In this article I will discuss the most important blood tests for any person who used, planning to use, or using at the moment using steroids.
steroids as we know have many negative effect on ones health, and have man potential risk, by understanding what happening in your body and what effect it have, you will be able to minimize the risk to the minimum, and will have the chance to do any necessary adjustment depend on the result.
I know many bodybuilders who rarely do tests, if ever, especially Arabs ones, I really recommend that each bodybuilder would at least do these tests at least once a year.

There are three types of tests needed, one pre cycle, on cycle and post cycle, we will discuss each and then explain about the tests:

The pre cycle Tests- Baseline necessary tests:

Hormones (steroids)
Lipids (standard full Set)
Full Liver Panel
Blood
Kidney
Electrolytes, Mineral and Glucose
Prostate

These tests are done prior to taking any steroids, or after sometime off.
It should be taken to give a baseline for our natural body results, and to check how it get affected by the use of steroids and to make sure it got back to these normal range after coming off.
Its also used to see if there is any underlying potential health condition that can be worsened with steroids, for example if you have high lipids or liver enzymes profile, then its not smart at all to start the use of steroids, as it will cause this condition to increase and may develop potential health risk.,
So you have to make sure that everything is in the normal range, and you have no problems, then the decision of starting to take steroids can be thought off, of course as one individual choice, we don't encourage the use of steroids for any purpose, if it's not done by doctors to fix medical condition.

The on cycle Tests - Tests needed during the use of steroids:

Lipids (standard full Set)
Liver Panel (especial with hepatotoxic)
Blood
Kidney
Electrolytes, Mineral and Glucose

This is best done after 3-4 weeks from starting steroids use, and then a good look at the results, to compare the results with the baseline ones and to normal range, if the body is too affected to a very dangerous rate, then steroids intake should be stopped and post cycle or necessary treatment should be use.

The post Cycle Tests - Tests needed after the use of steroids

Hormones (steroids, LH/FSH)
Lipids (Standard Full Set)
Liver Panel (especial with hepatotoxic)
Blood
Electrolytes, Mineral and Glucose
Prostate

The most important thing here is to look at the male hormones, and to make sure that the value are some what close to pre cycle levels, its shouldn't be the same, but as close as it can. Liver enzymes should also be lowering and closing to the baseline ones.
Now we will take a look at each Test by category and explain important things.

Hormone Tests

Steroids:
This test is used by physician to indentify androgen level of the person and see if they need therapy. One should make sure if they have upper high testosterone level results on the baseline tests to have also upper high levels in the post steroids tests, being in the normal range is not enough, tests after post cycle therapy should have the results similar to pre cycle ones.
Estradiol is the active form of estrogen in the body, its most important to check it during the intake of steroids, high level may be associated with estrogen side effect (ex. water retention, fat retention and Gynecomastia), this provide a good clue of how much anti estrogen you need to be taken.

Luteinizing hormones (LH) and Follicle stimulating hormone (FSH) panel:
Both of these hormones are responsible for stimulating testosterone production in the tests as well as spermatogenesis.
You should worry much if these values are down during the steroids intake; it's a normal effect from steroids use. In post cycle results its good to check LH/FSH with testosterone levels, if high LH/FSH and low testosterone levels presents, this is probably means that your testes haven't return to their previous size and need more time and PCT.

Thyroid:
Baseline results are the most important for thyroids, steroids may elevate thyroids levels slightly during the use, but it's very unlikely to have permanent levels. If thyroids levels remains high after the cycle and doesn't show any decline, one might need to check if there is any problems with a physician.

Lipids (cardiovascular) tests

This is regarded one of the most important steroid related tests.
It's well known that Anabolic/androgenic hormones have negative effect on lipids, which increase the risk of developing cardiovascular diseases.
one should moniter the results of this tests, sometimes cycles after cycle levels will be slowly rising, most cardiovascular disease take a long time to develop, so one should be careful to stay in a healthy range all time.

