Understanding Blood Tests

RedLang

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A few questions have come up recently regarding blood results. I thought i would round up some information to help those people who are on cycle, or on TRT to know what to look for with their results. I have added small snippets of information for each of the tests.

Please use this as a guide. If you have any health issues consult your physician.

Feel free to add suggestions to build on this!

To find a Blood Test, Press Control+F and type it into the search box. This will make it easier

Conversion of units can be done here - http://www.soc-bdr.org/rds/authors/unit_tables_conversions_and_genetic_dictionaries/e5196/index_en.html

Androgens

Testosterone Total
A total testosterone measurement is made up of free and bound testosterone. Testosterone is primarily bound to proteins like albumin and sex hormone binding globulin, the remaining (~2%) is free.

Standard Results
Male: 300 -1,000 ng/dL
Female: 15 - 70 ng/dL

Healthy males will want their total testosterone in the upper half of the range. Anything under 400ng/dl with classical symptoms may indicate underlying problems.

Testosterone Free
This is the unbound testosterone in the blood.

Standard Results
Male: 46 - 224 ng/dL

Sex Hormone Binding Globulin - SHBG
SHBG is a glycoprotien which most often binds itself to the primary sex hormones, oestradiol, progesterone and testosterone.

Standard Results
Male: 20 - 60 nmol/L
Female: 40 - 120 nmol/L

SHBG is ordered primarily when the total testosterone results do not seem to be consistent with clinical signs, such as decreased sex drive in men or hirsutism (excessive hair) in women.

Dehydro epiandrosterone Sulphate (DHEA-S)
Produced in the adrenal glands, this is the most abundant steroid in the human body. This test is usually ordered alongside other hormone tests when the patient presents symptoms of a decifient production of androgens, or hormone imbalances.

Standard Results
DHEA-S varies significantly depending on age.

Dihydrotestosterone - DHT
DHT is created through the 5AR enzyme reaction with Testosterone. DHT plays a role in sexual development, function and health. In adults, DHT is the primary androgen in the prostate in men and in the hair follicles in men and women. This is normally tested alongside other hormones to check balance.

Standard Results


Gonadal Hormones

Follicle Stimulating Hormone - FSH
This is released from the hypothalamus (through GnRH stimulation) and to stimulate Sertoli cells within the testicles, to initiate and regulate Spermatogenesis. When stimulated, the Sertoli cells also produce inhibin, which acts as negative feedback for the pituitary to stop FSH production. It is synergistic with Luteinizing hormone
In women, this stimulates ovarian follicles which are the basic units of reproduction. It also stimulates the production of estrogen.

Standard Results
Males: 1.5-12.4 mIU/mL
Female - Phases
Premenopausal: Follicular - 1.0-8.8 mIU/dL.
Mid-cycle - 4.0-25.0 mIU/mL.
Luteal - 1.0-5.1 mIU/mL

Low FSH is normal for people taking exogenous androgenic compounds. People with primary hypogonadism may have high levels of LH and FSH due to the lack of testosterone produced by the testicles.

Luteinizing hormone - LH
In Males, LH acts directly upon the leydig cells which are responsible for testosterone production in the testes.
In woman, it is a little more complicated. But it is involved in the production of estradiol, and also triggers ovulation.
In both sexes excessive prolactin, known as hyperprolactinemia, can also suppress LH.

Standard Results
Males: 1.8-8.6 IU/L
Females: 1-20 IU/L

Low LH in males, alongside low testosterone levels may indicate either excessive estradiol, or secondary hypogonadism.

In woman, low levels of LH are common with eating disorders, female athlete triad, high levels of stress and disorders of the pituitary or hypothalamus.

Oestradiol (E2)
Estradiol is the predominant sex hormone present in females. It is also present in males, produced in the testes, and also created through aromatisation of testosterone. Therefore as testosterone increases, so does estrogen.
Getting your ratio of E2 to Testosterone is most important.


Standard Results
Males: 14-55 pg/dl

In men, too little or too high E2 can cause
• Lethargic, and frequently fatigued.
• Headaches
• Depression
• Dry skin and hair
• Loss of libido
• Sore, achy joints
• Inability to concentrate
• Panic and anxiety sensations
• Potential cardiovascular risks
• Low bone density
• higher risks for osteoporosis and bone fractures

High levels of this hormone can cause
• Water retention
• Higher blood pressure
• Gynecomastia


Thyroid Function
The thyroid controls our rates of metabolism, our sensitivity to other hormones as well as the growth rate and other bodily processes.

