The Importance of Blood Work for AAS/PED Users
Before the onset of a steroid or performance enhancing drug cycle, the candidate should undergo specific blood tests. These tests will help evaluate his or her general health condition. Using a steroid cycle will likely stress some of their vital organs. Of course side effects and possible tissue damage are dependent on various parameters, such as age, time of use, dosage of PEDs, combination of them, lifestyle, proper nutrition, proper supplementation and family history. After the end of a cycle, when Post Cycle Therapy is through, the user should once again undergo specific blood tests. These labs are crucial in order to evaluate the kind of distortions that took place in different organs. Laboratory values such as hematocrit, liver enzymes, cholesterol, lipoproteins and renal indexes are quite important in order to clarify if ones health was compromised while on cycle. Other factors such as tumor markers could possibly reveal any kind of chronic inflammation that could turn into mutation and oncogenesis. Cancer is the result of a chronic inflammatory disease. Hormonal levels within the thyroid gland and gonads show how the HPTA (hypothalamic–pituitary–gonadal axis) works and if BMR (Basal Metabolic Rate) is affected as well. We usually measure biochemical and hormonal exams before and after, rather during a cycle- unless a serious medical reason exists. These recommended examinations are the below, along with their purpose: Hematocrit, Hemoglobin, Platelets, Iron, Ferritin and Cyanocobalamine. Polycytemia and anemia are possible to be diagnosed. Urea, Creatinine, Uric acid, 24h creatinine urine clearance and urinalysis Acute renal failure, glomerulosclerosis, and tubular necrosis are possible to be detected. Glucose, Τriglycerides, Total Cholesterol, HDL, LDL. Coronary Heart Disease, dyslipidemia or atherosclerosis-atheromatosis of arteries, diabetes mellitus type 2 and metabolic syndrome are highly possible to get diagnosed. SGOT/AST, SGPT/ALT, γGT, ALP, Bilirubin, LDH. Pharmaceutical hepatitis, cholestasis, cirrhosis are possible cases of liver disease. CPK, CK-MB. Excessive over-training leads to severe inflammation in muscle fibers, causing rhabdomyolysis and CPK elevation along with the elevation of SGOT/AST, SGPT/ALT. CPK is also present in cardiac muscle. The laboratory is able to distinguish between the different components of this enzyme. For example, the fraction coming from skeletal muscle is referred to as CK-MM and the one from heart muscle is designated as CK-MB. So the elevation of CK-MB from the cardiac tissue damage could reveal acute myocardial infarction. Sodium, Potassium, Calcium, Magnesium, Phosphorus, Chloride. Dehydration, muscle spasms, hypovolemia, renal damage are the result of electrolyte imbalance. INR, APTT, PT, FIB. AAS affect haemostatic mechanisms, since those factors are synthesized within liver parenchyma. FSH, LH, TT, FT, E2, PRL, SHBG. HPTA, spermatogenesis, endogenous testosterone production and estrogens are evaluated, that reflect on libido and fertility. TSH, T3, T4, FT3, FT4, ANTI-TPΟ, ANTI TG, U/S of thyroid gland. The thyroid gland’s metabolism reflects on BMR, proper thyroidal function, size of the gland or any scenario of possible nodulation is detected. In order to evaluate proper thyroid and gonadal function, measurements of the free-active forms of testosterone and thyroxin, triodothyronine, shall be counted as well. TT, FT, LH, FSH, PRL, E2 are necessary for the evaluation of HPTA, during am hours, since they are on their peak levels. CEA, CA 19/9, AFP, PSA, and FREE PSA. These are tumor markers that reflect on specific tissues, such as lungs, testicles, large intestine, prostatic gland, visceral organs. Tumor markers (CEA, AFP, PSA, CA 19-9) are reliable in case of particular inflammation, but also for the evaluation of the specific disease. However they are valuable for those who wish to use growth factors (HGH-IGF1, MGF peptides), since somatropin, somatomedin C, Mechanic Growth Factor and GHRH peptides are responsible for cellular growth, that leads to tissues growth and eventually to oncogenesis of a cancer. All of these blood measurements should be counted after 12 hours of fasting, with proper hydration. Cholesterol fragments and triglycerides calculation requite a lean diet the day before, in order for the results to be properly measured. A typical cardiovascular check up should be performed annually, and includes: Frontal X-ray of the thoracic cavity could show an enlarged myocardium and possible Left Ventricular Hypertrophy. U/S of myocardium , ECG, 24 hrs Holter, stress test/echo cardiac muscle hypertrophy (LVH), myocardial fibrosis, angina/ ischemia, coronary heart disease , arrhythmia, function of heart valves can be identified If necessary, a coronary magnetic resonance imaging (CMR), known as cardiac MRI, should be performed. Imaging studies (U/S, C/T) of the abdominal cavity could reveal hepatic/bile tumors, either adenoma or hepatocellular carcinoma. In case some of the following values are elevated, potential causes could be: Hematocrit: AAS, smoking, dehydration (falsely elevated due to increase in plasma concentration) Urea: Positive nitrogen balance, dehydration Creatinine: rhabdomyolysis (CPK>500), creatine loading phase, high consumption of red meat, increased BMI, NSAID’s abuse SGOT (AST), SGPT (ALT): Abuse of 17 alkylated AAS (pharmaceutical hepatitis), acetaminophen, rhabdomyolysis, over-training γGT, ALP: cholestasis-jaundince, alcoholism, liver cirrhosis LDL, Total cholesterol: SFA’s consumption, absence of UFAs (Ω-3,6,9), atherogenesis. Τriglycerides: absence of DHA, EPA (omega 3 PUFA’s) INR: AAS abuse CPK: rhabdomyolysis, overtraining B12: DECREASE equals to megaloblastic anemia (cyanocobalamine deficiency), as a result of either malnutrition, or alcoholism TSH: hypothyroidism T3, T4: hyperthyroidism CEA, AFP, Ca 19-9: Tumors of lungs, testicles (seminoma), large intestine (bowel), visceral organs (liver, bile, pancreas, stomach) PSA/free PSA: Benign prostate hypertrophy, prostatitis References: Achar S, Rostamian A, Narayan SM. Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm. Am J Cardiol. 2010 Sep 15; 106 (6): 893-901. Farzad Gheshlaghi, et al. Cardiovascular manifestations of anabolic steroids in association with demographic variables in body building athletes. J Res Med Sci. 2015 Feb; 20 (2): 165–168. Hartgens F, Kuipers H. Effects of androgenic-anabolic steroids in athletes. Sports Med. 2004; 34 (8):513-54 Hengevoss J, et al. Combined effects of androgen anabolic steroids and physical activity on the hypothalamic-pituitary-gonadal axis. J Steroid Biochem Mol Biol. 2015 Jun; 150:86-96.
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