Blood testing....a necessity in AAS usage


A Comprehensive Look at Lab Tests
by Cy Willson

You just had some blood work done, and the friggin' doctor or his nurses are guarding the results as if they're state secrets. However, after much cajoling and explaining that you'd like to at least be an informed partner in your own goshdarn health care, they begrudgingly give you a copy of your lab tests.

Trouble is, as much as you've been posturing about how you've had more than a smattering of medical education, you still can't figure out what half the tests are for and whether or not those abnormal values are anything to worry about.

Well, in the following article, I'm going to go over each of the most common tests. I'll include why it's performed, what it tells you, and what the typical ranges are for normal humans. That way, you'll have something more to go on in assessing your health other than your family doctor saying, "Well, these few values are a little worrisome, but you'll probably be okay."

One note, though, before I get started. The values I'll be listing are merely averages and the ranges may vary slightly from laboratory to laboratory. Also, if there's only one range given, it applies to both men and women.

Lipid Panel — Used to determine possible risk for coronary and vascular disease. In other words, heart disease.

HDL/LDL and Total Cholesterol

These lipoproteins should look rather familiar to most of you. HDL is simply the "good" lipoprotein that acts as a scavenger molecule and prevents a buildup of material. LDL is the "bad" lipoprotein which collects in arterial walls and causes blockage or a reduction in blood flow. The total cholesterol to HDL ratio is also important. I went in to detail about this particular subject — as well as how to improve your lipid profile — in my article "Bad Blood".

Nevertheless, a quick remonder: your HDL should be 35 or higher; LDL below 130; and total to HDL ratio should be below 3.5. Oh and don't forget VLDL (very low density lipoprotein) which can be extremely worrisome. You should have less than 30 mg/dl in order to not be considered at risk for heart disease.

On a side note, I'm sure some of you are wishing that you had abnormally low plasma cholesterol levels (as if it's something to brag about), but the fact is that having extremely low cholesterol levels is actually indicative of severe liver disease.


Triglycerides are simply a form of fat that exists in the bloodstream. They're transported by two other culprits, VLDL and LDL. A high level of triglycerides is also a risk factor for heart disease as well. Triglycerides levels can be increased if food or alcohol is consumed 12 to 24 hours prior to the blood draw and this is the reason why you're asked to fast for 12-14 hours from food and abstain from alcohol for 24 hours. Here are the normal ranges for healthy humans.

16-19 yr. old male
40-163 mg/dl

Adult Male
40-160 mg/dl

16-19 yr. old female
40-128 mg/dl

Adult Female
35-135 mg/dl


Unfortunately, this test isn't always ordered by the doctor. It should be. Homocysteine is formed in the metabolism of the dietary amino acid methionine. The problem is that it's a strong risk factor for atherosclerosis. In other words, high levels may cause you to have a heart attack. A good number of lifters should be concerned with this value as homocysteine levels rise with anabolic steroid usage.

Luckily, taking folic acid (about 400-800 mcg.) as well as taking a good amount of all B vitamins in general will go a long way in terms of preventing a rise in levels of homocysteine.

Normal ranges:

Males and Females age 0-30
4.6-8.1 umol/L

Males age 30-59
6.3-11.2 umol/L

Females age 30-59
4.5-7.9 umol/L

>59 years of age
5.8-11.9 umol/L

The Hemo Profile

These are various tests that examine a number of components of your blood and look for any abnormalities that could be indicative of serious diseases that may result in you being an extra in the HBO show, "Six Feet Under."

WBC Total (White Blood Cell)

Also referred to as leukocytes, a fluctuation in the number of these types of cells can be an indicator of things like infections and disease states dealing with immunity, cancer, stress, etc.

Normal ranges:



This is one type of white blood cell that's in circulation for only a very short time. Essentially their job is phagocytosis, which is the process of killing and digesting bacteria that cause infection. Both severe trauma and bacterial infections, as well as inflammatory or metabolic disorders and even stress, can cause an increase in the number of these cells. Having a low number of neutrophils can be indicative of a viral infection, a bacterial infection, or a rotten diet.

Normal ranges:

2,500-8,000 cells per mm3

RBC (Red Blood Cell)

These blood cells also called erythrocytes and their primary function is to carry oxygen (via the hemoglobin contained in each RBC) to varioustissues as well as giving our blood that cool "red" color. Unlike WBC, RBC survive in peripheral blood circulation for approximately 120 days. A decrease in the number of these cells can result in anemia which could stem from dietary insufficiencies. An increase in number can occur when androgens are used. This is because androgens increase EPO (erythropoietin) production which in turn increases RBC count and thus elevates blood volume. This is essentially why some androgens are better than others at increasing "vascularity." Anyhow, the danger in this could be an increase in blood pressure or a stroke.

