Steroids change the body in powerful ways. They affect hormones, the liver, the kidneys, the heart, and even mental health. On the outside, the changes might look like more muscle and less fat. But on the inside, the risks are often invisible.
That’s why blood work matters. It shows what’s happening beneath the surface. Without it, serious problems can build quietly until it’s too late.
This article explains why blood work is important, what tests should be done, when to do them, and what the results mean.
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Why Blood work Matters
Steroids raise testosterone far above natural levels. Some also raise estrogen, progesterone, or prolactin. When hormones shift, the body adjusts in other ways. Cholesterol may change. Blood pressure may rise. The liver may become stressed.
Many of these issues cause no immediate symptoms. A person can feel healthy while their blood work shows signs of long-term damage. That is the danger.
Blood work gives early warning signs. It lets the user see if a cycle is causing harm before it turns into something permanent.
What Tests to Run
Hormone Panel
- Total testosterone – Shows how much testosterone is in the blood. On steroids, this will be far above normal.
- Free testosterone – The portion actually active in the body.
- Estrogen (E2) – Can rise from testosterone conversion, leading to side effects like water retention and gynecomastia.
- LH and FSH – Show natural production. On cycle, these are usually suppressed.
- Prolactin and progesterone – Useful if running compounds that raise them.
General Health
- Complete blood count (CBC): Checks red and white cells. Steroids often raise red cell counts, which can make blood thicker. Thick blood increases the risk of clots.
- Liver function (AST, ALT, ALP, bilirubin): Oral steroids especially can strain the liver. High enzyme levels are a red flag.
- Kidney panel (creatinine, BUN, eGFR): Shows how well kidneys are filtering.
- Lipid panel (HDL, LDL, triglycerides): Steroids often lower HDL (“good cholesterol”) and raise LDL (“bad cholesterol”). This increases heart disease risk.
- Fasting glucose and HbA1c: Some steroids can affect insulin sensitivity.
Other Useful Checks
- Blood pressure: Not always part of standard blood work, but essential.
- PSA (prostate-specific antigen): For older men, this checks prostate health.
When to Test
Blood work should not be a one-time thing. It needs to be done in stages.
- Before starting a cycle
Baseline numbers are important. They show what “normal” looks like for you. Without a baseline, it’s hard to judge changes later. - Mid-cycle
Around week 4 to 6 is common. This shows how the body is responding in real time. If cholesterol is dropping fast or liver enzymes are climbing, changes can be made before it gets worse. - Post-cycle
After the cycle ends, blood work shows how recovery is going. Natural testosterone will usually be low. Estrogen and prolactin may still be high. This guides post-cycle therapy (PCT). - Long-term follow-up
Even months later, blood work matters. Some side effects don’t vanish when the cycle ends. Cholesterol, blood pressure, or liver markers may stay off balance. Regular testing shows if the body has returned to normal.
How to Read the Results
Hormones
- Testosterone: On cycle, levels may be many times above normal. After cycle, they may crash close to zero without PCT.
- Estrogen: Some rise is expected. Very high numbers mean risk of water retention, mood swings, and breast tissue growth.
- LH/FSH: These usually drop to near zero on cycle, showing natural production has shut down.
Liver
- AST/ALT: Mild increases can happen from training alone. Very high values may mean liver damage.
- Bilirubin: High levels can point to poor liver function.
Kidneys
- Creatinine and BUN: High levels suggest kidneys are under strain. Some muscle gain can raise creatinine, but very high numbers are dangerous.
Blood
- Hematocrit and hemoglobin: High levels mean blood is too thick. This raises clot and stroke risk. Sometimes blood donation is used to reduce it.
Lipids
- HDL (“good”) cholesterol: Often drops on cycle.
- LDL (“bad”) cholesterol: Often rises.
- Triglycerides: Can climb.
Together, these changes increase the risk of heart attack over time.
Risks of Ignoring Blood work
Without testing, a user may assume everything is fine. But common hidden problems include:
- High blood pressure with no symptoms
- Silent liver stress
- Dangerous cholesterol changes
- Thickened blood with clot risk
By the time symptoms show like chest pain, yellowing skin, or constant fatigue the damage may already be serious.
The Role of Blood work in Safer Use
No blood work makes steroid use blind. With blood work, risks don’t go away, but they become visible. That visibility allows decisions: lowering the dose, adding support drugs, or stopping the cycle.
It is not about making steroids safe. It is about reducing harm.
Closing Thoughts
Steroids change more than just muscle size. They affect hormones, blood, the heart, the liver, and the kidneys. These changes are not always felt, but they can be seen in blood work.
Testing before, during, and after a cycle is the only way to know what’s happening inside the body. Ignoring blood work is like driving at night with no headlights. You may not see the danger until you crash.
Steroids carry risks. Blood work doesn’t remove them, but it gives the information needed to act early. For anyone choosing to use, regular blood work is not optional, it is essential.
References
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- Nieschlag E, Vorona E. Medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol. 2015.
- Frati P, Busardò FP, Cipolloni L, De Dominicis E, Fineschi V. Anabolic androgenic steroid (AAS) related deaths: autoptic, histopathological and toxicological findings. Curr Neuropharmacol. 2015.
- Mayo Clinic. Cortisone shots: Risks. 2022.
- Hartgens F, Kuipers H. Effects of androgenic-anabolic steroids in athletes. Sports Med. 2004.