Blood work reports come with dozens of unfamiliar names, abbreviations, and ranges. If you have ever stared at a lab result wondering what "MCHC" or "RDW" actually means, you are not alone. This glossary covers 50 blood markers organized by physiological system — with function, units, athletic reference ranges, and AAS impact for each.
Bookmark this page for quick reference during your next blood work review. Each marker includes what it does in plain language, what the normal range looks like for an athletic population, and how AAS use typically affects it.
📖HOW TO USE THIS GLOSSARY
Each marker is grouped by the body system it relates to. Use the sections below to find the marker you need. Normal ranges shown are athletic ranges (where available), not general population ranges. AAS impact notes how androgens typically affect each marker — but individual responses vary.
Your kidneys filter waste from your blood and regulate fluid balance. On AAS, they work harder due to increased muscle mass, higher blood pressure, and direct metabolic effects. These markers tell you whether your kidneys are handling the load.
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eGFR (Estimated Glomerular Filtration Rate)
Measures how well your kidneys filter waste from your blood. Calculated from your creatinine level, age, sex, and sometimes race. Think of it as a percentage of normal kidney function — 100 means perfect, below 60 means trouble. For athletes, a mildly low eGFR from high creatinine is usually a muscle artifact, not real kidney damage.
Normal
≥ 90 mL/min/1.73m² (general), ≥ 75 (athletic)
Alert
Below 60 requires investigation; below 30 is serious
A waste product from the normal breakdown of muscle tissue. The more muscle you have, the more creatinine your body produces. This is why big, muscular athletes often show creatinine levels above the lab reference range — it does not mean their kidneys are failing, just that they have more muscle than the average person.
Normal
0.7-1.5 mg/dL (higher with more muscle mass)
Alert
Above 2.0 with low eGFR requires investigation
A kidney filtration marker that is NOT affected by muscle mass. This makes it the gold standard for true kidney function in athletes. If your creatinine-based eGFR looks low but your cystatin C-based eGFR looks normal, the creatinine elevation is from muscle, not kidney damage. If both are low, you have a real kidney issue.
Alert
Above 1.2 suggests true kidney impairment
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BUN (Blood Urea Nitrogen)
A waste product from protein metabolism. When you eat protein or your body breaks down muscle tissue, ammonia is produced and converted to urea. High BUN can mean high protein intake, dehydration, or kidney stress. On AAS with high protein diets, mildly elevated BUN is common.
Alert
Above 30 suggests dehydration or kidney stress
A breakdown product of purines, which are found in many foods and also produced by your body. AAS can increase uric acid levels. High uric acid is associated with gout (painful joint inflammation) and can also indicate kidney stress. Staying hydrated helps keep uric acid under control.
Alert
Above 9.0 increases gout risk; above 11 requires treatment
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Liver and Muscle Markers
Your liver processes everything you put into your body, including AAS. Oral androgens in particular are hepatotoxic (liver-stressing). These markers help distinguish between liver stress and muscle damage — a critical distinction for athletes who train hard and may show elevated enzymes from training alone.
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AST (Aspartate Aminotransferase)
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AST (Aspartate Aminotransferase)
Okay
An enzyme found in the liver, heart, and muscle cells. When any of these tissues are damaged or stressed, AST leaks into your blood. The problem is that AST alone does not tell you which tissue is the source. This is why AST is always interpreted alongside ALT and GGT.
Normal
10-80 U/L (athletic range, includes training elevation)
Alert
Above 2x normal requires investigation with GGT to determine source
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ALT (Alanine Aminotransferase)
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ALT (Alanine Aminotransferase)
Okay
An enzyme more specific to the liver than AST. While ALT can still rise from muscle damage, it is less affected by exercise than AST. When both ALT and AST are elevated but GGT is normal, the source is likely muscle (training). When GGT is also elevated, the source is likely liver.
Normal
10-60 U/L (athletic range)
Alert
ALT above 2x upper limit with elevated GGT suggests liver stress
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GGT (Gamma-Glutamyl Transferase)
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GGT (Gamma-Glutamyl Transferase)
Okay
The most liver-specific enzyme in your standard blood panel. Unlike AST and ALT, GGT is almost exclusively found in the liver and bile ducts. If GGT is normal but AST and ALT are elevated, the elevation is almost certainly from muscle, not the liver. This makes GGT the single most useful enzyme for athletes.
