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.
One thing to keep in mind: the reference ranges printed on your lab report are based on the general population, not on athletes. A healthy male who trains heavy and uses AAS will often have creatinine, AST, and ALT above the standard range even with perfectly functioning organs. That is why this glossary uses athletic ranges where available. If your licensed medical professional flags a value, ask whether the range they are using accounts for muscle mass, training volume, and androgen use. A 30-year-old powerlifter with a creatinine of 1.4 mg/dL is not the same as a sedentary 60-year-old with the same number. Context matters more than the flag.
Keep this page bookmarked and pull it up when you're reviewing your next blood work. Each marker covers what it does in plain language, the normal range for an athletic population, and how AAS use typically affects it.
When you get your results, start with the markers that are most likely to cause immediate problems: hematocrit, blood pressure, and liver enzymes. Then move to lipids and hormones. Do not panic over a single out-of-range value. Trends over time are what matter. For example, a one-time ALT of 60 U/L after a heavy leg day is different from a steady climb from 40 to 60 to 80 over three months. Keep a spreadsheet or a notes app with your results. That way you can spot patterns and have a real conversation with your licensed medical professional instead of guessing.
📖HOW TO USE THIS GLOSSARY
Markers are grouped by the body system they relate to, so use the sections below to find the one you need. The normal ranges shown are athletic ranges where available, not general population ranges. The AAS impact notes explain how androgens typically affect each marker, though individual responses vary.
Your kidneys are the filtration system for your blood, and they also keep your fluid balance in check. When you're on AAS, they take on extra work. More muscle mass means more metabolic waste, blood pressure runs higher, and the compounds themselves hit the kidneys directly. These markers are how you know whether your kidneys are keeping up with the load or starting to struggle.
The key kidney markers are creatinine, eGFR, BUN, and cystatin C. Creatinine is a waste product from muscle breakdown, so more muscle means higher baseline. On AAS, creatinine often runs 10 to 20 percent above the general range. eGFR is calculated from creatinine and drops as creatinine rises, so a low eGFR in a muscular athlete is not automatically kidney damage. BUN reflects protein metabolism and hydration; it goes up with high protein intake and dehydration. If your BUN is high and your creatinine is normal, drink more water. Cystatin C is a better marker because it is not affected by muscle mass, but it is not always included. If your licensed medical professional is worried, ask for it.
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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, meaning they stress the liver. 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.
Liver markers include AST, ALT, GGT, ALP, and bilirubin. AST and ALT are also found in muscle, so they rise after intense training. A common pattern on AAS is ALT elevated to 60 to 80 U/L while AST stays near normal, which points to liver stress rather than muscle damage. GGT is more specific to the liver and bile ducts; it does not rise from training. If GGT is elevated, that is a real liver signal. ALP can rise from bone activity as well as liver. Bilirubin is about red blood cell turnover and liver clearance. On AAS, high hematocrit increases bilirubin slightly. The practical rule: if AST and ALT are both elevated but GGT is normal, it is likely training. If GGT is also up, that's a genuine liver signal worth bringing to a licensed medical professional rather than managing by simply retesting later.
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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 hit cholesterol and cardiovascular markers hard, and that's well documented. These markers matter more than almost anything else for long-term health on AAS, because cardiovascular disease already kills more people than anything else in the general population, and running AAS only stacks more risk factors on top of that.
The lipid panel is where AAS do the most damage. Total cholesterol often stays roughly the same, but the composition shifts: LDL tends to rise, HDL tends to fall, sometimes sharply within weeks. That shift is a real cardiovascular risk factor on its own. Triglycerides also tend to rise, especially with orals like Anadrol or Winstrol. Diet, omega-3s, and regular cardio help at the margins, but the underlying effect is dose- and compound-dependent. A markedly low HDL, especially alongside an elevated ApoB, is worth bringing to a licensed medical professional rather than managing on your own — what changes from there is a protocol decision, not something to decide from this glossary. Lipids are consistently one of the earliest warning signs of cardiovascular strain in this population, which is exactly why they're worth tracking closely rather than dismissing as "just AAS."
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)
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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, so they hit these numbers harder and more consistently than almost anything else you're tracking. And they're the most immediately actionable of the bunch: high hematocrit is the most common reason guys have to intervene mid-cycle.