Androgen-using lifters who have high values should consider making modifications to their stack and/or immediately donating some blood.

Normal ranges:

Adult Male
4,700,000-6,100,000 cells/uL

Adult Female
4,200,000-5,400,000 cells/uL


Hemoglobin is what serves as a carrier for both oxygen and carbon dioxide transportation. Molecules of this are found within each red blood cell. An increase in hemoglobin can be an indicator of congenital heart disease, congestive heart failure, sever burns, or dehydration. Being at high altitudes, or the use of androgens, can cause an increase as well. A decrease in number can be a sign of anemia, lymphoma, kidney disease, sever hemorrhage, cancer, sickle cell anemia, etc.

Normal ranges:

Males and females 6-18 years
10-15.5 g/dl

Adult Males
14-18 g/dl

Adult Females
12-16 g/dl


The hematocrit is used to measure the percentage of the total blood volume that's made up of red blood cells. An increase in percentage may be indicative of congenital heart disease, dehydration, diarrhea, burns, etc. A decrease in levels may be indicative of anemia, hyperthyroidism, cirrhosis, hemorrhage, leukemia, rheumatoid arthritis, pregnancy, malnutrition, a sucking knife wound to the chest, etc.

Normal ranges:

Male and Females age 6-18 years

Adult Men

Adult Women

MCV (Mean Corpuscular Volume)

This is one of three red blood cell indices used to check for abnormalities. The MCV is the size or volume of the average red blood cell. A decrease in MCV would then indicate that the RBC's are abnormally large(or macrocytic), and this may be an indicator of iron deficiency anemia or thalassemia. When an increase is noted, that would indicate abnormally small RBC (microcytic), and this may be indicative of a vitamin B12 or folic acid deficiency as well as liver disease.

Normal ranges:

Adult Male
80-100 fL

Adult Female
79-98 fL

12-18 year olds
78-100 fL

MCH (Mean Corpuscular Hemoglobin)

The MCH is the weight of hemoglobin present in the average red blood cell. This is yet another way to assess whether some sort of anemia or deficiency is present.

Normal ranges:

12-18 year old
35-45 pg

Adult Male
26-34 pg

Adult Female
26-34 pg

MCHC (Mean Corpuscular Hemoglobin Concentration)

The MCHC is the measurement of the amount of hemoglobin present in the average red blood cell as compared to its size. A decrease in number is an indicator of iron deficiency, thalassemia, lead poisoning, etc. An increase is sometimes seen after androgen use.

Normal ranges:

12-18 year old
31-37 g/dl

Adult Male
31-37 g/dl

Adult Female
30-36 g/dl

RDW (Red Cell Distribution Width)

The RDW is an indicator of the variation in red blood cell size. It's used in order to help classify certain types of anemia, and to see if some of the red blood cells need their suits tailored. An increase in RDW can be indicative of iron deficiency anemia, vitamin B12 or folate deficiency anemia, and diseases like sickle cell anemia.

Normal ranges:

Adult Mal

Adult Female


Platelets or thrombocytes are essential for your body's ability to form blood clots and thus stop bleeding. They're measured in order to assess the likelihood of certain disorders or diseases. An increase can be indicative of a malignant disorder, rheumatoid arthritis, iron deficiency anemia, etc. A decrease can be indicative of much more, including things like infection, various types of anemia, leukemia, etc.

On a side note for these ranges, anything above 1 million/mm3 would be considered a critical value and should warrant concern and/or giving second thoughts as to whether you should purchase a lifetime subscription to Muscle Media.

Normal ranges:

(Most commonly displayed in SI units of 150-400 x 10(9th)/L

(Most commonly displayed in SI units of 150-400 x 10(9th)/L

ABS (Differential Count)

The differential count measures the percentage of each type of leukocyte or white blood cell present in the same specimen. Using this, they can determine whether there's a bacterial or parasitic infection, as well as immune reactions, etc.

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As explained previously, severe trauma and bacterial infections, as well as inflammatory disorders, metabolic disorders, and even stress can cause an increase in the number of these cells. Also, on the other side of the spectrum, a low number of these cells can indicate a viral infection, a bacterial infection, or a deficient diet.

