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Blood Testing - A necessity in AAS usage - Part 3
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Blood Testing - A necessity in AAS usage - Part 3 - 01-08-2013, 01:23 AM

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!


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