Thursday, January 08, 2004
THE IMPORTANCE OF BLOOD MONITORING
Despite the recent trend for sections of the medical community to try and convince the public of the safety and effectiveness of Testosterone Enanthate as a contraceptive, once again I think they are lying to us. Isn't it funny how the same idiots were telling us a few years ago about how anabolic steroids (which are mostly safer than testosterone) were not only ineffective in improving athletic performance, but they would kill you? In fact, I'm sad to say there are still those out there sprouting this crap. But now they tell us that there are no side effects from 300 mg or even 600 mg of T.E. a week. I don't know about you, but I find that hard to believe (I know I would be wanting to kill everyone if I was on 600 mg TE/week; reported side effects were acne in about 5% of subjects and breast tenderness in 3%). Oh, and they did notice a slight weight gain (funny that, I thought they didn't increase muscle mass!!). The unfortunate thing is they tell you what they want you to believe, which may or may not be the truth.
The point is, if you use AS, you should have regular blood tests to see if there are problems that you may not be aware of otherwise. A good example is the changes in blood lipid parameters, like HDL/LDL cholesterol changes, If your intake of AS is affecting your blood lipid profile adversely, you will not necessarily feel unwell. But it is not wise to put yourself at risk when it can be avoided by a change in AS type or dosage schedule. For this reason, it is advisable to have regular blood tests whether on or off a cycle.
The problems most people have is that they don't know what they should test for, and most doctors have little idea. I will try and give you a brief description of each parameter that I consider important to look at, together with a brief description of why they are relevant.
Cardiovascular Parameters: Probably the greatest concern for many who take AS is the long term effect on CV health. Specifically, atherosclerosis due to unfavorable changes in the blood lipid profile. As you know, the narrowing of the arteries due to cholesterol plaque deposits are one of the major factors in both heart attacks and strokes. Many people find that AS reduce their levels of the good cholesterol HDL, which helps clean cholesterol deposits out of the arteries and deposit them in the liver to be removed. At the same time, LDL or the "bad" cholesterol goes up. Therefore the ratio of HDL to LDL, which is called the cardiac risk factor, can change quite markedly. Should you have a blood test which shows a bad cardiac risk factor, you need to consider changing your dosage or type of AS. I have found that Stanozolol for example, is quite bad for increasing my LDL.
Other important CV parameters to look at are triglyceride levels (fasted, as for Cholesterol) and lipoprotein A levels.' Lipoprotein A is thought to be a protective blood lipid which goes up with Testosterone use. If you have bad results from these tests, you need to look at diet (fat content, add omega 6 fatty acid intake, have a glass of red wine a day) and exercise (aerobic exercise elevates HDL more that just weight training).
Liver Function tests: These can be divided into specific LFT's and non specific LFT'S. The non- specific LFT's are next to useless, because they are enzymes that are folind in the liver, but also in muscle, heart and other tissues. SGOT and SGPT are usually elevated in people who weight train, and are further increased by intramuscular injections.
The other two commonly used non-specific LFT's (alkaline phosphatase and gamma GT) are not as high in muscle, and therefore are a much better guide to possible liver problems than the previous two. However, they are not as good as indicators of liver stress from AS as the specific LFT, Billirubin. Billirubin is the breakdown product of the hemoglobin molecule contained in RBC to carry Oxygen. The liver first metabolises the hemoglobin to bilirubin, and then conjugates it joins to another molecule) before excreting the conjugated complex.
For this reason bulirubin levels are reported on the blood test as total, conjugated and free billirubin. It is usually the case in liver damage from AS Llse that the total and conjugated levels are elevated to a greater extent than the free billirubin levels. This is due to the fact that the damage causes a slow down in the excretion of the conjugated product, rather than a change in the levels of billirubin production. I believe that these levels are by far the best indicator of liver problems, the others are of questionable significance.
Full Blood Count: As a general health check, it is standard practice to have a FBC done. The information this provides includes: red blood cell number, size and hemoglobin levels; white blood cell types - and numbers; electrolyte levels (sodium, potassium, etc); albumin and globulin levels (blood proteins that have as one of their properties to bind to hormones and drugs).
Should there be any abnormal results on this test your doctor should be able to advise you of its likely cause. However, it is unlikely to be as a result of AS use because the only change I have seen is when there is a mild form of normochromic microcytic anemia (normochromic= normal hemoglobin levels per cell; microcytic= smaller RBC than normal). This occurs in some people who take stanozolol, but generally causes nothing detrimental. It does tend to mimic the signs of gastrointestinal blood loss, which is always a cause for concern, but if it occurs, first stop taking stanozolol before you let them stick tubes up both ends to have a look.