Percentile Range:



These cells, and in particular, eosinophils, are present in the event of an allergic reaction as well as when a parasite is present. These types of cells don't increase in response to viral or bacterial infections so if an increased count is noted, it can be deduced that either an allergic response has occurred or a parasite has taken up residence in your shorts.

Percentile Range:



Lymphocytes and Monocytes

Lymphocytes can be divided in to two different types of cells: T cells and B cells. T cells are involved in immune reactions and B cells are involved in antibody production. The main job of lymphocytes in general is to fight off — Bruce Lee style — bacterial and viral infections.

Monocytes are similar to neutrophils but are produced more rapidly and stay in the system for a longer period of time.

Percentile Range:



Selected Clinical Values


This cation (an ion with a postive charge) is mainly found in extracellular spaces and is responsible for maintaining a balance of water in the body. When sodium in the blood rises, the kidneys will conserve water and when the sodium concentration is low, the kidneys conserve sodium and excrete water. Increased levels can result from excessive dietary intake, Cushing's syndrome, excessive sweating, burns, forgetting to drink for a week, etc. Decreased levels can result from a deficient diet, Addison's disease, diarrhea, vomiting, chronic renal insufficiency, excessive water intake, congestive heart failure, etc. Anabolic steroids will lead to an increased level of sodium as well.

Normal range:

136-145 mEq/L


On the other side of the spectrum, you have the most important intracellular cation. Increased levels can be an indicator of excessive dietary intake, acute renal failure, aldosterone-inhibiting diuretics, a crushing injury to tissues, infection, acidosis, dehydration, etc. Decreased levels can be indicative of a deficient dietary intake, burns, diarrhea or vomiting, diuretics, Cushing's syndrome, licorice consumption, insulin use, cystic fibrosis, trauma, surgery, etc.

Normal range:

3.5-5 mEq/L


This is the major extracellular anion (an ion carrying a negative charge). Its purpose it is to maintain electrical neutrality with sodium. It also serves as a buffer in order to maintain the pH balance of the blood. Chloride typically accompanies sodium and thus the causes for change are essentially the same.

Normal range:

98-106 mEq/L

Carbon Dioxide

The CO2 content is used to evaluate the pH of the blood as well as aid in evaluation of electrolyte levels. Increased levels can be indicative of severe diarrhea, starvation, vomiting, emphysema, metabolic alkalosis, etc. Increased levels could also mean that you're a plant. Decreased levels can be indicative of kidney failure, metabolic acidosis, shock, and starvation.

Normal range:

23-30 mEq/L


The amount of glucose in the blood after a prolonged period of fasting (12-14 hours) is used to determine whether a person is in a hypoglycemic (low blood glucose) or hyperglycemic (high blood glucose) state. Both can be indicators of serious conditions. Increased levels can be indicative of diabetes mellitus, acute stress, Cushing's syndrome, chronic renal failure, corticosteroid therapy, acromegaly, etc. Decreased levels could be indicative of hypothyroidism, insulinoma, liver disease, insulin overdose, and starvation.

Normal range:

Adult Male
65-120 mg/dl

Adult Female
65-120 mg/dl

BUN (Blood Urea Nitrogen)

This test measures the amount of urea nitrogen that's present in the blood. When protein is metabolized, the end product is urea which is formed in the liver and excreted from the bloodstream via the kidneys. This is why BUN is a good indicator of both liver and kidney function. Increased levels can stem from shock, burns, dehydration, congestive hear failure, myocardial infarction, excessive protein ingestion, excessive protein catabolism, starvation, sepsis, renal disease, renal failure, etc. Causes of a decrease in levels can be liver failure, overhydration, negative nitrogen balance via malnutrition, pregnancy, etc.

Normal range:

10-20 mg/dl


Creatinine is a byproduct of creatine phosphate, the chemical used in contraction of skeletal muscle. So, the more muscle mass you have, the higher the creatine levels and therefore the higher the levels of creatinine. Also, when you ingest large amounts of beef or other meats that have high levels of creatine in them, you can increase creatinine levels as well. Since creatinine levels are used to measure the functioning of the kidneys, this easily explains why creatine has been accused of causing kidney damage, since it naturally results in an increase in creatinine levels.

However, we need to remember that these tests are only indicators of functioning and thus outside drugs and supplements can influence them and give false results, as creatine may do. This is why creatine, while increasing creatinine levels, does not cause renal damage or impair function. Generally speaking, though, increased levels are indicative of urinary tract obstruction, acute tubular necrosis, reduced renal blood flow (stemming from shock, dehydration, congestive heart failure, atherosclerosis), as well as acromegaly. Decreased levels can be indicative of debilitation, and decreased muscle mass via disease or some other cause.

