Going to the Doctor's; What Should Be Done?
- 04-23-2009, 01:05 AM
Going to the Doctor's; What Should Be Done?
I'm in my early 20's and am waiting on my new health insurance to become active. I haven't had a primary care physician, or even a physical in several years. I've done one hormonal cycle before (Havoc by RPN) and used appropriate on- and off-cycle supplements. I do plan on getting a physical done, including blood work and an STD/HIV test. But is there anything else that I should request? I'm wanting to get my health completely in check before hitting the gym again and beginning my Sustanon 250 cycle. Also, has anyone ever confided steroid use in their doctor, or are doctors required by some law to report such a thing to the authorities?
- 04-23-2009, 02:32 AM
I would definitely look into get an extensive blood test done, checking levels of everything you can think of.
- 04-23-2009, 10:52 AM
I'm getting a checkup for my general health, but also plan on getting pre, during and post-cycle tests done whenever I run a cycle.
I'm gonna try requesting a full hormone panel. I will be getting my liver function, lipids (cholesterol), testosterone and complete blood count tested. Am I missing anything? I'd like to cover all bases.
04-23-2009, 11:06 AM
04-23-2009, 05:37 PM
04-23-2009, 06:31 PM
04-23-2009, 07:20 PM
Well with my blood work, renal is in it anyway.
04-23-2009, 07:56 PM
renal should be in there. I'm talking basic kidney function not a specific renal test..
PSA levels if you can convince your doc that you have a family hisotory of prostate issues
stress test also
Unless you have a very close relationship with your doc, don't mention the roids. They have to report why you requested those test if something is suspected by the insurance co.
They will send you a paper requesting permission to get specific info from your doc. If they find that you use non prescript medications then you may very well be seen as a high risk and they could drop you or deny claim pay .... this has happened to 2 friends of mine and one other guy, who I know at my local work.
04-23-2009, 10:32 PM
Here is a good write up I found:
Glucose: This is the chief source of energy for all living organisms. A level greater than 105 in someone who has fasted for 12 hours suggests a diabetic tendency. If this level is elevated even in a non-fasting setting one must be concerned that there is a risk for developing diabetes. This is an incredibly powerful test and can predict diabetes ten years or more before one develops the strict definition of diabetes which is levels greater than 120.
Sodium: This element plays an important role in salt and water balance in your body. A low level in the blood can be caused by too much water intake, heart failure, or kidney failure. A low level can also be caused by loss of sodium in diarrhea, fluid or vomiting. A high level can be caused by too much intake of salt or by not enough intake of water.
Potassium and Magnesium: These elements are found primarily inside the cells of the body. Low levels in the blood may indicate severe diarrhea, alcoholism, or excessive use of water pills. A very low level of magnesium in the blood can cause your muscles to tremble. Low potassium levels can cause muscle weakness and heart problems.
Chloride: Is an electrolyte controlled by the kidneys and can sometimes be affected by diet. An electrolyte is involved in maintaining acid-base balance and helps to regulate blood volume and artery pressure. Elevated levels are related to acidosis as well as too much water crossing the cell membrane.
BUN (Blood Urea Nitrogen): BUN is a waste product derived from protein breakdown in the liver. Increases can be caused by excessive protein intake, kidney damage, certain drugs, low fluid intake, intestinal bleeding, exercise, heart failure or decreased digestive enzyme production by the pancreas. Decreased levels are most commonly due to inadequate protein intake, malabsorption, or liver damage.
Creatinine: Creatinine is also a protein breakdown product. Its level is a reflection of the bodies muscle mass. Low levels are commonly seen in inadequate protein intake, liver disease, kidney damage or pregnancy. Elevated levels are generally reflective of kidney damage and need to be monitored very carefully.
Uric Acid: Uric acid is the end product purine metabolism. High levels are seen in gout, infections, high protein diets, and kidney disease. Low levels generally indicate protein and molybdenum (trace mineral) deficiency, liver damage or an overly acid kidney.
Phosphate: Phosphate is closely associated with calcium in bone development. Therefore most of the phosphate in the body is found in the bones. But the phosphate level in the blood is very important for muscle and nerve function. Very low levels of phosphate in the blood can be associated with starvation or malnutrition and this can lead to muscle weakness. High levels in the blood are usually associated with kidney disease. However the blood must be drawn carefully as improper handling may falsely increase the reading.
