I used the Life Extension Foundation to have my tests done as they have good prices and an extensive list of tests many medical professionals are often unaware of or don't bother with***.
I had the major hormones of importance checked:
Testosterone
Free testosterone
IGF-1 Estradiol
DHEA/DHEA-s
Full thyroid panel
I also had a full cardiovascular risk profile done, which included:
Total cholesterol
LDL
HDL
Triglycerides
C-reactive protein
Homocysteine
I had the major liver function tests done: alkaline phosphatase, GGT, SGOT, and SGPT, as well as a PSA test to make sure my prostate was OK.
Finally, I had the major kidney function tests done: creatinine, BUN, and the creatnine/BUN ratio. As mentioned above, there was actually over 80 tests done (man they took a lot of blood out of me!) but those are the major tests of interest to readers and will give you a good idea of what should be looked at.
My results were as follows:
Testosterone:
520ng/dl (normal range 300 - 1200)
Free testosterone:
18.3pg/ml (normal range 8.7 - 25)
IGF-1:
102ng/ml (normal range 109-284)
Estradiol:
22pg/ml (normal range 5 - 53 for adult male)
DHEA-s:
410ug/dl (normal range 120 - 520)
Thyroid panel
T4:
5.5ug/dl (normal range 4.5 - 12 )
T3:
3.1pg/ml (normal range 2.3 - 4.2)
TSH:
3.743uIU/ml (0.350 - 5.500)
Total cholesterol:
262mg/dl (normal healthy range 100 - 199)
LDL fraction:
167mg/dl (normal range 0 - 99)
HDL fraction:
54mg/dl (normal range 40 - 59)
Triglycerides:
204mg/dl (normal range 0 - 149)
C-reactive protein:
0.75 mg/l (> 2 increased risk of MI and stroke)
Homocysteine:
6.3umol/L (normal range 6.3 - 15)
Alkaline phosphatase:
62IU/L (Normal range (25 - 150
GGT:
15IU/L (normal range 0 - 65)
SGOT:
28IU/L (normal range 0 - 40)
SGPT:
24IU/L (normal range 0-40)
PSA:
0.6ng/ml (normal 0.0 - 4.0)
Creatinine:
1.0mg/dl (normal 0.5 - 1.5)
BUN:
19mg/dl (normal range 5 - 26)
Creatinine/BUN ratio:
19 (normal 8 - 27)
Comments On My Blood Work
As I stated above, reading a blood test is one thing, interpreting the results is another. For example, the reader will note my total cholesterol (and triglycerides) were above what is considered normal, presenting a possible increased risk of cardiovascular disease (CVD). However, I had not fasted for the test, which always leads to higher numbers in blood lipids (which is why they tell you to fast prior to blood work).
Regardless, my total cholesterol tends to run about 220 anyway, which is 20 points above what is recommend. Does that worry me? Not at all. Total cholesterol levels are poorly correlated to CVD, I have an exceptionally high HDL level (giving me a favorable total cholesterol/HDL ratio), very low homocysteine levels, low C-reactive protein levels, high normal DHEA levels, and no family history of CVD. Thus my real CVD risk is quite low. Speaking of DHEA, the reason I have such favorable DHEA levels is I take 25mg per day of DHEA. Prior tests showed I was actually low "normal" in DHEA for my age group, so I adjusted it upward via a DHEA supplement. How would I have ever known I was low in DHEA without a blood test? I wouldn't!
My testosterone and free T levels are in pretty good shape, but could be better. Thyroid could also be better. In fact, several prior tests showed I had sub clinical hypothyroid (low normal t3 and t4 with high TSH) which was treated with Armour Thyroid. However, seeing these latest results shows that although my thyroid levels have improved, they could be far better, thus, due to these latest tests I know I need to increase my dose of thyroid medication to get into the high normal range.
Low thyroid hormone levels means a person will have a sub optimal metabolism for protein synthesis, keeping bodyfat to a minimum, among the many essential functions the thyroid hormones play in human metabolism. Again, only blood tests will tell a person where they stand. Conversely, I have known many bodybuilders who took large amounts of thyroid meds in hopes of shedding bodyfat pre contest, only to shrivel up like a raison as their hard earned muscle mass was catabolized due to the huge doses of thyroid meds. How does a bodybuilder tweak thyroid levels to optimize fat loss without losing hard earned muscle? Blood tests! Bodybuilders and other athletes spend thousands of dollars on drugs, but often won't spend a penny on blood tests...
