My Thoughts on Blood Testing

DrJMW

Community Veteran, Fitness Consultant
Thanks to thefantom1 for inviting me to the Board.

Blood testing needs to be done three times to get baseline readings. As a minimum, you want to test:

1. Cortisol, Total (367)
2. DHEA Sulfate (402)
3. IGF-1 (839)
4. IGFBP-3 (34458)
5. T3, Free (34429)
6. T4, Free (866-78)
7. TSH (899-75)
8. Testosterone, Total, Free and Weakly Bound (30741)
9. Hemoglobin A1C (496-39)
10. Fasting Insulin (561)

Cardiovascular

11. CBC (6399-20)
12. Comprehensive Metabolic Panel (10231-92)
13. Lipid Panel (7600-4)

Other

14. GGT (482-31) Important Liver Value not included in Comp Metabolic Panel
15. PSA (5363-64)

Your first test should be before starting an Anabolic Androgenic Steroids (AAS) cycle. You should be "clean" before the blood testing. The second test should be in the middle of the Anabolic Androgenic Steroids (AAS) cycle. The last test should be about 5-6 weeks into your recovery cycle. These three snapshots will give you all the information you need to properly plan cycles. Taking the results, along with your fitness goals, safe and effective cycles can be planned. Blood Testing will only need to be repeated once a year after this as a method of checking.

I hate to say it, but blood testing should be mandatory; otherwise, you are just experimenting and this is what gives Hormone Replacement Therapy (HRT) a bad name. The other problem is getting your own doc to order these tests. If he won't find someone who will (myself or other anti-aging/longevity type docs--there is one in every major city, you just ahve to find him/her.) Lastly, don't rely on your insurance. If you insurance picks up the tab, great. If it doesn't, be prepared to pay. All of the money spent on testing and the meds is an investment in your health and fitness. Don't let some third-party control your destiny.

I look forward to contributing more to the Board.
 
Welcome DrJMW. For those that don't know DrJMW is a real doctor and is very educated on AS. Very glad to see you over here doc.
 
good bro

drjmw is a good bro he provided some email advice to me last year , very helpful
 
Hi Doc, first let me say welcome. If you could check my blood work below and let me know what you think. My doc says all looks good except the LDL which is a little high. I ave more info but I'm not to sure what send you.Thanks. ps, age 41
no cycle in the past 3 year. Going to start 3/1

T4 - 1.4
T3 - 37
TEST,TOT - 5.1
HDL - 66
LDL - 156

DrJMW said:
Thanks to thefantom1 for inviting me to the Board.

Blood testing needs to be done three times to get baseline readings. As a minimum, you want to test:

1. Cortisol, Total (367)
2. DHEA Sulfate (402)
3. IGF-1 (839)
4. IGFBP-3 (34458)
5. T3, Free (34429)
6. T4, Free (866-78)
7. TSH (899-75)
8. Testosterone, Total, Free and Weakly Bound (30741)
9. Hemoglobin A1C (496-39)
10. Fasting Insulin (561)

Cardiovascular

11. CBC (6399-20)
12. Comprehensive Metabolic Panel (10231-92)
13. Lipid Panel (7600-4)

Other

14. GGT (482-31) Important Liver Value not included in Comp Metabolic Panel
15. PSA (5363-64)

Your first test should be before starting an Anabolic Androgenic Steroids (AAS) cycle. You should be "clean" before the blood testing. The second test should be in the middle of the Anabolic Androgenic Steroids (AAS) cycle. The last test should be about 5-6 weeks into your recovery cycle. These three snapshots will give you all the information you need to properly plan cycles. Taking the results, along with your fitness goals, safe and effective cycles can be planned. Blood Testing will only need to be repeated once a year after this as a method of checking.

I hate to say it, but blood testing should be mandatory; otherwise, you are just experimenting and this is what gives Hormone Replacement Therapy (HRT) a bad name. The other problem is getting your own doc to order these tests. If he won't find someone who will (myself or other anti-aging/longevity type docs--there is one in every major city, you just ahve to find him/her.) Lastly, don't rely on your insurance. If you insurance picks up the tab, great. If it doesn't, be prepared to pay. All of the money spent on testing and the meds is an investment in your health and fitness. Don't let some third-party control your destiny.

I look forward to contributing more to the Board.
 
Re: Re: My Thoughts on Blood Testing

XXX said:
Hi Doc, first let me say welcome. If you could check my blood work below and let me know what you think. My doc says all looks good except the LDL which is a little high. I ave more info but I'm not to sure what send you.Thanks. ps, age 41
no cycle in the past 3 year. Going to start 3/1

T4 - 1.4
T3 - 37
TEST,TOT - 5.1
HDL - 66
LDL - 156

First, thank you all for the warm welcome. I am looking forward to some intelligent discussion and I will try to post as much relevant info as I can. With all due respect, the Total Testosterone report is incomplete. I should see a reading for Total Testos, Free Testos, and Weakly Bound Testos. Second, Total Testos is usually reported in NG/DL..what units are your results in? Second, the most important statistic on the Lipid Panel is the LDL to HDL ratio. This has to be calculated by you or the doc. Your ratio is 2.36, which is normal. (Anything below 3 is considered normal). I would be more concerned about the elevated LDL if the ratio was elevated. The easiest thing to do to "normalize" one's HDL's and LDL's is to go a low carb diet for 4-5 weeks. You are OK.
 
