Bodybuilding is a tough sport and requires a lot of work and dedication, especially when it comes to maximizing benefits and minimizing side effects of testosterone and anabolic androgenic steroids (AAS). With the right training and nutrition, you can gain muscle, lose fat and get stronger. But you have to keep an eye on your health through chosen lab tests and panels, especially when there are obstacles to care brought by stigma and medical professionals’ judgment.

Proper nutrition, supplementation, and adequate rest are crucial for effective muscle recovery and overall training success. Insufficient recovery can lead to issues like overtraining and decreased performance.

In this article we will talk about harm reduction and list 14 lab tests and panels for bodybuilders to stay healthy while improving body composition and strength.

Bodybuilders who use testosterone and anabolic androgenic steroids (AAS) need to be smart about maximizing benefits and minimizing short-term and long-term side effects while exercising and eating well for muscle gain, fat loss, and quality of life. Anabolic hormones like growth hormone, testosterone, and insulin are key to muscle growth and strength training. This way they can get the most out of their testosterone and AAS use. Reduced harm is important, especially when there are obstacles to care like stigma and criticism from medical professionals.

Understanding Blood Tests for Bodybuilders

Blood tests are a crucial tool for bodybuilders to monitor their health, track their progress, and optimize their training and nutrition strategies. By understanding the importance of blood tests, bodybuilders can make informed decisions about their training and nutrition, and avoid potential health risks.

Importance of Blood Tests

Blood tests provide valuable insights into a bodybuilder’s overall health and fitness level. They can help identify potential issues with hormone balance, overtraining, and nutrition, and provide a baseline for tracking progress over time. Regular blood tests can also help bodybuilders detect any underlying health disorders that could affect their performance. For instance, a comprehensive metabolic panel can reveal imbalances in glucose levels, kidney function, and liver enzymes, which are critical for maintaining optimal health during intense training. By regularly monitoring these markers, bodybuilders can adjust their training and nutrition strategies to ensure they are supporting their muscle growth and overall health.

Bodybuilder Tests:

Here are 14 lab tests and panels to keep you healthy while improving body composition and strength:

Take blood sample after waking and before intense physical activity for accurate testing of specific health markers for male bodybuilders and weightlifters.

Complete blood count (CBC)

Here are the components of your blood that are measured by a complete blood count (CBC) test panel: red blood cells which carries oxygen; white blood cells which fights infection; hemoglobin which is the protein in red blood cells that carries oxygen; hematocrit which is the ratio of red blood cells to the fluid component in your blood (which correlates with blood thickness); and platelets which aids in blood clotting.

All androgens including testosterone and anabolic androgenic steroids (AAS) can increase red blood cells and its proportion in the blood (hematocrit) thus increasing blood thickness (polycythemia). High hematocrit is associated with cardiovascular disease, high blood pressure and headaches. This panel is important because it will tell you if you have reached 53 hematocrit which means you need to donate blood or undergo therapeutic phlebotomy.

Given the physical demands of intense training it’s important to monitor health markers like kidney and liver function through regular blood tests to prevent overstraining the body.

Tests included in the CBC panel:

  • White blood cell count (WBC or leukocyte count)

  • WBC differential count

  • Red blood cell count (RBC or erythrocyte count)

  • Hematocrit (Hct)

  • Hemoglobin (Hgb)

  • Mean corpuscular volume (MCV)

  • Mean corpuscular hemoglobin (MCH)

  • Mean corpuscular hemoglobin concentration (MCHC)

  • Red cell distribution width (RDW)

  • Platelet count

  • Mean Platelet Volume (MPV)

Complete Metabolic Profile (CMP)


The complete metabolic profile, also known as CMP panel, is a medical screening test that consists of 14 blood tests and is used to assess overall health. CMP blood test panel checks fluid and electrolyte balance, glucose level, kidney and liver function and electrolyte levels. FASTING IS REQUIRED.

Tests:

  • Glucose

  • Sodium

  • Potassium

  • Chloride

  • Carbon Dioxide

  • Calcium

  • Protein

  • Albumin

  • Alanine transaminase (ALT)

  • Aspartate transaminase (AST)

  • Bilirubin

  • Alkaline phosphatase (ALP)

  • Blood urea nitrogen (BUN)

  • Creatinine

  • eGFR

Lipid Profile


This panel includes LDL which is known as “bad cholesterol”, HDL which is known as “good cholesterol” and triglycerides (fatty acids in the blood). Higher dose of T or AAS may increase LDL cholesterol and decrease HDL cholesterol and triglycerides. Significant drop in HDL may lead to cardiovascular problems in the long run. FASTING IS NEEDED.

