapy benefits. So, it's a hormone that is hardly looked at unless you are a man that has very low testosterone blood levels at baseline or do not respond well (unresponsive erectile dysfunction) after eight weeks or ten weeks of testosterone replacement therapy and/or you are having high prolactin symptoms, like lactation. That's actually a very rare symptom that actually occurs in men with pituitary adenomas. Where to Buy Your Own TRT Tests: DiscountedLabs.com provides very low-cost blood testing in most US states. You don't need to see a doctor because the company has in-house physicians that provide a prescription. After ordering your lab test online, you receive an email with the lab request form that you take to the closest lab near you. Once you go to a lab and get your blood drawn, you receive an email with your results within five to seven business days, depending on the blood test. For more information, visit DiscountedLabs.com   Visit ExcelMale.com to download Nelson's latest book: Beyond Testosterone   Click here for TRT Resources

Nelson Vergel, author of Testosterone: A Man's Guide (Amazon.com) and founder of ExcelMale.com and DiscountedLabs.com, talks about what he thinks are the 10 most important things that all men on testosterone replacement therapy should know to maximize benefits and minimize side-effects. For questions for Nelson, please register on ExcelMale.com and post them on the forum page. For more detailed information about what blood test parameters are important to monitor while on testosterone replacement therapy, read: Testosterone Replacement Blood Test Targets and Their Management For blood tests to buy to monitor your testosterone replacement, check these lab test panels: Pre TRT Lab Test Panel TRT MALE Hormone/Wellness Follow Up Panel   Find out more about testosterone replacement therapy and what tests to perform   Video Transcript:   Hi everybody. Nelson Vergel with ExcelMale.com. Somebody gave me a really good idea on ExcelMale.com. It's a forum of over 14,000 members. We discuss everything related to testosterone replacement, nutrition, exercise, supplements, and other options like Trimix, hCG, and estradiol, et cetera. Somebody asked me, "Nelson, why don't you do a video of Nelson's Top 10 TRT Commandments?" And this is what I'm doing today. So, I'm going to include the different observations and suggestions I have after reading over 40,000 posts over the last three years on ExcelMale.com.   Testosterone is not a magic bullet.   The first one is testosterone is not a magic bullet, and I remind guys who have high expectations when they start testosterone replacement because they have low testosterone that things may improve in many ways, like improvements in sexual function and sex drive, energy, cognitive function, et cetera. But sometimes they may not improve as much as you expect because there are many factors involved, especially in sexual function, libido, and desire. I have another presentation or lecture that I did on the subject, so you can check it out on ExcelMale.com, or on the YouTube channel, also named ExcelMale.com. But there are over 12 factors involved in the sexual desire in men. Testosterone is one of them, obviously, so fixing the low testosterone issue tends to improve things in that department. However, if you're not sleeping well, if you have excessive weight, if you're drinking too much, if you have some illnesses like diabetes or cardiovascular disease, and if you're taking medications that may influence sex drive and erectile function like blood pressure medications, antidepressants, et cetera, you may not get all the benefits that one would expect from testosterone. So, check out that video, and I will get into more details on that subject.   Do not obsess about estradiol.   The second one is the second commandment: do not obsess about estradiol. Estradiol has become the hottest topic of discussion in men's health forums, and it's a topic that is filled with misconceptions and a lot of speculative information. We have data that shows that estradiol is a very important hormone in men. It is produced from the aromatization of testosterone into estradiol by aromatase enzyme in the liver and in fat cells. The body actually produces it for a good reason. There's a good reason why nature put estradiol downstream of testosterone. We need estradiol for bone health, cognitive health, sexual function, and drive, and even keeping good body composition and cardiovascular health.   A lot of men tend to freak out when they start testosterone and they think everything is related, all the side effects are related to high estradiol. Biggest problem I see is that very few men are actually testing their estradiol. Doctors are not monitoring estradiol levels, and if they are, they're using the wrong tests. They're using the immunoassay instead of the liquid chromatography/mass spectrometry assay. The former basically overestimates estradiol. Secondly, water retention and/or nipple sensitivity may have nothing to do with estradiol blood levels. So, men are jumping into starting treatment with an AI, when in fact their estradiol is under 40 picograms per milliliter, and they don't really need to be taking it.   Many crash their estradiol blood levels under 20 mg and they started losing sex drive and they start even getting fatter, because it's being studied in research that that's the case. So, do not obsess about estradiol. Estradiol is not an evil hormone. Estradiol is in our body for a reason. Do not over treat with anastrozole. I'm telling doctors, be very careful. They are giving people high doses, over 1mg a week of anastrozole to men. I'm also really concerned that many clinics out there, and I hope they're listening to me, are starting men on anastrozole at baseline when the fact is, they should have waited or they should way until follow up, after six or eight weeks follow up, and test the men's estradiol after they start testosterone replacement. And then, and only then, determine whether or not they have high estradiol over 40.   And as our testosterone blood levels increase, so does estradiol. Only 0.4% of testosterone becomes estradiol, so it's only logical that we should have higher estradiol when we have obviously higher testosterone levels because of injections or gels or creams or pellets. So that's my biggest concern out there. Estradiol is not an evil hormone and we need it. Do not obsess. Do not put all your ... do not blame it on all the side effects, especially if you're not testing the blood levels.   Monitor your hematocrit.   Your hematocrit. Monitor your hematocrit, is number three, very closely during the first six to eight months. Hematocrit is the proportion of the blood, the blood volume, that is made up of red blood cells. Testosterone replacement increases the production of red blood cells, which is a good thing if you have anemia. However, overproduction of red blood cells and an increase of hematocrit obviously, can increase the viscosity of the blood, and that can lead to cardiovascular risks and events. So, doctors pretty much monitor this parameter using a very cheap panel called the CBC, the cells and chemistry, cell count and chemistry profile. Very cheap. I think you can buy it on discountedlabs.com for $29, and that includes hematocrit. As your hematocrit starts climbing up closer to 52, it is time for you to go and donate blood at a blood center. What I'm seeing, I'm seeing a few problems there. I'm seeing men waiting too long so they get to 53, 54 in hematocrit and they get rejected for donations because the Red Cross and different blood centers have a limit of 53. So do not wait too long, otherwise you are not going to be able to donate blood for free.   If you do wait that long and your hematocrit is 53, 54, 55, whatever,. I've seen guys walking around with a 65, which is crazy. That's when doctors don't monitor that. Very upsetting. Anyway, if you get to those high levels, you're rejected by the nation and you will need an order from your doctor, like a prescription. Your doctor calls in any blood center and you may have to pay for the phlebotomy. It's called a therapeutic phlebotomy. You would probably have to pay. Many centers charge over $100. So, do not wait too long. Do not donate blood or do therapeutic phlebotomies more frequently than every three months, because that has been shown to decrease iron levels and ferritin, which may make you fatigued. So, if you are by any chance one of those unlucky men that really produces a lot of red blood cells, you may have your doctor check your iron or ferritin after you donate blood. If they are low, you can take an iron supplement for a few weeks until it's normalized.   The high hematocrit issue does not happen to everybody. Most men have a bump around three to four points higher. Most of the time, hematocrit stabilizes after 18 months. For instance, I've been using testosterone for over 34 years, and I've only donated blood once, and usually it's within the first six months that you know whether or not your hematocrit will be increasing. After six months, chances are... unless you increase the dose of testosterone, obviously, that you will stay pretty much stable there. So, it's not a long-term concern.   Inject testosterone using easier methods: subcutaneous or shallow IM.   Okay, the next commandment is exploring easier ways to inject, subcutaneously, shallowly, or IM, which is shallow intramuscular injections. The old way of injecting testosterone with a big old syringe of one and a half inches on your glutes or quads is pretty much gone. There is no need to suffer through painful injections with big needles anymore. We have good data that shows that subcutaneous injections under the skin with a very tiny, half-inch, 27-gauge, or even 29-gauge syringe are enough to get the body to absorb and get the blood levels up. So, there is no need to suffer. I inject in the shoulders at 90 degrees with a 27-gauge, one-inch... I'm sorry, half-inch syringe, and it's basically painless. Also, inject twice a week instead of injecting once a week. We are moving from the world where doctors were prescribing testosterone at 200 mg every two weeks to 100 to 150 mg, depending on the blood levels that you need, every week to 50 to 75 mg every two weeks. So, there are clinics that are prescribing it once a week, but there's nothing wrong with that. I really believe so. But many clinics are now splitting the dosage in two and also bringing in something called hCG, which I will talk about.   So, do not suffer. Do not dwell anymore with big needle syringes. You can inject under the skin. You can inject shallow, at half an inch, anywhere in the quads, delts, or even the glutes. And that will basically ensure that most of us adhere to a long-term therapy like testosterone replacement. As you all know, testosterone replacement is a long-term commitment—a lifetime commitment. Never cycle testosterone on and off.   The next commandment is obviously to never cycle testosterone replacement on and off. This is a lifetime commitment. If you stop testosterone replacement, your blood levels will crash. You will not produce testosterone for a while. People tend to email me to ask me how many weeks they're going to be in that situation. It is impossible to predict, impossible to predict. Some studies on bodybuilders have shown that it takes probably as long as you were on testosterone to get back to your baseline. Remember, all of us who started testosterone replacement had low testosterone at baseline. That's why we got into testosterone replacement. So even if your body tends to readjust after a few weeks and bring you back to what you used to be, you're probably going to have low testosterone. So, that's a discussion that I don't see doctors doing very well with patients that are about to start therapy. The fact that it is a commitment. No, you're not going to die if you stop testosterone. It is true that you're going to have a rough time with low libido, energy, and cognitive function for a few weeks, but things will move on and you'll basically go back to where you used to be before testosterone. Know your TRT blood tests.   The next one is knowing your blood tests and your schedule for blood testing. Yes, your doctor is supposed to remind you when you're supposed to get blood tests done, but it's not brain science; it's not rocket science. On ExcelMale.com, on discountedlabs.com, which is my company, my lab test company, you can get tests online anywhere in the United States, with exception to New York State, New Hampshire, and Massachusetts. Basically,  the northeastern states have passed legislation to limit options for consumers there, but in most states, you can go to discountedlabs.com, order your test there, pay by credit card or PayPal, and then we will email you the results after five to seven days when you give your blood at the lab or location closer to you.   You can check the scheduling for testosterone blood testing and monitoring on ExcelMale.com, also through one of my videos that I made on that subject, and also on the blog page of discountedlabs.com. But know, at least, that you have to have certain blood levels tested at baseline. The doctor will probably have you come in six to eight weeks later, just to see if a dosage is good enough for you. We'll ask you about all your symptoms to see if they're getting better. They may check not only hematocrit, estradiol, or other hormones but also see whether you need a readjustment or treatment with anastrozole, like I said before. So, it is also important to tell the doctor when you got your blood test done, your blood draw, because some guys forget that you should be getting your blood drawn right before your next injection. I'm talking about injections. Gels and creams are different because, since we're using the same dosage every day, it doesn't really matter when you get the blood drawn.   