BodybuildingPro.com Articles Database Articles by Writer Articles By Will Brink "It's in Your Blood"
in Your Blood"
By Will Brink, author of:
Muscle Building Nutrition
Muscle Gaining Diet, Training Routines by Charles Poliquin & Bodybuilding
Diet Supplements Revealed
Real World Fat Loss Diet & Weight Loss Supplement Review
in Your Blood"
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
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
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.
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
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,
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
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.
I used the Life Extension
Foundation to have my tests done as they have good prices and an extensive list
of tests many medical professionals are often unaware of or don't bother
I had the major hormones of
I also had a full
cardiovascular risk profile done, which included:
I had the major liver function
tests done: alkaline phosphatase, GGT, SGOT, and SGPT, as well as a PSA test to
make sure my prostate was OK.
Finally, I had the major kidney
function tests done: creatinine, BUN, and the creatnine/BUN ratio. As mentioned
above, there was actually over 80 tests done (man they took a lot of blood out
of me!) but those are the major tests of interest to readers and will give you a
good idea of what should be looked at.
were as follows:
||520ng/dl (normal range
300 - 1200)
||18.3pg/ml (normal range
8.7 - 25)
||102ng/ml (normal range
||22pg/ml (normal range 5
- 53 for adult male)
||410ug/dl (normal range
120 - 520)
||5.5ug/dl (normal range
4.5 - 12 )
||3.1pg/ml (normal range
2.3 - 4.2)
||3.743uIU/ml (0.350 -
||262mg/dl (normal healthy
range 100 - 199)
||167mg/dl (normal range 0
||54mg/dl (normal range 40
||204mg/dl (normal range 0
||0.75 mg/l (> 2 increased
risk of MI and stroke)
||6.3umol/L (normal range
6.3 - 15)
||62IU/L (Normal range (25
||15IU/L (normal range 0 -
||28IU/L (normal range 0 -
||24IU/L (normal range
||0.6ng/ml (normal 0.0 -
||1.0mg/dl (normal 0.5 -
||19mg/dl (normal range 5
||19 (normal 8 - 27)
Comments On My Blood Work
As I stated above, reading a
blood test is one thing, interpreting the results is another. For example, the
reader will note my total cholesterol (and triglycerides) were above what is
considered normal, presenting a possible increased risk of cardiovascular
disease (CVD). However, I had not fasted for the test, which always leads to
higher numbers in blood lipids (which is why they tell you to fast prior to
Regardless, my total
cholesterol tends to run about 220 anyway, which is 20 points above what is
recommend. Does that worry me? Not at all. Total cholesterol levels are poorly
correlated to CVD, I have an exceptionally high HDL level (giving me a favorable
total cholesterol/HDL ratio), very low homocysteine levels, low C-reactive
protein levels, high normal DHEA levels, and no family history of CVD. Thus my
real CVD risk is quite low. Speaking of DHEA, the reason I have such favorable
DHEA levels is I take 25mg per day of DHEA. Prior tests showed I was actually
low "normal" in DHEA for my age group, so I adjusted it upward via a DHEA
supplement. How would I have ever known I was low in DHEA without a blood test?
My testosterone and free T
levels are in pretty good shape, but could be better. Thyroid could also be
better. In fact, several prior tests showed I had sub clinical hypothyroid (low
normal t3 and t4 with high TSH) which was treated with Armour Thyroid. However,
seeing these latest results shows that although my thyroid levels have improved,
they could be far better, thus, due to these latest tests I know I need to
increase my dose of thyroid medication to get into the high normal range.
Low thyroid hormone levels
means a person will have a sub optimal metabolism for protein synthesis, keeping
bodyfat to a minimum, among the many essential functions the thyroid hormones
play in human metabolism. Again, only blood tests will tell a person where they
stand. Conversely, I have known many bodybuilders who took large amounts of
thyroid meds in hopes of shedding bodyfat pre contest, only to shrivel up like a
raison as their hard earned muscle mass was catabolized due to the huge doses of
thyroid meds. How does a bodybuilder tweak thyroid levels to optimize fat loss
without losing hard earned muscle? Blood tests! Bodybuilders and other athletes
spend thousands of dollars on drugs, but often won't spend a penny on blood
Finally, you may notice one
real bummer in my blood tests, which are my IGF-1 levels. They suck! IGF-1,
which is considered a reflection of GH levels (with some debate) have been low
for me for years and I have no explanation for it. IGF-1 levels respond to total
calorie intakes and total protein intakes, neither of which I lack. It's one
area of my blood work that remains a bit of a mystery but I am looking into the
I don't seem to suffer outward
signs of a lack of IGF-1, and the cost of GH replacement therapy is very
expensive and not without potential risks, so I don't consider it an option at
this time. GH HRT may or may not increase my IGF-1 levels, though it normally
does increase IGF-1 levels. Everything else looks in good shape. How does your
blood look? Do you know?
Optimizing Hormones Levels
There are some hormones that we
can be altered via diet, supplements, and or drugs, and there are some we have
little direct control over. As you can see from my own tests, I am in pretty
good shape, but not all is perfect. By knowing what's going on with my blood, I
get a great deal of insight into what's going on with my body in general, and
can make decisions from there.
The discussion and comments on
my own tests is a the proverbial tip of the iceberg regarding the many potential
variables that effect hormone levels, treatment options, effects of diet, supps,
and training, etc., and it's simply too extensive a topic to cover in this
article. It should also be noted that genetics play a large part in the equation
regarding hormone levels and other factors.
