A down and dirty primer and intro 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
One topic that seems to be a never-ending source of confusion is blood, or more precisely, understanding blood work and which tests to get and why. It never fails to amaze me that the vast majority of bodybuilders and other athletes have no issue spending literally thousands of dollars on supplements (some of which have virtually no science behind them to justify their use) and gym memberships each year, but won’t spend a penny on blood tests to see what’s really going on with their hormones and other indicators of health (e.g., cholesterol, liver function, etc.).
This is odd considering the fact that it’s those very hormones that are ultimately responsible for whether or not your hard work in the gym is a waste of time (read busting your ass and getting no place fast) or productive. Let me be as clear as possible here: if your blood chemistry is off, meaning your hormone levels are sub par, you can eat all the supplements you want, follow any fancy new routine you want, and eat all you want, and you will be spinning your wheels with little to no results!
Depending on how out of whack your hormones are, you will get less then optimal results from your hard work or virtually no results at all. Conversely, the person with naturally optimal levels of hormones, or the person that has optimized their hormone levels via external assistance (more on that later) is going to make the progress they expect from their training, nutrition, and supplement use.
Now, explaining everything there is to know about blood work, hormones, etc., is far beyond the scope of this article. What I hope to do is give people a primer, using my own recent blood tests as examples, so people understand the importance of regular blood work and will follow up by learning more about the topic via additional readings, talking to a doctor, surfing the net, and so on.
Most bodybuilders know about the major anabolic and catabolic hormones, such as testosterone, Insulin-like growth factor-1, GH, cortisol, etc. There are however other tests that give an overall picture that should be considered (e.g., estradiol, thyroid hormones, etc.) and not all hormones can be tested for easily by a single blood draw, such as GH, which does not last long enough in the blood and is released in a pulsatile fashion, making it difficult to test for unless you are hooked up for multiple blood draws throughout the day.
Reading Blood Tests 101
Many people are under the impression that blood tests are difficult to read and must be in some secret coded language only doctors can possibly understand. Nothing could be further from the truth. The trick is not in reading them per se but interpreting them. Interpreting a blood test, that is understanding the relevance of the results, is where the doctor’s education may come in and where years of research can be spent.
This does not mean however that even the average person can’t read a blood test and derive some very useful information regarding the state of their health, hormone levels, and so on. It’s not uncommon at all for a person to spot something of concern on a blood test a doctor either didn’t notice or didn’t feel was a concern (such as a low “normal” testosterone level) where the bodybuilder would be concerned (being you can’t build no damn muscle without adequate testosterone!).
Labs have a reference range for anything tested, such as testosterone, cholesterol, and so on. The test always has that range with the results of your test next to it, and it’s easy enough to read. For example: normal testosterone levels range from a low of 300ng/dl to a high of 1200ng/dl*. A testosterone level between those numbers (mine was 520) is considered “normal.” Free (unbound) testosterone has a low/high range of 8.7pg/ml – 25pg/ml. Mine was 18.3 which would be about mid “normal.”
So, it’s quite easy to read a blood test. Again, the challenge is understanding why a person has say low testosterone and what to do about it, such as run additional tests, consider hormone replacement therapy (HRT) and so on. So, reading them is easy, interpreting them is where the difficulty comes in and doctors are often as guilty as lay people in this respect. A perfect example; the many people who fall in the low “normal” range of some hormone. You will often see some poor bastard who is just a few points above the lowest possible “normal” level of testosterone, but most doctors won’t treat a person if they are low normal, even when the person is exhibiting symptoms of lacking testosterone.
A smart doctor will know that low normal testosterone levels, though technically “normal,” really sucks for adding new muscle, keeping body fat down, libido, mental function, and so on. Though technically sub-clinical, these low “normal” levels should be treated and the data is quite clear that men will greatly benefit from such treatments, often seeing an increase in libido, reduced depression, reduction in cholesterol levels, reductions in bodyfat, and improved muscle mass. Even when some doctors are aware that sub clinical levels of testosterone should be addressed (via HRT), they often won’t due to fear of liability.
There are other areas where sub clinical (low normal) levels of hormones should be treated, such as sub clinical levels of thyroid hormones T3 and T4 for example. Of course there can be levels of some hormone that can be too high (versus too low) yet still be technically in the normal range. For example, most of the medical profession refuses to understand the role estrogen – in particular estradiol – plays in a man’s physiology. To the majority of the medical profession, estradiol is a “woman’s” hormone and refuse to treat men (via an estrogen lowering drug or other modality) when high estrogen levels in men can cause a long list of undesirable effects, from gyno (bitch tits), to increases in bodyfat, to a loss of libido, etc.
Recent data also points to estradiol being correlated to prostate cancer and other ailments best avoided.** So, don’t think doctors have all the answers after viewing a blood test. They don’t. The best combination is an open-minded progressive doctor who works with a patient who has a general understanding of how to read their own blood tests. A partnership, so to speak, between doctor and patient. This segues us into a comment regarding (some) doctors and your blood tests. Always ask for a copy of your blood work versus simply taking the doctor’s word for it with a sweeping “your blood work looks fine” that they often use.
It’s very odd to note that some doctors will refuse to give a person a copy of their own blood work! I have no idea why they feel they have the right to do that, but they don’t. Any doctor that refuses to give a person a copy of their own blood work is no doctor you want to work with.
My Own Test Results…
Recently, I had over 80 different tests done on my blood, which I do at least once per year, and I consider it money very well spent. In most states you can simply walk into a lab and have your blood drawn and then check off on an order form which tests you want done. Some states may require a doctor to request the tests on your behalf. Some times you can get insurance to pay for it. However, some companies have packages they put together where you can save a considerable amount of money.
See Part 2!