Do not change more than one variable at a time. The next one is do not change more than one variable at a time, and I do remind everybody on ExcelMale. We are all kind of our own guinea pigs. Everybody has to experiment on themselves. Every time we start something, we can change the dosage, the frequency, or other things, but we cannot change more than one variable if you want to measure the impact of that change on your quality of life. And that's one of the biggest problems I'm seeing. Some guys start changing things around and then they forget what worked and what didn't. I know it's a basic concept, but we all get very impatient, and that's another thing I'm seeing: the expectations are not well-described by doctors at baseline. So, we start changing things around without telling the doctor, and then obviously everybody's lost. You and the doctor are lost.   So, one variable at a time. It takes a while to do that. To be a good guinea pig with good experimentation, good dosage adjustment, et cetera, it takes a while. It takes like six months average to get to that point where you say, "Okay, I'm pretty much in the dosage I need to be, frequency I need to be, anastrozole dosage if I need, hCG," which I'll be speaking about hCG, et cetera, et cetera. So, don't be impatient. I know most of us who are getting onto testosterone replacement are a little desperate. We are not feeling that great; our relationships are hurting because of sexual dysfunction or things like that, and we need a quick fix. It is not a quick fix. It takes a while, but generally, you will have good results if you do it well   You can’t change what you don’t measure.   The next one is that you can't change what you can't measure. I remind people, even I forget how I felt last week. And when you're going to the doctor, you haven't seen the doctor in eight weeks or 12 weeks, and the doctor asks you how you have been feeling? You're pretty much are going to say how you've been feeling the past few days, since you remember that. So, I kept that in mind and we created an app, available on the Apple Store or on Google Play, called TRT Analyzer. That app basically sends you a text message or a message during the day to ask you how you felt, and there are different variables like fatigue, exercise intensity, libido, if you had a morning erection, et cetera. And then you can graph. Inside the app, there's a graphing option and you can actually email the graphs to your doctor, even print them, and bring them to your next office visit. That will show basically what happened in the last 12 weeks or eight weeks that you haven't seen the doctor.   So, doctors love it because it helps them. It helps them. They actually score with the graph on every single parameter. So TRT Analyzer. Download it for free. There's been over 600 downloads this month, so we're very happy. Another site that I created is called myhealthgraphs.com. Myhealthgraphs.com. We'll probably be changing it into an app too. But it's a website. It's not an app. It's a website where you can add your blood test results, whatever you're following: testosterone, estradiol, hematocrit, et cetera, and it will also plot values for your doctor to see too. Doctors are busy. Doctors need people who save them time. Doctors tend to treat patients that save them time better than those that do not save them time. Doctors are human beings. They are really busy with a lot of pressure, and we walk into a doctor's office expecting the doctor to remember everything we told them last time. Even though it's written, some of them don't even have time to read the notes that they made from last time.   So, be a good patient and monitor everything; chart everything. Bring your reports on how you feel to the doctor. Believe me, you're going to get treated better than those who do not. The same doctor can treat two different patients differently just based on that behavior. I wish I had data to show, but it's my speculation.   Protect your testicles.   The next commandment is protecting your testicles, fertility, and upstream hormones. Talk to your doctor about hCG, or human chorionic gonadotropin. I made a video also on hCG, so check it out also on ExcelMale.com or the ExcelMale YouTube channel. But the thing about testosterone replacement when we started was that our testicle Leydig cells shut down. They don't produce testosterone anymore and they also start decreasing their production of sperm and our fertility gets really impacted, especially if we are obviously looking forward to having another kid with your wife or your girlfriend. So, that's a concern. Many doctors wrongly make patients stop testosterone replacement when they want to have a kid, which is a horrible thing to do. Instead, we have now some data from Baylor College of Medicine, Lipshult’s team, that shows that using testosterone and hCG together can prevent not only the atrophy of the testicles, or the shrinkage of the testicles, but also improve fertility.   Lately, we have gotten some data on the fact that hCG can reactivate all the hormones that are upstream of testosterone that were shut down by testosterone replacement. Testosterone replacement is obviously a good thing to do, but it shuts down LH, FSH, pregnenolone, progesterone, and even DHEA in many cases. So, all those hormones upstream tend to be reactivated by the effect of hCG. I'm going to get into many details on that because I have a video in which, actually, I think I drew a diagram on a whiteboard so that you can understand more of what I am trying to say. Because a lot of doctors say, "No, I don't prescribe hCG. I think there's no use for that," and I think after you watch that video, you will be able to negotiate with your doctor about the use of hCG in a much more educated fashion.   Don’t stay behind on TRT advances.   The next commandment is: don't stay behind on advances. Actually, that's the last commandment—the 10th one. And this is an evolving field—testosterone replacement and men's health in general. We don't only talk about testosterone on ExcelMale.com. We talk about thyroid hormones, about DHEA, about pregnenolone and progesterone, about supplements, about exercise, about, you name it, diet, even some cognitive practices, et cetera. It's really amazing how many studies are coming through every week, and even for me, I read everything that I can every day. Even before going to bed, I print out a few papers. Even for me, it's hard to keep up, and I know that if I'm not staying current, I may be missing things that are coming through in the field and obviously will not be able to help others with my information. But don't stay behind on advances. Register on ExcelMale.com and learn more, because an educated patient pretty much gets a lot better care.   So, thank you so much for watching this video.  Subscribe to the ExcelMale YouTube channel and register on ExcelMale.com. Thank you.    

TRT Blood Work Tests For Monitoring Men on Testosterone Therapy Before undergoing testosterone replacement therapy (TRT), it’s vital to obtain a number of blood tests, which require a blood sample. The main blood tests to measure are total and free testosterone, hematocrit, PSA, estradiol, HDL cholesterol and others. Pre-treatment testing provides doctors with baseline values to diagnose hypogonadism (low testosterone) and assess overall health. Baseline tests are also conducted during TRT as well, ensuring that doctors can adjust TRT dose and catch side effects before they become an issue. Hematocrit Test PSA Test Estradiol Test Blood Pressure Estimated Glomerular Filtration Rate eGFR Liver Enzymes Test TSH Test Free T3 Test Total Testosterone Test Free Testosterone Test Ferritin Test HDL Cholesterol Test Click here for the Pre- TRT panel and the TRT panel (after 6-8 weeks on TRT) But do you know why these tests are needed or what they mean? Below, you’ll find some of the main blood tests that have been shown to be affected by TRT, so doctors measure them before and during therapy to prevent or manage side effects: Understanding Testosterone Blood Tests A testosterone blood test is a crucial diagnostic tool used to measure the level of testosterone in your blood. Testosterone, produced by the adrenal glands and gonads (testes in men and ovaries in women), plays a vital role in the development and maintenance of male reproductive tissues, bone density, and muscle mass. This test is commonly employed to diagnose and monitor conditions related to abnormal testosterone levels, such as hypogonadism (low testosterone) and hyperandrogenism (high androgen levels). There are several types of testosterone blood tests, each serving a unique purpose. The total testosterone blood test measures the overall amount of testosterone in your blood, including both bound and free testosterone. The free testosterone test measures the testosterone that is not bound to proteins in the blood, making it readily available to the body’s tissues. Additionally, the bioavailable testosterone test measures the testosterone that is available to the body’s tissues and is not bound to sex hormone-binding globulin (SHBG). Understanding these different tests helps in accurately diagnosing and managing conditions related to testosterone levels. Why Monitor Testosterone Levels on TRT? Testosterone replacement therapy (TRT) is a medical treatment designed to increase testosterone levels in individuals with hypogonadism. Monitoring testosterone levels on TRT is essential to ensure the treatment’s effectiveness and safety. Here are some key reasons why monitoring testosterone levels on TRT is crucial: Ensuring Normal Testosterone Levels: The primary goal of TRT is to elevate testosterone levels to within the normal range. Regular monitoring helps ensure that the treatment is effective and that testosterone levels are neither too high nor too low. Adjusting Dosage: Monitoring testosterone levels allows healthcare providers to adjust the TRT dosage as needed, ensuring optimal treatment outcomes. Identifying Side Effects: TRT can cause side effects such as acne, hair loss, and mood changes. Regular monitoring helps healthcare providers identify these side effects early and adjust the treatment plan accordingly. Monitoring Long-term Effects: TRT can have long-term effects on the body, including changes in bone density and cardiovascular health. Regular monitoring helps healthcare providers track these changes and make necessary adjustments to the treatment plan. By keeping a close eye on testosterone levels, healthcare providers can ensure that TRT is both effective and safe for the patient. Hematocrit Test Hematocrit refers to the proportion or percentage of red blood cells present in your total blood volume. Your red blood cells are responsible for transporting oxygen and nutrients throughout your body. Without enough red blood cells (a condition known as anemia), your body suffers from oxygen and nutrient deprivation. On the flip side, too many red blood cells cause high hematocrit that can turn your blood into a thick slurry that can seriously affect your circulation. A normal hematocrit for an adult male is anywhere from 42 to 54%. If your hematocrit results are lower than 41%, it means you have low proportion of red blood cells. Over 55%, and you have too many. One of the primary side effects of TRT is the production of too many red blood cells, leading to high hematocrit. High hematocrit can be lowered by blood donation or therapeutic phlebotomies (ordered by your doctor if you are not allowed to donate blood at a blood bank due to exclusion criteria). Just be careful: Do not donate blood more frequently than every 2 months since this can deplete your iron stores and make you tired. This test is included in CBC (chemistries and blood count) panel.   PSA Test Prostate-specific antigen, or PSA, is a protein that is produced in your prostate gland. It's designed to liquefy semen, which is necessary for the free swimming of sperm in ejaculate. It may also help to dissolve the cervical mucus to allow the sperm to enter the uterus for the purposes of impregnation. Normal PSA levels for men under 40 range between 0 and 2 ng/mL, while PSA levels for men older may raise slowly. A PSA test helps to detect extra-high levels of this protein. High PSA levels are the result of disruptions of the cellular structure of the prostate gland, which can be caused by a number of diseases--including cancer or an infection. Benign prostate hyperplasia, urinary retention, and prostatitis can be the cause of high PSA, but your doctor will want to monitor your PSA levels just to be sure the problem isn't a serious one. If PSA levels are high, your doctor may recommend a prostate exam or even a biopsy to determine the cause of your elevated PSA levels. TRT is contraindicated for men with PSA greater or equal than 4. Estradiol Test Estradiol is the primary female sex hormone, but did you know that the male body produces it from testosterone? It is produced in fat and liver cells from testosterone via the aromatase enzyme. Due to several factors like fat content, liver disease, medication effects and genetics, some men may produce more estradiol from testosterone than other men. New information has shown that men require a special estradiol test called sensitive estradiol test. The regular test used for women may overestimate estradiol in men due to interference of inflammatory markers like C-Reactive Protein (CRP). For the average man, estradiol levels should remain lower than 50 pg/mL, although there is little evidence of what the top of the estradiol test is in men who do not have low testosterone. If estradiol levels are higher than 50 and you start showing symptoms of high estradiol (gland growth under nipples, too much water retention), it may be necessary to take an estrogen blocker (aromatase inhibitor) . However, taking aromatase inhibitor like anastrozole should be done with careful monitoring of sensitive estradiol blood test since overdosing can cause health issues in men. A few of the reported effects of low estradiol levels include: joint pain, eye fatigue, loss of erections, limited sensitivity in the penis, sleepiness, and excessive urination. Long term low estradiol can decrease bone density. A few of the reported effects of high estradiol levels (in the presence of low testosterone) include: soft erections, water retention, excessive sweating, insomnia, bloating, hot flushes, brain fog, and high blood pressure. Blood Pressure The term "blood pressure" refers to the pressure in your arteries during the beating of your heart. There are two numbers: 1) The top number, or systolic, tells you the pressure in your arteries when the muscles of your heart contract. 