Normal range:

Adult Male
0.6-1.2 mg/dl

Adult Female
0.5-1.1 mg/dl

BUN/Creatinine Ratio

A high ratio may be found in states of shock, volume depletion, hypotension, dehydration, gastrointestinal bleeding, and in some cases, a catabolic state. A low ratio can be indicative of a low protein diet, malnutrition, pregnancy, severe liver disease, ketosis, etc. Keep in mind, though, that the term BUN, when used in the same sentence as hamburger or hotdog, usually means something else entirely. An important thing to note again is that with a high protein diet, you'll likely have a higher ratio and this is nothing to worry about.

Normal range:



Calcium is measured in order to assess the function of the parathyroid and calcium metabolism. Increased levels can stem from hyperparathyroidism, metastatic tumor to the bone, prolonged immobilization, lymphoma, hyperthyroidism, acromegaly, etc. It's also important to note that anabolic steroids can also increase calcium levels. Decreased levels can stem from renal failure, rickets, vitamin D deficiency, malabsorption, pancreatitis, and alkalosis.

Normal range:

9-10.5 mg/dl

Liver Function

Total Protein

This measures the total level of albumin and globulin in the body. Albumin is synthesized by the liver and as such is used as an indicator of liver function. It functions to transport hormones, enzymes, drugs and other constituents of the blood.

Globulins are the building blocks of your body's antibodies. Measuring the levels of these two proteins is also an indicator of nutritional status. Increased albumin levels can result from dehydration, while decreased albumin levels can result from malnutrition, pregnancy, liver disease, overhydration, inflammatory diseases, etc. Increased globulin levels can result from inflammatory diseases, hypercholesterolemia (high cholesterol), iron deficiency anemia, as well as infections. Decreased globulin levels can result from hyperthyroidism, liver dysfunction, malnutrition, and immune deficiencies or disorders.

As another important side note, anabolic steroids, growth hormone, and insulin can all increase protein levels.

Normal range:

Total Protein: 6.4-8.3 g/dl
Albumin: 3.5-5 g/dl
Globulin: 2.3-3.4 g/dl

Albumin/Globulin Ratio:



Bilirubin is one of the many constituents of bile, which is formed in the liver. An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation. Drugs that may increase bilirubin include oral anabolic steroids (17-AA), antibiotics, diuretics, morphine, codeine, contraceptives, etc. Drugs that may decrease levels are barbiturates and caffeine. Non-drug induced increased levels can be indicative of gallstones, extensive liver metastasis, and cholestasis from certain drugs, hepatitis, sepsis, sickle cell anemia, cirrhosis, etc.

Normal range:

Total Bilirubin for Adult
0.3-1.0 mg/dl

Alkaline Phosphatase

This enzyme is found in very high concentrations in the liver and for this reason is used as an indicator of liver stress or damage. Increased levels can stem from cirrhosis, liver tumor, pregnancy, healing fracture, normal bones of growing children, and rheumatoid arthritis. Decreased levels can stem from hypothyroidism, malnutrition, pernicious anemia, scurvy (vitamin C deficiency) and excess vitamin B ingestion. As a side note, antibiotics can cause an increase in the enzyme levels.

Normal range:

16-21 years
30-200 U/L

30-120 U/L

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AST (Aspartate Aminotransferase, previously known as SGOT)

This is yet another enzyme that's used to determine if there's damage or stress to the liver. It may also be used to see if heart disease is a possibility as well, but this isn't as accurate. When the liver is damaged or inflamed, AST levels can rise to a very high level (20 times the normal value). This happens because AST is released when the cells of that particular organ (liver) are lysed. The AST then enters blood circulation and an elevation can be seen. Increased levels can be indicative of heart disease, liver disease, skeletal muscle disease or injuries, as well as heat stroke. Decreased levels can be indicative of acute kidney disease, beriberi, diabetic ketoacidosis, pregnancy, and renal dialysis.