DrJMW......I always thought that the cholesterol ratio was calculated by dividing one's "total chol" by "HDL" , or are they two completly different ratios ?

Here is an example of my last blood work results.

LIPID PROFILE......07/02............01/03............normal range
Cholesterol...........6.04..............4.67...............[<5.2]mmol/L
Triglyceride...........2.02..............1.12...............[<2.3]mmol/L
HDL Cholesterol....0.21..............0.99...............[>.90]mmol/L
LDL ""................4.91..............3.17...............[<3.4]mmol/L
Total Chol/HDL Ratio..28.8..............4.7................*
*males; avg=5,less than 3.5(low risk), greater than 9(high risk)
 
Re: Re: Re: My Thoughts on Blood Testing

This test was from a physical I had last week. I guess that's what i get from HMO insurance
I've been on a low carb diet for the past four week now. Will the fats that I'm eating raise the LDL levels?
Thanks again,

DrJMW said:
First, thank you all for the warm welcome. I am looking forward to some intelligent discussion and I will try to post as much relevant info as I can. With all due respect, the Total Testosterone report is incomplete. I should see a reading for Total Testos, Free Testos, and Weakly Bound Testos. Second, Total Testos is usually reported in NG/DL..what units are your results in? Second, the most important statistic on the Lipid Panel is the LDL to HDL ratio. This has to be calculated by you or the doc. Your ratio is 2.36, which is normal. (Anything below 3 is considered normal). I would be more concerned about the elevated LDL if the ratio was elevated. The easiest thing to do to "normalize" one's HDL's and LDL's is to go a low carb diet for 4-5 weeks. You are OK.
 
Welcome to the board bro.

I am just wondering what your opinion is of aromatase blockers, especially fermara, and its impacts on the cholesterol profile, what do you think is the best method for combating the negative impact. Would garlic supps be a good option?
 
I just was referred to this post. I have a couple of observations to offer.

Yours is indeed a good, comprehensive panel. However, I have not been drawing DHEA because, IMPO, there is no real value in spending money on this assay. Low DHEA and low testosterone are well correlated. Also, you cannot increase T levels in males through DHEA supplemention, so why monitor same?

Next, I just run what is called a "Bioavailable Testosterone". I say this for the readers out there who may see it listed, but not know that is the sum of the Free T and that which is loosely bound to proteins such as albumin. That is where the real bang for the buck comes from.

Finally, this is a proper Anti-Aging panel (perhaps with homocycteine assay added), but isn't necessarily what steroid athletes are looking for, as it includes assays which are of no real use to them. For instance, the IGFBP-3 would be a waste in this case.

I would definitely add (for the case of a true Hormone Replacement Therapy (HRT) work-up) Prolactin and Estradiol (must be specified as a "sensitive" assay for males, aka "Extraction Method" per Quest Diagnostics Nichols Institute). NO hormonal work-up is complete without Estradiol, and this is also an important assay for Anabolic Androgenic Steroids (AAS) athletes as well. And 5-8% of hypogonadism (back to Hormone Replacement Therapy (HRT) stuff now) is associated with hyperprolactinemia. Elevated levels of same may also provide a marker for a pituitary tumor, as cause of hypogonadism.

As prostate cancer is rare in men under the age of fifty, I wouldn't waste money on a PSA in men under the age of forty. Also, heavy androgen supplementation such as Anabolic Androgenic Steroids (AAS) use will definitley boost PSA, especially with all that bouncing around the guys do on their prostates secondary to their wildly increased libido. LOL.

I think we have to be careful to separate out that which is of value to steroid athletes (as this is what this Forum is about) from the true Hormone Replacement Therapy (HRT) work-up. We have a hard enough itme getting them to monitor their health while "on", and since most will either elect, or have to, pay for the labs themselves, I don't want the expense to be any greater than it has to be.
 
Darko--The AI's damage the Lipid Profile only when they are allowed to drive estrogen levels too low. This is why they must never be used during PCT.
 
SWALE said:
I just was referred to this post. I have a couple of observations to offer.

PARDON THE CAPS. I REALLY LIKE THESE COMMENTS.

Yours is indeed a good, comprehensive panel. However, I have not been drawing DHEA because, IMPO, there is no real value in spending money on this assay. Low DHEA and low testosterone are well correlated. Also, you cannot increase T levels in males through DHEA supplemention, so why monitor same?

I TEND TO AGREE WITH YOU. PART OF THE AGING PROCESS INTERFERS WITH THE CONVERSION OF DHEA TO TESTOSTERONE. THIS STILL A DEBATABLE SUBJECT AMONG ANTI-AGERS. THE ONLY THING ABOUT THE DHEA-S TESTING IS IT IS ONE LINK IN A LONG CHAIN TO THE FABRICATION OF TESTOS. WE ARE ABLE TO RETRACE "UP-THE-LINE" TO SEE WHERE THE DEFICIENCY IS. AGAIN, WE COULD PROBABLY DO WITHOUT THIS TEST.

