# Interpreting Blood Test Results



## thebrick (Oct 26, 2011)

Most don't know what most of the more specific tests are looking for or why the results may be off. These links below specify normal ranges in blood tests (remember there is some variance among the population) - MassiveG.

Blood Tests and Interpreting Blood Test Results

What are the results of my Blood test? What Does My Blood Test Mean? - BloodBook, Blood Information for Life

How to interpret your blood test results

Special Considerations in Interpreting Liver Function Tests - April 15, 1999 - American Academy of Family Physicians


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## K1 (Oct 26, 2011)

The Complete Guide to Understanding Your Blood Test Results

By: Midnight

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Everyone knows that getting your blood tested during, but particularly after, an AAS cycle is a smart move... But did you know that if you are a first time user, you should have what is called a “baseline” blood panel done first?

A baseline means you are testing your normal ranges during a “pristine” phase - a phase where there have been no toxins to speak of introduced to the body for prolonged periods of time... If you are a drug user on a regular basis - marijuana, cocaine or other drugs - that may change things a bit... You won’t get a normal reading of your average levels of any portion of the blood if that’s the case... But let’s assume that you’re “clean” before starting a cycle of AAS...

The reason a baseline is important is to establish a “normal” for you... That is, establish a basis for comparison when readings go off the charts or run in the higher reaches of a particular range... So, for example, if normally your lipid panel indicates a tendency toward high cholesterol and that runs in your family, then you won’t be as alarmed if you read it a few points higher while on a cycle... AAS is going to push a lot of readings around and you have to know where you were to start to know where the danger zones are on AAS...

Not knowing this is almost worse than not doing testing at all, anytime, during or after cycles...

So remember that blood panel elements have a “range” or span of what is acceptable and normal based on the mien average of all human beings... You may run higher or lower on any of these normally, which changes the way you interpret and read the results when on a cycle or just finishing one...

Also, ranges can vary from lab to lab... I’ve indicated ranges that differ between the sexes if it is applicable... Otherwise, there is one range that is acceptable for both men and women...

Lipid Panel — A lipid panel is used to determine risk factors and probabilities for coronary and vascular disease... In other words, heart disease, stroke or other cardiovascular difficulty..... There has been a lot of research that suggests that carrying higher levels of fat in the blood can contribute to heart disease and cause incidents such as strokes or heart attacks... Since AAS raises blood pressure, this is something serious to watch... Lipids are expressed in HDL (high density lipoproteins) and LDL (high density lipoproteins) levels... HDL is good cholesterol and LDL is bad cholesterol...

Normal ranges: Your HDL should be 35 or higher; LDL below 130; and total to HDL ratio should be below 3.5...

The Hemo Profile

The series of Hemo profile tests in a blood panel examine several different components of a person’s blood and looks for any abnormalities that could be indicative of an emerging disease process...

WBC Total (White Blood Cell)

You may hear your doctor refer to your WBC as leukocytes too... Any and all fluctuations in the number of these types of cells may be early indicators and markers of infections or disease processes that are pushing the white cells up in number to deal with fighting something in your body or organs... Your immune system usually feels fine during an AAS cycle, but you are susceptible to infection and illness after you come off and have a slightly suppressed or compromised immune system... You’ll need further investigative tests to determine what’s going on if you are elevated here...

Normal WBC ranges: 4,500-11,000/mm3

Neutrophils

This is just one type of white blood cell in circulation and really only for a short period of time... Their job is phagocytosis - which is essentially just a process whereby these cells kill and digest bacteria that cause infection... Severe trauma like bone breaks, tissue tears, internal injuries to the organs and some bacterial infections, as well as inflammatory or metabolic disorders, can cause an increase in these... Even garden variety severe stress can cause an increase... But having a low number of neutrophils can indicate other problems, such as higher viral load and viral infection... A poor diet can also cause this...

