Blood work knowledge & HCG's effect on HPTA

[Arnold jr]

Posted by Masswithclass on Musclesci

Bloodwork Knowledge

Blood tests

You just had some blood work done, and the friggin' doctor or his nurses are guarding the results as if they're state secrets. However, after much cajoling and explaining that you'd like to at least be an informed partner in your own goshdarn health care, they begrudgingly give you a copy of your lab tests.

Trouble is, as much as you've been posturing about how you've had more than a smattering of medical education, you still can't figure out what half the tests are for and whether or not those abnormal values are anything to worry about.

Well, in the following article, I'm going to go over each of the most common tests. I'll include why it's performed, what it tells you, and what the typical ranges are for normal humans. That way, you'll have something more to go on in assessing your health other than your family doctor saying, "Well, these few values are a little worrisome, but you'll probably be okay."

One note, though, before I get started. The values I'll be listing are merely averages and the ranges may vary slightly from laboratory to laboratory. Also, if there's only one range given, it applies to both men and women.

Lipid Panel — Used to determine possible risk for coronary and vascular disease. In other words, heart disease.

HDL/LDL and Total Cholesterol

These lipoproteins should look rather familiar to most of you. HDL is simply the "good" lipoprotein that acts as a scavenger molecule and prevents a buildup of material. LDL is the "bad" lipoprotein which collects in arterial walls and causes blockage or a reduction in blood flow. The total cholesterol to HDL ratio is also important. I went in to detail about this particular subject — as well as how to improve your lipid profile — in my article "Bad Blood".

Nevertheless, a quick remonder: your HDL should be 35 or higher; LDL below 130; and total to HDL ratio should be below 3.5. Oh and don't forget VLDL (very low density lipoprotein) which can be extremely worrisome. You should have less than 30 mg/dl in order to not be considered at risk for heart disease.

On a side note, I'm sure some of you are wishing that you had abnormally low plasma cholesterol levels (as if it's something to brag about), but the fact is that having extremely low cholesterol levels is actually indicative of severe liver disease.

Triglycerides

Triglycerides are simply a form of fat that exists in the bloodstream. They're transported by two other culprits, VLDL and LDL. A high level of triglycerides is also a risk factor for heart disease as well. Triglycerides levels can be increased if food or alcohol is consumed 12 to 24 hours prior to the blood draw and this is the reason why you're asked to fast for 12-14 hours from food and abstain from alcohol for 24 hours. Here are the normal ranges for healthy humans.

16-19 yr. old male
40-163 mg/dl

Adult Male
40-160 mg/dl

16-19 yr. old female
40-128 mg/dl

Adult Female
35-135 mg/dl

Homocysteine

Unfortunately, this test isn't always ordered by the doctor. It should be. Homocysteine is formed in the metabolism of the dietary amino acid methionine. The problem is that it's a strong risk factor for atherosclerosis. In other words, high levels may cause you to have a heart attack. A good number of lifters should be concerned with this value as homocysteine levels rise with anabolic steroid usage.

Luckily, taking folic acid (about 400-800 mcg.) as well as taking a good amount of all B vitamins in general will go a long way in terms of preventing a rise in levels of homocysteine.

Normal ranges:

Males and Females age 0-30
4.6-8.1 umol/L

Males age 30-59
6.3-11.2 umol/L

Females age 30-59
4.5-7.9 umol/L

>59 years of age
5.8-11.9 umol/L

The Hemo Profile

These are various tests that examine a number of components of your blood and look for any abnormalities that could be indicative of serious diseases that may result in you being an extra in the HBO show, "Six Feet Under."

WBC Total (White Blood Cell)

Also referred to as leukocytes, a fluctuation in the number of these types of cells can be an indicator of things like infections and disease states dealing with immunity, cancer, stress, etc.

Normal ranges:

4,500-11,000/mm3

Neutrophils

This is one type of white blood cell that's in circulation for only a very short time. Essentially their job is phagocytosis, which is the process of killing and digesting bacteria that cause infection. Both severe trauma and bacterial infections, as well as inflammatory or metabolic disorders and even stress, can cause an increase in the number of these cells. Having a low number of neutrophils can be indicative of a viral infection, a bacterial infection, or a rotten diet.