Alert
Above 2x normal is a strong indicator of liver or bile duct stress
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ALP (Alkaline Phosphatase)
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ALP (Alkaline Phosphatase)
Okay
An enzyme found in the liver, bone, and bile ducts. ALP can be elevated during periods of bone growth or healing, making it tricky to interpret in athletes. It can also rise when bile flow is obstructed. Isolated ALP elevation with normal GGT is usually bone-related.
Alert
Above 150 with elevated GGT suggests biliary stress
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Bilirubin (Total and Direct)
A yellow breakdown product of red blood cells. Your liver processes bilirubin and excretes it in bile. Elevated total bilirubin with normal liver enzymes is often Gilbert's syndrome (a benign genetic condition affecting ~10% of the population). But elevated bilirubin plus elevated liver enzymes suggests significant liver stress.
Normal
0.1-1.2 mg/dL (total); < 0.3 (direct)
Alert
Above 2.0 with elevated enzymes requires investigation
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LDH (Lactate Dehydrogenase)
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LDH (Lactate Dehydrogenase)
Okay
An enzyme found in most body tissues. LDH is non-specific — it can be elevated from training, red blood cell breakdown (hemolysis), or tissue damage. Think of it as a general 'something is happening' marker. Useful as a trend indicator but not diagnostic on its own.
Alert
Above 400 requires investigation into the source
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CK (Creatine Kinase)
Okay
An enzyme released from damaged muscle tissue. This is the marker that spikes the most from training — intense leg day can push CK to 5,000 or higher. On AAS, training intensity often increases, which can raise CK further. The key is knowing your baseline and watching for unusually high values with symptoms.
Normal
Up to 1,200 U/L post-training (athletic range)
Alert
Above 2,000 with dark urine suggests rhabdomyolysis — seek medical attention
❤️CARDIOVASCULAR AND LIPIDS
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Cardiovascular and Lipid Markers
AAS have well-documented effects on cholesterol and cardiovascular markers. These are arguably the most important markers for long-term health on AAS, as cardiovascular disease is the leading cause of death in the general population and AAS use accelerates several risk factors.
The total amount of cholesterol in your blood, including both HDL (good) and LDL (bad). On its own, total cholesterol does not tell you much — two people can have the same total with very different risk profiles. The composition matters far more than the total number.
Alert
Above 240 requires deeper analysis of HDL, LDL, and ApoB
The 'good' cholesterol that transports cholesterol from your tissues back to your liver for disposal. HDL is suppressed by androgens via AR signaling in the liver. Low HDL is expected on AAS and, in isolation, is not actionable. However, extremely low HDL (< 20) combined with high LDL is concerning.
Normal
≥ 40 mg/dL (general); ≥ 25 mg/dL (acceptable on AAS)
Alert
Below 20 is concerning even on AAS; below 15 requires intervention
The 'bad' cholesterol that carries cholesterol to your tissues. LDL increases with AAS use, especially oral compounds. But not all LDL particles are equally dangerous — small, dense LDL is worse than large, fluffy LDL. ApoB gives a better picture of particle count than LDL alone.
Normal
< 130 mg/dL (optimal); < 160 (acceptable on AAS)
Alert
Above 190 with elevated ApoB requires active management
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ApoB (Apolipoprotein B)
Okay
The single best predictor of cardiovascular risk. Every atherogenic (plaque-forming) particle — whether LDL, VLDL, IDL, or Lp(a) — contains exactly one ApoB molecule. So ApoB directly measures the number of dangerous particles in your blood. This is the advanced lipid test every athlete should prioritize.
Normal
< 90 mg/dL (optimal); < 110 (acceptable for AAS users)
Alert
Above 130 requires aggressive management regardless of LDL level
The main form of fat circulating in your blood. High triglycerides are strongly associated with insulin resistance, metabolic syndrome, and cardiovascular risk. They can spike on AAS (especially orals) and with high-carb diets. Fasted measurement is essential for accuracy.
Normal
< 150 mg/dL (fasting)
Alert
Above 200 suggests insulin resistance; above 500 requires medical attention
A genetically determined LDL-like particle that is highly atherogenic. Your Lp(a) level is largely set by your genes and does not change much with diet or exercise. A high Lp(a) means you need to be more aggressive about managing other risk factors because you have less room for error.
Alert
Above 50 with high ApoB significantly increases cardiovascular risk
An amino acid linked to cardiovascular risk when elevated. Homocysteine can increase with AAS use, particularly with certain compounds. The good news is that it is easily managed with B-vitamin supplementation (B12, B6, and folate). A simple and effective intervention.
