Monitoring · Anabolic steroids and exogenous androgens
Where we stand
TrueVitals does not supply, prescribe, recommend or encourage anabolic steroid use. Anabolic steroids are Class C controlled drugs in the UK; possession for personal use is not an offence, supply is. This page exists because a large number of people use them, most do so without any medical supervision, and the harms that kill or hospitalise are largely measurable and largely preventable. If you are using, the single most useful thing you can do is test regularly and involve a doctor.
The damage from androgen use is not usually the thing people worry about. It is a haematocrit climbing past 54 percent, an ApoB doubling while HDL collapses, blood pressure nobody has measured in two years, and a testicular axis that does not restart. All of those are visible in blood months before they cause a problem, and all of them respond to acting early. This page covers what to test before your first cycle, what to watch while on, and what recovery should look like afterwards.
Venous draw at 103 UK clinics or at home. Report within 48 hours of the lab receiving your sample. No GP referral, no judgement.
Last reviewed 17 September 2026
The short answer
Test three times: a baseline before you start, one mid-cycle (around week 6 to 8), and one 8 to 12 weeks after you come off. The markers that matter most are haematocrit and haemoglobin, ApoB with full lipids, liver markers read correctly for a lifter, kidney function with cystatin C rather than creatinine, total and free testosterone with SHBG, LH and FSH, oestradiol, prolactin, PSA if over 40, and hs-CRP. Blood pressure is not a blood test and is the most under-monitored risk of the lot, so buy a cuff.
Tell us, and the report is written differently
The lifestyle questions include a confidential field for medications, hormones and anything else you are taking. If you say what you are on, the compound, the dose and where you are in the cycle, your report is written with that in mind: a suppressed LH is expected rather than alarming, a low HDL is read against the compound causing it, and the advice focuses on harm reduction rather than telling you to eat more oily fish. It is not shared with your GP, your employer or your insurer, and no clinician sees it except the professional reviewing your report. Most people testing on cycle have never been able to tell anyone. You can tell us.
What to test
| Marker | What androgens do to it | The level that matters | Panel |
|---|---|---|---|
| Haematocrit and haemoglobin | Androgens stimulate red cell production. Thicker blood means higher clot, stroke and heart attack risk, and this is the commonest serious finding in people on cycle | Above 52% warrants action; above 54% is the threshold at which clinicians intervene, usually by reducing or stopping the androgen and sometimes by venesection. Donating blood is not a treatment plan but it is what many people do | All panels |
| ApoB, LDL, HDL, triglycerides | Oral 17-alpha-alkylated compounds crush HDL and raise ApoB severely, often within weeks. This is the mechanism behind the cardiovascular disease seen in long-term users, and it is silent | ApoB is the number to watch, not total cholesterol. An HDL below 0.8 mmol/L with a rising ApoB is a serious signal, and orals are the usual cause | ApoB and lipids in all; Lp(a) in Ultimate and Signature |
| Liver: ALT, AST, GGT, ALP, bilirubin | Orals are hepatotoxic. But ALT and AST also leak from skeletal muscle after heavy training, so a lifter can show raised ALT with a perfectly healthy liver | GGT and ALP are far more specific to the liver in this group, and a raised bilirubin with dark urine or yellow eyes is urgent. If ALT and AST are up but GGT is normal, training is the likelier explanation, particularly if creatine kinase is also raised | All panels |
| Kidney: creatinine, eGFR, cystatin C, urea | Creatinine comes from muscle, so a heavily muscled person on a high-protein diet using creatine will look like they have kidney impairment when they do not | Cystatin C is independent of muscle mass and gives the true reading. If cystatin C eGFR is normal and creatinine eGFR is low, your kidneys are fine. If cystatin C is genuinely falling, that is real and needs a doctor | Creatinine and eGFR in all; cystatin C in Ultimate and Signature |
| Total and free testosterone, SHBG | Shows what you are actually running. Many people are taking far more or far less than they think, particularly with underdosed or mislabelled product | Interpretation depends entirely on the compound, the ester and when you last injected, which is why disclosure matters. Trough levels before the next injection are the most repeatable | Testosterone in Advanced; free testosterone and SHBG in Ultimate and Signature |
| LH and FSH | Suppressed to near zero within weeks of starting, which is expected. Their recovery is what tells you whether your own production is coming back after you stop | On cycle, near-undetectable is normal. At 8 to 12 weeks off, LH and FSH still flat with a low testosterone means the axis has not restarted, and that needs an endocrinologist rather than another cycle | Ultimate and Signature |
| Oestradiol | Aromatised from testosterone. Too high causes water retention, gynaecomastia and mood swings; too low, usually from over-using an aromatase inhibitor, wrecks joints, libido, mood and bone density | Both extremes are harmful. Crashing oestradiol with an AI is one of the commonest self-inflicted harms in this group and is entirely avoidable with a test | Core hormones in Advanced; full set in Ultimate and Signature |
| Prolactin | Raised by 19-nor compounds such as nandrolone and trenbolone, causing sexual dysfunction and, rarely, nipple discharge | A markedly raised prolactin should be investigated properly rather than self-treated, because a pituitary cause needs excluding | Ultimate and Signature |
| PSA | Androgens can raise PSA and stimulate existing prostate disease | Worth a baseline from 40, or younger with a family history. A rising PSA on cycle needs a GP, not a forum | Ultimate and Signature (total, free and ratio) |
| hs-CRP, HbA1c, fasting insulin | Some compounds worsen insulin sensitivity and raise inflammatory markers; growth hormone and insulin use, common alongside, do so much more | HbA1c creeping above 38 in a lean, trained person is not normal and is worth acting on early | HbA1c and hs-CRP in all; fasting insulin in Ultimate and Signature |
Creatine kinase is almost always raised in trained people and does not indicate damage on its own; it is useful mainly for interpreting raised ALT and AST. Guides: ApoB, liver, kidney and cystatin C, testosterone, PSA, blood tests for athletes.