2) The bottom number, or diastolic, tells you the pressure in your arteries when your heart relaxes and refills with blood in the pause between heartbeats. Healthy blood pressure is lower than 120/80. If your blood pressure rises anywhere from 121/81 to 139/89, you are pre-hypertensive. Crack 140/90, and you suffer from hypertension. Anyone over 180/100 is in serious hypertensive crisis. TRT can increase water retention, sodium uptake and hematocrit is some men, factors that can increase blood pressure. If your blood pressure rises too much, it can place excess strain on your blood vessels and potentially cause a crack. Should the blood vessels crack, the resulting clotting (your body's attempt to stop internal bleeding) can interfere with healthy blood flow--potentially leading to heart attacks, strokes, peripheral arterial disease, and other cardiovascular problems. Estimated Glomerular Filtration Rate eGFR Your glomerular filtration rate (GFR) is an indication of your kidney function. The higher your GFR, the more blood passes through the glomeruli (the filters in your kidneys that remove waste from your blood) every minute. A healthy GFR is anywhere from 90 to 120 mL/min/1.73 m2. Senior citizens will often have lower GFR levels, due to the fact that kidney function decreases with age. Note: It's important to understand that each lab has its own measurements, so what is "healthy" to some may be low with others. If your GFR drops below 60 and remains at that low level for more than 3 months, it's an indication of chronic kidney disease. Liver Enzymes Test Your liver is responsible for a number of important functions, such as breaking down nutrients, producing the proteins that clot your blood, and eliminating toxins. The enzymes produced by your liver are responsible for carrying out these functions. However, if the liver suffers damage, those enzymes tend to leak into your bloodstream. High levels of liver enzymes are a good indicator that your liver has been damaged ALT and AST are the two most common liver enzymes. AST should be anywhere from 10 to 40 units per liter of blood, and ALT should be from 7 to 56 units in every liter of blood. Be aware that exercise may increase these two enzymes in a non-clinically significant way. Only oral testosterone replacement has been shown to increase liver enzymes. TSH Test Thyroid-stimulating hormone, or TSH, is a hormone produced by your pituitary glands in order to stimulate your thyroid gland to produce T3 and T4 hormones. These thyroid hormones play a role in your body's metabolic function. Normal TSH levels should be between 0.5 and 3.5 U/ml (different guidelines show different upper TSH levels). Many educated doctors test for free T3 and free T4 (the unbound thyroid hormones) when TSH is over 3 since they believe this will provide a better picture of thyroid health. If TSH levels are low, it's an indication of hyperthyroidism. If TSH levels are very high, it's an indication of hypothyroidism. Free T3 Test Free T3 refers to unbound T3 (thyroid) hormone in your bloodstream. T3 is the more important of the thyroid hormones, but it can only be produced from T4. This means your body needs to produce T4 then turn it into T3. Once the T3 is unbound from the protein molecules, it can then be used by your body to stimulate metabolic function in all your cells. Normal Free T3 levels are anywhere from 230 to 620 pg/d. If free T3 is low, your doctor may test for thyroid antibodies to ensure that you do not have an autoimmune disease called Hashimoto's. Total Testosterone Test Total testosterone test measures refer to all of the testosterone circulating in your body. Some testosterone circulates freely, while some is bound to protein molecules. The whole point of TRT is to increase your testosterone levels. A normal testosterone range is anywhere from 350 to 1070 ng/dL. Low testosterone can cause low mood, sex drive, fatigue and other symptoms. In some men, too much testosterone in the body can lead to excessive estradiol, acne, oily skin, hair loss, testicular shrinking, and increased blood viscosity due to high red blood cells. Free Testosterone Test Free testosterone refers to the testosterone circulating in your body that is NOT bound to protein molecules like albumin and sex hormone binding globulin. It is believed that your body is more easily able to use free testosterone. It usually runs at about 2 percent or higher of total testosterone. Testosterone Test Results and Interpretation Testosterone test results are typically reported in nanograms per deciliter (ng/dL). The normal range for testosterone levels varies depending on age, sex, and the laboratory performing the test. Here are some general guidelines for interpreting testosterone test results: Normal Testosterone Levels in Adult Men: 300-1,000 ng/dL Normal Testosterone Levels in Adult Women: 15-70 ng/dL Low Testosterone Levels: Less than 300 ng/dL in men or less than 15 ng/dL in women High Testosterone Levels: Greater than 1,000 ng/dL in men or greater than 70 ng/dL in women It’s important to note that testosterone levels can fluctuate throughout the day and may be influenced by various factors such as sleep, stress, and exercise. Therefore, a single testosterone test result may not provide a complete picture of an individual’s overall testosterone levels. Healthcare providers may recommend repeat testing to confirm the results and monitor changes in testosterone levels over time. Understanding your testosterone test results and their implications can help you and your healthcare provider make informed decisions about your treatment plan. Ferritin Test Ferritin is a protein that is responsible for storing iron and releasing it when your body needs to produce red blood cells. If you suffer from an iron deficiency, your ferritin level are likely to be low. Ferritin levels also fall when you give blood (a common method of lowering hematocrit). Normal ferritin levels for men is anywhere from 30 to 300 ng/mL. However, if ferritin levels are too low (after a blood donation), your body is unable to store iron, meaning it will not be able to produce new red blood cells. If you are considering donating blood to lower your hematocrit, it's a good idea to check your ferritin levels first. Your body needs enough of this protein to reproduce the red blood cells you are donating HDL Cholesterol Test High density lipoprotein, also known as HDL cholesterol, is the "good" type of cholesterol. It's responsible for counteracting the effects of low-density lipoprotein, or LDL cholesterol. Low HDL and high LDL may lead to a wide range of cardiovascular problems, including blocked arteries, stroke, heart attack, and peripheral arterial disease. According to experts, even a 5 mg/dL decrease in HDL cholesterol can increase your risk of coronary heart disease by as much as 25% Normal HDL cholesterol levels are anything above 40 mg/dL. Unfortunately, decreased HDL is a known side effect of TRT in some men using higher testosterone doses. Your doctor will monitor HDL cholesterol via a lipid panel in order to ensure that you are not at risk for heart disease. Educate yourself about testosterone replacement side effects 

Are you a bodybuilder looking to maximize your performance and ensure optimal health? Regular bodybuilding blood work is key to achieving these goals. It provides valuable insights into your body's functioning, allowing you to make informed decisions about your training, nutrition, and supplementation. In this blog, we will explore the importance of regular blood work for bodybuilders and how it can help you strike the right balance between performance and health. We'll also address common factors that can affect blood test values in bodybuilders, as well as essential lab tests that every bodybuilder should consider. Don't miss out on this valuable information that can take your bodybuilding journey to new heights. Table of Contents The Importance of Regular Bodybuilding Blood Work Maximizing Performance and Health: A Balance Ergogenic Effects Associated with Anabolic Steroids and High TRT Doses Physician Stigma About PEDs Keeps Bodybuilders From Seeking Care Factors that Affect Blood Test Values in Bodybuilders Anabolic Steroid Use Without Testosterone Can Decrease Testosterone Blood Levels Resistance Exercise Can Increase Liver Enzymes Creatine Supplementation Can Cause Artificial Decreases in Kidney Function as Measured by Creatinine Some Oral Anabolic Steroids and Supplements Can Increase Liver Enzymes and Decrease HDL cholesterol High Doses of Anabolics Can Decrease Ferritin in Bodybuilders Understanding Essential Bodybuilding Blood Work Tests Complete Blood Count (CBC) Hematocrit Comprehensive Metabolic Panel (CMP) Lipid Test Panel Cystatin C with EGFR Kidney Test eGFR Kidney Test GGT Liver Test Total Testosterone by Liquid Chromatography/Mass Spectrometry, plus Free Testosterone by Equilibrium Ultrafiltration. Free Testosterone (Equilibrium Ultrafiltration) Test Ultra-Sensitive Estradiol (E2) Test Prolactin Test DHT Test IGF-1 Test Ferritin Test How do these tests help optimize bodybuilding performance? The role of these tests in muscle gain, fat loss, and quality of life How can bodybuilders prepare for these tests? Why is regular bodybuilding blood work essential? How to Buy Affordable Bodybuilding Blood Work on DiscountedLabs.com Conclusion   The Importance of Regular Bodybuilding Blood Work Regular bodybuilding blood work plays a crucial role in monitoring hormone levels and overall health, including high blood pressure. By conducting regular blood tests, bodybuilders can identify potential health issues before they become serious. Additionally, blood work provides valuable insights for optimizing nutrition and supplementation, leading to better performance. Tracking blood markers allows bodybuilders to make informed decisions about their training and recovery strategies. Ultimately, regular blood work is essential for long-term health and longevity in the world of bodybuilding. By staying on top of blood markers like testosterone, hormone levels, glucose, and kidney function, bodybuilders can ensure they are in optimal condition to achieve their goals. Maximizing Performance and Health: A Balance Regular monitoring of bodybuilding blood work, including testosterone tests, is crucial for bodybuilders to maximize their performance and maintain good health. Through regular blood tests, bodybuilders can monitor hormone levels, nutrient deficiencies, and overall organ function. This information is invaluable in making informed adjustments to diet, supplements, and training routines. By maintaining a balance between performance and health, bodybuilders can optimize their training and achieve their goals. Prioritizing health through regular blood work is essential for long-term success and sustainable progress in bodybuilding. It allows bodybuilders to identify any potential imbalances and make the necessary adjustments for optimal performance. By utilizing comprehensive metabolic panels, lipid panels, and hormone level tests, bodybuilders can ensure that their training is effective and their bodies are functioning optimally. Ergogenic Effects Associated with Anabolic Steroids and High TRT Doses   According to a scientific review, the use of anabolic steroids has the following ergogenic effects: ■ Increase in lean body mass ■ Increase in muscle cross-sectional area ■ Decrease in body fat percent ■ Increase muscle strength & power ■ Enhance recovery between workouts ■ Enhance recovery from injury ■ Increase in protein synthesis ■ Increase in muscle endurance ■ Increase in erythropoiesis, hemoglobin, and hematocrit ■ Increase in bone mineral density ■ Increase in glycogen storage ■ Increase in lipolysis ■ Increase in neural transmission ■ Reduced muscle damage ■ Increase in pain tolerance   However, the use of these agents could have the following side effects: Cardiovascular ■ Lipid profile changes ■ Elevated blood pressure ■ Decreased myocardial function Increased in blood viscosity due to high hematocrit Dermatological ■ Acne ■ Male pattern baldness Endocrine ■ Gynecomastia ■ Decreased sperm count ■ Testicular atrophy ■ Impotence and transient infertility Hepatic ■ Increased liver enzymes Renal Decreased kidney function Genitourinary Males ■ Reduced sperm counts ■ Decreased testicular size Females ■ Menstrual irregularities ■ Clitoromegaly ■ Masculinization Males and Females ■ Gynecomastia ■ Libido changes Physician Stigma About PEDs Keeps Bodybuilders From Seeking Care The stigma surrounding performance-enhancing drugs (PEDs) frequently makes bodybuilders reluctant to seek medical attention. Many bodybuilders are reluctant to disclose their PED use due to fear of judgment or a lack of understanding from healthcare professionals. This can impede their access to important resources such as regular blood work, which is vital for monitoring health and performance. Healthcare professionals need to be knowledgeable about the potential risks and side effects associated with PEDs in order to provide appropriate care and guidance. Open communication and support between bodybuilders and healthcare professionals can foster collaboration for optimizing performance while minimizing health risks.   