Normal ranges:

2,500-8,000 cells per mm3

RBC (Red Blood Cell)

These blood cells also called erythrocytes and their primary function is to carry oxygen (via the hemoglobin contained in each RBC) to varioustissues as well as giving our blood that cool "red" color. Unlike WBC, RBC 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. An increase in number can occur 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 essentially why some androgens are better than others at increasing "vascularity." Anyhow, the danger in this could be an increase in blood pressure or a stroke.

Androgen-using lifters who have high values should consider making modifications to their stack and/or immediately donating some blood.

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 what serves as a carrier for both oxygen and carbon dioxide transportation. Molecules of this are found within each red blood cell. An increase in hemoglobin can be an indicator of congenital heart disease, congestive heart failure, sever 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, sever hemorrhage, cancer, sickle cell anemia, etc.

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

The hematocrit is used to measure the percentage of the total blood volume that's made up of red blood cells. 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, malnutrition, a sucking knife wound to the chest, etc.

Normal ranges:

Male and Females age 6-18 years
32-44%

Adult Men
42-52%

Adult Women
37-47%

MCV (Mean Corpuscular Volume)

This is one of three red blood cell indices used to check for abnormalities. The MCV is the size or volume of the average red blood cell. A decrease in MCV would then indicate that the RBC's are abnormally large(or macrocytic), and this may be an indicator of iron deficiency anemia or thalassemia. When an increase is noted, that would indicate abnormally small RBC (microcytic), and this may be indicative of a vitamin B12 or folic acid deficiency as well as liver disease.

Normal ranges:

Adult Male
80-100 fL

Adult Female
79-98 fL

12-18 year olds
78-100 fL

MCH (Mean Corpuscular Hemoglobin)

The MCH is the weight of hemoglobin present in the average red blood cell. This is yet another way to assess whether some sort of anemia or deficiency is present.

Normal ranges:

12-18 year old
35-45 pg

Adult Male
26-34 pg

Adult Female
26-34 pg


MCHC (Mean Corpuscular Hemoglobin Concentration)

The MCHC is the measurement of the amount of hemoglobin present in the average red blood cell as compared to its size. A decrease in number is an indicator of iron deficiency, thalassemia, lead poisoning, etc. An increase is sometimes seen after androgen use.

Normal ranges:

12-18 year old
31-37 g/dl

Adult Male
31-37 g/dl

Adult Female
30-36 g/dl

RDW (Red Cell Distribution Width)

The RDW is an indicator of the variation in red blood cell size. It's used in order to help classify certain types of anemia, and to see if some of the red blood cells need their suits tailored. An increase in RDW can be indicative of iron deficiency anemia, vitamin B12 or folate deficiency anemia, and diseases like sickle cell anemia.

Normal ranges:

Adult Mal
11.7-14.2%

Adult Female
11.7-14.2%

[Arnold jr]

Part II

Platelets

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

On a side note for these ranges, anything above 1 million/mm3 would be considered a critical value and should warrant concern and/or giving second thoughts as to whether you should purchase a lifetime subscription to Muscle Media.

Normal ranges:

Child
150,000-400,000/mm3
(Most commonly displayed in SI units of 150-400 x 10(9th)/L

Adult
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.

Pt. 2

Neutrophils

As explained previously, severe trauma and bacterial infections, as well as inflammatory disorders, metabolic disorders, and even stress can cause an increase in the number of these cells. Also, on the other side of the spectrum, a low number of these cells can indicate a viral infection, a bacterial infection, or a deficient diet.

Percentile Range:

55-70%

Basophils

These cells, and in particular, eosinophils, are present in the event of an allergic reaction as well as when a parasite is present. These types of cells don't increase in response to viral or bacterial infections so if an increased count is noted, it can be deduced that either an allergic response has occurred or a parasite has taken up residence in your shorts.

Percentile 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 are involved in immune reactions and B cells are involved in antibody production. The main job of lymphocytes in general is to fight off — Bruce Lee style — bacterial and viral infections.

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

Percentile Range:

Lymphocytes
20-40%

Monocytes
2-8%

Selected Clinical Values

Sodium

This cation (an ion with a postive charge) 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, Cushing's syndrome, excessive sweating, burns, forgetting to drink for a week, etc. Decreased levels can result from a deficient diet, Addison's disease, 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

On the other side of the spectrum, you have the most important intracellular cation. 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, Cushing's syndrome, licorice consumption, insulin use, cystic fibrosis, trauma, surgery, etc.

