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Best Blood Tests for Evaluating Liver Function During Anabolic Steroid Use

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  1. #1
    Purple One
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    Question Best Blood Tests for Evaluating Liver Function During Anabolic Steroid Use

    Best Blood Tests for Evaluating Liver Function During Anabolic Steroid Use

    Question: “What blood test values are the most useful for evaluating liver function during anabolic steroid cycles?”

    Answer: While AST and ALT often get the most attention, three other values are much more useful for evaluating liver function in anabolic steroid cycles.

    GGT is present in liver cells and is released into the blood when these cells are damaged. Unlike AST and ALT, there’s little or no release of GGT into the blood when muscle cells are damaged by exercise. As a result, a GGT test remains valid even when doing intensive exercise.

    Where 17α-alkylated steroids are used, abnormally high GGT levels most commonly will be from liver damage from oral steroids. It’s a warning sign to take seriously.

    Other causes of high GGT are possible, such as chronic use of excessive alcohol, statins, aspirin, acetaminophen, or NSAID’s. GGT can also be elevated from cardiovascular disease, diabetes, or metabolic syndrome. Further, liver disease from other causes can elevate GGT.

    A normal GGT value can completely discount any concern from elevated AST/ALT values, while a greatly elevated (twice the reference limit) value should be taken as a serious warning.

    Unfortunately, often GGT isn’t included when ordering a blood chemistry panel. But when you have the value, it can be very useful.

    Another key marker is serum bilirubin.

    Bilirubin is a breakdown product of pigmented proteins, including hemoglobin and myoglobin. Elevated bilirubin levels, beyond about twice the reference limit, can be a product of cholestatic liver disease. This is a reduction or stoppage of the flow of bile, which can be caused by use of oral anabolic steroids.

    However, abnormal bilirubin elevation can occur for reasons other than liver damage. Another possible cause is breakdown of blood cells, or hemolysis. However, if the cause is hemolysis, red blood cell count or reticulocyte count would usually be low as well.

    As with GGT, serum bilirubin is not elevated from exercise. On finding a serum bilirubin value more than twice the reference limit I’d discontinue oral steroid use. I prefer not exceeding the reference limit at all. However, quite a few individuals will somewhat exceed the reference limit even when in perfect health. For this reason, it’s not an absolute rule to never exceed the reference limit.

    Lastly, as with GGT and bilirubin, ALT is unaffected or little affected by exercise. Abnormal elevation during an anabolic steroid cycle most likely indicates liver damage. But even where significant cholestatic liver damage has already occurred, often ALT values will be only two or three times the upper limit of the reference range. So, don’t wait for a really high value to be concerned about this one.

    If all three of these are good, there almost certainly is no real liver problem.

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    Question

    Anabolic Steroids, Liver Function and AST and ALT Blood Test

    Question: “How do I evaluate the AST and ALT values of my blood test? I wanted to have before-cycle values, but waited till the last minute to order a test online. By the time I actually did the test, I was a week into my cycle. I’m using testosterone 500 mg/week plus Dianabol 50 mg/day and letrozole 1 mg/day. Already these values are very elevated. Could I have liver problems already from the Dianabol?”

    Answer: AST and ALT values often provide false positives for diagnosing liver problems. By false positives, I mean that levels flagged as abnormally high often do not mean that a real problem exists. We need to look at other values to come to such a conclusion.

    AST and ALT are enzymes found within many types of cells, including liver and muscle cells. Some amounts always exists in the blood. Even where individuals are healthy, the amounts found will vary. For either of these enzymes, 97.5% of healthy people will have an amount no greater than the top end of the reference range.

    However, another 2.5% of healthy individuals will have no liver problem at all while having an amount exceeding the limit of the reference range.

    This is simply how the reference range is defined. Rather than it defining healthy versus unhealthy, it’s purposely set such that 2.5% of healthy individuals will be outside the range. It will be up to the doctor or individual to decide whether a high value is a matter of concern. A high value is a flag that there could be an issue, rather than that there is an issue.

    Cell damage can cause release of these enzymes, thus elevating blood levels. Liver damage is one possible cause of this. High levels could indicate liver damage.

    Another possible cause is muscle damage, including the type of muscle damage commonly occurring in weight training. There are still further possible causes.

    Problematically, weight training can elevate AST and ALT levels to many times the upper limit of the reference range. As your other values are good, it’s highly likely that your high values for AST and ALT are entirely from your exercise program and not at all from your current oral anabolic steroid usage.

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