The CBC is the most actionable panel on AAS. Hematocrit is the percentage of red blood cells in your blood, and on AAS it commonly runs well above the general population's range. A raised hematocrit by itself is not the danger signal it's often made out to be — it becomes a real clotting risk specifically in combination with an elevated platelet count (the material a clot is built from) and reduced physical activity (which lets flow slow down enough for that material to settle). Separately, a raised hematocrit tends to push blood pressure up, because the heart works harder to move thicker blood — and it's that resulting blood pressure, sustained over time, that actually damages arteries and kidneys. So the hematocrit number is best read alongside platelets, blood pressure, and how much you're training, not on its own. Routinely donating blood on a fixed schedule regardless of that context is not a substitute for reading it properly — donation also depletes iron and ferritin, so if it's used, ferritin needs monitoring, and it's a decision to make with a licensed medical professional rather than a default response to a number.
The percentage of your blood volume made up of red blood cells. AAS stimulate EPO production, raising Ht. On its own this number says less than it seems to — read it alongside platelet count and blood pressure before drawing conclusions.
Normal
40-50% (general); 45-54% (AAS athletic range)
Alert
Above 55% is worth a licensed medical professional's attention, especially with high platelets or rising blood pressure
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 AAS hits hardest. If you want to use androgens safely and effectively, you need to understand them cold. On cycle, most of these will be driven to complete suppression. How they recover afterward is the key measure of your post-cycle health.
On cycle, your natural testosterone production shuts down. LH and FSH drop to near zero, and your total testosterone will reflect whatever you are injecting. The real value of these markers is post-cycle. After you stop, LH and FSH should start rising within weeks. If they stay suppressed for more than 8 weeks, you may need a restart protocol. Estradiol is the tricky one. It can be high from aromatization, causing water retention and mood issues, or too low from overusing an AI, causing joint pain and low libido. The goal is a balance, usually 20 to 40 pg/mL for men. Do not chase a number; use symptoms as your guide. And remember, prolactin can rise with certain compounds like nandrolone, so check it if you have nipple sensitivity.
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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 is a result to bring to a licensed medical professional promptly
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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 runs the show on metabolic rate: how fast you burn energy, how warm you feel, and how efficiently your cells function. AAS can knock thyroid hormone levels around, primarily by suppressing thyroid-binding globulin (TBG) and messing with the conversion of T4 to T3.
Thyroid markers on AAS are often misinterpreted. Total T4 and T3 can look low because AAS suppress thyroid-binding globulin (TBG), which carries these hormones in the blood. Free T4 and free T3 are the active forms and are usually normal. TSH is the pituitary signal; it may be slightly low on cycle but should stay within range. If your TSH is above 4.5 mIU/L or below 0.3, that is a real problem. Most AAS users do not need thyroid medication. The exception is if you are using growth hormone or insulin, which can alter thyroid dynamics. If you feel fatigued, cold, or have unexplained weight gain, get a full thyroid panel including free T3 and reverse T3, not just TSH.
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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 show how your body processes energy and nutrients. AAS can blunt insulin sensitivity, and that matters because insulin sensitivity is the bedrock of metabolic health. Keep an eye on these values and you can spot metabolic trouble early, long before it hardens into full-blown insulin resistance or diabetes.
Metabolic markers include fasting glucose, insulin, and HbA1c. AAS, especially orals, can reduce insulin sensitivity. Fasting glucose above 100 mg/dL is a warning sign. HbA1c reflects average glucose over 3 months; anything above 5.6 percent is pre-diabetic. Insulin resistance is a silent process that can lead to diabetes and cardiovascular disease. The good news is it is reversible: diet quality, regular cardio, and — where a licensed medical professional agrees it's appropriate — metformin are the standard levers. Some athletes use berberine or other supplements, but the evidence is mixed. Compounds like Anadrol or Trenbolone at higher doses are more commonly associated with glucose creeping up, which makes this a marker worth watching closely on those protocols and a finding worth discussing with whoever manages the cycle rather than adjusting unilaterally.
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 they're what keep your nerves firing, your muscles contracting, and your fluid balance in check. On AAS they tend to stay pretty stable, but training, hydration, and kidney function can all throw them off.
Electrolytes are often overlooked until something goes wrong. Sodium, potassium, chloride, and calcium are the main ones. On AAS, potassium can rise if you are using an ACE inhibitor or ARB for blood pressure, or if kidney function is declining. High potassium above 5.5 mEq/L can cause dangerous heart rhythms. Calcium is affected by vitamin D and parathyroid hormone, not directly by AAS, but it can be elevated if you are taking calcium supplements or have high blood pressure. The practical advice: stay hydrated, do not overuse potassium supplements, and get your electrolytes checked if you are on diuretics or have muscle cramps. Most athletes are fine, but if you are running high doses and sweating heavily, a basic metabolic panel will catch any imbalance early.
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. Know what each marker does, what the right range is for you, and how AAS affects it. That's 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.