Normal ranges: 2,500-8,000 cells per mm3

RBC (Red Blood Cell)

These blood cells also called erythrocytes, so if you see it expressed in that manner, you’ll know... The primary function of an RBC is to carry oxygen (via hemoglobin in each RBC) to various tissues, and to give your blood that cool “red” color... RBCs 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, and also cause a lack of oxygen exchange within the body... An increase in WBC number can often happen 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 why some androgens are better than others at increasing “vascularity.” But I will say that the danger in could be an increase in blood pressure, or if the circulatory system is stressed too far, it could result in an actual stroke... In other words, don’t carry higher than normal values for long periods, or you’ll have to make modifications to alleviate some of the pressure (literally)... Some say to give blood, but that doesn’t alleviate the number of blood cells per ml.
Normal ranges: Adult Male 4,700,000-6,100,000 cells/uL ~
Adult Female 4,200,000-5,400,000 cells/uL

Hemoglobin

Hemoglobin is a carrier for oxygen and carbon dioxide transportation... Molecules are found within each red blood cell. Increases in hemoglobin can be an indicator of congenital heart disease, congestive heart failure, severe 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, internal hemorrhaging, cancer, or sickle cell anemia...

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

Hematocrit

Hematocrit levels measure the percentage of the total blood volume that’s made up of red blood cells... So looking at this in relation to your RBC count can be telling in terms of heart disease and overall cardiovascular stress... 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, or even malnutrition...

Normal ranges:
Male and Females age 6-18 years
32-44%
Adult Men
42-52%
Adult Women
37-47%

MCH (Mean Corpuscular Hemoglobin):

The MCH is the weight of hemoglobin present in the average red blood cell... This is also a reading to balance with Hematocrit and RBC results because it is another way to assess whether some sort of anemia or deficiency is present, or whether you are carrying too much EPO or need to water down the volume of RBCs, Hemoglobin and Hematocrit in cells... Blood thinners can often be used in these cases...

Normal ranges:
12-18 year old
35-45 pg

Adult Male
26-34 pg
Adult Female
26-34 pg

Platelets

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

A note: Anything above 1 million/mm3 would be considered a critical value and should warrant concern...

Normal ranges: Men and women - 150,000-400,000/mm3
(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., via percentage...

Percentage Range: 55-70%

Basophils

These cells, particularly eosinophils, are present in the event of an allergic reaction to some substance or allergen... It can also be present when there is a parasite in residence... These types of cells don’t increase in number like some of the other cell types in response to viral or bacterial infections... So having said that, if there is an increased count of Basophils, the assumption might be that either an allergic response has occurred or you are now hosting a parasite...

Percentage Range:
Basophils
0.5-1%
Eosinophils
1-4%

Lymphocytes and Monocytes

Lymphocytes can be divided in to two different types of cells: T cells and B cells. T cells become involved in immune reactions and B cells are involved in antibody production... The main job of lymphocytes in general is to battle bacterial and viral infections...

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

Percentage Range:

Lymphocytes
20-40%
Monocytes
2-8%

Selected Clinical Values

Sodium

Sodium is an ion with a postive charge and 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... Diseases like Cushing’s syndrome, or excessive sweating, severe second and third degree burns, not drinking very much water, can cause deficiencies... These decreased levels can result from a deficient diet, from diseases such as Addison’s disease, from 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:
Adults
136-145 mEq/L

Potassium

Sodium and potassium work hand in hand to ensure proper fluid balance on an intercellular level and intracellular level... Potassium is probably the important intracellular cation in terms of muscle flexion and overall balance... 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, insulin use, cystic fibrosis trauma and surgery... FYI, it can also appear low because of licorice consumption...

Normal range:
Adults
3.5-5 mEq/L

Chloride

Chloride is the major extracellular anion (an ion carrying a negative charge)... Its purpose is to maintain electrical neutrality with sodium... It also serves as a buffer in order to maintain the pH balance of the blood... Many bodybuilding blood buffering products, that rid the blood of lactic acid, contain chloride... Chloride typically accompanies sodium and replenishes loss from fluid, while balancing how sodium works in the body and muscles...

Normal range:
Adult
98-106 mEq/L

Carbon Dioxide

The CO2 content is used to evaluate the pH of the blood. It also is measured to evaluate electrolyte levels... Increased levels of carbon dioxide can be indicative of severe diarrhea since concentrations rise when dehydration occurs... But starvation, vomiting, emphysema, metabolic alkalosis, etc. can also increase levels... Decreased levels can be indicative of kidney failure, metabolic acidosis, and shock (such as following a physical trauma)...