Factors that Affect Blood Test Values in Bodybuilders Muscle damage and inflammation can impact blood test results in bodybuilders, as the body's response to intense training can cause temporary changes in certain blood markers. Additionally, high protein intake, which is common among bodybuilders, may affect kidney function and liver enzymes but is not clinically significant, which is concerning to doctors not familiar with this fact. Steroid use can also lead to hormonal imbalances and abnormal blood test results. Dehydration, which can occur during intense workouts or when bodybuilders are cutting weight, can cause changes in electrolyte and blood cell levels. Weight training can also increase certain live enzymes in a non-clinical way. Supplements like creatine can falsely increase serum creatinine, which can alarm certain physicians. It is important for bodybuilders to address any nutritional deficiencies identified through blood testing, as these deficiencies can impact performance and overall health. Anabolic Steroid Use Without Testosterone Can Decrease Testosterone Blood Levels Anabolic steroid use without testosterone can result in a decline in testosterone levels among bodybuilders, leading to low testosterone, or TSH. Testosterone plays a crucial role in muscle growth, recovery, and overall performance in bodybuilding. To ensure optimal health and performance, bodybuilders should regularly monitor their testosterone levels. Consulting with a healthcare professional can help them effectively manage their hormone levels. It is essential to maintain balanced testosterone levels to avoid negative side effects and maximize results. By being proactive in monitoring testosterone levels, bodybuilders can optimize their performance and achieve their desired outcomes. Resistance Exercise Can Increase Liver Enzymes Intense resistance exercise can result in temporary elevations in liver enzymes, including alkaline phosphatase, which is a normal response to muscle damage and repair. It is crucial for bodybuilders to inform their healthcare provider about their exercise routine before getting blood work done. Although elevated liver enzymes due to exercise are typically harmless and resolve on their own, regular monitoring of liver enzymes is essential for bodybuilders to ensure optimal health and performance. By keeping track of liver enzyme levels, bodybuilders can identify any abnormalities early on and take appropriate actions to maintain their liver function. Creatine Supplementation Can Cause Artificial Decreases in Kidney Function as Measured by Creatinine Creatine supplementation can temporarily decrease kidney function markers, leading to lower creatinine and potassium levels in bodybuilders. It is important for bodybuilders to inform their healthcare providers about any dietary supplements before undergoing blood tests. Once creatine supplementation is discontinued, creatinine and potassium levels can normalize. However, monitoring kidney function through multiple biomarkers is essential for an accurate assessment. By incorporating these measures, bodybuilders can ensure that their kidney function is accurately evaluated. Some Oral Anabolic Steroids and Supplements Can Increase Liver Enzymes and Decrease HDL cholesterol Certain oral anabolic steroids used by bodybuilders have the potential to increase liver enzymes and decrease HDL cholesterol levels, leading to an increase in total cholesterol and low-density lipoprotein. Regular blood tests are vital for bodybuilders who use these oral steroids to monitor their impact on liver function and cholesterol levels. Elevations in liver enzymes can be a sign of liver damage, while decreased HDL cholesterol levels pose a risk for cardiovascular health. Working with a healthcare professional is essential to mitigating these potential risks associated with the use of oral anabolic steroids. By closely monitoring liver health and cholesterol levels, bodybuilders can make informed decisions about their supplementation and take necessary steps to protect their overall health. High Doses of Anabolics Can Decrease Ferritin in Bodybuilders High doses of anabolic steroids can result in decreased ferritin levels among bodybuilders, impacting their overall performance. Ferritin plays a crucial role as a protein that stores iron, and deficiencies can have negative effects on muscle growth and health. To optimize supplementation and monitor ferritin levels, regular blood tests are essential. Consulting with a healthcare professional can provide personalized guidance on maintaining optimal ferritin levels and growth hormone levels. It is important for bodybuilders to be aware of the potential impact of high doses of anabolic steroids on ferritin levels and take proactive measures to ensure balanced hormone levels and nutrition. By prioritizing the monitoring of ferritin levels, bodybuilders can support their muscle growth and overall well-being. Understanding Essential Bodybuilding Blood Work Tests Regular blood work is vital for bodybuilders to monitor their health and optimize their performance. Key lab tests for bodybuilders include hormone levels, liver function, kidney function, and thyroid function. These tests can help identify potential health issues and allow for adjustments in training and nutrition plans. Working with a healthcare professional who specializes in sports medicine or bodybuilding is beneficial to ensure an accurate interpretation of the results. By regularly monitoring hormone levels, such as testosterone and estradiol, bodybuilders can address any imbalances and make necessary adjustments to their supplementation or hormone replacement therapy. Additionally, liver function tests like ALT and AST can assist in identifying any liver abnormalities or damage that may result from the use of anabolic steroids. Kidney function tests, like creatinine and BUN, are crucial for assessing the impact of intense training and supplement use on the kidneys. These lab tests provide valuable insights into a bodybuilder's health and play a crucial role in maintaining optimal performance, including CMP. 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. Hematocrit All androgens, like testosterone and AAS, can increase red blood cells and their proportion in the blood (hematocrit), increasing blood thickness (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 panel, 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, electrolytes, 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 Since higher muscle mass, protein intake, and creatine supplementation can all affect creatinine as the primary variable, cystatin C is a more accurate way to assess kidney function in people with higher muscle mass. 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 (CCRCr 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. eGFR Kidney Test The eGFR kidney test is an important tool for bodybuilders to monitor their kidney health and ensure optimal performance. By measuring how well the kidneys are functioning, this test can help detect any potential kidney issues that may arise, affecting metabolism. It is crucial for bodybuilders to regularly check their eGFR levels, as low levels under 60 can indicate kidney damage or impaired kidney function, which can have a negative impact on performance. Maintaining a healthy eGFR level is essential for overall health and athletic performance. Consulting with a healthcare professional is recommended for interpreting eGFR results and taking the necessary steps to support kidney health. 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. Free Testosterone (Equilibrium Ultrafiltration) Test The equilibrium ultrafiltration test is a precise method used to measure the amount of unbound testosterone in the bloodstream. Free testosterone plays a crucial role in muscle growth, strength, and overall performance for bodybuilders. Monitoring free testosterone levels can provide valuable insights into potential imbalances or deficiencies that may impact training, recovery, and hormone balance. By regularly testing free testosterone, bodybuilders can optimize their training and supplement plans to maximize their performance and health. This test, along with other essential lab tests, helps bodybuilders maintain optimal hormone levels and ensure their body is functioning at its best. 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 is your estradiol. Be very careful in 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. Regular monitoring of hormone levels is essential for bodybuilders, and the prolactin test plays a crucial role in this process. This test helps detect potential imbalances that can impact performance and overall health. Elevated prolactin levels may indicate issues such as reduced testosterone production or the presence of pituitary gland tumors. Therefore, it is vital for bodybuilders to undergo regular prolactin testing to optimize their performance and maintain their overall well-being. However, interpreting the results accurately requires consultation with healthcare professionals. By keeping prolactin levels in the optimal range, bodybuilders can enhance muscle growth, support recovery, and promote their overall physical and mental well-being. 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. DHT test (LC/MS) measures dihydrotestosterone levels, a hormone linked to muscle growth and male characteristics. It helps bodybuilders evaluate hormonal balance for enhanced performance. Monitoring DHT levels provides insights into potential side effects or risks associated with supplements or steroid use. Regular testing tracks progress and informs decisions on training and supplementation. Discussing results with healthcare professionals creates personalized strategies for goals. 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. The IGF-1 test, performed using LC/MS, is a crucial tool for bodybuilders to assess their performance and overall health. This test measures the levels of insulin-like growth factor-1, a hormone that plays a vital role in muscle growth and repair. By analyzing IGF-1 levels, bodybuilders can determine whether they have optimal hormone levels for performance and recovery. Low levels of IGF-1 may indicate potential limitations in muscle growth or underlying health issues. 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 anabolic steroids 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 who use TRT and anabolic steroids and have high hematocrit (increased blood thickness due to TRT or anabolic steroids) frequently donate blood or undergo therapeutic phlebotomy to lower 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. How do these tests help optimize bodybuilding performance? Bloodwork tests play a crucial role in optimizing bodybuilding performance. They provide valuable insights into hormone levels, nutrient deficiencies, and overall health. By identifying imbalances or deficiencies, bodybuilders can make targeted adjustments to their diet and supplementation, enhancing muscle growth, recovery, and overall performance. Regular blood work helps track progress and make necessary adjustments to training and nutrition protocols. The role of these tests in muscle gain, fat loss, and quality of life Blood tests play a vital role in bodybuilding, specifically when it comes to muscle gain, fat loss, and overall quality of life. These tests provide valuable insights into hormone levels, such as testosterone and cortisol, which are crucial for optimal muscle growth and fat loss. By monitoring these blood markers, bodybuilders can optimize their recovery and prevent overtraining. Additionally, blood work can reveal any nutrient deficiencies that may be hindering progress in muscle gain or fat loss. Moreover, assessing liver and kidney function through blood tests ensures the overall health and longevity of bodybuilders. Regular blood work is essential for identifying potential health risks and allowing for timely intervention to maintain a high quality of life. How can bodybuilders prepare for these tests? To prepare for bodybuilding blood work, it's important for bodybuilders to stay hydrated, avoid strenuous exercise or heavy lifting 48 hours before the test, follow any fasting requirements given by the healthcare provider, and inform them about any supplements or medications being taken. Why is regular bodybuilding blood work essential? Regular monitoring of crucial parameters is essential for bodybuilders. It helps ensure optimal performance and overall health. By tracking hormone levels, liver function, and kidney function, bodybuilders can make informed decisions about their training, nutrition, and supplementation strategies. Regular blood work also provides a baseline for comparison and allows assessment of the effectiveness of lifestyle choices on health and performance. How to Buy Affordable Bodybuilding Blood Work on DiscountedLabs.com To buy affordable bodybuilder blood work on DiscountedLabs.com, simply visit the website and create an account. Then, search for the specific bodybuilder blood work panel you need and add it to your cart. Proceed to checkout and apply any available discount codes before completing your purchase. Bodybuilder Panels Sold by DiscountedLabs.com Bodybuilder Blood Test Panel- Basic Bodybuilder Blood Test Panel- Beginner Bodybuilder Blood Test Panel- Comprehensive Conclusion Regular bodybuilding blood work is essential for maximizing performance and maintaining good health. It helps bodybuilders identify any imbalances or potential health risks caused by their training regimen and performance-enhancing agents. Understanding the importance of these tests and regularly monitoring key parameters such as testosterone levels, kidney function, liver enzymes, and lipid profiles can help bodybuilders optimize their muscle gain, fat loss, and overall quality of life. To ensure accurate results, it is important for bodybuilders to prepare for these tests by following specific guidelines. Regular monitoring of these parameters allows bodybuilders to make adjustments to their training and nutrition plans, minimizing potential risks and improving long-term outcomes. DiscountedLabs.com offers affordable bodybuilder blood work, making it easier for individuals to access these crucial tests. Take charge of your bodybuilding journey and prioritize your health and performance with regular blood work.        