Normal range:

0-35 U/L (Females may have slightly lower levels)

ALT (Alanine Aminotransferase, previously known as SGPT)

This is yet another enzyme that is found in high levels within the liver. Injury or disease of the liver will result in an increase in levels of ALT. I should note however, that because lesser quantities are found in skeletal muscle, there could be a weight-training induced increase . Weight training causes damage to muscle tissue and thus could slightly elevate these levels, giving a false indicator for liver disease. Still, for the most part, it's a rather accurate diagnostic tool. Increased levels can be indicative of hepatitis, hepatic necrosis, cirrhosis, cholestasis, hepatic tumor, hepatotoxic drugs, and jaundice, as well as severe burns, trauma to striated muscle (via weight training), myocardial infarction, mononucleosis, and shock.

Normal range:

4-36 U/L

Endocrine Function

Testosterone (Free and Total)

This is of course the hormone that you should all be extremely familiar with as it's the name of this here magazine! Anyhow, just as some background info, about 95% of the circulating Testosterone in a man's body is formed by the Leydig cells, which are found in the testicles. Women also have a small amount of Testosterone in their body as well. (Some more than others, which accounts for the bearded ladies you see at the circus, or hanging around with Chris Shugart.) This is from a very small amount of Testosterone secreted by the ovaries and the adrenal gland (in which the majority is made from the adrenal conversion of androstenedione to Testosterone via 17-beta HSD).

Nomal range, total Testosterone:


Age 14
<1200 ng/dl

Age 15-16
100-1200 ng/dl

Age 17-18
300-1200 ng/dl

Age 19-40
300-950 ng/dl

Over 40
240-950 ng/dl


Age 17-18
20-120 ng/dl

Over 18
20-80 ng/dl

Normal range, free Testosterone:

50-210 pg/ml

LH (Luteinizing Hormone)

LH is a glycoprotein that's secreted by the anterior pituitary gland and is responsible for signaling the leydig cells to produce Testosterone. Measuring LH can be very useful in terms of determining whether a hypogonadic state (low Testosterone) is caused by the testicles not being responsive despite high or normal LH levels (primary), or whether it's the pituitary gland not secreting enough LH (secondary). Of course, the hypothalamus — which secretes LH-RH (luteinizing hormone releasing hormone) — could also be the culprit, as well as perhaps both the hypothalamus and the pituitary.

If it's a case of the testicles not being responsive to LH, then things like clomiphene and hCG really won't help. If the problem is secondary, then there's a better chance for improvement with drug therapy. Increased levels can be indicative of hypogonadism, precocious puberty, and pituitary adenoma. Decreased levels can be indicative of pituitary failure, hypothalamic failure, stress, and malnutrition.

Normal ranges:

Adult Male
1.24-7.8 IU/L

Adult Female
Follicular phase: 1.68-15 IU/L
Ovulatory phase: 21.9-56.6 IU/L
Luteal phase: 0.61-16.3 IU/L
Postmenopausal: 14.2-52.3 IU/L


With this being the most potent of the estrogens, I'm sure you're all aware that it can be responsible for things like water retention, hypertrophy of adipose tissue, gynecomastia, and perhaps even prostate hypertrophy and tumors. As a male it's very important to get your levels of this hormone checked for the above reasons. Also, it's the primary estrogen that's responsible for the negative feedback loop which suppresses endogenous Testosterone production. So, if your levels of estradiol are rather high, you can bet your ass that you'll be hypogonadal as well.

Increased estradiol levels can be indicative of a testicular tumor, adrenal tumor, hepatic cirrhosis, necrosis of the liver, hyperthyroidism, etc.

Normal ranges:

Adult Male
10-50 pg/ml

Adult Female
Follicular phase: 20-350 pg/ml
Midcycle peak: 150-750 pg/ml
Luteal phase: 30-450 pg/ml
Postmenopausal: 20 pg/ml or less

Thyroid (T3, T4 Total and Free, TSH)

T3 (Triiodothyronine)

T3 is the more metabolically active hormone out of T4 and T3. When levels are below normal it's generally safe to assume that the individual is suffering from hypothyroidism. Drugs that may increase T3 levels include estrogen and oral contraceptives. Drugs that may decrease T3 levels include anabolic steroids/androgens as well as propanolol (a beta adrenergic blocker) and high dosages of salicylates. Increased levels can be indicative of Graves disease, acute thyroiditis, pregnancy, hepatitis, etc. Decreased levels can be indicative of hypothyroidism, protein malnutrition, kidney failure, Cushing's syndrome, cirrhosis, and liver diseases.