Cystatin C and EGFR Kidney Tests


Cystatin C is a more accurate way of measuring kidney function in individuals with higher muscle mass. This is because factors like increased muscle mass, protein intake and creatine supplementation can affect the use of creatinine as the primary variable. Cystatin C is more reliable. Estimated glomerular filtration rate is another parameter used to assess kidney function (eGFR). The rate at which fluid is filtered through the kidney is called glomerular filtration rate. Creatinine clearance rate, also known as CCRCr or CrCl, is a good estimate of glomerular filtration rate (GFR). It is the volume of blood plasma cleared of creatinine per unit of time. eGFR below 60 may indicate kidney function problems.

GGT Liver Test


The gamma-glutamyl transpeptidase (GGT) blood test looks for an enzyme or protein by that name in your blood. GGT stands for gamma-glutamyl transpeptidase. GGT is present in the cells of the liver. Your doctor can use this test to check for liver damage or the ducts that drain it. If the results of another blood test, alkaline phosphatase, is abnormal this test can also help to differentiate between liver diseases and bone diseases. Higher than normal results may indicate liver damage from diseases like hepatitis, cirrhosis, tumors or pancreatic cancer. GGT is not affected by resistance training unlike other liver enzymes in the CMP like AST and ALT. So using GGT is a more accurate way to know if a bodybuilder has liver disease.

Total testosterone was measured by liquid chromatography/mass spectrometry and free testosterone by equilibrium ultrafiltration.

Since the standard total testosterone test by immunoassay has a ceiling of 1,500 ng/dL, men with high testosterone cannot use the test. Testosterone replacement therapy (TRT) in bodybuilding can have significant implications, especially when combined with intense training and anabolic steroid use. It is crucial to be aware of the health risks associated with TRT and to conduct regular blood tests to monitor hormonal and health changes. Measuring luteinizing hormone (LH) along with testosterone is important to understand hormonal imbalances and optimize training and supplementation. The LC/MS test for testosterone has no ceiling. Some labs also provide calculated free testosterone instead of equilibrium ultrafiltration-based one which is more accurate for this value.

Ultra-Sensitive Estradiol (E2) Test


The estradiol level may be overestimated by the test used. This test uses immunoassay technology which cannot distinguish between C-Reactive Protein (involved in inflammation) and estradiol; so it interprets the combination of the two as estradiol. This ultrasensitive estradiol test uses assay technology called liquid chromatography/mass spectrometry (LC/MS) which is not limited by the above mentioned limitation. DHT analogs like oxandrolone can significantly lower estradiol levels which can cause joint pain and other problems related to low estradiol. Notice that only 0.4% of total testosterone is converted to estradiol during aromatization. The body does this to counteract the beneficial effect of estradiol on lipids which is a result of testosterone’s negative effect on lipids. When your total testosterone is high your estradiol will also be high. When you assume an aromatase inhibitor is needed you should be very careful. Click the link to know the effect of high and low estradiol levels on men’s health. How to measure estradiol levels with different dosages of testosterone.

Prolactin Test


Prolactin levels are a concern for many bodybuilders because of the correlation with erectile dysfunction.

DHT Test


This test measures the amount of dihydrotestosterone (DHT) in the blood. In some men excessive levels of dihydrotestosterone (DHT) is linked to acne, hair loss and benign prostatic inflammation while low levels is linked to low libido.

IGF-1 Test


Insulin-like Growth Factor 1, also known as IGF-1 is measured to determine the amount of human growth hormone in the blood. This hormone controls the growth and metabolism of glucose and is produced by the liver and other tissues. Lack of IGF-1 will prevent muscle growth.

Ferritin Test

Iron is stored in the body via ferritin. Iron is needed for the formation of red blood cells which carries oxygen throughout the body. Lack of ferritin in the blood is anemia. TRT and anabolics increases the production of red blood cells in the body (erythrocytosis). Because of the increased production, iron reserves and ferritin levels decreased. Additionally, thyroid hormones play a crucial role in regulating metabolism, energy levels, and body composition, which are essential for bodybuilders.

Testosterone decreases ferritin. Men who are on TRT or anabolics and have high hematocrit (thick blood due to TRT or anabolics) often donate blood or undergo phlebotomy. Every time you donate blood ferritin level drops by about 30 points on average. Low ferritin can cause various symptoms including tiredness, muscle aches and restless leg syndrome. Monitoring thyroid-stimulating hormone (TSH) is also important as part of a comprehensive evaluation of thyroid function for bodybuilders. TSH levels can significantly impact metabolism, energy levels, and overall performance.