Standard Full Set:
The most important in this test is the LDL/HDL ratio, as it reflects the on going balance between the plaque deposition (LDL) and the removal of good (HDL) in the arteries. It's used to assess heart risk, especially with people that have elevated cholesterol levels.

Additional Testing:
C-reactive protein and homocysteine are both important additional markers in cardiovascular health examination.
-C-reactive protein is a key indicator of inflammation in the body.
-Homocysteine is involved with LDL cholesterol oxidation and blood clotting.

Liver function tests

We discussed these tests in our article (bodybuilding and liver health), we will discuss them again here.
Of course as we know, many steroids especially 17AA and oral ones, put lots of strain on the liver.
Liver enzymes ALT Alanine aminotransferase and AST Aspartate aminotransferase are the most important factors that show how much stress is on the liver.
Both indicators are mostly elevated with steroids users. However there have been cases where there values weren't that high even with liver damage, this calls for additional tests for other indicators.

ALP Alkaline phosphatase and GGT gammaglutamyltranspeptidase are both cholestatic enzymes, which means they stop the flow of bile (bile is the greenish fluid that aids digestions and produced in the liver).
Elevated results with these indicators indicate bile duct obstruction (intehepatic cholestasis), which means the liver can no longer properly metabolize and transport bile. This means there is a serious steroids induced liver toxicity.

One should always take liver support with steroids, read (bodybuilding and liver health) for more info, and if the results show
concern, then one should discontinue the offending steroids.

Muscles enzymes tests

Creatine kinase enzyme CK is used as a marker for muscles damage, kidney damage, and heart damage.
Elevated level can be found with exercise with high intensity and endurance as well, and sometimes it's mistaken for potential heart and kidney risks, its better to take this test after some rest from a very hard intense exercise for better results. High level should be checked for more details, as it may reflect kidney and heart damage.

Blood tests

This is a very common test; you probably all have undergone this test. It can reflect a good view of overall health.
During the steroids intake, and due to their effect on eythropoiesis, red blood cell count, hematocrit and hemoglobin concentration tend to increase. This have positive effect on aerobic capacity as oxygen carrying is more, but the increase in red blood cells cause an increase in the thickness of the blood and elevated hematocrit, which increase the risk of a heart attack or stroke.

Kidney tests

Here the three primary waste products that is filtered and excreted through the kidney are measured. And bad results may indicate serious kidney problem and farther tests would be needed.
As some results may not indicate real risk, for example high protein intake elevate the blood urea nitrogen, and as bodybuilders we all consume high protein intake, so the result shouldn't scare us much, unless its very elevated accompanied by other indicators.

Electrolytes, Minerals, and Glucose tests

If there is a problem with fluid and electrolyte balance, it will be shows by this test, although it may be because something simple as sodium or potassium imbalance, it also may reflect something more serious such as kidney disease.
Glucose level is good to know many health conditions such as metabolic syndromes, diabetes, pancreatic disease, liver disease or kidney failure.

Prostate tests

PSA Prostate-specific antigen (PSA) is a protein produced by cells in prostate gland. Elevated levels indicate cases of benign prostate hypertrophy or prostate cancer.
Steroids may cause some hypertrophy of the prostate, and if existing problem with the prostate exists.

Thats about the importance of different tests to be taken with steroids use, I know its sometimes not practical, as they may cost more than the cycles themselves, and you still have PCT, which also cost alot, supplements and gym memberships...etc, no wonder why many bodybuilders dont undergo these tests, most bodybuilders i know, especiall in the Arab world arent doing great financially, but one should be careful, and should remember that doing these tests may prevent your from thousands of money with a serious health problem, so make sure to be doing them at least once a year.

Shady Eid is a certified personal trainer, writer and competitive bodybuilders based in UAE, for questions and comments you can contact him at: Shady@arabianmuscles.com