Calcium: Calcium is the most abundant mineral in the body. It is involved in bone metabolism, protein absorption, fat transfer, muscular contraction, transmission of nerve impulses, blood clotting, and heart function. It is highly sensitive to elements such as magnesium, iron, and phosphorous as well as hormonal activity, vitamin D levels, CO2 levels and many drugs. Diet, or even the presence of calcium in the diet has a lot to do with "calcium balance" - how much calcium you take in and how much you lose from your body.
Albumin: The most abundant protein in the blood, it is made in the liver and is an antioxidant that protects your tissues from free radicals. It binds waste products, toxins and dangerous drugs that might damage the body. Is also is a major buffer in the body and plays a role in controlling the precise amount of water in our tissues. It serves to transport vitamins, minerals and hormones. The higher this number is, the better. The highest one can reasonably expect would be 5.5.
Alkaline Phosphatase: Alkaline phosphatase is an enzyme that is found in all body tissue, but the most important sites are bone, liver, bile ducts and the gut. A high level of alkaline phosphatase in your blood may indicate bone, liver or bile duct disease. Certain drugs may also cause high levels. Growing children, because of bone growth, normally have a higher level than adults do. Low levels indicate low functioning adrenal glands, protein deficiency, malnutrition or more commonly, a deficiency in zinc.
Transaminases (SGTP) & (SGOT): These are enzymes that are primarily found in the liver. Drinking too much alcohol, certain drugs, liver disease and bile duct disease can cause high levels in the blood. Hepatitis is another problem that can raise these levels. Low levels of GGTP may indicate a magnesium deficiency. Low levels of SGPT and SGOT may indicate deficiency of vitamin B6.
Gamma-Glutamyltranserase (GGTP): Believed to be involved in the transport of amino acids into cells as well as glutathione metabolism. Found in the liver and will rise with alcohol use, liver disease, or excess magnesium. Decreased levels can be found in hypothyroidism and more commonly decreased magnesium levels.
Lactate Dehydrogenase (LDH): LDH is an enzyme found in all tissues in the body. A high level in the blood can result from a number of different diseases. Also, slightly elevated levels in the blood are common and usually do not indicate disease. The most common sources of LDH are the heart, liver, muscles, and red blood cells.
Total Protein: This is a measure of the total amount of protein in your blood. A low or high total protein does not indicate a specific disease, but it does indicate that some additional tests may be required to determine if there is a problem.
Iron: The body must have iron to make hemoglobin and to help transfer oxygen to the muscle. If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function up to par. If this test is low you should consider getting a Ferritin test, especially if you are a female who still has menstrual cycles.
Triglycerides: These are fats used as fuel by the body, and as an energy source for metabolism. Increased levels are almost always a sign of too much carbohydrate intake. Decreased levels are seen in hyperthyroidism, malnutrition and malabsorption.
Cholesterol: Group of fats vital to cell membranes, nerve fibers and bile salts, and a necessary precursor for the sex hormones. High levels indicate diet high in carbohydrates/sugars. Low levels indicate low fat diet, malabsorption, or carbohydrate sensitivity.
HDL/LDL: LDL is the "bad cholesterol", which carries cholesterol for cell building needs, but leaves behind any excess on artery walls and in tissues. HDL is the "good cholesterol" which helps to prevent narrowing of the artery walls by removing the excess cholesterol and transporting it to the liver for excretion. A low HDL percentage frequently indicates diets high in refined carbohydrates and/or carbohydrate sensitivity.
CO2: The CO2 level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system. Generally, when used with the other electrolytes, carbon dioxide levels indicate pH or acid/alkaline balance in the tissues. This is one of the most important tests that we measure. Most people have too much acid in their body. If you garden you will know that it is very difficult to grow plants in soil where the pH is incorrect. Our blood is similar to soil in many respects and it will be difficult to be healthy if our body's pH is not well balanced.
WBC: White blood count measures the total number of white blood cells in a given volume of blood. Since WBCs kill bacteria, this count is a measure of the body's response to infection.