Normal range:

Adults
3.5-5 mEq/L

Chloride

This is the major extracellular anion (an ion carrying a negative charge). Its purpose it is to maintain electrical neutrality with sodium. It also serves as a buffer in order to maintain the pH balance of the blood. Chloride typically accompanies sodium and thus the causes for change are essentially the same.

Normal range:

Adult
98-106 mEq/L

Carbon Dioxide

The CO2 content is used to evaluate the pH of the blood as well as aid in evaluation of electrolyte levels. Increased levels can be indicative of severe diarrhea, starvation, vomiting, emphysema, metabolic alkalosis, etc. Increased levels could also mean that you're a plant. Decreased levels can be indicative of kidney failure, metabolic acidosis, shock, and starvation.

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. Both 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, insulinoma, 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. Increased levels can stem from shock, burns, dehydration, congestive hear 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 therefore the higher the levels of creatinine. Also, when you ingest large amounts of beef or other meats that have high levels of creatine in them, you can increase creatinine levels as well. 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.

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

A high ratio may be found in states of shock, volume depletion, hypotension, dehydration, gastrointestinal bleeding, and in some cases, a catabolic state. A low ratio can be indicative of a low protein diet, malnutrition, pregnancy, severe liver disease, ketosis, etc. Keep in mind, though, that the term BUN, when used in the same sentence as hamburger or hotdog, usually means something else entirely. An important thing to note again is that with a high protein diet, you'll likely have a higher ratio and this is nothing to worry about.

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 hyperparathyroidism, metastatic tumor to the bone, prolonged immobilization, lymphoma, hyperthyroidism, acromegaly, etc. It's also important to note that anabolic steroids can also increase calcium levels. Decreased levels can stem from renal failure, rickets, vitamin D deficiency, malabsorption, pancreatitis, and alkalosis.

Normal range:

Adult
9-10.5 mg/dl

Liver Function

Total Protein

This measures 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.

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.

As another important side note, anabolic steroids, growth hormone, and insulin can all increase protein levels.

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. An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation. 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. Non-drug induced increased levels can be indicative of gallstones, extensive liver metastasis, and cholestasis from certain drugs, hepatitis, sepsis, sickle cell anemia, cirrhosis, etc.

Normal range:

Total Bilirubin for Adult
0.3-1.0 mg/dl

Alkaline Phosphatase

This enzyme is found in very high concentrations in the liver and for this reason is used as an indicator of liver stress or damage. Increased levels can stem from cirrhosis, liver tumor, pregnancy, healing fracture, normal bones of growing children, and rheumatoid arthritis. Decreased levels can stem from hypothyroidism, malnutrition, pernicious anemia, scurvy (vitamin C deficiency) and excess vitamin B ingestion. As a side note, antibiotics can cause an increase in the enzyme levels.

Normal range:

16-21 years
30-200 U/L

Adult
30-120 U/L

Pt. 3

AST (Aspartate Aminotransferase, previously known as SGOT)

This is yet another enzyme that's used to determine if there's damage or stress to the liver. It may also be used to see if heart disease is a possibility as well, but this isn't as accurate. When the liver is damaged or inflamed, AST levels can rise to a very high level (20 times the normal value). This happens because AST is released when the cells of that particular organ (liver) are lysed. The AST then enters blood circulation and an elevation can be seen. 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, previously known as SGPT)

This is yet another enzyme that is found in high levels within the liver. Injury or disease of the liver will result in an increase in levels of ALT. I should note however, that because lesser quantities are found in skeletal muscle, there could be a weight-training induced increase . Weight training causes damage to muscle tissue and thus could slightly elevate these levels, giving a false indicator for liver disease. Still, for the most part, 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), myocardial infarction, mononucleosis, and shock.

Normal range:

Adult
4-36 U/L

Endocrine Function

Testosterone (Free and Total)

This is of course the hormone that you should all be extremely familiar with as it's the name of this here magazine! Anyhow, just as some background info, about 95% of the circulating Testosterone in a man's body is formed by the Leydig cells, which are found in the testicles. Women also have a small amount of Testosterone in their body as well. (Some more than others, which accounts for the bearded ladies you see at the circus, or hanging around with Chris Shugart.) This is from a very small amount of Testosterone secreted by the ovaries and the adrenal gland (in which the majority is made from the adrenal conversion of androstenedione to Testosterone via 17-beta HSD).