Next, I just run what is called a "Bioavailable Testosterone". I say this for the readers out there who may see it listed, but not know that is the sum of the Free T and that which is loosely bound to proteins such as albumin. That is where the real bang for the buck comes from.

I TEND TO AGREE WITH THIS AS WELL. PERSONALLY, I THINK THE FREE TESTOS LEVEL IS MOST IMPORTANT, FOLLOWED BY THE BIOAVAILABLE. I REALLY DO LIKE LOOKING AT THE FULL PICTURE (TOTAL TESTOS, FREE TESTOS, BIOAVAILABLE TESTOS, ALBUMIN AND SHBG).

Finally, this is a proper Anti-Aging panel (perhaps with homocycteine assay added), but isn't necessarily what steroid athletes are looking for, as it includes assays which are of no real use to them. For instance, the IGFBP-3 would be a waste in this case.

IT IS IMPORTANT TO KNOW THE IGFBP-3 LEVELS ALONG WITH THE IGF-1. THEY DO NOT ALWAYS CORRELATE. GH DEFICIENCY AND GH RESISTANCE WILL LOOK DIFFERENT GIVEN THE RESULTS OF IGF-1 AND IGFBP-3. INTERESTINGLY, MANY ATHLETES HAVE LOW IGF-1 AND HIGH IGFBP-3.

I would definitely add (for the case of a true Hormone Replacement Therapy (HRT) work-up) Prolactin and Estradiol (must be specified as a "sensitive" assay for males, aka "Extraction Method" per Quest Diagnostics Nichols Institute). NO hormonal work-up is complete without Estradiol, and this is also an important assay for Anabolic Androgenic Steroids (AAS) athletes as well. And 5-8% of hypogonadism (back to Hormone Replacement Therapy (HRT) stuff now) is associated with hyperprolactinemia. Elevated levels of same may also provide a marker for a pituitary tumor, as cause of hypogonadism.

I USED TO INCLUDE ESTRADIOL EXTRACTION AND PROLACTIN. ALL OF THE RESULTS (I AHVE SEEN TO DATE) HAVE COME BACK NORMAL PRE-CYCLE. IF PROPERLY MEDICATED, THE ESTRADIOL AND PROLACTIN LEVELS STAY NORMAL OR DECREASE DURING A CYCLE, AS DEMONSTRATED BY BLOOD TEST RESULTS. I JUST DIDN'T FIND THESE TELLING. I SHOULD ADD LH TO THE BASELINE TESTING. IT IS VERY IMPORTANT TO DETERMINE WHY NATURAL TESTOS LEVELS ARE LOW. IT COULD BE A TESTICULAR PROBLEM OR IT COULD BE A PITUITARY PROBLEM OR IT COULD BE LOTS OF STEPS IN BETWEEN.

As prostate cancer is rare in men under the age of fifty, I wouldn't waste money on a PSA in men under the age of forty. Also, heavy androgen supplementation such as Anabolic Androgenic Steroids (AAS) use will definitley boost PSA, especially with all that bouncing around the guys do on their prostates secondary to their wildly increased libido. LOL.

IN SOME PEOPLE, EXOGENOUS TESTOS WILL BOOST DHT. I AM MOST CONCERNED WITH DHT'S EFFECT ON THE PROSTATE. THIS IS PRECAUTIONARY. IT IS ALSO DEBATABLE AS TO WHETHER THIS TEST IS NEEDED OR ACCURATE, BUT IT IS THE BEST WE HAVE FOR NOW. OTHER SIDES OF EXCESSIVE DHT INCLUDE ACNE AND HAIRLOSS (KIND OF LIKE PUTERY ALL OVER AGAIN). PROSTATE PROBLEMS ARISE FROM EXCESSIVE DHT AND LACK OF USE OF THE GLAND.

I think we have to be careful to separate out that which is of value to steroid athletes (as this is what this Forum is about) from the true Hormone Replacement Therapy (HRT) work-up. We have a hard enough itme getting them to monitor their health while "on", and since most will either elect, or have to, pay for the labs themselves, I don't want the expense to be any greater than it has to be.

I AGREE WITH THE ECONOMICS OF THIS. I KNOW THAT I AM ALWAYS OPEN TO SUGGESTIONS, AND I AM WILLING TO MAKE CHANGES TO MY FORMAT. SO FAR THIS YEAR, I AHVE BEEN PLEASED WITH THIS BLOOD TEST FORMAT. IT REALLY ONLY NEEDS TO BE RUN TWO TIMES AND THEN PERIODCIALLY, MODIFICATIONS DEPENDING ON THE CYCLING AND PROBLEMS FOUND. BOTTOM LINE: IT IS FOOLISH TO PROCEED TO ELECTIVELY USE Anabolic Androgenic Steroids (AAS) AND ANCILLARIES WITHOUT BLOOD TESTING.
 
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