Maximize Benefits Today: Bodybuilder Blood Test Results What are the key parameters that bodybuilders should look for in their blood test results? Key parameters bodybuilders should focus on in blood test results include testosterone levels, liver function markers, kidney function markers, iron levels, and cholesterol levels. Monitoring these can help optimize performance, prevent injuries, and ensure overall health while pursuing bodybuilding goals. Bodybuilders who take testosterone and anabolic androgenic steroids (AAS) must be smart about maximizing benefits and limiting short- and long-term side effects while exercising and eating well to achieve respectable muscle gain, fat loss, and quality of life. Harm reduction is crucial, mainly when the stigma and prejudice of medical professionals act as barriers to care. However, it's important to note that training hard puts the body under a lot of stress, so it's essential to give your body enough time to recover and rebuild. Overtraining is a real risk for bodybuilders and passion and commitment to training may sometimes be the thing that prevent progress. There are 14 carefully selected lab tests and panels listed below that are vital for maintaining health while boosting strength and body composition. What Tests are Included in the Bodybuilder Blood Test Panels? Complete Blood Count (CBC) A complete blood count (CBC) test panel measures immune cells, hemoglobin, the oxygen-carrying protein in red blood cells; hemoglobin concentration, the proportion of red blood cells to fluid in your blood (called hematocrit, which correlates with blood thickness); and platelets, which help in blood clotting. All androgens, including testosterone and AAS (polycythemia), raise the percentage of red blood cells (hematocrit), which affects blood thickness. High hematocrit can result in high blood pressure, headaches, and cardiovascular risks. This panel is essential because it indicates when your hematocrit reaches 53 and you need to donate blood or undergo therapeutic phlebotomy. Comprehensive Metabolic Panel (CMP) The complete metabolic panel (CMP panel), a preliminary medical screening tool for evaluating overall health, consists of 14 blood tests. The CMP blood test panel measures kidney, liver, glucose, electrolytes, and fluid balance levels. FASTING IS REQUIRED. Lipid Panel This panel has triglycerides, LDL (bad cholesterol), and HDL (good cholesterol) (fatty acids dissolved in the blood). Greater dosages of T and AAS can cause an increase in LDL while decreasing HDL and triglycerides. Cardiovascular issues may develop over time if HDL levels are significantly low. FASTING IS REQUIRED. EGFR and cystatin C kidney test Cystatin C is a more accurate method to evaluate renal function in people with higher muscle mass because growing muscle mass, consuming more protein, and supplementing with creatine can all change creatinine levels. Another measure of renal function is the estimated glomerular filtration rate (eGFR) and the cystatin C kidney test. The glomerular filtration rate is the rate at which fluid filters through the kidney. The creatinine clearance rate (CCRCr or CrCl), which measures the amount of blood plasma that is cleared of creatinine per unit of time, is a useful indicator of the estimated GFR. A low eGFR could indicate issues with renal function, as well as high levels of blood urea nitrogen (BUN). Accurate Liver (GGT) Test The GGT blood test looks for gamma-glutamyl transpeptidase (GGT), an enzyme or protein, in your blood. GGT is found in the liver's cells. This examination helps your doctor look for damage to the liver or the liver ducts. Alkaline phosphatase results, a separate blood test, can help distinguish between liver and bone diseases if they are abnormal. A test result that is higher than normal could be a sign of liver damage from cirrhosis, tumors, or pancreatic cancer, among other diseases. GGT is superior to liver enzymes included in the CMP, like AST and ALT, in that resistance training has no effect on its value, making it a more accurate method to diagnose liver disease in bodybuilders. Gold Standard: Total and Free Testosterone Tests Equilibrium ultrafiltration to determine free testosterone and liquid chromatography/mass spectrometry to determine total testosterone. Men with high testosterone levels cannot use the standard total testosterone test based on immunoassays since its upper limit is 1,500 ng/dL. Our testosterone test uses mass spectrometry, the most advanced and accurate testosterone test. Also, some laboratories offer computed free testosterone rather than the equilibrium ultrafiltration-based method we use, which is more accurate for this important number. Ultra-Sensitive Estradiol Testing (E2) The commonly used test may overstate estradiol. The combination of estradiol and C-Reactive Protein, which is associated with inflammation, is interpreted as estradiol by the immunoassay technique employed in that test because it is unable to differentiate between the two substances. This ultrasensitive estradiol test is based on the liquid chromatography/mass spectrometry (LC/MS) assay technique, which does not have that limitation. Furthermore, it has been demonstrated that DHT analogs like oxandrolone drastically suppress estradiol, which can lead to joint discomfort and other low estradiol issues. Interestingly, estradiol aromatization occurs in 0.4% of total testosterone. The body achieves balance by doing this to counteract the opposing effects of testosterone and estradiol on lipids. If your total testosterone is high, your estradiol will also be high. Use extreme caution when assuming that an aromatase inhibitor is necessary. For more information, please click on the effect of high and low estradiol on men's health. calculating estradiol using different testosterone dosages. Prolactin Test Many bodybuilders worry about elevated prolactin since it has been linked to erectile problems. DHT Test This test determines the amount of dihydrotestosterone (DHT) in the blood. High DHT has been linked to benign prostatic inflammation, acne, and hair loss in a small number of men. Low libido has been connected to decreased DHT. IGF-1 Test IGF-1 Test Human growth hormone levels in the blood are measured using the biomarker insulin-like growth factor 1, or IGF-1. It is a hormone that the liver and other organs produce and that affects processes supporting glucose metabolism and growth. Low IGF-1 may impede muscle growth. Ferritin Test A protein known as ferritin is where iron is kept. Iron is essential for the production of red blood cells and the distribution of oxygen throughout the body. Low amounts of ferritin cause anemia. TRT and anabolic steroids increase red blood cell production in the body (erythrocytosis). This increased production lowers ferritin levels and iron stores. Testosterone is known to cause ferritin levels to drop. Due to their high hematocrit (increased blood thickness from TRT and anabolics), men who use TRT and anabolics frequently donate blood or undergo therapeutic phlebotomy. Every donation causes a 30-point or more drop in ferritin. Low ferritin can cause fatigue, restless legs syndrome, muscle aches, and other issues. Get your bodybuilder test panel today! Bodybuilder Blood Test Guide: Are you a bodybuilder looking to keep track of your blood test results? A bodybuilder blood test can help monitor changes in hormone levels caused by the use of anabolic steroids and high doses of testosterone. But finding accurate and affordable tests can be challenging. Fortunately, DiscountedLabs offers comprehensive yet inexpensive lab tests for bodybuilders across the United States; no doctor’s visit is required. Get informed on how to prepare for a bodybuilder blood test, also known as bloodwork, and what results to expect with this helpful guide. What is a Bodybuilder Blood Test? A bodybuilder blood test is a series of tests that measure various aspects of health, such as hormone levels, cholesterol, and other markers. It can also measure the levels of high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in your blood, which is important for bodybuilders as high levels of cholesterol and triglycerides can increase the risk of heart disease and other health problems. The results of these tests can provide valuable insight into how to optimize your training and nutrition for better results. Overview of the Test A doctor or other healthcare professional typically orders and has a laboratory perform blood tests on bodybuilders. These tests measure different components in the blood, including hormones, electrolytes, enzymes, proteins, minerals, and vitamins. Depending on what type of test you get done, it will determine which specific biomarkers are tested for, especially if you are taking any dietary supplements. Benefits of the Test The primary benefit of getting a bodybuilder blood test is gaining insight into your overall health status, including general health, so you can make informed decisions about optimizing your diet and exercise routine for maximum gains in muscle mass and strength. Additionally, these tests can also reveal any potential deficiencies or imbalances that could be hindering progress toward achieving fitness goals. Finally, they may uncover any underlying medical issues that need further investigation from a physician before continuing with an intense workout program or taking certain supplements/medications without proper guidance from an expert healthcare professional first. Types of Tests Available How to Prepare for a Bodybuilder Blood Test? Pre-Test Instructions: Before taking a bodybuilder blood test, it is important to follow the instructions provided by your doctor or healthcare provider. These may include avoiding certain medications and supplements for a period of time before the test, as well as fasting for 8 to 12 hours prior to having your blood drawn. It is also important to inform your doctor about any recent illnesses or medical procedures you have had in order to ensure accurate results. Fasting Requirements: Fasting is an essential part of preparing for a bodybuilder blood test. This means not eating or drinking anything other than water for at least 8 hours before the test. During this time, it is best to avoid strenuous physical activity and alcohol consumption in order to get accurate results from the tests. The CMP test and the lipid panel require fasting for at least 8 hours. Certain medications can interfere with bodybuilder blood tests, so it is important to inform your doctor about all prescription and over-the-counter drugs you are taking before getting tested. Your doctor may recommend that you stop taking some medications temporarily while waiting for the results of your tests in order to ensure accuracy. Additionally, if you take vitamins or herbal supplements regularly, be sure to let your doctor know so they can advise whether these should be avoided prior to testing as well. Preparing for a bodybuilder blood test? Make sure to fast 8-12 hours, avoid strenuous activity & alcohol, and inform your doctor about any medications or supplements you take. #bodybuilding #bloodtest Click to Tweet Understanding the Results of a Bodybuilder Blood Test This type of test can help diagnose medical conditions related to hormone imbalances or deficiencies, as well as monitor progress during bodybuilding training. It’s important to understand what each component measures and how it affects your health before undergoing this type of testing. Common Abnormalities Detected in Tests: A bodybuilder blood test typically includes measurements for testosterone, estrogen, cortisol, thyroid-stimulating hormone (TSH), insulin-like growth factor 1 (IGF-1), albumin/globulin ratio (AGR), and luteinizing hormone (LH). High or low levels of any one of these components may indicate an underlying medical condition, such as hypogonadism or hyperthyroidism. Other abnormalities that may be detected, highlighting the critical role of these hormones in bodybuilding, include high cholesterol levels, elevated liver enzymes, abnormal red blood cell counts, or white blood cell counts. Interpreting Bodybuilder Test Results with Your Doctor: After receiving your results from a bodybuilder blood test, it’s important to discuss them with your doctor so they can explain what the numbers mean and if any further testing is needed. Depending on the results, you may need additional lab work to confirm a diagnosis or rule out certain conditions. Your doctor will also be able to recommend lifestyle changes or medications that can help improve your overall health, including heart health, based on the results of this type of testing. The Side Effects of Anabolic Steroids and High Doses of TRT on Bodybuilder Blood Test Results Anabolic steroids and high doses of testosterone can have serious effects on a person’s health, including their blood tests. It