Short answer: after stopping anabolic steroids, check your hormones (LH, FSH, testosterone, SHBG, oestradiol, prolactin), your red cells (haematocrit), cholesterol and ApoB, liver, kidneys and HbA1c, first about 6 to 8 weeks after your last dose and again at around 3 months. In the largest prospective study of men doing a cycle, most hormone, blood and cholesterol changes had returned to pre-cycle levels by three months after stopping, but not for everyone. A test shows whether your body has recovered; it can't diagnose anything on its own, and anything that hasn't settled should go to your GP.
The safest option is not to use anabolic steroids. This page is about health monitoring only: no doses, no cycle plans, no drug protocols. Sources: Smit et al., HAARLEM study (Human Reproduction 2021; Andrologia 2022; Scand J Med Sci Sports 2021); Rasmussen et al., PLoS One 2016; NHS; NICE PH52. Written by James Smillie, TrueVitals, reviewed by the TrueVitals clinical review team. Sources checked November 2026.
Anabolic steroids are synthetic versions of testosterone. While you are taking them, your brain senses plenty of testosterone and stops sending the two signals that make your own: luteinising hormone (LH) and follicle-stimulating hormone (FSH). The testes shrink and sperm production falls. Stopping doesn't switch those signals straight back on, which is why the weeks after a cycle are when many people feel worst: the NHS lists depression, anxiety, tiredness, poor sleep and low sex drive among the symptoms of coming off steroids.
Hormones aren't the only thing that moves. The best evidence comes from the HAARLEM study in the Netherlands, which followed 100 men before, during and after a self-chosen steroid cycle (Smit et al., Andrologia 2022). By the end of the cycle, on average:
| Measure | Average change during the cycle | Three months after |
|---|---|---|
| Haematocrit (red cell share of blood) | +0.03 L/L | Back to baseline |
| LDL cholesterol | +0.45 mmol/L | Back to baseline |
| ApoB (atherogenic particles) | +18.2 mg/dL | Back to baseline |
| HDL ("good") cholesterol | −0.40 mmol/L | Back to baseline |
| Blood pressure | +6.9 / +3.2 mmHg | Back to baseline |
The same cohort also saw mean ALT rise by 18.7 U/L and creatinine by 4.7 µmol/L during the cycle, and 58% reported low libido after it (Smit et al., Scand J Med Sci Sports 2021). The authors call the cardiovascular changes "small but clinically relevant" and note that a one-year study can't tell us the long-term heart risk. Averages also hide individuals: some men recover quickly, some don't.
That is the case for testing after a cycle: not to "prove" you got away with it, but to find out whether your hormones, red cells, cholesterol, liver and kidneys have actually come back, and to catch the people for whom they haven't. If you tested before the cycle (see our blood test before steroids guide), you can compare like with like.
Test the same markers each time, at the same lab, in the morning, so the results can be compared.
| Marker | What it tells you after a cycle | What recovery looks like |
|---|---|---|
| LH and FSH | Whether the pituitary has started signalling the testes again. Low during and just after a cycle. | Back inside the lab range. |
| Total testosterone | Whether your own production has returned. Early on it may still contain drug that hasn't cleared. | In range, with LH and FSH also in range. |
| SHBG and free androgen index | Steroids can lower SHBG, which changes how much testosterone is available. The free androgen index is calculated from testosterone and SHBG. | Close to your pre-cycle value. |
| Oestradiol | Testosterone converts to oestradiol; high or very low levels can go with breast tissue changes, mood and libido problems. | In the male range for your lab. |
| Prolactin | A pituitary hormone; a raised level can suppress testosterone and libido and needs a doctor to look at it. | In range. |
| Full blood count: haematocrit, haemoglobin | Steroids push up red cell production. Thicker blood raises clot risk. High haematocrit explained. | Below about 0.52 for men (labs vary), and back near your baseline. |
| Lipids and ApoB | HDL falls and LDL and ApoB rise on a cycle. Lp(a) can also fall during use and return after. | HDL, LDL and ApoB back to your usual values. |
| Liver: ALT, AST, GGT, bilirubin | ALT and AST also come from muscle, so heavy training raises them. GGT and bilirubin are more liver-specific. Oral steroids are the bigger liver risk. | GGT and bilirubin normal; ALT and AST settling once you rest before the test. |
| Kidneys: creatinine, eGFR, cystatin C | Creatinine rises with muscle mass and creatine use, which can make eGFR look falsely low. Cystatin C is far less affected by muscle. | Cystatin C-based eGFR normal. |
| HbA1c | Average blood sugar over about three months. Part of the general health picture, particularly after a long surplus or bulk. | Below the prediabetes range. |
Not a blood test but just as important: blood pressure. It rose by about 7 mmHg systolic in the HAARLEM cohort. A pharmacy or your GP surgery can check it for free. Men over 40 may also want PSA, because steroids act on the prostate (see our testosterone blood test guide for how the hormone markers fit together).
There is no official UK schedule for testing after a steroid cycle. This is how we suggest timing it, based on what the research measured. Count from your last dose, not from when you planned to stop: injected steroids can stay in the body for weeks, so an early test can still show the drugs rather than your own hormones.
Not a good time to judge recovery: results mostly reflect what is still in your system. Don't wait for a test, though, if you have chest pain, breathlessness, a painful swollen leg, yellow skin or eyes, or thoughts of harming yourself: get help the same day (999, NHS 111 or your GP).
First check (our suggestion, not a guideline). Haematocrit, lipids, liver and kidney markers should be heading back towards normal. LH, FSH and testosterone may still be low; that is common at this stage, so read them as a direction of travel, not a verdict.