Nomal range, total Testosterone:

Male

Age 14
<1200 ng/dl

Age 15-16
100-1200 ng/dl

Age 17-18
300-1200 ng/dl

Age 19-40
300-950 ng/dl

Over 40
240-950 ng/dl

Female

Age 17-18
20-120 ng/dl

Over 18
20-80 ng/dl

Normal range, free Testosterone:

Male
50-210 pg/ml

LH (Luteinizing Hormone)

LH is a glycoprotein that's secreted by the anterior pituitary gland and is responsible for signaling the leydig cells to produce Testosterone. Measuring LH can be very useful in terms of determining whether a hypogonadic state (low Testosterone) is caused by the testicles not being responsive despite high or normal LH levels (primary), or whether it's the pituitary gland not secreting enough LH (secondary). Of course, the hypothalamus — which secretes LH-RH (luteinizing hormone releasing hormone) — could also be the culprit, as well as perhaps both the hypothalamus and the pituitary.

If it's a case of the testicles not being responsive to LH, then things like clomiphene and hCG really won't help. If the problem is secondary, then there's a better chance for improvement with drug therapy. Increased levels can be indicative of hypogonadism, precocious puberty, and pituitary adenoma. Decreased levels can be indicative of pituitary failure, hypothalamic failure, stress, and malnutrition.

Normal ranges:

Adult Male
1.24-7.8 IU/L

Adult Female
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

With this being the most potent of the estrogens, I'm sure you're all aware that it can be responsible for things like water retention, hypertrophy of adipose tissue, gynecomastia, and perhaps even prostate hypertrophy and tumors. As a male it's very important to get your levels of this hormone checked for the above reasons. Also, it's the primary estrogen that's responsible for the negative feedback loop which suppresses endogenous Testosterone production. So, if your levels of estradiol are rather high, you can bet your ass that you'll be hypogonadal as well.

Increased estradiol levels can be indicative of a testicular tumor, adrenal tumor, hepatic cirrhosis, necrosis of the liver, hyperthyroidism, etc.

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)

T3 is the more metabolically active hormone out of T4 and T3. When levels are below normal it's generally safe to assume that the individual is suffering from hypothyroidism. Drugs that may increase T3 levels include estrogen and oral contraceptives. Drugs that may decrease T3 levels include anabolic steroids/androgens as well as propanolol (a beta adrenergic blocker) and high dosages of salicylates. 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 just another indicator of whether or not someone is in a hypo or hyperthyroid state. It too is rather reliable but free thyroxine levels should be assessed as well. Drugs that increase of decrease T3 will, in most cases, do the same with T4. Increased levels are indicative of the same things as T3 and a decrease can be indicative of protein depleted states, iodine insufficiency, kidney failure, Cushing's syndrome, and cirrhosis.

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

Since only 1-5% of the total amount of T4 is actually free and useable, this test is a far better indicator of the thyroid status of the patient. An increase indicates a hyperthyroid state and a decrease indicates a hypothyroid state. Drugs that increase free T4 are heparin, aspirin, danazol, and propanolol. Drugs that decrease it are furosemide, methadone, and rifampicin. Increased and decreased levels are indicative of the same possible diseases and states that are seen with T4 and T3.

Normal ranges:

0.8-2.8 ng/dl or 10-36 pmol/L

TSH (Thyroid Stimulating Hormone)

Measuring the level of TSH can be very helpful in terms of determining if the problem resides with the thyroid itself or the pituitary gland. If TSH levels are high, then it's merely the thyroid gland not responding for some reason but if TSH levels are low, it's the hypothalamus or pituitary gland that has something wrong with it. The problem could be a tumor, some type of trauma, or an infarction.

Drugs that can increase levels of TSH include lithium, potassium iodide and TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine, T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and congenital cretinism. Decreased levels are indicative of hypothyroidism (pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.

Normal ranges:

Adult
2-10 uU/ml or 2-10 mU/L

Knowing how to interpret these tests can be a very valuable tool in terms of health and your body building and athletic progress. Use your new knowledge wisely.