Hemoglobin: Hemoglobin provides the main transport of oxygen and carbon in the blood. It is composed of "globin", a group of amino acids that form a protein and "heme", which contains iron. It is an important determinant of anemia (decreased hemoglobin) or poor diet/nutrition or malabsorption.
Hematocrit: Hematocrit is the measurement of the percentage of red blood cells in whole blood. It is an important determinant of anemia (decreased), dehydration (elevated) or possible overhydration (decreased).
MCV: Thismeasures the average size of the red blood cells and their volume. These components together can indicate iron deficiency anemia (decreased), B12/folate deficiency anemia (increased), or rheumatoid arthritis (decreased).
Normal Lab Values
Red Blood Cells
RBC (Male) 4.2 - 5.6 M/µL
RBC (Female) 3.8 - 5.1 M/µL
RBC (Child) 3.5 - 5.0 M/µL
White Blood Cells
WBC (Male) 3.8 - 11.0 K / mm cubed
WBC (Female) 3.8 - 11.0 K / mm cubed
WBC (Child) 5.0 - 10.0 K / mm cubed
Hgb (Male) 14 - 18 g/dL
Hgb (Female) 11 - 16 g/dL
Hgb (child) 10 - 14 g/dL
Hgb (Newborn) 15 - 25 g/dL
Hct (Male) 39 - 54%
Hct (Female) 34 - 47%
Hct (Child) 30 - 42%
MCV 78 - 98 fL
MCH 27 - 35 pg
MCHC 31 - 37%
Neutrophils 50 - 81%
Bands 1 - 5%
Lymphocytes 14 - 44%
Monocytes 2 - 6%
Eosinophils 1 - 5%
Basophils 0 - 1%
Troponin I 0 - 0.1 ng/ml (onset: 4-6 hrs, peak: 12-24 hrs, return to normal: 4-7 days)
Troponin T 0 - 0.2 ng/ml (onset: 3-4 hrs, peak: 10-24 hrs, return to normal: 10-14 days)
Myoglobin (Male) 10 - 95 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)
Myoglobin (Female) 10 - 65 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)
Acetone 0.3 - 2.0 mg%
Albumin 3.5 - 5.0 gm/dL
Alkaline Phosphatase 32 - 110 U/L
Anion gap 5 - 16 mEq/L
Ammonia 11 - 35 µmol/L
Amylase 50 - 150 U/dL
AST, SGOT (Male) 7 - 21 U/L
AST, SGOT (Female) 6 - 18 U/L
Bilirubin, Direct 0.0 - 0.4 mg/dL
Bilirubin, Indirect total minus direct
Bilirubin, Total 0.2 - 1.4 mg/dL
BUN 6 - 23 mg/dL
Calcium (total) 8 - 11 mg/dL
Carbon dioxide 21 - 34 mEq/L
Carbon monoxide symptoms at greater than or equal to 10% saturation
Chloride 96 - 112 mEq/L
Creatine (Male) 0.2 - 0.6 mg/dL
Creatine (Female) 0.6 - 1.0 mg/dL
Creatinine 0.6 - 1.5 mg/dL
Ethanol 0 mg%; Coma: greater than or equal to 400 - 500 mg%
Folic acid 2.0 - 21 ng/mL
Glucose 70 - 110 mg/dL (diuresis greater than or equal to 180 mg/dL)
HDL (Male) 25 - 65 mg/dL
HDL (Female) 38 - 94 mg/dL
Iron 52 - 169 µg/dL
Iron binding capacity 246 - 455 µg/dL
Lactic acid 0.4 - 2.3 mEq/L
Lactate 0.3 - 2.3 mEq/L
Lipase 10 - 140 U/L
Magnesium 1.5 - 2.5 mg/dL
Osmolarity 276 - 295 mOsm/kg
Parathyroid hormone 12 - 68 pg/mL
Phosphorus 2.2 - 4.8 mg/dL
Potasssium 3.5 - 5.5 mEq/L
Protein (total) 6.0 - 9.0 gm/dL
SGPT 8 - 32 U/L
Sodium 135 - 148 mEq/L
T3 0.8 - 1.1 µg/dL
Thyroglobulin Less than 55 ng/mL
Thyroxine (T4) total 5 - 13 µg/dL
Total protein 5 - 9 gm/dL
TSH Less than 9 µU/mL
Urea nitrogen 8 - 25 mg/dL
Uric acid (Male) 3.5 - 7.7 mg/dL
Uric acid (Female) 2.5 - 6.6 mg/dL
LIPID PANEL (ADULT)
Cholesterol (total) Less than 200 mg/dL desirable
Cholesterol (HDL) 30 - 75 mg/dL
Cholesterol (LDL) Less than 130 mg/dL desirable
Triglycerides (Male) Greater than 40 - 170 mg/dL