Alert
Above 15 requires B-vitamin supplementation
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hs-CRP (High-Sensitivity C-Reactive Protein)
A marker of systemic inflammation. Your liver produces CRP in response to inflammatory signals from anywhere in the body. High hs-CRP can indicate inflammation from infection, autoimmune disease, high training load, or cardiovascular inflammation. Always interpret in context.
Normal
< 1.0 mg/L (low risk); 1.0-3.0 (moderate risk)
Alert
Above 3.0 requires investigation into the source of inflammation
These markers measure your red blood cells, white blood cells, and platelets. AAS directly stimulate red blood cell production, making these markers among the most consistently affected by androgen use. They are also the most immediately actionable — high hematocrit is the most common reason for intervention on cycle.
The percentage of your blood volume made up of red blood cells. AAS stimulate EPO production, raising Ht. This is the single most important blood marker to monitor on cycle.
Normal
40-50% (general); 45-54% (AAS athletic range)
Alert
Above 55% requires active management; above 58% is urgent
The oxygen-carrying protein in red blood cells. Rises alongside Ht on AAS. Higher Hb means better oxygen delivery, but above 18 g/dL, the blood becomes thick enough to increase cardiovascular strain.
Normal
13.5-17.5 g/dL (general); 14-18 g/dL (AAS athletic)
Alert
Above 18.5 with high Ht needs monitoring
The number of red blood cells in your blood. Tracks closely with hematocrit and hemoglobin. All three markers usually move together, so looking at any one of them gives you a good sense of the others. But subtle differences between them can provide diagnostic clues.
Alert
Above 6.5 requires investigation
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MCV (Mean Corpuscular Volume)
The average size of your red blood cells. High MCV (macrocytic cells) can indicate B12 or folate deficiency, or alcohol use. Low MCV (microcytic cells) can indicate iron deficiency. MCV shifts slowly over months, so it is a useful long-term health indicator.
Alert
Above 105 or below 75 requires investigation
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RDW (Red Cell Distribution Width)
Measures how much your red blood cells vary in size. High RDW indicates increased red cell turnover or a nutrient deficiency (iron, B12, folate). It is often the first hematology marker to shift when something is off, making it a useful early warning indicator.
Alert
Above 16% suggests nutrient deficiency or increased red cell turnover
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Platelets (Thrombocytes)
Small cell fragments that form blood clots when you bleed. Platelets are your first responders for injury repair. On AAS, some compounds can increase platelet count and reactivity. High platelets combined with elevated Ht significantly increases clotting risk — this is the compound danger.
Normal
150,000 - 400,000 /mcL
Alert
Above 400,000 with high Ht significantly increases thrombotic risk
Your body's iron storage protein. AAS use lowers ferritin because increased red blood cell production consumes iron. This is why frequent blood donors often develop low ferritin. Low ferritin can cause fatigue, brain fog, and poor recovery even when your hemoglobin looks normal.
Alert
Below 20 causes fatigue; below 10 is iron deficiency anemia
These are the markers most directly affected by AAS use. Understanding them is the foundation of safe and effective androgen use. Many of these markers will be completely suppressed on cycle, and their recovery is the key measure of post-cycle health.
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Total Testosterone (TT)
Okay
The total amount of testosterone in your blood, including both bound (inactive) and free (active) fractions. TT is the marker being directly manipulated by AAS use. A high TT number alone, without evidence of organ damage or adverse symptoms, is not inherently dangerous.
Normal
300-1,100 ng/dL (natural); varies by protocol on AAS
Alert
Any level is acceptable if organ function is normal, but extremely high levels (> 3,500) warrant monitoring
The biologically active, unbound fraction of testosterone. This is the testosterone that can actually enter cells and exert effects. Free T is even more elevated on AAS than TT because androgens suppress SHBG, meaning more of the total testosterone is available.
Normal
15-30 pg/mL (natural); significantly higher on AAS
Alert
Very high free T is expected on cycle; monitor for symptoms, not the number
Your primary estrogen, produced when the aromatase enzyme converts testosterone into E2. E2 is critical for bone density, cognitive function, cardiovascular health, and libido in men. The goal is not to minimize E2 but to keep it in a ratio appropriate to your testosterone level.