[udeluz]

That is one of the best posts EVER....

Make it a sticky!!!!!

[Arnold jr]

That is one of the best posts EVER....

Make it a sticky!!!!!

Done

[ZEEK]

NICE thanks for the info Arnold

[POB]

Thanks 4 taking the time

[Luv2Hurt]

Very complete and well written.  Easy for anyone to understand.  Good work AJ this was needed.

Everyone gearing up should have a complete blood panel like this done every year at a minimum.  Would be a good idea to watch and monitor your blood pressure and cholesterol more often like 3 times a year.

[Jr. Yates]

Very complete and well written.  Easy for anyone to understand.  Good work AJ this was needed.

Everyone gearing up should have a complete blood panel like this done every year at a minimum.  Would be a good idea to watch and monitor your blood pressure and cholesterol more often like 3 times a year.

agreed. thanks alot.

[STANG50]

To get your bloodwork done you should see a urologist right ? What is the best dr to see for a general exam ? Thanks ahead of time and gj on this post.

[beefbrains]

Great post and very worthwhile to warn folks about high rbc counts. I've known a number of guys who were unaware of that danger until they suffered a stroke or heart problems - which was what prompted me to get mine checked. Good thing, too, as mine was dangerously high - when they actually phlebotomized (bled) me, my blood was so thick it actually clogged three needles and when we finally got it to drain, it was the consistency of ketchup. Not good for your heart at all. In fact, polycythemia (the official term for high rbc counts) is a big culprit in the heart damage you hear afflicting longterm juicers.

It's especially common in older guys (I'm 47) and the main symptoms are shortness of breath and pounding headaches. It's also not a bad idea to take low-dose aspirin every day. I give blood once a month now, and it keeps everything in good working order.

[RDW]

I decided to write this based on a number of PMs and other questions I have recieved regarding HCG.

First lets start with HPTA.
HPTA stands for hypothalamic-pituitary-testicular (or sometimes gonadal) axis.  HPTA is a reference we give the combined function of the hypothalamus, pitultary gland, and testes so we can speak of them as a single system.  The hypothalamus produces GnRH (Gonadotropin-Releasing Hormone), this hormone tells the pituitary gland to release LH (Luteinizing Hormone). LH travels from the pituitary through the bloodstream to the testes where it triggers the production and release of testosterone.  No LH means the testes shut down testosterone production, which means... your balls shrink (temporarily of course).  If you don't understand this just get this, Hypothalamus makes GnRH -> Pituitary makes LH -> Testes makes Testosterone.  If any one part of that system fails, the end result fails, which means no test production.

Now, what happens when we take AAS?
When a male takes AAS (I'm assuming everyone knows that means Anabolic Androgenic Steroids), the body natural feedback loops shut down it's testosterone production.  These natural feedback loops are like the proportional-integral contol loops we use in things like air conditioning, if its too cold, the compressors shut down.  Like in electronic controls (good ones anyway) there is a hysterysis to inhibit the system from bouncing back on and off. The body has to see the deficiency or surplus for a period of time before stopping or secreting hormones.  So when AAS are introduced the Hypothalamus (the beginning of our HPTA loop) shuts down production of GnRH.  With no GnRH the pituitary makes no LH, which means the testes makes no testosterone.  Now this is okay while we are on AAS because WE ALL USE TESTOSTERONE AS THE BASE OF OUR CYCLES RIGHT?   You don't have to use test while on AAS, but it is wise to as to keep your body functioning as normal as possible, not to mention the anabolic and androgenic benefits of test.  But let's continue, so we have been taking AAS for some weeks now and are ready to stop.