Normal range:
Adults
23-30 mEq/L

Glucose

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... This is a separate test and something you’ll have to plan for by fasting. Do this on a separate day from blood testing though, since fasting can skew other values... Both high and low blood glucose 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, 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... Then again, I wouldn’t do the test during the final week prior to a competition since you’ll be ingesting nothing but protein, practically, and would skew values... On normal days, however, an increased in levels can stem from shock, burns, dehydration, congestive heart 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:
Adults
10-20 mg/dl

Creatinine

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, logically, the higher the levels of creatinine... But creatine and creatinine are different and shouldn’t be confused... Eating large amounts of beef or other meats that have high levels of creatine in them, such as pre-contest, you can increase creatinine levels... 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... But this is simplistic and not exactly the best way to look at things...

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

This is where creative interpretation of results matter and where diagnostics take information and extrapolate answers... A high ratio between these two may be found in states of shock, hypotension, dehydration, gastrointestinal bleeding, and in some cases, a catabolic state - as in pre-contest... A low ratio can be indicative of a low protein diet, malnutrition, pregnancy, severe liver disease, ketosis, etc... This ratio is almost always skewed in bodybuilders though, so if your doctor can’t ascertain that you lift on his own, you ought to really tell him...

Normal range:
Adult
6-25

Calcium

Calcium is measured in order to assess the function of the parathyroid and calcium metabolism... Increased levels can stem from hyper-parathyroidism, metastatic tumor to the bone, prolonged immobilization, lymphoma, hyperthyroidism, etc... It’s also important to note that anabolic steroids can increase calcium levels. Decreased levels can stem from renal failure, vitamin D deficiency, malabsorption, pancreatitis, and alkalosis... It’s important to know why it is high or low, based on lifestyle, habits, etc.. Discuss those with your doctor to get a real feel of why your readings are what they are...

Normal range:
Adult
9-10.5 mg/dl

Liver Function Test

Total Protein

Albumins
Total protein values measure 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... Healthy levels here shouldn’t be skewed by the lifestyle of bodybuilding, so if you’re off, you need to examine this because it is affecting absorption and is a real indicator of how you are actually metabolizing AAS and manufacturing your own hormones off season...

Globulins
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...

Note: Anabolic steroids, GH, and insulin can all increase protein levels, so assess what you’re on and interpret results from there...

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

Albumin/Globulin Ratio:

Adult
0.8-2.0

Bilirubin

Bilirubin is one of the many constituents of bile, which is formed in the liver and gallbladder... An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation to gallbladder... 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... If you’re not on a cycle, then higher levels may indicate gallstones... Fat, white and 40 is the rule here, so older bodybuilders should stay lean and not eat overly acidic, high protein diets...

Normal range:

Total Bilirubin for Adult
0.3-1.0 mg/dl

Alkaline Phosphatase

AP enzyme is found in high concentrations in the liver... Because of this reason it is used as an indicator of liver stress or damage... Increased levels can stem from cirrhosis, liver tumor, pregnancy, healing fracture, and rheumatoid arthritis... Decreased levels can result from hypothyroidism, malnutrition, pernicious anemia, and excess vitamin B ingestion. People who inject B-12 often have high levels of AP... As a side note, antibiotics can cause an increase in the enzyme levels too, so make all prescription drug histories available to your physician if he wasn’t the one who prescribed them or if you took them on your own (from Mexico or a buddy’s drug cabinet at the first sign of a scratchy throat - a big NO-NO!)...

Normal range:
16-21 years
30-200 U/L

Adult
30-120 U/L

AST (Aspartate Aminotransferase, formerly known as SGOT)

This is yet another enzyme that’s used to determine damage or stress to the liver... It may also be used to see if heart disease is a possibility but isn’t as accurate. When the liver is damaged or inflamed, AST levels can rise to a very high level (20-30 times the normal value)... 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:
Adult
0-35 U/L (Females may have slightly lower levels)

ALT (Alanine Aminotransferase, formerly known as SGPT)

ALT is an enzyme that is found in high levels within the liver too and any injury or disease of the liver will result in an increase in levels of ALT... But keep in mind that because lesser quantities are found in skeletal muscle, there could be a weight-training induced increase here... Weight training causes damage to muscle tissue and thus could slightly elevate these levels, giving a false indicator for liver disease or the body catabolizing itself... Still 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), mononucleosis, and shock...