Free T4
0.8 -2.8 ng/dL
Much more useful then total T4. Total T4 is highly effected by TBG

Total T4
4.5 -11.5 mg/dL

Total T3
75 -200 ng/dL

Reverse T3 (rT3)
90 -350 pg/mL

TSH
0.5 - 4.70 mIU/L

Thyroglobulin
5-25 ng/mL

Thyroid Antibodies

If your test shows you are below the minimum numbers, you may be suffering from hypothyroidism, or low thyroid. If your scores are above the normal range, you may have an overly active thyroid, or hyperthyroidism.


Haematology

Haemoglobin - HgB
This is the protien found in red blood cells that carries oxygen.

Standard Results
Men: 13 to 18 g/dL
Female: 12 to 16 g/dL

Use of AAS will produce increases HgB levels. Blood donation is common practice to reduce elevated HgB in AAS users.


Haematocrit - Hct
This is the volume percentage of red blood cells in blood.

Standard Results
Male: 40 - 50%
Female: 37 - 47%

Hct can be slightly effected by hydration levels. AAS are known to increase Hct as with HgB. Blood donation is common practice to reduce elevated Hct in AAS users.


Red Cell Count - RCC
This test can indicate if there is a problem with red blood cell production and/or lifespan, but it cannot determine the underlying cause. In addition to the full CBC, some other tests that may be performed at the same time or as follow up to establish a cause include a blood smear, reticulocyte count, iron studies, vitamin B12 and folate levels, and in more severe conditions, a bone marrow examination

Standard Results
Male: 4.5 - 6.5 x 10^12/L.
Female: 3.8 - 5.8 x 10^12/L

Some causes of a low RBC count include: Trauma, Acute or chronic bleeding from the digestive tract, kidney failure or nutritional deficiency.
Some causes of an increased RBC count include: Polycythemia, dehydration, smoking, EPO and AAS.


Mean corpuscular volume - MCV or also (Hct divided by RBC)
This test measures the average volume of red blood cells, or the average amount of space each red blood cell fills.

Standard Results
80-100 fL

Irregularities could indicate anemia, alcholism, or other blood problems.

White Cell Count - WCC also known as WBC
The WBC count is used to suggest the presence of an infection, an allergy, heavy stress or leukaemia. It is also used to help monitor the body’s response to various treatments and to monitor bone marrow function.


Some AAS can cause an increase or decrease in WCC. Other causes of changes in WCC are B12 deficiency, folate, and hypothyroidism.
Neutrophils
Standard Results
40-75%

Lymphocytes
Standard Results
20% to 40%

Monocytes
Standard Results
2% to 8%

Eosinophils
Standard Results
1% to 4%

Basophils
Standard Results
0.5% to 1%



Platelets
These are small cell fragments that circulate in the blood and aid in blood clotting. Excessive platelets can lead to clotting, while reduced number of platelets will increase the ease and amount of bruising.

Standard Results
150–450×109/L - or 150,000 - 450,000 per µL

ESR
This is the rate at which red blood cells sediment in a period of one hour. It is a non-specific measure of inflammation.
Standard Results
Ages 18-50: 1-20 mm/hour
Ages >50: 1-30 mm/hour


Iron Studies
Iron Studies are a set of blood tests to measure and estimate the amount of iron carried in the blood and stored in the body tissues.Iron stores are reflected by the ferritin level in this test, and levels may be decreased long before red blood cell production is affected and before actual anaemia develops

Too much iron can lead to damage to a number of organs, including the heart, liver, and pancreas where insulin is produced. The most common cause of iron excess is the genetic disease known as haemochromatosis.

Serum Iron
Diets high in red meat and iron fortified foods will increase the bodies iron stores.

Standard Results
60 - 170 mcg/dL

Total Iron Binding Capacity - TIBC
This is a blood test to see if you may have too much or too little iron in the blood. Iron moves through the blood attached to a protein called transferrin.

Standard Results
240-450 mcg/dL


Transferrin Saturation
The value of the transferrin saturation is calculated with the formula, Serum Iron level x100 divided by TIBC.This is the percentage of iron binding sites occupied by iron.

Standard Results
Males: 15–50%
Females: 12–45%


Serum Ferritin
Ferritin is the primary protien which controls the storage and release of Iron.

Standard Results
Males: 20-250 µg/L
Females: 15-150 µg/L


Vitamin B12
Vitamin B12 is a nutrient that helps keep the body's nerve and blood cells healthy. It also heklps create the genetic material DNA.