Hormones and Muscle Growth

Hormones play a critical role in muscle growth and development. Understanding the role of hormones in bodybuilding can help bodybuilders optimize their training and nutrition strategies to promote muscle mass.

Role of Hormones in Bodybuilding

Hormones such as testosterone, growth hormone, and insulin-like growth factor-1 (IGF-1) are essential for muscle growth and development. Testosterone, in particular, is a key anabolic hormone that drives muscle growth and development in men. It promotes protein synthesis, which is crucial for muscle repair and growth after intense training sessions. Growth hormone and IGF-1 also play significant roles by stimulating muscle cell growth and increasing the uptake of amino acids into muscle cells. For women, oestrogen and growth hormone are important anabolic hormones that support muscle growth and development. By understanding the functions of these anabolic hormones, bodybuilders can tailor their training and nutrition strategies to maximize muscle mass and enhance performance.

Blood Test Results

Blood test results can be confusing especially for bodybuilders who are not familiar with medical terms. But understanding these results is key to making informed decisions on training and nutrition. A full blood test panel will give you insights on overall health and fitness including muscle growth, hormone levels and kidney function. By reading these results bodybuilders can adjust their training and nutrition plan to maximize performance and minimize health risks.

Results

When reading blood test results, always refer to the normal reference ranges for each biomarker. For example a testosterone level of 300-1000 ng/dL is normal for adult male. If the result is out of this range it means there’s an underlying issue that needs to be addressed. Bodybuilders should consult a healthcare professional to interpret their blood test results and create a plan to adjust their training and nutrition. This way any abnormality will be identified and managed immediately and overall health and performance will be supported.

Nutrition in Bodybuilding

Nutrition is a big part of bodybuilding and blood tests can give you insights on nutritional deficiencies or imbalances. A full metabolic panel can measure biomarkers such as glucose, electrolytes and liver enzymes which can tell you how well your body is utilizing nutrients. By knowing these markers bodybuilders can adjust their diet to make sure they are getting the necessary nutrients for muscle growth and recovery.

How Blood Tests Affects Nutrition Decisions

Blood tests can affect nutrition decisions by identifying potential deficiencies or imbalances. For example low vitamin D means you need to supplement or increase sun exposure. High cortisol means you need to reduce stress or adjust training and nutrition. By using blood test results to guide nutrition decisions bodybuilders can optimize their diet and training plan to support muscle growth and recovery. Blood tests can also help identify nutritional deficiencies that impact muscle recovery, emphasizing the importance of proper nutrition, supplementation, and adequate rest for effective muscle recovery and overall training success. This proactive approach will keep you at peak performance and overall health.

Common Nutrient Deficiencies

Nutrient deficiencies can negatively impact muscle growth and recovery. Common nutrient deficiencies in bodybuilders include iron, vitamin D, and magnesium deficiencies. Iron is essential for transporting oxygen to the muscles, which is vital for energy production during workouts. Vitamin D and magnesium are important for muscle function and recovery, helping to prevent muscle cramps and promote muscle relaxation. Protein is also essential for muscle growth and repair, but excessive intake can cause kidney damage. By regularly monitoring nutrient levels through blood tests, bodybuilders can identify deficiencies early and adjust their diet or supplementation accordingly. This proactive approach ensures that they are getting the necessary nutrients to support muscle growth, recovery, and overall health.

By understanding the importance of blood tests and the role of hormones in bodybuilding, bodybuilders can make informed decisions about their training and nutrition strategies to optimize their performance and promote muscle growth. Regular blood tests can help bodybuilders detect any underlying health disorders and avoid potential health risks, ensuring that they can continue to train and compete at their best.

How Often to Get Blood Tests

Frequency and timing of blood tests depends on individual goals and circumstances. Bodybuilders on hormone replacement therapy (HRT) or anabolic steroids need to get blood tests more frequently to monitor hormone levels and potential side effects. Monitoring helps to adjust dosages and prevent adverse effects so that the benefits of these therapies are maximized while minimizing risks.

How Often Should Bodybuilders Get Blood Tests?

As a general rule bodybuilders should get blood tests at least once a year to monitor overall health and fitness. But bodybuilders on HRT or anabolic steroids should get blood tests every 3-6 months to monitor hormone levels and potential side effects. Bodybuilders who are experiencing symptoms like fatigue, muscle weakness or joint pain should get blood tests more frequently to identify underlying issues. Blood testing is a proactive measure to ensure any health concern is addressed immediately and long term health and performance is supported.

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