Normal
20-40 pg/mL (on TRT); 40-80 (on higher doses)
Alert
Below 10 causes joint pain and libido loss; above 100 may cause symptoms
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SHBG (Sex Hormone Binding Globulin)
A protein produced by the liver that binds to testosterone and estradiol, regulating how much is free vs. bound. Androgens directly suppress SHBG production. Low SHBG on AAS is expected — it means more of your testosterone is available to do its job.
Normal
10-50 nmol/L (natural); 8-20 (TRT); 3-10 (blast)
Alert
Extremely low (< 5) may indicate unnecessarily high androgen load
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LH (Luteinizing Hormone)
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LH (Luteinizing Hormone)
Okay
A hormone produced by your pituitary gland that signals your testes to produce testosterone. On exogenous AAS, LH is suppressed to near zero because your body detects the external testosterone and stops sending signals. LH recovery is the single most important sign that your HPTA is waking up post-cycle.
Normal
1.5-9.0 IU/L (natural); suppressed to near-zero on AAS
Alert
Persistent suppression below 1.0 at week 12 post-cycle requires investigation
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FSH (Follicle-Stimulating Hormone)
A pituitary hormone that stimulates sperm production (spermatogenesis). Like LH, FSH is suppressed on exogenous AAS. FSH recovery often lags behind LH by several weeks. For fertility considerations, FSH recovery is equally as important as LH.
Normal
1.0-12.0 IU/L (natural); suppressed on AAS
Alert
Persistent suppression affects fertility
A hormone primarily involved in lactation and reproductive function, but also affects mood, libido, and immune function. Prolactin can rise with 19-nor compounds (trenbolone, nandrolone) due to their progestogenic activity. High prolactin can cause mood issues, libido problems, and in extreme cases, galactorrhea.
Alert
Above 25 may cause symptoms; above 50 requires cabergoline or compound discontinuation
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DHT (Dihydrotestosterone)
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DHT (Dihydrotestosterone)
Okay
A potent androgen converted from testosterone via the 5-alpha-reductase enzyme. DHT is 3-5 times more potent at the androgen receptor than testosterone. It contributes to hair loss (in genetically predisposed individuals), prostate growth, and acne. Some AAS compounds directly convert to DHT or DHT-like metabolites.
Normal
30-85 ng/dL (natural); elevated on AAS
Alert
No defined danger level; effects are cosmetic (hair, acne, prostate)
Your thyroid gland regulates your metabolic rate — how fast your body burns energy, how warm you feel, and how efficiently your cells function. AAS can affect thyroid hormone levels, primarily by suppressing thyroid-binding globulin (TBG) and affecting conversion of T4 to T3.
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TSH (Thyroid Stimulating Hormone)
A pituitary hormone that tells your thyroid to produce thyroid hormones (T4 and T3). TSH is your thyroid's thermostat — when the body needs more thyroid activity, TSH rises; when it has enough, TSH falls. AAS can mildly suppress TSH.
Alert
Above 4.5 suggests hypothyroidism; below 0.3 suggests hyperthyroidism
The inactive thyroid hormone produced by your thyroid gland. Free T4 is converted into the active form (T3) in your tissues. AAS can decrease T4 levels by suppressing TBG. Low T4 with normal TSH may be an AAS effect rather than thyroid disease.
Alert
Below 0.6 or above 2.0 requires investigation
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Free T3 (Triiodothyronine)
The active thyroid hormone that drives your metabolic rate. T3 is what actually enters cells and turns up the metabolic furnace. Low T3 contributes to fatigue, feeling cold, and metabolic slowdown. AAS can impair T4-to-T3 conversion, leading to low T3 even with normal T4.
Alert
Below 2.0 causes metabolic symptoms; above 5.0 suggests hyperthyroidism
Autoantibodies that attack your thyroid peroxidase enzyme. A positive TPO antibody test means your immune system is attacking your thyroid — this is Hashimoto's thyroiditis, an autoimmune condition. Not directly affected by AAS, but worth testing once to rule out underlying autoimmune thyroid disease.
Alert
Positive result indicates autoimmune thyroid condition
🍬METABOLIC AND NUTRITIONAL
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Metabolic and Nutritional Markers
These markers track how your body processes energy and nutrients. AAS can impair insulin sensitivity, which is the foundation of metabolic health. Monitoring these markers helps catch metabolic problems early, before they develop into full-blown insulin resistance or diabetes.