Standard results
200 - 900 pg/mL

When vitamin B12 is deficient or impaired, cell division can be drastically slowed.. B12 also effects the nervous system and can present itself in many ways.
Some of the common symptoms may include tiredness, tingling of the limbs, confusion and mental fogginess.

Red Cell Folate
Folate is important for the normal production of red blood cells, and in prevention of neural tube defects such as spina bifida, in the unborn babies of pregnant women.

Standard Results
360-1400 nmol/L

Anaemia tends to cause paleness of the skin, tiredness, decreased energy, shortness of breath on minimal exertion, and postural light-headedness or faintness when standing up.


Kidney Analysis

Urea
Urea is essentially the waste produced by the body after metabolization of amino acids. It is produced when the liver breaks down protiens and ammonia. The kidneys then transfer the urea from the bloodstream to the urine.
This can be an indicator of how well kidneys are operating.

Standard Results
10 - 20 mg/dl


Urate - Uric Acid
Uric acid is created when the body breaks down substances called purines. Purines are found in some foods and drinks, such as liver, anchovies, mackerel, dried beans and peas and beer.High levels of uric acid in the body is called hyperuricemia.

Standard Results
Males: 3.6 - 8.3 mg/dL
Females: 2.3 - 6.6 mg/dL

Creatinine
This is the breakdown of the product creatine phosphate within muscles. It is a direct indicator of kidney function due to its ease of measurement through the by product of muscle metabolism. Creatinine can be proportional to muscle mass. Example a bodybuilder or athlete may have a higher baseline creatinine level than a normal person.

Standard Results
Males: 0.5 to 1.0 mg/dl
Females: 0.7 to 1.2 mg/dl

Estimated Glomerular Filtration Rate (eGFR)
Another kidney function test, this one measures how well your kidneys filter wastes from your blood. The higher the result the more efficient your kidneys are functioning.

Standard Results
>90 - 100 mL/min
60-89 mL/min low normal

Lower eGFR suggests kidney daamage. Many people with very low eGFR require dialysis.


Glucose
This measures the amount of glucose in the blood. It is the body's main source of energy

Standard Results
Fasting
3.9 - 5.5 mmol/l (70.2 - 100 mg/dl) Normal
5.6 - 7 mmol/l (100 - 126 mg/dl) Pre diabetes or Insulin Resistant
>7 mmol/L Risk of Diabetes

Pre-meal
4 - 7 mmol/l (72 - 126 mg/dl) Normal
5.5 - 7 mmol/l (101 – 125 mg/dl) - Pre diabetes or Insulin Resistant
>7mmol/L Risk of Diabetes

In the short term the body suppresses appetite when glucose levels rise. Over longer periods high glucose can cause damage to internal organs, nervous system damage, eye damage and heart disease.
AAS use can decrease insulin resistance.

Serum Insulin
Insulin levels are most frequently requested following an abnormal glucose test and/or when a patient has short or long term symptoms of hypoglycaemia, such as sweating, palpitations, hunger, confusion, visual problems, and seizures.
It can also be used to determine the amount of insulin the body is producing. ie for type 1 diabetics with high blood sugar

Standard Results
5-20 mu/L

Liver Panel

Total Protein
This is a measurement of the total amount of protien in hte blood. Its a combination of albumin and globulin.

Standard Results
60-85g/L

In liver disease and acute infections, this can be low.

Albumin
This may be requested alongside other tests to look for kidney or liver damage. It can also show if the body is not absorbing enough protien.

Standard Results
3.4 - 5.4 g/dL


Globulin
These are protiens found in the blood which help regulate the circulatory system. The ratio between Albumin and globulin should be close to 1.

Standard Results
2.6 - 4.6 g/dL

Bilirubin
This is the product of red cell destruction. It is excrete through bile and urine and elevated levels may indicate an issue.

Standard Results
0.1 to 1.9 mg/dL

Alkaline Phosphatase - ALP
The ALP test is used to detect bone or liver diseases, or problems with biliary system. Liver cells that have been damaged with also release ALP into the bloodstream. This is used alongside other liver tests to determine the cause of elevation.

Standard Results
20 to 140 IU/L

Oral AAS may cause an increase in these values as well as OTC pain relief medications. Exercise close to the blood test will also show elevated levels.

Aspartate transaminase - AST
Another liver panel test this determines if any and alongside other tests, the type of liver disorder present.

Standard Results
Male: 8 - 40 IU/L
Female: 6 - 34 IU/L

Oral AAS may cause an increase in these values as well as OTC pain relief medications. Exercise close to the blood test will also show elevated levels.