So what would be an optimal
level of the hormones mentioned above and how does one achieve it? The optimal
hormone levels for adding muscle mass, minimizing bodyfat, and having a superior
metabolism in general, would have high normal testosterone levels (total T,
800-1200, with free T 20-25), high normal IGF-1 (250-300), DHEA levels in the
400 - 500 range, low normal estradiol levels**** (below 25), high normal thyroid
levels (T3, 3.5 - 4.5, T4, 8 - 12), with favorable blood lipids and CVD risk
factors (e.g., C-reactive protein, etc), and normal kidney and liver functions.
Of course the above recommendations do not take into account many variables,
such as genetic individuality and other possible factors, as well as other tests
that can be done.
The above recommended hormone
levels and other variables can be achieved with diet, supplements, proper
training, and when needed, HRT or other drugs. As mentioned, genetics plays a
major role here. Some people simply have higher or lower levels of various
hormones then others. At the same time, even simple changes can effect some
hormones. For example, one high level Olympic sprinter I worked with had fairly
low testosterone levels. On examination of his diet, it was found he was
following a high carb low fat diet, which sucks for testosterone levels*****. By
altering his diet, we were able to increase his testosterone levels by over 30%.
Steroids & Other Drugs
Finally, what of steroids and
other drugs? Steroids will of course have profound effects on the above
discussion. Injecting say 500-1000mg per week of Sustanon (a testosterone blend)
will shoot total and free testosterone levels far above the high normal range,
and will have all sorts of additional effects on things like estradiol (will go
up), cholesterol levels, etc, etc. The person will also put on a considerable
amount of lean bodymass on such a regimen, but potential side effects may occur
that will have to be dealt with.
The addition of other steroids,
GH, insulin, anti estrogens, etc, etc, further complicates things and adds a new
level of potential issues that are beyond the scope of this article. Suffice it
to say: (a) this article is generally directed at people not using large doses
of steroids and other drugs (though low dose HRT is often needed for some people
to optimize their metabolism) and (b) people that are using steroids and other
drugs that bring them far above normal lab values need to have regular blood
work done for obvious reasons, such as seeing if the drugs are having a negative
impact on liver function, cholesterol levels, etc. If a person is using the
above example of 500mg per week of Sustanon, there is no real reason to test for
Testosterone levels now is there?
This article is designed to be
a down and dirty primer and introduction 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. It's not intended as an exhaustive review
of the topic or a guide to take matters into your own hands without the guidance
of your doctor.
It is intended to give the
reader a solid foundation they can work from and make bodybuilders and other
athletes realize they are throwing away literally thousands of dollars each year
on supplements, drugs, etc., not to mention a great deal of wasted time, if
their hormones are sub optimal. See you in the gym!
About the Author - William D. Brink
Will Brink is a columnist, contributing consultant, and writer for various
health/fitness, medical, and bodybuilding publications. His articles relating to
nutrition, supplements, weight loss, exercise and medicine can be found in such
publications as Lets Live, Muscle Media 2000, MuscleMag International, The Life
Extension Magazine, Muscle n Fitness, Inside Karate, Exercise For Men Only, Body
International, Power, Oxygen, Penthouse, Women?s World and The Townsend Letter
He is the author of Priming The Anabolic Environment and Weight
Loss Nutrients Revealed. He is the Consulting Sports Nutrition Editor and a
monthly columnist for Physical magazine and an Editor at Large for Power
magazine. Will graduated from Harvard University with a concentration in the
natural sciences, and is a consultant to major supplement, dairy, and
He has been co author of several studies relating to sports nutrition and health
found in peer reviewed academic journals, as well as having commentary published
in JAMA. He runs the highly popular web site BrinkZone.com which is
strategically positioned to fulfill the needs and interests of people with
diverse backgrounds and knowledge.
The BrinkZone site has a following with many
sports nutrition enthusiasts, athletes, fitness professionals, scientists,
medical doctors, nutritionists, and interested lay people. William has been
invited to lecture on the benefits of weight training and nutrition at
conventions and symposiums around the U.S. and Canada, and has appeared on
numerous radio and television programs.
William has also worked with athletes ranging from professional bodybuilders,
golfers, fitness contestants, to police and military personnel.
See Will's ebooks online here:
Muscle Building Nutrition
A complete guide bodybuilding supplements and eating to gain lean muscle
Diet Supplements Revealed
A review of diet
supplements and guide to eating for maximum fat loss
He can be contacted at: PO Box 812430
Wellesley MA. 02482.
* Different labs can
have slightly different values for testosterone and other tests. That
was the high/low value for testosterone with the lab I used. Others can
be as low as 250ng/dl and as high as 1500ng/dl of testosterone.
** No, DHT is not the sole
cause of prostate cancer. It's far more complicated then that and estradiol
appears to play a pivotal role in addition to other physiological variables that
have yet to be fully elucidated.
*** Life Extension uses LabCorp
as their primary testing facility.
**** Contrary to popular
belief, men do require some estrogen just as women require some testosterone.
The goal is not to have zero estradiol in men.
***** Studies have found approx
30% of calories from fat is required for optimal testosterone levels. Data also
suggests that not all fat is created equal here with some saturated fat being
needed in the diet. That's why the diet I recommend in my recent book Anabolic
Nutrition, which can be found at my main web site (www.BrinkZone.com) attempts
to optimize fat intakes and other nutrients for anabolic hormones such as
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