Normal ranges:

16-20 years old
80-210 ng/dl

20-50 years
75-220 ng/dl or 1.2-3.4 nmol/L

Over 50
40-180 ng/dl or 0.6-2.8 nmol/L

T4 (Thyroxine)

T4 is just another indicator of whether or not someone is in a hypo or hyperthyroid state. It too is rather reliable but free thyroxine levels should be assessed as well. Drugs that increase of decrease T3 will, in most cases, do the same with T4. Increased levels are indicative of the same things as T3 and a decrease can be indicative of protein depleted states, iodine insufficiency, kidney failure, Cushing's syndrome, and cirrhosis.

Normal ranges:

Adult Male
4-12 ug/dl or 51-154 nmol/L

Adult Female
5-12 ug/dl or 64-154 nmol/L

Free T4 or Thyroxine

Since only 1-5% of the total amount of T4 is actually free and useable, this test is a far better indicator of the thyroid status of the patient. An increase indicates a hyperthyroid state and a decrease indicates a hypothyroid state. Drugs that increase free T4 are heparin, aspirin, danazol, and propanolol. Drugs that decrease it are furosemide, methadone, and rifampicin. Increased and decreased levels are indicative of the same possible diseases and states that are seen with T4 and T3.

Normal ranges:

0.8-2.8 ng/dl or 10-36 pmol/L

TSH (Thyroid Stimulating Hormone)

Measuring the level of TSH can be very helpful in terms of determining if the problem resides with the thyroid itself or the pituitary gland. If TSH levels are high, then it's merely the thyroid gland not responding for some reason but if TSH levels are low, it's the hypothalamus or pituitary gland that has something wrong with it. The problem could be a tumor, some type of trauma, or an infarction.

Drugs that can increase levels of TSH include lithium, potassium iodide and TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine, T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and congenital cretinism. Decreased levels are indicative of hypothyroidism (pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.

Normal ranges:

2-10 uU/ml or 2-10 mU/L

Knowing how to interpret these tests can be a very valuable tool in terms of health and your body building and athletic progress. Use your new knowledge wisely!
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This character who calls himself "Cy Willson", in an attempt to make people think he's smarter than he is by insulting physicians, has made a few very simple and basic errors in his post.

I also find it ironic that he chooses to insult whomever he was initially responding to, when he himself does not know how to order, and interpret the labs he claims to be such an expert on.

To wit:
1. It is irresponsible to posture the medical community as being against creating informed patients. Indeed, the best patients are informed ones, and everyone knows and accepts this. He is trying to create an antagonistic environment which only serves to damage Doctor/Patient relationship, because it then becomes a self-fulfilling prophecy. This phenomenon has been well-proven.

2. Patient records are also property of the patient. I have yet to see a single instance where ANY physician has refused to share results. In fact, such would be cause for review by the Medical Board. Of note, I have fielded a couple of complaints from patients that such seemed to be the case, but when I investigated it found it was really a matter of a lack of communication between the two parties. THERE is where we should be focusing our efforts.

3. Doctors sometimes say "Well, these few values are a little worrisome, but you'll probably be okay" exactly because, given the circumstance, that is EXACTLY the best response. The given situation around any and every medical condition can be very complicated, and it may include dealing with patients who cannot comprehend complex information, relating to family members, trying to get a patient to relax (when doing so is best for the patient), etc.

4. The ranges "Cy" gives as being acceptible for the Lipid Profile do not reflect optimum health by any means.

5. If you had severe hepatic disease, your CHOL levels would be the last of your concerns.

6. He is completely incorrect in saying that a physician is remiss if he does not order a homocysteine level on each and every patient. What hogwash! One of the first things a lowly medical student learns in his/her first year of clinical experience is to always ask themself "what am I going to do with the results of this test?" Meaning, "will it in any way change my treatment?" AN "expert" such as "Cy Willson" should know this. Most Anabolic Androgenic Steroids (AAS) athletes are young, fit, and well-supplemented patients. Therefore, screening for homocysteine levels (especially in absence of documented family history of severe CAD) is a waste of precious health care dollars. Of note, many of my patientsd pay for their labs with cash, so I am very careful not to waste their hard-earned dollars. They trust me to look out for them. Finally, if homocysteine levels are known to rise with Anabolic Androgenic Steroids (AAS) use, what are you going to do with the results anyway?

I find it ironic that this guy seems so worried about the Lipid Profile, when his "recovery protocol" will only extend the time before the components of same return to baseline--thus resulting in unnecessarily causing plaque deposition within the lining of the cardiovascular system. I tried repeatedly to explain this to him, without success.

7. There is no evidence whatsoever that androgen-induced erythropoiesis results in greater vascularity. Also, doing so does not necessarily increase the blood pressure, and it's only the systolic IF it does.