What does our body do when we stop?
When you stop taking AAS your body will continue to metabolize them for some time depending on the drug.  For example Testosterone Enanthate has a half life of 10.5 days.  What this means is that 10.5 days after injecting 500mg of Test E your body will have metabolized 250mg.  So in another 10.5 days your body will have metabolized the remaining 250 then right? - Wrong.  In an additional 10.5 days your body will have metabolized half of what is remaining, which is (1/2) * 250 = 125.  So in total, after 21 days the body has metabolized 375 out of 500mg of the Test E.  The formula for half lives is [Injection-(AmountAllreadyMetabolize d*(2)^(-TimeInDays/HalfLifeInDays))].  The easiest way to do this is to make an excel spreadsheet.  You can then find out exactly what your levels will be at any given time during your cycle.  The average adult male body produces between 40 and 120mg of test per week (That is a rather large range because of ages, obviously younger is higher).  What we want to do is find out at what point will the test we were injecting metabolize at a rate near what our normal body levels are at.  For a male in good condition who is between 25 and 35 I'm going to day that the average test level is around 70mg/week or 10mg/day.  For test E 18 days after injecting 500mg the body will be metabolizing about 10mg/day for that last injection, BUT the previous weeks injections are still metabolizing as well, this is where Excel comes in handy. In reality after 18 days your body is still metabolizing nearly 28mg/day of the test.  This is why a PCT needs to start later with long esters, they stay with you for a long time.  Now, just because our test levels are still above normal doesn't mean our body isn't starting to see negative effects.  Our estrogen levels and possibly progestin are rising.  This is what the nolvadex/clomid is for.  Some people wait 2 weeks after last injection for these, this is usually fine, but there is no reason you can't start taking them right away.  It is much harder to know or calculate estrogen and progestin levels than test (without bloodwork).  Don't be afraid of the anti Es! 

SO WHAT ABOUT HCG ALL READY?!
"Jesus christ you made me read this whole fucking thing that was supposed to be about hCG and you haven't even mentioned it yet!"  Okay the goal of hCG is to start up testosterone production.  The way HCG does this is by mimicing LH.  Remember this is Step 4 in the 6 step HPTA process.  It does NOT restart the Hypthalamus, therefore does not produce GnRH, therefore does not stimulate the pituitary.  However, the pituitary does not need to produce LH since the hCG is mimicing it.  The key to all of this is timing.  As I mentioned there is a hysterysis built in that will not allow the hypothalamus to start up right away, so what we want to do is to stimulate the rest of the HPTA system so that when the hypothalamus is ready the rest of the system is out of atrophy and ready to produce, namely the testes.  So once our test levels starts to approach our normal level (generally about 3 weeks depending on the esters) we can start with HCG injections, I personally do the following:
Day 1 3000IU
Day 4 1500IU
Day 7 750 IU
Day 10 500IU

OR

500 IU ED for 2 weeks

There are a number of different ways, but most of them implement the use of 3-10,000 IU over the course of 10-14 days.  The goal is to stimulate the testes without producing too much testosterone that it further hinders the hypothalamus.  If you start the HCG too early, which is what most people do, then you will help keep your test levels up enough that it will take even longer for the hypothalamus functions to restart, thus resulting in atrophy of the testes again and wasting a bottle of hCG and a few weeks of recovery. 

Is HCG really necessary?
As with most things, it is really dependant on your body.  Some people don't recover well and go through depression, mood swings, and other physical and psychological problems during a post-cycle.  Using hCG properly can significantly reduce these feelings.  Will your body come back to normal without it? Yes, barring rare disorders and circumstances.  If you experience significant or even moderate psycological effects or lethargy during PC I highly recommend using hCG.

hCG is one of the most misunderstood and misused ancillaries involced in AAS.  I hope this was able to help some people who didn't fully understand it's workings. Please feel free to ask any questions!

* Modified for changes to the hCG dosages

[trab]

Good Stuff RDW. EVERY Guy inquiring about 1st time  AAS use should get this page link & read it.
They most all fail to realize the most important thing - Resumption of natural testes function.
You cant mess w/ the AC system if you dont know how it works.....

[Arnold jr]

Thanks for writing this RDW...this has been needed on this board for a good while now...hopefully it will clear some things up for some of the guys.

[Luv2Hurt]

Yes good work!

[willie mosconi]

didn't mass with class pass away a while back?

[Captain Equipoise]

Excellent post, a must read for all newbs.

[supermannpc]

this helps so much thanks

[Emmortal]

To get your bloodwork done you should see a urologist right ? What is the best dr to see for a general exam ? Thanks ahead of time and gj on this post.

You can see a general practice doctor to get blood work done, doesn't have to be a specialist.

[freakinrican]

very informative thank u

[GetBigOrDieTrying]

RDW ,

Thanks for this information...

Its just very different to how ive been told to use HCG. I have basic understanding of all of this so insight would always be appreciated.