Endocrine parameters: The use of AS brings about predictable changes to the blood hormone levels. If testosterone injections are taken, these will show up on the blood test, and are indistinguishable from the body's own testosterone. However, in both cases the Luteinising Hormone (LH) will be low due to the negative feedback system. When the pituitary gland senses that the blood levels of test. or AS are high. It drastically reduces its output of LH - the hormone that stimulates the testicles to produce testosterone. The idea is that the levels of test. secreted by the body (endogenous= from within) are kept fairly constant this way. Obviously, the situation changes when exogenous (from outside) test. or AS are present.
A lot of people make a big deal out of how long it takes for the hormone levels to return to normal, due to pituitary suppression, but I question whether this is relevant unless one is trying to start a family. In which case 3000 IU of HCG every 3 days should do the trick. Obviously, there will be a tendency to lose muscle mass at the end of a cycle, but this will happen regardless of whether you use HCG or not. This is due to the fact that HCG will stimulate test. release for a while, but once it is stopped, you will still go through a period where there is next to no test. or LH. HCG is an analogue of LH and as such inhibits LH release from the pituitary. My answer, is to stay on high physiological levels of test. (about 200-300mg /week) and cycle anabolics up to 1000 mg/wk for 1012 weeks on and 6 off.
It is also important to consider the levels of free and bound test. as well as total. Test. circulates in the blood mainly bound to albumin or Sex Hormone Binding Globulin (SHBG). The bound fraction of test, is not available to bind to the receptors, and as such acts as a kind of reservoir. The free hormone is available to bind to the receptor and when it does, one of the molecules of the bound hormone becomes free. There is an equilibrium between the bound and free fractions which depends in part, on the level of SHBG and albumin. When the levels of AS are high, the SHBG often increases, and this may be a sign of receptor downregulation. It is certainly an indication that the body is adapting to the dosage. So, the relevant endocrine parameters to test for are:
-Testosterone (bound and free), Luteinising Hormone, Sex Hormone Binding, Globulin and perhaps Estrogen if using an aromatase enzyme inhibitor such as cytadren (to monitor its effectiveness). All of the normal levels are reported along with the results o the tests, so I won't bore you with them here.
Summary: I hope this has cleared up a lot o confusion about what is important to test for and why. Remember your long term health WILL be important to you even if it's not now. So be careful and train hard and use any drugs wisely or not at all.
Despite the recent trend for sections of the medical community to try and convince the public of the safety and effectiveness of Testosterone Enanthate as a contraceptive, once again I think they are lying to us. Isn't it funny how the same idiots were telling us a few years ago about how anabolic steroids (which are mostly safer than testosterone) were not only ineffective in improving athletic performance, but they would kill you? In fact, I'm sad to say there are still those out there sprouting this crap. But now they tell us that there are no side effects from 300 mg or even 600 mg of T.E. a week. I don't know about you, but I find that hard to believe (I know I would be wanting to kill everyone if I was on 600 mg TE/week; reported side effects were acne in about 5% of subjects and breast tenderness in 3%). Oh, and they did notice a slight weight gain (funny that, I thought they didn't increase muscle mass!!). The unfortunate thing is they tell you what they want you to believe, which may or may not be the truth.
The point is, if you use AS, you should have regular blood tests to see if there are problems that you may not be aware of otherwise. A good example is the changes in blood lipid parameters, like HDL/LDL cholesterol changes, If your intake of AS is affecting your blood lipid profile adversely, you will not necessarily feel unwell. But it is not wise to put yourself at risk when it can be avoided by a change in AS type or dosage schedule. For this reason, it is advisable to have regular blood tests whether on or off a cycle.
The problems most people have is that they don't know what they should test for, and most doctors have little idea. I will try and give you a brief description of each parameter that I consider important to look at, together with a brief description of why they are relevant.
Cardiovascular Parameters: Probably the greatest concern for many who take AS is the long term effect on CV health. Specifically, atherosclerosis due to unfavorable changes in the blood lipid profile. As you know, the narrowing of the arteries due to cholesterol plaque deposits are one of the major factors in both heart attacks and strokes. Many people find that AS reduce their levels of the good cholesterol HDL, which helps clean cholesterol deposits out of the arteries and deposit them in the liver to be removed. At the same time, LDL or the "bad" cholesterol goes up. Therefore the ratio of HDL to LDL, which is called the cardiac risk factor, can change quite markedly. Should you have a blood test which shows a bad cardiac risk factor, you need to consider changing your dosage or type of AS. I have found that Stanozolol for example, is quite bad for increasing my LDL.