Your blood sugar level after not eating for at least 8 hours. Some AAS (especially orals) can impair insulin sensitivity, raising fasting glucose. A mildly elevated fasting glucose is an early warning sign that your metabolism is under stress.
Normal
70-100 mg/dL (fasting)
Alert
Above 100 suggests prediabetes; above 126 is diabetic
Your 3-month average blood glucose level. HbA1c measures how much glucose has attached to your red blood cells over their 120-day lifespan. This gives a much better picture of long-term metabolic health than a single fasting glucose reading.
Alert
Above 5.7% is prediabetic; above 6.5% is diabetic
The amount of insulin your pancreas produces when fasting. High fasting insulin with normal glucose is 'compensated' insulin resistance — your pancreas is working overtime to keep your blood sugar normal. This can be detected years before glucose starts rising, making it a valuable early warning marker.
Alert
Above 15 with normal glucose suggests insulin resistance
A calculated score that estimates insulin resistance from your fasting glucose and insulin levels. Formula: (glucose x insulin) / 405. A high HOMA-IR score means your cells are not responding properly to insulin, forcing your pancreas to produce more. This is the most practical measure of insulin sensitivity.
Normal
< 2.0 (optimal); 2.0-2.5 (mild IR)
Alert
Above 2.5 suggests significant insulin resistance requiring intervention
Iron is essential for red blood cell production and energy metabolism. On AAS, iron stores (ferritin) often decrease because increased red cell production consumes iron. Regular blood donors are especially at risk for iron deficiency. The iron panel includes iron, transferrin, and transferrin saturation.
Normal
Iron: 60-180 mcg/dL; Transferrin: 200-360 mg/dL; Sat: 20-50%
Alert
Low iron + high transferrin = iron deficiency; high sat > 50% = possible overload
Electrolytes are minerals that carry an electric charge and are essential for nerve function, muscle contraction, and fluid balance. They are usually stable on AAS but can be affected by training, hydration, and kidney function.
The primary electrolyte regulating fluid balance and nerve function. Usually very stable in healthy individuals. Low sodium can indicate overhydration or kidney issues. High sodium is usually just a reflection of recent salt intake or dehydration.
Alert
Below 130 or above 150 requires investigation
Critical for muscle contraction and nerve signaling. Potassium can be elevated from intense training (muscle breakdown releases potassium into the blood). Always rest for 24-48 hours before testing potassium. True high potassium (hyperkalemia) is dangerous for heart rhythm.
Alert
Below 3.0 or above 5.5 requires medical attention
Essential for bone health, muscle contraction, and nerve signaling. Usually very stable. Abnormal calcium may indicate parathyroid issues, bone problems, or, rarely, malignancy. Total calcium is most commonly measured, but ionized calcium (free, unbound) is the biologically active form.
Alert
Above 11.0 or below 7.5 requires investigation
Essential for muscle relaxation, energy production, and protein synthesis. Magnesium is often low in athletes due to sweat losses and high metabolic demand. Low magnesium can cause muscle cramps, poor sleep, anxiety, and difficulty recovering from training.
Alert
Below 1.5 causes symptoms; above 3.0 requires investigation
Your primary stress hormone, produced by your adrenal glands. Cortisol follows a daily rhythm — highest in the morning, lowest at night. AAS may suppress cortisol production. Chronically low cortisol can cause fatigue, poor recovery, and difficulty handling stress.
Normal
6-23 mcg/dL (AM); much lower in PM
Alert
Chronically low AM cortisol requires adrenal function assessment
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PSA (Prostate-Specific Antigen)
A protein produced by the prostate gland. PSA can rise with DHT and androgen activity. A mildly elevated PSA in a young athlete on AAS is usually benign, but above 4.0 ng/mL requires urological follow-up to rule out prostate pathology. Always establish a baseline before starting AAS.
Alert
Above 4.0 requires urological follow-up; rapid rise above baseline is concerning
A fat-soluble vitamin crucial for bone health, immune function, and mood regulation. Vitamin D is often low in athletes — especially those who train indoors or live in northern latitudes. Low vitamin D is linked to poor recovery, increased injury risk, and mood disturbances.
Alert
Below 20 is deficient and requires supplementation
📖KEEP THIS HANDY
Bookmark this glossary and cross-reference it with your next blood work. Understanding what each marker does, what the right range is for you, and how AAS affects it is the foundation of informed health decisions. The more you understand your markers, the better equipped you are to have productive conversations with your healthcare provider.