In the past I would normally start HCG 1 week after a long acting ester. At 1500iu and then continue to take 1500iu every 5th day  for 3 consecutive weeks. On the 15 day after the final shot of HCG I would start Clomid 100mg for first 4 day followed by 50mg for another 10 days. I would use Nolva through out.

My understanding was a higher dose of HCG  (5000IU) was more detrimental to starting natural test production than an aid and one should rather use 500iu -1500iu. Also that they are long term negative side effect in using higher dosages of HCG. I read this a long long time ago but will see if I can find it.

Also when you shoot your HCG do you shoot it sub or muscle?

Thanks in advance.

[GetBigOrDieTrying]

Found it...

Think Anthony Roberts wrote this , maybe wrong?

"As regards HCG´s use of Post-Cycle-Therapy (PCT), smaller and more frequent doses after a cycle of AAS would give the best results with the least amount of side effects. A dose of 250iu to 500iu everyday (ed) for 2 to 3 weeks is plenty and should very little from person to person (3). The Physicians Desk Reference recommends 500iu/day, as did the late, great, Dan Duchaine. The smaller doses are sufficient enough to begin reversal of testicular atrophy and used in conjunction with nolvade, will help the already present problem of recovery without raising the levels of estrogen to high and increasing the risk of gynecomastia in the user. Lower doses of 250iu to 500iu also avoid the further risk of down regulating LH receptors in the testes. The old saying more is better definitely does not apply to the use of HCG. You don´t want to finish PCT after using too much HCG only to find out your back at the beginning again. Your best bet is to start at 250iu or 500iu ed for 5 or 6 days, and if you don´t notice anything happening (nuts dropping and getting bigger) up the dose slightly. Small doses like 500iu two days a week isn´t going to cut it like some people think. The only thing small doses of HCG ay be useful (sublingually) for is reducing symptoms of benign prostatic hyperplasia (7). Yeah, that´s right, you can probably reduce some symptoms of an enlarged prostate with the use of small doses of HCG.

As stated above the cycles of HCG should be in the 2 to 3 week range with a least one month off in between, you could stretch your cycle out to four weeks without any major concern if you are using lower doses. One should however take care when using HCG as prolonged use could repress the body´s natural production of gonadotropins permanently, but this is mostly just pure speculation as it does not have yet to be reported nor has there been a case of an overdose. To be on the safe side shorter cycles of HCG seem to be that of the norm. Most users cycle HCG near the end of a steroid cycle, you should start your HCG therapy on the last week of your cycle. For best results you should also run nolva while you run HCG as taking HCG by itself will do little to nothing and gyno even though rare may also flair up. Once the HCG cycle is finished you continue with your usual clomid or nolvadex (preferably the latter) for pct as it is more effective when used in conjunction HCG for pct. With an AAS cycle of 6 to 10 weeks HCG may not be necessary unless extreme doses of AAS were used or there is an existing problem of testicular atrophy or you are running a heavy oral only cycle. AAS cycles of 12 or more weeks should have HCG as a part of post cycle plan."

[DirtyDirt]

i had my tests done two weeks ago after reading this post.
I'm 33 years old and although i haven't had any bloodwork done in about 5 years, i was always a healthy cat. I decided that it was time to go again since it's been quite a while and i was about to start a cycle. My main concern was my HDL cholesterol which was diagnosed as being quite low 5 years ago. Whe i went back last week for my results i specifically asked the dr about my HDL, he said it was an 83, which was high and good. he asked if i've been drinking red wine, which i haven't. He asked what i've been doing that would have brought it from low to outstandingly high and i didn't realize what it was until i got home. Every morning i have a protein shake with VPX fiberteq (Fiber supplement) and VPX thinfat EFA, i've been having this shake at least 5 days a week for about 1 1/2 years now, turns out that was the golden ticket....for those of you juicers reading this, juice actually lowers your HDL, if this is the case, follow my steps, it works....good luck!!!!

[muscleup]

Really helpful information.  I knew that HCG was recommended, but did not really understand the physiology behind the usage.

[witless]

i would have to say this is one of the best post i have had the pleasure of reading...thanks

[littlechris]

i am on hormone replacement therapy year round, at 300 mg test per week.  doctor recommends 500 iu of h.c.g. twice per week indefinetly. i also take 0.5 mg anastrozole per day. hope this helps