Alanine Transaminase - ALT
As with the above, it is used to determine liver issues alongside other tests.

Standard Results
Male 10–50 IU/L
Female 5–38 IU/L

Oral AAS may cause an increase in these values as well as OTC pain relief medications. Exercise close to the blood test will also show elevated levels.

Chemistry

Sodium
This mineral helps your body store and balance water levels and helps with nervous system function and muscle contraction.

Standard Results
135 to 145mEq/L

Potassium
This mineral is essential for nervous system health, and regulation of the heart beat.

Standard Results
3.7 to 5.2 mEq/L

Diuretics and blood pressure medication can effect potassium levels.

Chloride
This test is used to evaluate kidney function and acid base status

Standard results
98 to 106 mEq/L

Bicarbonate
This test is most often done as part of an electrolyte or basic metabolic panel. Changes in your CO2 level may suggest that you are losing or retaining fluid, which causes an imbalance in your body's electrolytes.

Standard Results
23-29 mEq/L

Gamma-glutamyl transpeptidase - GGT
GGT is present in the cell membranes of many tissues, including the kidneys, bile duct, pancreas, gallbladder, spleen, heart, brain, and seminal vesicles. It is involved in the transfer of amino acids across the cell membrane.

Standard Results
Males: 15-85 IU/L
Females: 5-55 IU/L

Elevated serum GGT activity can be found in diseases of the liver, biliary system, and pancreas. In this respect, it is similar to alkaline phosphatase (ALP) in detecting disease of the biliary tract

Lactate Dehydrogenase - LDH
Currently, the main use for LDH is as a general indicator of the existence and severity of acute or chronic tissue damage and, sometimes, as a monitor of progressive conditions such as some cancers, kidney disease, and liver disease.

Standard Results
48 to 115 IU/L


Lipids
Cholesterol

Standard Results
<200 mg/dL Desireable level - Less risk for coronary heart disease
200 - 239 mg/dL This is borderline high.
>240 mg/dL High blood cholesterol. This increases the risk of coronary heart disease by 100% compared to someone who is <200 mg/dL

Low Density Lipoprotien - LDL Bad Cholesterol
The lower your LDL, the lower the risk of heart disease. LDL is a better guage on risk factors than total cholesterol.

Standard Results
<100 mg/dL Optimal levels
100 to 129 mg/dL Near optimal
130 to 159 mg/dL Borderline High
160 to 189 mg/dL High
190 mg/dL and above Very High


High Density Lipoprotien - HDL Good Cholesterol
With HDL (good) cholesterol, higher levels are better.

Standard Results
<40mg/dL Low HDL. This increases your risk for heart disease
>60 mg/dL High HDL Cholestrol. This is considered protective against heart disease

Triglycerides
Triglycerides are the most common fat in the body. A high proportion of people that have heart disease or diabetes have high triglyceride levels. Combine this with low HDL or high LDL and it increases the risk of coronary heart issues (atherosclerosis).

Standard Results
<100 mg/dL Optimal levels
<150 mg/dl Normal
150–199 mg/dL Borderline High
200–499 mg/dL High
>500 mg/dL Very high

C-Reactive Protien - CRP
This is another generalised test for inflammation. Tissue injury and infection will increase CRP.

Standard Results
0 - 10 mg/L


Prostate Specific Antigen (PSA)
PSA is present in small quantities in the serum of men with healthy prostates, but is often elevated in the presence of prostate cancer or other prostate disorders.
It seems that PSA screening atthis point should only be a guide and not a diagnosis. It can be unreliable.

Standard Results
PSA < 4 Low-risk
PSA 4 - 10 Medium Risk
PSA >10 High Risk

Prolactin
This is sometimes taken when men initally go for testosterone replacement therapy. It is to see if there may be a prolactinoma or pituitary tumours.
In women it stimulates breast development and milk production/

Standard Results
Males: 2 - 18 ng/mL
Nonpregnant females: 2 - 29 ng/mL
Pregnant women: 10 - 209 ng/mL

Prolactin can rise when taking particular AAS - 19 NOR compounds.

Cortisol
Cortisol is tested to find issues with the pituitary or adrenal glands. Cortisol is used in the body to regulate sugar and fat for metabolism, it is also used to manage stress for short periods of time.
Cortisol is highest during the morning and tapers off during the day.

Standard Results
160 - 650 nmol/L

--Red
 

metsfan4life

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Excellent post kind sir. I understand most of my bloods but there were some I just draw a blank on. This is will help so many out
 

StoliFTW

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***** Thanks for the definitions!
 

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