Other important CV parameters to look at are triglyceride levels (fasted, as for Cholesterol) and lipoprotein A levels.' Lipoprotein A is thought to be a protective blood lipid which goes up with Testosterone use. If you have bad results from these tests, you need to look at diet (fat content, add omega 6 fatty acid intake, have a glass of red wine a day) and exercise (aerobic exercise elevates HDL more that just weight training).
Liver Function tests: These can be divided into specific LFT's and non specific LFT'S. The non- specific LFT's are next to useless, because they are enzymes that are folind in the liver, but also in muscle, heart and other tissues. SGOT and SGPT are usually elevated in people who weight train, and are further increased by intramuscular injections.
The other two commonly used non-specific LFT's (alkaline phosphatase and gamma GT) are not as high in muscle, and therefore are a much better guide to possible liver problems than the previous two. However, they are not as good as indicators of liver stress from AS as the specific LFT, Billirubin. Billirubin is the breakdown product of the hemoglobin molecule contained in RBC to carry Oxygen. The liver first metabolises the hemoglobin to bilirubin, and then conjugates it joins to another molecule) before excreting the conjugated complex.
For this reason bulirubin levels are reported on the blood test as total, conjugated and free billirubin. It is usually the case in liver damage from AS Llse that the total and conjugated levels are elevated to a greater extent than the free billirubin levels. This is due to the fact that the damage causes a slow down in the excretion of the conjugated product, rather than a change in the levels of billirubin production. I believe that these levels are by far the best indicator of liver problems, the others are of questionable significance.
Full Blood Count: As a general health check, it is standard practice to have a FBC done. The information this provides includes: red blood cell number, size and hemoglobin levels; white blood cell types - and numbers; electrolyte levels (sodium, potassium, etc); albumin and globulin levels (blood proteins that have as one of their properties to bind to hormones and drugs).
Should there be any abnormal results on this test your doctor should be able to advise you of its likely cause. However, it is unlikely to be as a result of AS use because the only change I have seen is when there is a mild form of normochromic microcytic anemia (normochromic= normal hemoglobin levels per cell; microcytic= smaller RBC than normal). This occurs in some people who take stanozolol, but generally causes nothing detrimental. It does tend to mimic the signs of gastrointestinal blood loss, which is always a cause for concern, but if it occurs, first stop taking stanozolol before you let them stick tubes up both ends to have a look.
Endocrine parameters: The use of AS brings about predictable changes to the blood hormone levels. If testosterone injections are taken, these will show up on the blood test, and are indistinguishable from the body's own testosterone. However, in both cases the Luteinising Hormone (LH) will be low due to the negative feedback system. When the pituitary gland senses that the blood levels of test. or AS are high. It drastically reduces its output of LH - the hormone that stimulates the testicles to produce testosterone. The idea is that the levels of test. secreted by the body (endogenous= from within) are kept fairly constant this way. Obviously, the situation changes when exogenous (from outside) test. or AS are present.
A lot of people make a big deal out of how long it takes for the hormone levels to return to normal, due to pituitary suppression, but I question whether this is relevant unless one is trying to start a family. In which case 3000 IU of HCG every 3 days should do the trick. Obviously, there will be a tendency to lose muscle mass at the end of a cycle, but this will happen regardless of whether you use HCG or not. This is due to the fact that HCG will stimulate test. release for a while, but once it is stopped, you will still go through a period where there is next to no test. or LH. HCG is an analogue of LH and as such inhibits LH release from the pituitary. My answer, is to stay on high physiological levels of test. (about 200-300mg /week) and cycle anabolics up to 1000 mg/wk for 1012 weeks on and 6 off.
It is also important to consider the levels of free and bound test. as well as total. Test. circulates in the blood mainly bound to albumin or Sex Hormone Binding Globulin (SHBG). The bound fraction of test, is not available to bind to the receptors, and as such acts as a kind of reservoir. The free hormone is available to bind to the receptor and when it does, one of the molecules of the bound hormone becomes free. There is an equilibrium between the bound and free fractions which depends in part, on the level of SHBG and albumin. When the levels of AS are high, the SHBG often increases, and this may be a sign of receptor downregulation. It is certainly an indication that the body is adapting to the dosage. So, the relevant endocrine parameters to test for are:
-Testosterone (bound and free), Luteinising Hormone, Sex Hormone Binding, Globulin and perhaps Estrogen if using an aromatase enzyme inhibitor such as cytadren (to monitor its effectiveness). All of the normal levels are reported along with the results o the tests, so I won't bore you with them here.
Summary: I hope this has cleared up a lot o confusion about what is important to test for and why. Remember your long term health WILL be important to you even if it's not now. So be careful and train hard and use any drugs wisely or not at all.