Triglycerides (Female) Greater than 35 - 135 mg/dL
Specific Gravity 1.003 - 1.040
pH 4.6 - 8.0
Na 10 - 40 mEq/L
K Less than 8 mEq/L
Cl Less than 8 mEq/L
Protein 1 - 15 mg/dL
Osmolality 80 - 1300 mOsm/L
24 HOUR URINE
Amylase 250 - 1100 IU / 24 hr
Calcium 100 - 250 mg / 24 hr
Chloride 110 - 250 mEq / 24 hr
Creatinine 1 - 2 g / 24 hr
Creatine Clearance (Male) 100 - 140 mL / min
Creatine Clearance (Male) 16 - 26 mg / kg / 24 hr
Creatine Clearance (Female) 80 - 130 mL / min
Creatine Clearance (Female) 10 - 20 mg / kg / 24 hr
Magnesium 6 - 9 mEq / 24 hr
Osmolality 450 - 900 mOsm / kg
Phosphorus 0.9 - 1.3 g / 24 hr
Potassium 35 - 85 mEq / 24 hr
Protein 0 - 150 mg / 24 hr
Sodium 30 - 280 mEq / 24 hr
Urea nitrogen 10 - 22 gm / 24 hr
Uric acid 240 - 755 mg / 24 hr
ACT 90 - 130 seconds
APTT 21 - 35 seconds
Platelets 140,000 - 450,000 / ml
Plasminogen 62 - 130%
PT 10 - 14 seconds
PTT 32 - 45 seconds
FSP Less than 10 µg/dL
Fibrinogen 160 - 450 mg/dL
Bleeding time 3 - 7 minutes
Thrombin time 11 - 15 seconds
CEREBRAL SPINAL FLUID
Glucose 40 - 85 mg/dL
Osmolality 290 - 298 mOsm/L
Pressure 70 - 180 mm/H2O
Protein 15 - 45 mg/dL
Total cell count 0 - 5 cells
WBC's 0 - 6 / µL
Cardiac Index 2.5 - 4.2 L / min / m squared
Cardiac Output 4 - 8 LPM
Left Ventricular Stroke Work Index 40 - 70 g / m squared / beat
Mean Arterial Pressure 70 - 105 mm Hg
Pulmonary Vascular Resistance 155 - 255 dynes / sec / cm to the negative 5
Pulmonary Vaslular Resistance Index 255 - 285 dynes / sec / cm to the negative 5
Right Ventricular Stroke Work Index 7 - 12 g / m squared / beat
Stroke Volume 60 - 100 mL / beat
Stroke Volume Index 40 - 85 mL / m squared / beat
Systemic Vascular Resistance 900 - 1600 dynes / sec / cm to the negative 5
Systemic Vascular Resistance Index 1970 - 2390 dynes / sec / cm to the negative 5
Systolic Arterial Pressure 90 - 140 mm Hg
Diastolic Arterial Pressure 60 - 90 mm Hg
Central Venous Pressure 2 - 6 mm Hg; 2.5 - 12 cm H2O
Ejection Fraction 60 - 75%
Left Arterial Pressure 4 - 12 mm Hg
Pulmonary Artery Systolic 15 - 30 mm Hg
Pulmonary Artery Diastolic 5 - 15 mm Hg
Pulmonary Artery Pressure 10 - 20 mm Hg
Pulmonary Artery Wedge Pressure 4 - 12 mm Hg
Pulmonary Artery End Diastolic Pressure 8 - 10 mm Hg
Right Atrial Pressure 4 - 6 mm Hg
Right Ventricular End Diastolic Pressure 0 - 8 mm Hg
Cerebral Perfusion Pressure 70 - 90 mm Hg
Intracranial Pressure 5 - 15 mm Hg or 5 - 10 cm H2O
pH 7.35 - 7.45
PaCO2 35 - 45 mm Hg
HCO3 22 - 26 mEq/L
O2 sat 92 - 100%
PaO2 80 - 100 mm Hg
BE -2 to +2 mmol/L
pH 7.31 - 7.41
PaCO2 41 - 51 mm Hg
HCO3 22 - 29 mEq/L
O2 sat 60 - 85%
PaO2 30 - 40 mm Hg
BE 0 to +4 mmol/L
Hormone / antagonist Life stage Value
Progesterone (nanograms per milliliter or nano-moles per liter) < 1.0 ng/ml
(< 3.18 nmol/L)
17-Hydroxyprogesterone (nanograms per deciliter or nano-moles per liter) 5 –250 ng/dl
( 0.15 –7.5 nmol/L)
Estradiol (picograms per milliliter or pico-moles per liter) < 60 pg/ml
(< 185 pmol/L)
FSH (units per liter) 1.0 –12.0 U/L
LH (units per liter)
2.0 –14.0 U/L
SHBG (nano-moles per liter) 6–50 nmol/L
Dehydroepiandrosterone (DHEA) (nanograms per deciliter or nano-moles per liter) 180 –1250 ng/dl
( 6.24 –43.3 nmol/L)
Dehydroepiandrosterone sulfate (DHEAS) (micrograms per deciliter) 10 –619 µg/dl