Normal range:
Adult
4-36 U/L

Endocrine Function

Testosterone (Free and Total)

Nomal range, total Testosterone:

Male
Age 14
<1200 ng/dl
Age 15-18
100-1200 ng/dl
Age 19-40
300-950 ng/dl
Over 40
240-950 ng/dl

Normal range, free Testosterone:
Male
50-210 pg/ml

Female testosterone range:
20-80 ng/dl

LH (Luteinizing Hormone)

LH is a glycoprotein secreted by the anterior pituitary gland... It signals Leydig cells to produce testosterone in men and is a part of the 28 day mentrual cycle for women, and signals sloughing of blood cells in the uterus. Quantifying LH can be highly useful in determining whether testicles are not responsive despite high or normal LH levels and/or whether it’s the pituitary gland not secreting enough LH... Problems with the hypothalamus could also be at play...

If testicles are not responsive, Clomiphene and hCG won’t do much and is the reason you hear such a variety of results from people about how hCG works or doesn’t work to restart testosterone after a cycle... Decreased levels can be indicative of pituitary failure, hypothalamic failure, stress, and malnutrition. Increased can be indicative of hypogonadism - but then who ever really suffered from having too big a pair of balls...

Normal ranges:
Adult Male
1.24-7.8 IU/L

Adult Female (4 phase reading of LH and LH is part of a 5 part sequential release of hormones, LH, FSH, Estrogen, Progesterone and Testosterone)
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

Estradiol

You don’t need a doctor to tell you when you’re holding water, or have bitch tits, but it can explain why you have extra pockets of fat in areas where estrogen receptors are, such as the abdomen and low back/ hip area... For men, it’s important to get levels of this hormone checked for these reasons... It’s also the primary estrogen responsible for suppression of endogenous Testosterone production... So, if your levels of estradiol are higher than normal, you can safely assume you’ll be hypogonadal too...

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)

This is the most metabolically active thyroid hormone out of T4 and T3... When below normal it’s safe to assume you suffer from hypothyroidism... Estrogen and oral contraceptives increase T3. Anabolic steroids/androgens and high dosages of salicylates decrease it. ..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 tricky to interpret... It is another indicator of a hyper or hypo thyroid... However, free thyroxine levels also need assessing... Anything suppressing T3 will likely also suppress T4...
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

Only about 1-5 percent of T4 is actually useable, so this is actually a more accurate assessment of true thyroid function in a test... Increased levels indicate hyperthyroid state and decreased levels indicate a hypothyroid state... Drugs that increase free T4 are aspirin, danazol, and propanolol... Drugs that decrease it are furosemide (a diuretic), and opioid- inhibiting drugs such as methadone...

Normal ranges:
0.8-2.8 ng/dl or 10-36 pmol/L

TSH (Thyroid Stimulating Hormone)

Measuring TSH is helpful in determining if any hyper- or hypothyroid problem lie with the thyroid gland itself or with the assisting pituitary gland... If TSH levels are high, the thyroid gland is probably not responding for what may be a variety of reasons, but if TSH levels are low, it is a definite indicator that the hypothalamus or pituitary gland is ailing... A tumor or some kind of problem needs assessing in separate tests...

Drugs that increase TSH levels are lithium, potassium iodide and TSH itself... Drugs that may decrease TSH are aspirin, dopamine, and/or T3. n...

Normal ranges:
Adult
2-10 uU/ml or 2-10 mU/L

Interpreting tests is not really for the novice, but this is a way to remain informed about what your doctor may be looking for when considering all matter and factors of your lifestyle... Remember that you are never going to be as “healthy” on paper on AAS as you might be with 10 weeks clean... That’s one good reason to stay off of AAS at least one time per year for a longer duration than the normal 5 or 6 weeks between cycles... Try to stay clean for 10 weeks at some point so that you can reestablish your baseline readings and start with a clean slate... This is ever important in determining whether you are truly healthy in between... Five or six weeks simply isn’t enough to reestablish a baseline reading...

Remember that just as in a cholesterol test, some readings can fluctuate almost daily, depending upon diet, stress and other factors. But some of the ranges listed are true indicators of processes - disease or otherwise - which took a bit longer to establish and will take a bit longer to correct or tweak...

Even though in some cities blood panels of the complete form we’ve covered (not all blood panels include endocrine readings and you can get both abbreviated or expanded readings) can cost up to $200 per time, remember that your health and monitoring of your health is crucial to both your success and longevity... Some people don’t care as much about health in the sport, and that’s sad... But accepting that fact, those folks can begin to think of this as a way to learn how to maximize the unhealthy things they do (AAS) so that their bodies can absorb and use all that they are doing that also puts them at risk...


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