is important to understand the potential risks associated with anabolic steroid use or high doses of testosterone, as well as how it may affect your bodybuilder's blood test results. A. Potential Health Risks Associated with Anabolic Steroids and High Doses of Testosterone: Anabolic steroids are synthetic hormones that mimic the effects of testosterone in the body. Athletes and bodybuilders frequently use them to increase muscle mass, strength, and endurance, but they have a variety of negative side effects, including liver damage, heart issues, depression, aggression, infertility, and more. High doses of testosterone can also cause similar side effects as anabolic steroids but at a lesser degree due to its natural origin in the body. The use of anabolic steroids or high doses of testosterone can lead to changes in certain blood tests, such as increased levels of red blood cells (RBC), hemoglobin (Hb) and hematocrit (HCT). These changes could indicate underlying medical conditions such as polycythemia vera, which is caused by too many red blood cells being produced by the bone marrow, leading to thickening of the blood, increasing risk for stroke or heart attack if left untreated. White blood cell count (WBC) levels that drop can mean infection or inflammation; higher creatinine levels can mean kidney damage; higher cholesterol levels can raise the risk of heart disease; higher liver enzyme levels can mean liver toxicity; lower thyroid hormone production can lead to hypothyroidism; lower potassium levels can cause fatigue and other symptoms; and higher calcium levels can cause kidney stones and other problems related to an imbalance in calcium metabolism. These changes in blood tests serve as a baseline for understanding your general health and can also reveal potential health conditions that may interfere with your bodybuilding training and nutrition requirements. It is important that you discuss any abnormal results from your bodybuilder's lab test panel with your doctor so they can provide further guidance on what treatment options may be best suited for you depending on your individual situation. DiscountedLabs offers affordable lab testing without a doctor’s visit, so you can get tested regularly without breaking the bank. Where to Buy Affordable Bodybuilder Blood Tests from DiscountedLabs? DiscountedLabs is a great resource for bodybuilders looking to purchase affordable blood tests. DiscountedLabs offers a wide variety of lab tests, including those specifically designed for bodybuilders. These tests can help provide insight into the health and wellness of an individual, as well as their progress in achieving their fitness goals. DiscountedLabs provides convenient access to laboratory testing services without the need for a doctor’s visit or insurance coverage. They offer discounted rates on many types of lab tests, including those specifically designed for bodybuilders, such as hormone panels, cholesterol levels, liver function tests and more. In addition to providing discounts on these specific types of lab tests, they also offer additional services such as free shipping and 24/7 customer support via phone or email.   Bodybuilder Panels Sold by Discounted Labs: Bodybuilder Blood Test Panel- Basic Bodybuilder Blood Test Panel- Beginner Bodybuilder Blood Test Panel- Comprehensive   FAQs About Bodybuilder Blood Tests What blood tests do bodybuilders get? Bodybuilders typically get a variety of blood tests to monitor their health and performance. These include tests such as complete blood count (CBC), lipid panel, thyroid-stimulating hormone (TSH), testosterone, cortisol, iron levels, electrolytes, and energy levels. Higher levels of testosterone can also lead to increased energy levels, improved mood, and a higher sex drive, making it an important factor for bodybuilders to monitor. All these tests help bodybuilders assess their overall health status and determine if they are getting the proper nutrition for optimal muscle growth. Additionally, some bodybuilders may opt for additional specialized testing depending on their goals or medical history. Discounted Labs offers affordable lab testing in most cities across the U.S., allowing bodybuilders to easily access the necessary tests without having to visit a doctor’s office. What blood test do I need for steroids? The type of blood test you need for steroids depends on the specific steroid being used. Generally, tests are done to measure levels of testosterone, estradiol, and other hormones related to steroid use. Additionally, tests may be done to check for markers of liver damage or kidney function that can be affected by long-term steroid use. It is important to speak with a doctor before taking any form of steroids in order to determine which blood tests are necessary and how often they should be taken. Is there a blood test for muscle mass? Yes, there is a blood test for muscle mass. It's called the Creatinine Kinase (CK) test and it measures the amount of an enzyme in your bloodstream that is released when muscles are damaged or stressed. The CK test can help determine if you have too much or too little muscle mass, as well as provide insight into other health issues such as kidney damage or a heart attack. Results from this type of lab test are usually available within 1–7 business days after taking the sample. Discounted Labs offers affordable CK tests in most cities across the U.S., including measures of muscle tissue, so you don't need to visit a doctor's office to get tested. What is TRT blood work? TRT blood work is a type of lab test used to measure the levels of testosterone in the body. It is commonly used to diagnose and treat conditions related to low testosterone, such as hypogonadism or male infertility. The test measures both total and free testosterone levels, which can help determine if hormone replacement therapy, also known as testosterone replacement therapy, may be necessary. TRT blood work can also provide insight into other health issues that may be affecting overall well-being. Conclusion It is important for bodybuilders to monitor their blood tests regularly, especially if they are using anabolic steroids or high doses of testosterone. A bodybuilder's blood test can provide valuable insight into the health and wellness of a person's body. With DiscountedLabs, you can purchase affordable and reliable bodybuilder blood tests without having to visit a doctor's office. So don't wait any longer - get your bodybuilder blood test today.

Your hormones control everything from energy and strength to recovery and muscle-building. Regular testing can identify imbalances that hold you back and help fine-tune your training, diet, and recovery. Here’s a quick summary of the 8 key hormone tests every athlete and bodybuilder should know about: Testosterone: Measures muscle growth and recovery potential. Cortisol: Tracks stress and recovery balance. Growth Hormone (GH): Supports muscle repair and fat metabolism. Thyroid Function: Regulates energy and metabolism. IGF-1: Reflects growth hormone activity for muscle building. Estradiol: Affects recovery, bone health, and fat distribution. DHEA: Precursor to testosterone and estrogen, key for hormonal balance. LH & FSH: Monitors reproductive health and testosterone production. Why it matters: Hormonal imbalances can lead to fatigue, poor recovery, and reduced performance. Testing provides actionable data to optimize training and avoid overtraining. Pro Tip: Start with a testosterone-to-cortisol ratio or thyroid panel if you're noticing fatigue, slow recovery, or muscle loss. Dive into the full article for details on each test and how to use them to improve your results. Fitness Improvement Requires Stress & Cortisol 1. Testosterone Levels Testing testosterone levels is crucial for athletes, as it directly affects muscle growth, recovery, and overall performance. Understanding Testosterone Testing Blood tests are used to measure two key types of testosterone: total testosterone (which includes both free and protein-bound forms) and free testosterone (the active form). For the most accurate results, it's recommended to test between 7 a.m. and 10 a.m., when levels are naturally highest [3]. Services like DiscountedLabs.com offer hormone panels at over 2,200 locations across the U.S., delivering confidential results in just 2–7 business days. This detailed measurement helps assess performance potential and identify areas for improvement. Normal Testosterone Ranges for Athletes Gender Normal Range (ng/dL) Men 300–1,000 Women 15–70 Dr. Paul Gittens, a board-certified urologist and founder of the Rockwell Centers for Sexual Medicine and Wellness, emphasizes: "It's not all about numbers. It's about how your numbers reflect with your symptoms." [2] How Testosterone Affects Athletic Performance Maintaining balanced testosterone levels is essential for any athlete aiming to maximize strength and recovery. Testosterone supports several key functions, including: Promoting muscle protein synthesis Maintaining bone density Speeding up post-workout recovery Regulating fat distribution It's worth noting that testosterone levels naturally decline by about 1.6% per year, which can influence performance over time. Signs of Low Testosterone Be alert to these potential warning signs of low testosterone: Loss of muscle mass despite consistent training Longer recovery periods after workouts Reduced strength gains Unusual fatigue during exercise Lack of motivation to train Dr. Justin Dubin, a urologist and men's health expert at Memorial Healthcare System, points out: "Just because your testosterone is very, very high doesn't mean you have a better libido or anything. Everyone's body is different." [2] 2. Cortisol Measurement Cortisol, often referred to as the "stress hormone", can directly impact recovery and performance when levels remain elevated for too long. For athletes and bodybuilders, keeping cortisol in check is key to improving training outcomes. This hormone plays a role in regulating metabolism, immune response, and inflammation [7]. Testing Methods and Timing Cortisol levels can be assessed using three primary methods: Test Type Collection Time Normal Range (8 a.m.) Blood Test Morning + 4 p.m. 5-25 mcg/dL Saliva Test Before bedtime Varies by lab 24-hour Urine Full day collection Lab-specific Impact on Athletic Performance When exercise intensity exceeds 60% of VO2 max, cortisol levels naturally rise [6]. While short-term spikes are part of the body's normal response, consistently high levels can lead to: Poor muscle recovery Weakened immune function Loss of bone density Trouble sleeping Increased fat storage Professor Chris McLellan highlights the importance of monitoring cortisol: "Cortisol testing provides coaches, trainers and health & fitness professionals with increased capacity in conjunction with existing performance monitoring methods to establish preparedness for training and competition and optimize recovery. With cortisol, what gets measured, gets managed." [4] Understanding these effects is just the first step. The next challenge is learning how to control elevated cortisol levels. Managing Cortisol Levels Overtraining can cause a surge in cortisol that slows recovery and breaks down muscle tissue [8]. To keep cortisol levels balanced: Post-workout nutrition: After exercise, drink a carb-to-protein mix in a 3:1–4:1 ratio to help regulate cortisol [5]. Training structure: Build workout routines that include proper rest periods, especially for endurance-focused athletes [5]. Recovery strategies: Incorporate stress management techniques and prioritize high-quality sleep [4]. 3. Growth Hormone Testing Growth hormone (GH) testing plays an important role for athletes and bodybuilders aiming to improve performance and recovery. Since GH levels naturally rise and fall throughout the day, accurate testing can reveal useful details about hormonal health and how well training is working. Testing Methods and Accuracy Measuring GH isn't straightforward because of its pulsatile secretion pattern. Standard blood tests aren't enough. Instead, endocrinologists rely on specialized tests: Test Type Purpose Normal Range Approximate Cost IGF-1 Blood Test Primary screening Age/gender specific $70 GH Stimulation Diagnose deficiency >4 ng/mL (adults) Varies GH Suppression Diagnose excess <1 ng/mL Varies Macimorelin Test Oral diagnostic ≤2.8 μg/L Varies Dr. Jennifer Osipoff, a Pediatric Endocrinologist at Stony Brook Children's Hospital, notes: "A random GH level is not a clinically relevant value if assessing for growth hormone deficiency or excess. Instead, endocrinologists will measure insulin-like growth factor 1 (IGF-1), a protein that is made in response to GH secretion." [10] Impact on Athletic Performance GH plays a role in muscle growth, protein synthesis, fat metabolism, and recovery. Studies show that athletes using GH supplementation gained an average of 4.6 pounds of lean body mass [11]. However, GH alone doesn't lead to noticeable improvements in strength or exercise performance. This underscores the importance of focusing on natural ways to optimize GH levels. Natural GH Optimization Tracking GH levels can help adjust training plans. Here are some insights: Women produce about 50% more GH than men over a 24-hour period [9]. GH production decreases by roughly 14% per decade after early adulthood [9]. Anaerobic workouts stimulate more GH release compared to steady-state cardio [9]. Testing Considerations When preparing for GH testing, keep the following in mind: Follow fasting guidelines carefully. Inform your doctor about any medications that could affect results. Schedule tests at times when GH levels are most likely to be measurable. Consider pairing GH testing with IGF-1 measurement for a more complete picture. 