Why blood work matters
You cannot feel your cholesterol. You cannot feel your liver enzymes rising. You cannot feel your haematocrit creeping towards a dangerous level. By the time you feel symptoms from many of the health impacts of steroid use, significant damage may already have occurred.
Blood work gives you objective data about what is happening inside your body. It lets you catch problems early, make informed decisions about whether to continue a cycle, adjust doses, or stop entirely. Without it, you are flying blind.
Blood work tells you
What to test
The specific panel you need depends on what you are using, but the following covers the essentials. Most private blood test providers in the UK offer steroid-specific panels that include most or all of these.
Hormones
Liver function
Cardiovascular
Other markers
When to test
Timing matters. A single blood test is useful, but a series of tests at the right times gives you a complete picture.
Before your cycle (baseline)
EssentialThis is the most important test. It tells you where your body sits naturally before you change anything. Without this, you have no reference point for whether values are abnormal during or after a cycle. Get this done at least 2-4 weeks before starting.
Mid-cycle (weeks 6-8)
EssentialShows how your body is responding. Check liver, lipids, haematocrit, oestrogen. If something is significantly out of range, you can adjust or stop before it gets worse. For oral compounds, testing earlier (week 4) is advisable due to faster liver impact.
End of cycle (optional)
RecommendedUseful if mid-cycle bloods showed concerning values and you want to check before starting PCT. Also useful to see peak impact on lipids and other markers.
After PCT (4-6 weeks post-PCT)
EssentialThe recovery check. LH, FSH, and testosterone should be recovering towards your baseline. If they are not, your body may need more time, or you may need medical intervention.
Tips for accurate results
- Fast for 8-12 hours before the test (water is fine)
- Test in the morning (before 10am) — testosterone levels are highest in the morning and drop throughout the day
- Do not train intensely the day before — this can elevate liver enzymes (AST) and creatinine
- Do not inject testosterone the day of the test if you want to see trough levels (test the morning before your next injection)
- Be consistent with timing between tests so results are comparable
How to read your results
Blood test results come with reference ranges — the range that is considered “normal” for the general population. There are some important things to understand about these:
Reference ranges are for the general population
Being within the “normal” range does not necessarily mean optimal, and being slightly outside does not necessarily mean there is a problem. Context matters — your age, your baseline values, and the trend over time are all important.
Compare to your baseline, not just the range
If your HDL cholesterol was 1.5 mmol/L at baseline and is now 0.6 mmol/L, that is a significant and concerning drop — even if 0.6 might technically be within some lab reference ranges. Trends matter more than individual numbers.
On-cycle values will not look “normal”
If you are on cycle, your testosterone will be above the reference range (that is the point). Your LH and FSH will be suppressed to near zero. Some liver values may be elevated. The question is not whether values are normal — it is whether they are at a level that poses immediate danger.
Key markers to focus on
Should ideally be above 1.0 mmol/L. Below 0.5 mmol/L is a serious concern. Oral steroids can obliterate HDL levels.
Normal range is roughly 38-50%. Above 54% is a significant concern — your blood is becoming too thick. Donating blood can help bring this down (though this should be discussed with a doctor).
Normal range is roughly 10-40 U/L. Mildly elevated (up to 2-3x) can happen with intense training. Significantly elevated (5x+ normal) on oral compounds is a clear signal to stop.
After PCT, these should be rising. If LH and FSH remain suppressed 8+ weeks after PCT, your HPTA is not recovering and you should seek medical advice.
UK providers
You do not need to go through your GP to get blood work done (though you can — see below). Several private providers in the UK offer comprehensive blood panels designed for steroid users. These are the most commonly used:
Medichecks
The most popular provider among UK steroid users. They offer specific panels like the “Sports Hormone Check” and “Ultimate Performance Blood Test” that cover the key markers. Options for finger-prick home tests or venous draw at a clinic.
Forth
Another well-regarded UK provider with a clean interface and good tracking over time. They offer panels that cover hormones, liver, lipids, and full blood count. Good for tracking trends between tests.
Finger-prick vs venous draw
Finger-prick tests are convenient but can sometimes give less accurate results for certain markers (particularly haematocrit and some hormones). If you can, a venous draw (blood taken from a vein by a phlebotomist) is more reliable. Many providers offer this at partner clinics for a small additional fee. For your baseline test especially, consider a venous draw.
Red flags — act now
Certain blood results require immediate action. Do not wait for your next test or hope they improve on their own.
Haematocrit above 54%
Stop cycle. See a doctor. Your blood is dangerously thick. Risk of stroke and blood clots is significantly elevated. Therapeutic phlebotomy (blood donation) may be needed.
ALT/AST above 5x the normal upper limit
Stop oral compounds immediately. Your liver is under serious stress. If values continue to rise, seek medical attention. Do not restart orals until values have returned to near baseline.
HDL cholesterol below 0.5 mmol/L
This is a significant cardiovascular risk factor. Consider stopping the compounds most likely responsible (usually orals). Increase cardio, add omega-3s, review your cycle.
Blood pressure consistently above 160/100
This is stage 2 hypertension. See a doctor. You may need antihypertensive medication. Consider dropping or reducing compounds. This level of blood pressure causes organ damage over time.
Creatinine significantly elevated (above reference range)
Could indicate kidney strain. Rule out dehydration and high meat intake first — in muscular individuals creatinine can be naturally higher. If persistently elevated, see a doctor.
LH/FSH still undetectable 8+ weeks post-PCT
Your HPTA may not be recovering. See an endocrinologist. You may need further treatment or, in some cases, long-term TRT.
Talking to your GP
Many steroid users avoid their GP because they are worried about being judged, lectured, or having it put on their medical record. These concerns are understandable, but having a doctor who knows what you are doing can be genuinely valuable — and in some cases, lifesaving.
Things worth knowing
- GPs have a duty of confidentiality. They cannot tell your employer, insurer (unless you consent), or anyone else.
- Steroid use is not illegal for personal use in the UK. Your GP cannot report you for using.
- It will go on your medical record, which could theoretically affect life insurance or certain professions. This is a real consideration, but it needs to be weighed against the benefit of medical oversight.
- Some GPs are knowledgeable about PED use; others are not. If yours is dismissive or unhelpful, you can request a different GP or find a more specialised clinic.
- You can request blood work through your GP. They may or may not agree to run a comprehensive hormone panel, but they can check liver, kidneys, lipids, and full blood count on the NHS.
If you have blood results that concern you and you are not sure what to do, seeing a doctor is always the right call. Bring your private blood work results with you — having data makes the conversation much easier.
Get Blood Work Done
Do not wait. Whether you are about to start your first cycle or have been using for years, getting a blood test is the single best thing you can do for your health today.
Check Medichecks or Forth for their latest panels and pricing.