Finally, you may notice one real bummer in my blood tests, which are my IGF-1 levels. They suck! IGF-1, which is considered a reflection of GH levels (with some debate) have been low for me for years and I have no explanation for it. IGF-1 levels respond to total calorie intakes and total protein intakes, neither of which I lack. It's one area of my blood work that remains a bit of a mystery but I am looking into the problem.
I don't seem to suffer outward signs of a lack of IGF-1, and the cost of GH replacement therapy is very expensive and not without potential risks, so I don't consider it an option at this time. GH HRT may or may not increase my IGF-1 levels, though it normally does increase IGF-1 levels. Everything else looks in good shape. How does your blood look? Do you know?
Optimizing Hormones Levels
There are some hormones that we can be altered via diet, supplements, and or drugs, and there are some we have little direct control over. As you can see from my own tests, I am in pretty good shape, but not all is perfect. By knowing what's going on with my blood, I get a great deal of insight into what's going on with my body in general, and can make decisions from there.
The discussion and comments on my own tests is a the proverbial tip of the iceberg regarding the many potential variables that effect hormone levels, treatment options, effects of diet, supps, and training, etc., and it's simply too extensive a topic to cover in this article. It should also be noted that genetics play a large part in the equation regarding hormone levels and other factors.
So what would be an optimal level of the hormones mentioned above and how does one achieve it? The optimal hormone levels for adding muscle mass, minimizing bodyfat, and having a superior metabolism in general, would have high normal testosterone levels (total T, 800-1200, with free T 20-25), high normal IGF-1 (250-300), DHEA levels in the 400 - 500 range, low normal estradiol levels**** (below 25), high normal thyroid levels (T3, 3.5 - 4.5, T4, 8 - 12), with favorable blood lipids and CVD risk factors (e.g., C-reactive protein, etc), and normal kidney and liver functions. Of course the above recommendations do not take into account many variables, such as genetic individuality and other possible factors, as well as other tests that can be done.
The above recommended hormone levels and other variables can be achieved with diet, supplements, proper training, and when needed, HRT or other drugs. As mentioned, genetics plays a major role here. Some people simply have higher or lower levels of various hormones then others. At the same time, even simple changes can effect some hormones. For example, one high level Olympic sprinter I worked with had fairly low testosterone levels. On examination of his diet, it was found he was following a high carb low fat diet, which sucks for testosterone levels*****. By altering his diet, we were able to increase his testosterone levels by over 30%.
Steroids & Other Drugs
Finally, what of steroids and other drugs? Steroids will of course have profound effects on the above discussion. Injecting say 500-1000mg per week of Sustanon (a testosterone blend) will shoot total and free testosterone levels far above the high normal range, and will have all sorts of additional effects on things like estradiol (will go up), cholesterol levels, etc, etc. The person will also put on a considerable amount of lean bodymass on such a regimen, but potential side effects may occur that will have to be dealt with.
The addition of other steroids, GH, insulin, anti estrogens, etc, etc, further complicates things and adds a new level of potential issues that are beyond the scope of this article. Suffice it to say: (a) this article is generally directed at people not using large doses of steroids and other drugs (though low dose HRT is often needed for some people to optimize their metabolism) and (b) people that are using steroids and other drugs that bring them far above normal lab values need to have regular blood work done for obvious reasons, such as seeing if the drugs are having a negative impact on liver function, cholesterol levels, etc. If a person is using the above example of 500mg per week of Sustanon, there is no real reason to test for Testosterone levels now is there?
Conclusion
This article is designed to be a down and dirty primer and introduction to understanding the value of regular blood work with some strategies and pointers for optimizing hormones and other things that negatively or positively impact your health and ability to add lean body mass and minimize bodyfat levels. It's not intended as an exhaustive review of the topic or a guide to take matters into your own hands without the guidance of your doctor.
It is intended to give the reader a solid foundation they can work from and make bodybuilders and other athletes realize they are throwing away literally thousands of dollars each year on supplements, drugs, etc., not to mention a great deal of wasted time, if their hormones are sub optimal. See you in the gym!
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