Bodybuilder Lab Test Panel- Comprehensive
Bodybuilders using testosterone and anabolic androgenic steroids (AAS) have to be smart about maximizing benefits and minimizing short and long term side effects while exercising and eating effectively for proper muscle gain, fat loss, and quality of life. Harm reduction is key especially in the presence of barriers to care caused by stigma and judgement from medical practitioners. Here is a list of 14 carefully selected lab tests and panels that are essential in maintaining proper health while improving body composition and strength: Hematocrit, Lipid panel (LDL, HDL, triglycerides), Cystatin C kidney test, eGFR kidney test, GGT liver test, Total Testosterone (LC/MS), Free Testosterone (Equilibrium Ultrafiltration), Ultrasensitive Estradiol, Prolactin, DHT test (LC/MS), IGF-1 test (LC/MS), and ferritin. Fasting is required.
Bodybuilders using testosterone and anabolic androgenic steroids (AAS) have to be smart about maximizing benefits and minimizing short and long term side effects while exercising and eating effectively for proper muscle gain, fat loss, and quality of life. Harm reduction is key especially in the presence of barriers to care caused by stigma and judgement from medical practitioners. Here is a list of 14 carefully selected lab tests and panels that are essential in maintaining proper health while improving body composition and strength:
Complete Blood Count (CBC)
A complete blood count (CBC) test panel measures several components of your blood including:Red blood cells, which carry oxygen, White blood cells, which fight infection, Hemoglobin, the oxygen-carrying protein in red blood cells, Hematocrit, the proportion of red blood cells to the fluid component in your blood (which correlated with blood thickness), and Platelets, which help with blood clotting
All androgens like testosterone and AAS can increase red blood cells and its proportion in the blood (hematocrit), which can increase blood thickness (polycythemia). This panel is important since it determines when you are reaching a hematocrit of 53, the value that indicates that blood donation or therapeutic phlebotomy is needed. High hematocrit can cause high blood pressure, headaches, and cardiovascular risks.
Comprehensive Metabolic Panel (CMP)
The comprehensive metabolic panel or cmp panel consists of 14 blood tests which serve as an initial medical screening tool to review overall health. The CMP blood test panel functions as a check for glucose, kidney function, liver function, electrolyte and fluid balance. FASTING IS REQUIRED.
Lipid Test Panel
This panel includes LDL (bad cholesterol), HDL (good cholesterol), and triglycerides (fatty acids dissolved in the blood). Higher dose T and AAS can increase LDL, and decrease HDL and triglycerides. Severely decreased HDL may cause cardiovascular issues in the long term. FASTING IS REQUIRED.
Cystatin C with EGFR Kidney Test
Cystatin C is a more accurate way to determine kidney function in people with higher muscle mass since using creatinine as the main variable can be affected by not only higher muscle mass but also protein intake and creatine supplementation. Another one of the measures of kidney function is the estimated glomerular filtration rate (eGFR). Glomerular filtration rate describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. eGFR under 60 may indicate issues that are affecting kidnet function.
GGT Liver Test
The GGT blood test looks for an enzyme, or protein, called gamma-glutamyl transpeptidase (GGT) in your blood. GGT is found in liver cells. This test helps your doctor look for possible 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 normal test results could be a sign of 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 important variable.
Ultra-Sensitive Estradiol (E2) Test
The commonly used estradiol test may overestimate estradiol. That test uses immunoassay technology that cannot differentiate C-Reactive Protein (involved in inflammation) from estradiol, so it reads the combination of the two as estradiol. This ultrasensitive estradiol test is based on liquid chromatography/mass spectrometry (LC/MS), an assay technology that does not have that limitation. Furthermore, DHT analogs like oxandrolone may dramatically decrease estradiol causing joint aches and other low estradiol issues. Note: 0.4 percent of total testosterone aromatizes to estradiol. This is the body's way to balance testosterone's negative effect on lipids with estradiol's benefitial effect on lipids. If you total testosterone is high, so will your estradiol. Be very careful in assuming that an aromatase inhibitor is needed. For more information click on effect of high and low estradiol in men's health. How to predict estradiol for different testosterone doses.
Many bodybuilders worry about increased prolactin since it has been associated with erectile dysfunction.
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.
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 produced by the liver and other tissues which affects growth-promoting activities and glucose metabolism. Low IGF-1 may impede muscle growth.
Ferritin is a protein that stores iron. Red blood cells need iron to form normally and carry oxygen around your body. Low levels of ferritin lead to anemia. TRT and anabolics make the body make more red blood cells (erythrocytosis). This increased production decreases iron stores and ferritin.
Testosterone has been shown to decrease ferritin. Men on TRT and/or anabolics with high hematocrit (increased blood thickness caused by TRT/anabolics) usually donate blood or get a therapeutic phlebotomy to decrease hematocrit. There is a loss of around 30 points of ferritin during every donation. Low ferritin can cause fatigue, restless leg syndrome, muscle aches and other issues.
Other tests that may be of interest:
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Suggested Reading: Testosterone Replacement Blood Test Targets
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