4. Thyroid Function Tests Thyroid tests provide important insights for athletes looking to refine their training. These hormones play a key role in metabolism, muscle function, and overall performance, making thyroid health essential for athletic success. Core Thyroid Panel Components Test Type Purpose Indicator TSH (Thyroid Stimulating Hormone) Initial screening test General thyroid function Free T4 Measures active thyroid hormone Direct thyroid output Free T3 Measures active thyroid hormone Reflects metabolic activity Thyroid Antibodies Identifies autoimmune issues Autoimmune conditions How Thyroid Hormones Affect Performance Thyroid hormones impact several areas critical to athletes: Muscle strength, recovery, and protein synthesis Energy production and usage Heart rate and blood pressure regulation Body temperature control Weight stability Dr. Sumedha Chablani, an endocrinologist and clinical assistant professor at NYU Grossman School of Medicine, notes: "Both hypothyroidism and hyperthyroidism can present with fatigue or changes in energy levels, which can impact athletic performance and endurance."[13] Understanding these effects helps athletes address potential issues early. Signs to Watch For Athletes should pay attention to these symptoms for thyroid imbalances: Hyperthyroidism (Overactive Thyroid) Unexplained weight loss with increased appetite Muscle weakness Rapid heart rate Excessive sweating Sleep problems Hypothyroidism (Underactive Thyroid) Persistent fatigue Trouble building or maintaining muscle Slower recovery from workouts Joint and muscle pain Unexplained weight gain If you notice these signs, testing is critical to confirm and address the issue. Testing Tips for Athletes Studies show that 57–90% of hypothyroid patients have elevated creatine kinase (CK) levels [12]. To ensure accurate results: Schedule tests in the early morning. Keep follow-up tests at consistent times. Let your provider know about any medications, supplements, or thyroid concerns. Athletes using androgenic anabolic steroids should be particularly cautious, as these substances can disrupt thyroid function [12]. Supporting Thyroid Health Regular testing can guide adjustments to training and recovery routines. Thyroid hormones are important for muscle function, especially in promoting faster muscle fiber types in muscles with a higher proportion of slow fibers [14]. To maintain thyroid health, athletes should focus on: Prioritizing quality sleep Managing training-related stress Following a well-rounded diet Monitoring thyroid levels regularly Taking care of thyroid health ensures you’re getting the most out of your training efforts. sbb-itb-2f7d8a0 5. IGF-1 Blood Test The IGF-1 blood test measures muscle growth, recovery, and tissue development influenced by growth hormone activity. IGF-1 works alongside growth hormone to support tissue building and muscle protein synthesis. Understanding IGF-1's Role About 75% of IGF-1 is produced in the liver [18]. Unlike growth hormone, which fluctuates throughout the day, IGF-1 levels remain steady, making it a reliable marker for assessing average growth hormone activity [16][17]. IGF-1 Function Impact on Performance Muscle Growth Promotes protein synthesis and muscle development Recovery Activates satellite cells to aid muscle repair Metabolism Improves insulin sensitivity and glucose uptake Bone Health Contributes to bone growth and strength Testing Considerations The United States Anti-Doping Agency (USADA) highlights the importance of medical oversight when it comes to IGF-1: "IGF-1 is produced in response to physiological or pharmaceutical growth hormone (GH), and is responsible for many of the anabolic effects of GH. It can enhance the production of lean muscle as well as aid in recovery time, but when used without medical necessity, exogenous IGF-1 can cause serious harm." [15] Supporting IGF-1 Naturally Boost IGF-1 levels through a diet rich in protein and selenium, paired with progressive strength training. Age-Related Trends IGF-1 levels naturally rise during childhood, peak during puberty, and decline with age. Always refer to age-specific ranges for accurate interpretation. Performance Benefits IGF-1 can improve athletic performance in several ways: Stimulating satellite cells to repair and rebuild muscle fibers Activating the mTOR pathway to increase protein synthesis Reducing protein breakdown by inhibiting FoxO-1 Enhancing insulin sensitivity for better glucose uptake [18] Regular IGF-1 testing can help fine-tune your training plan while ensuring compliance with anti-doping regulations. 6. Estradiol Measurement Estradiol testing is valuable for both male and female athletes aiming to improve their performance. This hormone plays a role in muscle growth, recovery, bone strength, and overall hormone balance, making it an important factor in crafting an effective performance strategy. Normal Reference Ranges Understanding baseline estradiol levels is essential for accurate analysis: Gender/Status Normal Range (pg/mL) Male 10–50 Female (Premenopausal) 30–400 Female (Postmenopausal) 0–30 Impact on Athletic Performance Balanced estradiol levels contribute to muscle strength, recovery, bone density, fat distribution, and mood stability. Studies indicate that estradiol can enhance muscle recovery and strength [20]. Testing Considerations Accurate estradiol measurements require sensitive testing methods. Opt for FDA-approved techniques to ensure reliable results. Warning Signs In men, estradiol levels above 40 pg/mL may indicate potential performance issues. Low estradiol levels can result in: Reduced bone density Slower muscle recovery Sexual health challenges Increased fat accumulation [19] Identifying these imbalances early helps fine-tune training and overall health strategies. Optimization Strategies To maintain healthy estradiol levels: Engage in strength training and maintain a balanced body composition Follow an anti-inflammatory diet rich in vitamin D and calcium Manage stress effectively and prioritize good sleep For athletes using performance-enhancing substances, avoid excessive estradiol suppression, as it can cause negative health effects [19]. Making informed adjustments based on estradiol levels can lead to better training outcomes. Regular Monitoring Incorporate estradiol testing into your routine hormone panel checks to refine your performance strategy and identify any additional markers for optimization. 7. DHEA Blood Test The DHEA blood test is a useful tool for monitoring hormonal health. DHEA, a steroid hormone produced mainly by the adrenal glands, plays a key role in the production of testosterone and estrogen. Understanding DHEA Levels DHEA-S (sulfate) levels naturally vary based on age and gender. They typically peak during puberty and slowly decline as you age. Since lab reference ranges can differ, it's important to review your results with a healthcare provider. How DHEA Affects Performance DHEA can influence athletic performance in several ways: It supports muscle growth when combined with resistance training. It helps reduce muscle damage and soreness with doses of about 100 mg daily. It aids in maintaining hormonal balance as a precursor to testosterone and estrogen [22] [23]. When Should You Test? Athletes might consider testing if they notice signs like unexplained fatigue, reduced performance, difficulty building or maintaining muscle, slow recovery, or other hormonal imbalance symptoms. Women experiencing menstrual irregularities or signs of virilization might also benefit from testing. Identifying these issues early can help you address potential setbacks. What High or Low Levels Mean High DHEA-S levels: Could indicate conditions like congenital adrenal hyperplasia, adrenal tumors, or polycystic ovary syndrome (PCOS). Low DHEA-S levels: May suggest adrenal insufficiency or hypopituitarism. They might also reflect the natural decline in hormone production with age. Tips for Maintaining Healthy DHEA Levels Athletes looking to maintain or improve their DHEA levels can take these steps: Use trusted providers like Discounted Labs for hormone panels at over 2,200 U.S. locations. Get regular tests every three to six months to track changes. Prioritize quality sleep, manage stress, and follow a balanced diet to support overall hormonal health. Key Points to Remember DHEA supplements are banned by the World Anti-Doping Agency (WADA) [21]. Research shows that plasma DHEA-S levels can drop by up to 80% between ages 25 and 75 [22]. Regular blood tests and professional guidance are essential for keeping your hormones in check and staying on top of your performance. 8. LH and FSH Testing LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone) tests offer insight into hormonal balance and endocrine health, especially for athletes and bodybuilders. These hormones, produced by the pituitary gland, play key roles in reproductive health. What Do LH and FSH Do? In men, LH stimulates the Leydig cells in the testes to produce testosterone, which is crucial for sperm production. FSH, on the other hand, supports the development of healthy sperm. For women, LH is involved in triggering ovulation and regulating the menstrual cycle, while FSH helps ovarian follicles grow and mature. Normal LH levels in men aged 20 to 70 usually range from 0.7 to 7.9 IU/L [25]. These functions highlight why testing is important, particularly when performance or recovery issues arise. When Should You Get Tested? Consider testing LH and FSH levels if you notice: Unexplained fatigue or a drop in performance Loss of muscle mass or strength Low sex drive Irregular menstrual cycles (for female athletes) Struggles with workout recovery What Do Test Results Mean? Elevated levels may indicate ovarian or testicular failure, while low levels could point to problems with the pituitary gland or hypothalamus. These imbalances can result from chronic stress, overtraining, poor recovery, or nutritional gaps [26]. Supporting Healthy Hormone Levels To maintain balanced LH and FSH levels, athletes can: Eat a well-rounded diet Adjust training intensity as needed Prioritize recovery time Address insulin resistance through dietary changes [24] Consider a Mediterranean-style diet to support overall hormonal health The Importance of Regular Monitoring Routine testing helps athletes keep track of their hormone levels and address imbalances early. Consulting healthcare professionals ensures proper interpretation of results and helps guide effective interventions. This is particularly important for competitive athletes, as prolonged training stress can disrupt the hypothalamus and reduce LH production [24]. Conclusion Regular hormone testing plays a crucial role for athletes who want to fine-tune their performance. Research shows that up to 85% of people may deal with hormonal imbalances [27], making these tests an important tool for staying in top physical shape. For instance, a testosterone-to-cortisol ratio drop of 30% or more can signal poor recovery and overtraining [28]. Experts like Dr. Zane Hauck and Dr. Mini Sara Cherian highlight how blood tests help athletes adjust workload, recovery, and overall health [1][29]. These insights ensure training programs are based on solid data. To get the most out of hormone testing, athletes should keep these factors in mind: Timing Matters: Tests should account for variables like time of day, hydration, training intensity, and - for women - the menstrual cycle [30]. Diet Adjustments: Results may suggest dietary changes. For example, consuming up to 2 grams of protein per kilogram of body weight and maintaining moderate fat intake can help keep hormone levels in check [30]. Recovery Insights: Monitoring hormones can guide recovery strategies and help avoid overtraining [30]. From testosterone to LH/FSH, each test adds to a comprehensive view of hormonal health. Fortunately, FDA-approved labs across the country now widely offer these tests, making it easier than ever for athletes to maintain optimal hormonal health.