8. RDW is an indicator of how fast the body is producing RBC's. Not whatever it is "Cy" is claiming. Perhaps he should invest in a Physiology book before claiming elite "expert" status.

9. I think he missed a good opportunity to state that use of creatine products elevate serum creatinine levels. An "expert" would have.

10. The important thing about the BUN/creatinine ratio is that when it reaches 20, that means the patient is dehydrated. Seeing this on a lab printout mean that other values are probably falsely elevated by sero-concentration. This could cause mis-diagnosed liver dysfunction or polycythemia, for instance. That is why I always tell my patients to remember to still drink water while fasting for their labs. This is another example where the author should know how to actually use these tests before writing about them.

11. I guess I just don't put as much emphasis on the ALT assay as he does. I see levels that are quite elevated in strength athletes who are not using steroids. It would have been nice to mention GGT in this section, which has much greater value as a marker for steroid-induced hepatotoxicity.
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I went to my doctor to have a blood test done. I specifically requested to have my total and free test, DHT, LH, and estradiol levels tested. After giving me a nice lecture about how test levels vary so drastically and that there was nothing I could do about them (heh heh), she told me that I couldn't get it tested anyway because I would need a frozen sample. I told her to get whatever I could get tested, since I had already been fasting for 12 hours to get an accurate measurement of glucose. I got a copy of the results today and, lo and behold, testosterone is on there and listed as 325ng/dL, but no free test or anything else. Is my doctor screwing with me or do I really need a frozen sample for the rest?

LH requires a frozen sample, but am not sure about any of the others. The labs take care of all this, anyway (typical doctor's response!).

LH DOES vary tremendously, so is of limited value. I get them more to look for highly ELEVATED concentrations, as that would lead to a diagnosis of a specific kind of secondary hypogonadism. I also get a FSH, which has a half-life 8 times longer than LH, so has less variability and therefore more value. Also, the relationship between LH and FSH is of interest to me.

Also, Free Testosterone is being given MUCH too much emphasis lately. The assay of choice is Bioavailable (aka "Free and Loosely Bound") Testosterone, which is the concentration actually available in the capillary beds surrounding the muscles. It may be up to 50 times the value of Free Testosterone.

Yes, serum T levels fluctuate. But we generally grab a sample in the morning, and we sort of assume it's of value then (when it is more likely to be higher).
Thanks for the quick response. My sample was taken at 11am in the morning, and I am 20. How I've managed to build muscle (about 20 lbs in a little over a year) at 325 is beyond me. I'm going to try to go back and convince my doc to give me a prescription to get blood work done on a frozen sample taken at the lab. I'd like to find out whether it's my hypothalamus, pituitary, or testes that are shortchanging me... haha!... and whether I can treat it any way besides exogeneous testosterone (nolva, clomid or hcg).

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You don't need to worry about this frozen section stuff. The labs know what to do, and they will take care of it automatically.

Clomid has been shown to increase srum T levels, but is worthless as testosterone replacement therapy (TRT). If it worked, all Hormone Replacement Therapy (HRT) doctors would be giving guys a couple pills each day instead of worrying about injections.

Many Hormone Replacement Therapy (HRT) doctors use Human Chorionic Gonadotropin (HCG) as sole testosterone replacement therapy (TRT), but I no longer do. It just doesn't make sense to me any more, for a variety of reasons.
A quote from an anti-aging website:

Testosterone, depending on the laboratory, is measured in nanograms per deciliter (ng/dl)—the number of billionths of a gram found in 100 milliliters of blood serum. The “normal range” usually reported on a laboratory report runs from about 290 to 900 ng/dl. The problem with this “normal range” is that it is determined by using a standard Gaussian distribution (bell-shaped curve) of all of the patients who, at one time or another, for various reasons have had their blood tested for testosterone. The lower number is equal to two standard deviations below the average and the higher number two above it. Two standard deviations means that if you are below the 290, then your testosterone level is in the bottom 2.5 percent of all male testosterone levels. Unfortunately, most doctors think that if the test value falls in the “normal” range, then there is no problem. What they don’t understand is that the groups of men that form the basis of this normal range at most laboratories are not homogeneous. They can be 80 years old, or 20 years old; they can be chronically ill, or very healthy; they can be obese or thin; and they can be under a great deal of stress or stress free. All of these conditions can profoundly alter a man’s testosterone level.