Androstenedione (nanograms per milliliter) 0.8-2 ng/ml
Androstenediol (nanograms per milliliter) 0.2-2 ng/ml
Total testosterone - morning sample (nanograms per deciliter or nano-moles per liter) 270 –1070 ng/dl
(9.36 –37.10 nmol/L)
Free testosterone - morning sample (picrograms per milliliter or pico-moles per liter) 20 –40 yr 15.0 –40.0 pg/ml (520 –1387 pmol/L)
41 –60 yr 13.0 –35.0 pg/ml (451 –1213 pmol/L)
61 –80 yr 12.0 –28.0 pg/ml (416 –971 pmol/L)
Prolactin (nanograms per milliliter) 0 –15 ng/ml
04-23-2009, 10:59 PM
Only thing the op has to remember is that those numbers may not necessarily translate into the same numbers which his lab may use. My labs rankings are totally different than the numbers posted above, yet, they mean the same.
---The internet is the father of the electronic lynch-mob---
04-23-2009, 11:02 PM
Very good point, thanks for catching that side of things.
04-24-2009, 12:03 AM
People should be leery about medical advice from others that aren't so clear.
04-24-2009, 02:21 AM
04-24-2009, 02:22 AM
04-24-2009, 03:23 PM
04-24-2009, 05:01 PM
What do you think about a TSH test?
04-24-2009, 06:11 PM
I believe the renal analysis important given the typically higher protein consumption of people who lift weights, as higher protein intake generally creates more work for the renal system. Add to this the consumption of creatine, very low carbohydrate intake, or very low fat intake, and the kidneys are being asked to do a lot. Sodium is easy to eat and also calls for extra renal work, so that is a consideration as well. Having the test done certainly can't hurt anything. If nothing else, it would provide baseline numbers for any future problems.
Doctor-patient privilege and confidentiality (there is a distinct difference) often depend on who is paying for the visit. If your new insurance company is paying for the tests before they are giving you coverage, I would have as little work performed as possible. In this case, the doctor is a pseudo employee of the insurance company and there may not be any privilege or confidentiality at all. However, if you go and see the doctor on your own terms, whether you are filing with an insurance company or not, privilege and confidentiality should exist. You have to check state law if you want to be absolutely sure.
Someone I know confided in their doctor about potentially taking steroids. The patient asked their physician if regular bloodwork could be performed and the physician said the tests would not be a problem. You could also look into paying for specific blood tests out-of-pocket, as this might keep your insurance company out of the loop. Some blood tests are relatively inexpensive.
Edit: At least one of the values for the "Normal Lab Values" posted above look different than those I've seen. Creatinine sticks out. Additionally, I'm guessing those values are for white people. If you're black, there is a correction factor of something around 1.2 times the posted values.
04-24-2009, 06:25 PM
Sodium does not call for extra renal work and a baseline is not really necessary because of reference ranges.
04-24-2009, 07:36 PM
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