Table of Contents SHBG and the Free Testosterone Relationship What Causes High SHBG? Other factors that can contribute to high SHBG include:   Get Your Levels Checked: SHBG Test, Free & Total Testosterone Test How to Lower SHBG Levels: Very Low SHBG : Low SHBG has also been associated with: Is SHBG an Enemy of Hormone? - Emerging Studies References: Testosterone is the primary and dominant male hormone. It is responsible for numerous functions within the human body in men and women, and when levels are too low, it can lead to multiple health issues. Unfortunately, as many know, testosterone levels naturally decline as we age. Numerous external factors can contribute to lower levels of testosterone. In either case, age or external, symptoms occur, problems arise, and solutions are needed to stop the decline. For many men, testosterone replacement therapy (TRT) is the answer to this problem.  Men should ensure that their testosterone free and total, estradiol and other hormone factors are within normal levels. One of those hormone tests to monitor is the Sex Hormone Binding Globulin (SHBG) test.   SHBG and the Free Testosterone Relationship   When our body produces testosterone or provides it exogenously, a set level of testosterone flows through the body. This testosterone blood level can be measured precisely through a simple blood test aptly referred to as the Total Testosterone blood test. For most adult men, when testing their total testosterone, if it falls in the 350 ng/dl to 1100 ng/dl range, this will be considered medically optimal. Such individuals, even exhibiting low testosterone symptoms, will often not be prescribed TRT. In some cases, this may be a correct diagnosis; in other cases, symptoms exist for different reasons, but in most cases, something else is at play, which makes SHBG important.   While useful, measuring total testosterone is only useful with also measuring Free Testosterone. Free testosterone is a small fraction of your total testosterone. It is often referred to as "unbound," meaning the testosterone your body will use for its intended androgenic function. Free testosterone is so important that if your total testosterone levels are within range, if free testosterone levels are low, in most cases, the man will be symptomatic of low testosterone. This issue is often due to high levels of SHBG in the body.   For this reason, many men will attempt to lower their SHBG or even fret over it. However, SHBG serves an essential purpose. As is with estrogen, too much can be problematic, but so can too little. SHBG is no different.   Of all the testosterone flowing through your body, only 2% is what we can refer to as unbound or free testosterone. From a layman's perspective, to increase free and unbound testosterone, they'd need to increase their total testosterone. Unfortunately, it doesn't always work that way – it often helps and often fixes the issue, but not always – and here's why: our testosterone is bound to albumin and sex hormone-binding globulin (SHBG). Approximately one-third of total testosterone binds to albumin, and the rest to SHBG.   Albumin is a protein that binds testosterone, and we can say it does so loosely. This protein carries testosterone through the bloodstream and releases it as needed. The testosterone detaches and becomes what's often referred to as bioavailable or free testosterone. The testosterone that separates from albumin becomes the testosterone that influences your body's functions from sex organs, muscle tissue, brain function, and a host of other areas of bodily function. Testosterone attached to SHBG cannot do this; it is attached and does not detach.   What Causes High SHBG?   As testosterone attached to SHBG is relatively useless, if SHBG levels increase within the body, there will be more attaches and less free testosterone to circulate. Conversely, lower levels of SHBG are associated with higher levels of free testosterone, which is often associated with positive influences on bodily functions, such as libido, mood, muscle mass, etc.   Numerous factors influence how much sex hormone-binding globulin we have in our bodies. Age is one of the primary factors that affect SHBG. Often as we age, SHBG levels increase, and as a result, free testosterone levels go down. Even if our total testosterone levels remain high or optimal, our bioavailable testosterone decreases if SHBG levels increase.   Other factors that can contribute to high SHBG include: Fatty Liver Excessive or what we might call chronic alcohol consumption can lead to a fatty liver and impending higher levels of SHBG and corresponding lower levels of free testosterone. The disease can also be a factor, such as cirrhosis or cancer. Thyroid issues An underactive and overactive thyroid can lead to elevated SHBG, not to mention issues associated with the thyroid. Overactive thyroid or hyperthyroidism is often associated with graves' disease, thyroid nodules, or thyroiditis. It can also exist due to abuse of thyroid medications, such as Cytomel (T3). Underactive thyroid or hypothyroidism may be caused by inflammation of the thyroid gland, pituitary damage, too little iodine in the diet, or genetic factors, along with other possible reasons. Elevated estradiol High levels of estradiol can occur for numerous reasons, which are not limited to using certain antibiotics, some mental health medications, obesity, and abuse of exogenous testosterone. Obesity & High triglycerides While not as expected of a factor for increasing SHBG, being overweight with a low lipid profile can negatively impact. Inflammation While some level of inflammation is necessary for general health in the fight against disease or injury, what we might call chronic inflammation can lead to increases in SHBG and corresponding lower levels of free testosterone   Get Your Levels Checked: SHBG Test, Free & Total Testosterone Test   Testing your SHBG levels along with both total and free testosterone is particularly important if one wants to get to the bottom of hypogonadism (low testosterone) symptoms they may be experiencing. Remember, a total testosterone test alone, which some physicians will run, is not enough. For most adult men, SHBG levels will run between 10 nmol/L and 60 nmol/L if in the optimal range. If SHBG levels are greater than 60 nmol/L and your free testosterone is less than 2% of your total testosterone, there is a good chance your SHBG levels are too high.   Discounted Labs sells several lab test panels that measure SHBG levels that you can buy without a doctor's visit:   Testosterone (Total and Free), SHBG, CBC - Hematocrit, Ultrasensitive Estradiol and PSA   Testosterone, Free, Bioavailable and Total (Upper Limit T 1,500 ng/dL) plus SHBG   CBC, CMP, TT, FT, Lipids, Prolactin, Ultra-Sensitive Estradiol, and SHBG   Testosterone, Free, Bioavailable, and Total, LC/MS (No Upper Limit) plus SHBG   As we now understand SHBG, our next question is what can be done to lower it, increasing free testosterone in the body? There is nothing we can do about aging. As each day passes, we grow older, but there are still things we can do that will improve this factor.   How to Lower SHBG Levels:   The most obvious answer to the problem of low free testosterone and high levels of SHBG is to increase testosterone. Exercise more, consume a cleaner diet, and lose weight; all of these things will increase your testosterone levels. Your levels may not increase massively, but some increase means a higher total to pull from and a greater amount of free testosterone based on the 2% fraction. If this isn't enough - perhaps you're not reaching a 2% fraction due to elevated SHBG – one may need to consider talking to their doctor about testosterone supplementation. However, even if supplementing with exogenous testosterone, the habits mentioned are good for overall health and can only have a positive impact.   Another possible solution, and one of the more commonly needed, is lowering estradiol levels in the body. We tend to think estrogen hormones are needed for females only, but they are also crucial for men, granted in smaller amounts. As it pertains to estrogen, too much estradiol can lead to elevated levels of SHBG. If testosterone levels are also low, this can lead to even more negative factors. But it's important not to get carried away as estradiol that's too low will bring with it numerous symptoms; in fact, your life could be miserable in that regard.   Many men who are at least somewhat familiar with testosterone have been wrongly been told that too much testosterone can lead to gynecomastia due to elevated levels of estrogen in the body due to the aromatization of testosterone to estrogen. But low levels of testosterone in the body with present high levels of SHBG and estradiol can have the effect of causing gynecomastia. In order to combat high levels of estradiol, avoiding certain foods, especially those that are soy-based, will be important. Equally important is living a healthy lifestyle and incorporating what was mentioned above: adequate exercise, a healthy diet, and getting enough sleep. These things will help lower estradiol. Some men will also need medical help through medications known as aromatase inhibitors if they have gynecomastia, although most men on TRT do not need an AI. Too many men have relied on aromatase inhibitors out of fear for too many years. In reality, most men who supplement with exogenous testosterone can, in fact, control estrogen via non-medicated factors.   Some studies have shown that supplementation with DHEA (Dehydroepiandrosterone) may also lower SHBG. However, more study is needed to understand this properly, as too much DHEA can prove problematic. High doses of DHEA supplements have been associated with increased estradiol, so you must speak to your doctor first before beginning such a supplementation regimen.   Very Low SHBG :   We are then left with one factor we've yet to discuss much because it isn't all that common: low SHBG, or rather, levels of SHBG that are too low. Levels of SHBG that are too low may be an indicator of other underlying health issues. This may be an indicator of a metabolic problem. Low levels of SHBG are a standard indicator of those with diabetes. It doesn't appear, as data suggests, that insulin resistance is caused by low SHBG, but it may be a useful marker. More data is currently needed on this topic.   An A1c test will be needed to know with certainty in terms of your diabetic health.   While low SHBG is not a common concern for most men, new data has produced interesting results and information. A recent study published in the Journal of Clinical Endocrinology and Metabolism provides such information.   The process showed a man with undetectable levels of SHBG and low levels of testosterone accompanied by nearly a decade of hypogonadism symptoms. They discovered a family with a missense mutation in the SHBG gene from studying this individual. Interestingly enough, they found this issue did not interfere with the individual's spermatogenesis or general gonadal development. This leads the study to conclude SHBG may not play a significant role in the maturation of the male species physiologically or sexually.   More interesting than the JCEM study is things that new data suggest may negatively impact all men. Low levels of SHBG have recently been associated with three medical conditions that are known to be the silent killers of many men: heart disease, metabolic syndrome, and diabetes. Again, currently, it is being viewed as a marker and not as direct causation, but this new information is important as it acknowledges that more studies must be done.   Low SHBG has also been associated with:   Obesity Obesity is a factor we all well understand and is an issue that leads to problems in many health areas, and often in numerous possible directions. Cushing Disease It is associated with extended exposure to high levels of cortisol. Hypothyroidism It is associated with an under-active thyroid. Excessive levels of growth hormone Exceedingly rare for most, although possible via genetic factors or abuse of exogenous forms. Abuse through anabolic steroids     Is SHBG an Enemy of Hormone? - Emerging Studies   As we mentioned, androgens like testosterone and DHEA and estrogens are transported to the sex hormone binding globulin (SHBG). SHBG is believed to keep sex hormones inactive and to control the amount of free hormones that enter cells by passive diffusion. Contrary to the free hormone hypothesis, some researchers have demonstrated that megalin, a receptor in ovaries and testicles, acts as a pathway for cellular uptake of biologically active androgens and estrogens bound to SHBG. We will see more data on this newly found receptor that actually enables the body to use hormones bound to SHBG in the near future.   In endocrinology, the body has no “harmful” or “good” hormone. Their balance and harmony with each other matters for the best health.     References:   Ding et al. Sex hormone-binding globulin and risk of type 2 diabetes in women and men. The New England Journal of Medicine. Aug 2009. Vos et al. Sex Hormone Binding Globulin Deficiency Due to a Homozygous Missense Mutation. Journal of Clinical Endocrinology and Metabolism. Sept 2014 SHBG and Free Testosterone - Everything You Need to Know Hammes et al. Role of Endocytosis in Cellular Uptake of Sex Steroids. Cell. Sept 2005