The medical definition of hypogonadism generally uses a level below 300 ng/dl because virtually all men below this range exhibit the signs and symptoms discussed above. But what about a level of 350 or 450 ng/dl? The difference between a man with this level and a man who meets the cut off for “hypogonadism” is less than between him and a man with a level of 800 ng/dl. And what about the average level of about 600; is it adequate or does a man with a level of 900 feel better, have denser bones, stronger muscles, and greater sexual potency? A clue to the answer is thinking back to how you felt when you were 18 years old, a time when testosterone levels run between about 800 and 1500.

I'm perfectly healthy and just turned 20 and fall barely within the normal range depending on who you ask. But as the article notes, that's most likely not the normal range for 20 year olds, but the normal range for 20-80 year olds. I don't know if I should pursue Hormone Replacement Therapy (HRT) at my age (your opinion?), but I know that my doctor won't bother listening to what I have to say about it. I'm going to have followup work done at a lab as soon as I can, and that's probably going to be the determining factor for me, as to whether I go to someone else. It so happens that the quote I took is from a center here in New York.

I think they did a real nice job of describing the situation.

Real Hormone Replacement Therapy (HRT) doctors know that men are healthiest and happiest in the top quartile of "normal" range for total testosterone.

Were I you, I'd contact that clinic and make an appointment.
do you tell the doc you have juiced or what? Or do you just go in and tell him you want your bloodwork done just because you feel you need it. Does it cost money to have the bloodwork done if you have insurance?
I haven't juiced (was planning on it in 3-4 months though now I'm probably going to hold off), and yes the blood work is free with my insurance (Blue Cross). When I went and asked for blood work and specifically to have my testosterone tested, the doc basically told me that I shouldn't bother because there was nothing I could do about it. I countered by asking her what was so wrong about wanting to be informed. It shouldn't be much of a problem but if it is be persistent.

If you've had good post-cycle therapy in the past I would say that your levels should have stabilized down to baseline. But if they are abnormal, well, good thing you got it done! I think the common values to look out for after extended Anabolic Androgenic Steroids (AAS) use are the RBC and the rest of the lipid panel. Good luck.

Frankly, you need to find someone who is more comfortable with this situation.
my doctor was a punk about it because I told him I juiced so he did'nt want to help me so i went somewhere else and tried the more subtle approach and got all the help i needed ,,,,,,,,,,,,,it sucks you cant get help from certain doctors because they dont agree with you lifestyle , Im like look doc. why dont you just help me out cause im gonna go do what im gonna do whether you like it or not so atleast you'll know i wont be back in your office with a problem you could have helped prevent.
I wanted to point out that Physician-patient privilege does not apply in all jurisdictions in the USA. So basically disclosing your steroid use to a physician would not be the best idea since he could turn around and tip off the police who would possibly decide to investigate. You should be sure to make sure your state/jurisdiction has doctor patient privilege before you spout off to your doctor you're using illegal drugs. If the doctor does indeed tell someone you are then if in the proper jurisdiction you could sue the doctor(And any probably evidence that came from the doctors tip would be thrown out since it was obtained illegally).
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Dr/Pt confidentiality indeed applies in every single state in this country. Any physician who contacted Law Enforcement over a patient's Anabolic Androgenic Steroids (AAS) use would soon find him/herself on the receiving end of a significant challenge to their medical license, as well as a law suit from the injured party (should same decide to, and have the wherewithal).

It's not like hearing your patient is molesting children.

It is also important to note that no doctor HAS to acept you as a patient. "Steroid Use" is not one of the parameters identified as protected status.
SWALE said:
Dr/Pt confidentiality indeed applies in every single state in this country. Any physician who contacted Law Enforcement over a patient's Anabolic Androgenic Steroids (AAS) use would soon find him/herself on the receiving end of a significant challenge to their medical license, as well as a law suit from the injured party (should same decide to, and have the wherewithal).

It's not like hearing your patient is molesting children.

It is also important to note that no doctor HAS to acept you as a patient. "Steroid Use" is not one of the parameters identified as protected status.

I'm not sure it applies in all states. Do you have a source from that? I read on WIKIpedia and it said it didn't apply in all jurisidctions or states.

In the United States, the extent of the privilege varies depending on the law of the applicable state. For example, in Texas there is virtually no meaningful physician-patient privilege in criminal proceedings, and the privilege is limited in civil cases as well. See generally Texas Occupations Code section 159.003 and Texas Rules of Evidence, Rule 509(b).

I don't know if we should make a new thread for this discussion or keep it here either.