The key test. In the HAARLEM study, average testosterone was no longer different from pre-cycle levels three months after the cycle ended, and haematocrit, blood pressure, LDL, HDL and ApoB had returned to baseline (Smit et al., 2021 and 2022). If yours haven't, this is the point to book a GP appointment.
Retest anything that was still abnormal at three months. Recovery isn't guaranteed: a year after starting a cycle, 11% of HAARLEM participants still had low testosterone and 34% still had a sperm count below 40 million, with slower recovery in men with more past steroid use.
In a Danish study, 27% of former users had testosterone below the lab's lower limit an average of 2.5 years after stopping, compared with none of the non-users (Rasmussen et al., PLoS One 2016). Persistent symptoms years later are worth raising with a GP, not putting up with.
On the day: book a morning draw, ideally before 10am, because testosterone is highest in the morning. Rest from hard training for 48 to 72 hours so muscle enzymes (CK, AST, ALT) don't distort the liver picture (our blood test for gym-goers guide explains why). Drink normally beforehand, since dehydration can push haematocrit up. Fast if your panel includes glucose and insulin.
These are common patterns, not diagnoses. Your own results need reading together, with your history, by a clinician.
The pituitary hasn't restarted the signal yet. Expected early on. If it persists beyond about three to six months, especially with symptoms, doctors call this anabolic steroid-induced hypogonadism and it is a reason to see your GP, who can refer you to an endocrinologist.
The signal is back but the testes aren't responding fully. This needs a GP and usually further tests.
Good news: hormonally, you look recovered. Fertility can lag behind; if you are trying for a baby, ask your GP about a semen analysis.
UK pathways investigate men whose haematocrit stays above 0.52 for more than two months. Repeat it well hydrated; if it is still raised three months after stopping, see your GP. Never try to remove blood yourself.
Often muscle rather than liver, particularly after training. Retest after a few rest days. A raised GGT or bilirubin, or any jaundice, needs a GP.
Worth a GP conversation about overall heart risk, especially with a family history of early heart disease or a high Lp(a).
Can explain low libido, erection problems or breast tissue changes. A raised prolactin should be confirmed and assessed by a doctor.
Tell your GP you've used steroids. It is confidential, it changes how your results are read, and having steroids for your own use isn't a crime. See your GP if:
Get urgent help for chest pain, sudden breathlessness, a painful swollen calf, signs of a stroke, or thoughts of suicide: call 999 or go to A&E. For urgent advice, call NHS 111. Samaritans are free to call on 116 123, day or night.
Please don't buy drugs online to "restart" your hormones. A GP or endocrinologist can work out why your levels are low and treat you with proper monitoring if you need it.
Can test, investigate and refer you, and the NHS says a GP may refer you to a specially trained drugs counsellor if you feel dependent on steroids.
Free, confidential local services for anyone who injects, including steroids. NICE guidance (PH52) asks them to serve people who inject image and performance enhancing drugs, with easy access to HIV and hepatitis testing and hepatitis B vaccination. Many pharmacies run one; your local drug service can tell you where.
Free, confidential drug information and advice: call 0300 123 6600 or text 82111, any time. FRANK can also point you to local support.
The safest option is not to use anabolic steroids. Testing reduces harm by catching problems; it doesn't make steroid use safe, and normal results don't rule out effects a blood test can't see, such as changes to the heart muscle.
In the UK, anabolic steroids are Class C drugs. The NHS explains that it is legal to have them for personal use, but illegal to possess, import or export them if it is believed you are supplying or selling them, and that includes giving them to friends. The maximum penalty is an unlimited fine or up to 14 years in prison. If you compete in tested sport, steroids are banned in and out of competition.
TrueVitals doesn't supply, recommend or endorse steroid use, and we don't give doses, cycle plans or drug protocols. We test blood and explain what the results show.
The Ultimate panel (140 biomarkers, 139 for women) includes every blood marker in the table above: testosterone, SHBG, free androgen index, LH, FSH, oestradiol and prolactin; a full blood count with haematocrit; a full lipid panel with ApoB and Lp(a); ALT, AST, GGT and bilirubin; creatinine, eGFR and cystatin C; HbA1c; creatine kinase; and PSA for men. Samples are analysed by Nationwide Pathology, a UKAS-accredited laboratory, and the clinician-reviewed report arrives within 4 working days of the lab receiving your sample. It is written from your own lifestyle quiz, where you can tell us about past steroid use in confidence, and it reads the results together rather than marker by marker. If you test again at three months, you can compare the two reports side by side.
When we're not the right choice:
Written by James Smillie and reviewed by the TrueVitals clinical review team, 2 November 2026. Figures come from the HAARLEM prospective cohort (Smit et al., Human Reproduction 2021; Andrologia 2022; Scandinavian Journal of Medicine & Science in Sports 2021), the Danish case-control study of former users (Rasmussen et al., PLoS One 2016), NHS guidance on anabolic steroid misuse, NICE public health guideline PH52 and NHS haematology pathways, all checked in November 2026. The testing schedule above is our suggestion based on those studies, not an official guideline. TrueVitals is a UK blood testing company, so we have an interest in you testing; we've tried to say plainly when you don't need us.
Hormones, haematocrit, lipids and ApoB, liver and kidneys in one venous draw, with a clinician-reviewed report within 4 working days. Confidential, no referral, no judgement.
Not sure what you need? Take the free quiz: answer a few questions about you and see which markers are worth checking. Ultimate can be split into 3 interest-free payments of £133 with Klarna.
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