Introduction

Medical lab tests are essential in assessing and diagnosing health conditions. Prior to starting an Anabolic Androgenic Steroid (AAS) regimen, individuals considering these steroids must undergo thorough health evaluations. This is to assess their general health and uncover any hidden medical issues that might be risky and are only identifiable through lab tests. 

Entering a steroid cycle can strain crucial organs like the heart, liver, and kidneys. The risk of adverse effects and potential tissue harm varies based on factors like age, duration of steroid use, AAS/PEDs dosage, steroid type, pharmaceutical forms, stacking practices, lifestyle choices, nutrition and supplementation, adherence to medical guidelines, pre-existing congenital defects, and genetic background. 

Common issues include dyslipidemia, elevated liver enzymes, increased red blood cell counts, and elevated blood urea nitrogen levels. Sometimes, these conditions worsen during a cycle, possibly leading to its termination. Post-cycle, individuals must undergo specific lab evaluations (biochemical and hormonal) to monitor their health and any side effects. 

Lab Evaluations Pre and Post Steroid Cycle

Lab tests should be conducted before and after a steroid cycle, but not during, unless medically necessary. The evaluations include:

Blood/Urine Tests

  • Hematological profile: Complete Blood Count (CBC) with Differential (including hematocrit, hemoglobin, mean corpuscular volume, etc.), Iron, Ferritin, Folate, and Vitamin B12.
  • Renal profile: Urea, Creatinine, Uric Acid, Glomerular Filtration Rate, 24-hour Creatinine Urine Clearance, and Urinalysis.
  • Lipid Profile: Total Cholesterol, HDL, LDL, Triglycerides, Homocysteine, Lipoprotein A, Apolipoproteins.
  • Liver profile: Liver enzymes (ALT, AST), γGT, ALP, Bilirubin, Lactate Dehydrogenase.
  • Metabolic Profile: Glucose, HbA1c, Total Protein, Albumin, Electrolytes.
  • Creatine Kinase: Differentiates between muscle types (CK-MM, CK-MB).
  • Coagulation tests: INR, aPTT, PT, TT, Fibrinogen.
  • Hormonal profile: FSH, LH, Testosterone levels, Estradiol, Prolactin, SHBG.
  • Thyroid Profile: TSH, T4, T3, Thyroid Antibodies, Thyroid Ultrasound.
  • Tumor markers: CEA, CA 19/9, Alpha-fetoprotein, PSA.

These tests should be performed in the morning and after fasting for 12 hours.

Cardiovascular Assessment

Includes blood pressure evaluation, chest X-ray, ECG, Echocardiography, and potentially a 24-hour Holter monitor, stress test, or Cardiac MRI.

Imaging Studies

Ultrasound or CT of the abdomen for liver conditions, MRI for prostate cancer screening.

Interpreting Lab Values

Understanding changes in lab values due to AAS use is crucial, including effects on hematocrit, urea, creatinine, liver enzymes, lipids, glucose, and hormonal levels.

It's vital for athletes using AAS to undergo regular lab testing. Doctors should guide their patients in maintaining health. The assessment is key to understanding health risks and the impacts of AAS/PEDs use, but it should complement physical exams and patient history.