Stop and get medical help today if
Chest pain or tightness, breathlessness at rest, a severe or sudden headache, weakness or numbness on one side, slurred speech, calf pain or swelling, yellowing of the eyes or skin, dark urine with pale stools, or vomiting blood. Do not wait for a blood result. Call 999 for the first five, and see a GP the same day for the rest. Tell them what you are taking; they are there to treat you, not report you, and they cannot help properly without knowing.
When to test
Before you start
Your natural testosterone, your haematocrit, your lipids, your liver and kidney function before anything changes. Without it, every later result is guesswork: a testosterone of 14 nmol/L off-cycle means something completely different if you started at 25 than if you started at 15. It also finds the people who should not start at all: an existing high haematocrit, high Lp(a), raised blood pressure or a family history of early heart disease.
Week 6 to 8 on
Haematocrit and lipids have moved by now, and this is the test that catches the problems while they are still reversible. Draw at trough, just before your next injection, for a repeatable testosterone reading. If haematocrit is above 54 or HDL has collapsed, that is information you can act on rather than find out about in A&E.
8 to 12 weeks off
LH, FSH and total testosterone tell you whether your own production has come back. This is the test most people skip and the one that matters most for the next twenty years. Flat LH with a low testosterone at three months off is not something to fix with another cycle; it is a reason to see an endocrinologist while recovery is still likely.
If you are on TRT rather than cycling, the pattern is different: the axis stays suppressed by design, and monitoring focuses on haematocrit, oestradiol, PSA and lipids every six to twelve months. Blood tests before TRT.
Which panel
Advanced
74 biomarkers · £269
Full blood count with haematocrit, ApoB and full lipids, complete liver panel, kidney, HbA1c, hs-CRP, total testosterone, oestradiol and thyroid. Enough to catch the dangerous stuff.
View AdvancedThe cycle panel
Ultimate
114 biomarkers · £349
Adds free testosterone and SHBG, LH and FSH (recovery), prolactin, PSA with free ratio, cystatin C (the real kidney reading for a lifter), Lp(a) and fasting insulin. Every row in the table.
View UltimateHealth plans
2, 3 or 4 tests · from £706
Baseline, mid-cycle and post-cycle bought together at a lower price per test, each report compared against the last. The trend is the entire point here.
View health plansClinic draw £19. At-home £39. Morning slot, fasted from 10pm, and ideally at trough before your next injection. Train lightly for 48 hours beforehand so creatine kinase, ALT and AST are readable.
Being straight
It will not tell you what is in the vial. Underdosed, overdosed and mislabelled product is common in an unregulated market, and a testosterone level tells you what reached your bloodstream, not what was on the label. It will not make a cycle safe; it makes the harms visible earlier, which is a different and lesser claim. It will not measure your blood pressure, which is the most under-monitored risk in this group and needs a £25 cuff and two readings a week. It will not replace a doctor: if your haematocrit is 57 or your bilirubin is climbing, you need a clinician that week, and a report is what you take to them. And it cannot undo years of use, though it can tell you where you stand, which is usually better news than people fear and occasionally much worse.
If you want to talk to someone who will not judge you, your GP is the right place and many are more pragmatic about this than people expect. Some areas also have IPED clinics or needle exchange services that offer bloods and harm-reduction advice free, and they are worth finding.
After your result
A suppressed LH is explained as expected rather than flagged as alarming; a low HDL is read against the compound causing it; ALT is interpreted alongside creatine kinase rather than assumed to be liver damage. The urgent findings are flagged plainly at the top.
Haematocrit and blood pressure. Both are manageable, both are ignored by most users, and both are what turn a cycle into a cardiac event. The report tells you the numbers and where the thresholds are.
Mid-cycle if this was your baseline, or 8 to 12 weeks off if this was mid-cycle. Each report compares against the last, so you can see haematocrit climbing or lipids recovering rather than guessing. Retest plans.
FAQs
Yes. We test blood and explain results for anyone, and your report will be honest about what it shows. Testing your blood is not an endorsement of what you are taking, and we would rather you were doing this with a doctor involved.
Yes. What you enter in the lifestyle questions is used to write your report and is not shared with your GP, employer or insurer. Your data is handled under UK GDPR as special category health data. How we handle your data.
A full blood count with haematocrit, ApoB and full lipids, a complete liver panel, kidney function with cystatin C, total and free testosterone with SHBG, LH and FSH, oestradiol, HbA1c, hs-CRP and, from 40, PSA. That is your baseline, and without it later results are far harder to interpret.
ALT and AST are released by skeletal muscle as well as liver, and heavy training raises both, often substantially. GGT and ALP are far more liver-specific, so raised ALT with a normal GGT and a high creatine kinase usually points to training rather than liver injury. Raised GGT, ALP or bilirubin is a different matter and needs attention.
Above 52 percent warrants action and above 54 percent is where clinicians typically intervene, because clot, stroke and heart attack risk rise sharply. Management usually means reducing or stopping the androgen, and sometimes venesection, which is a medical decision rather than something to arrange informally.
At trough, immediately before your next injection, in the morning and fasted. That is the most repeatable point, and comparing trough to trough is the only way to see a real change. Tell us the compound, dose and timing so the report reads the number properly.
LH, FSH and total testosterone at 8 to 12 weeks after your last dose. Recovering LH and FSH with a rising testosterone means the axis is restarting. Flat LH and FSH with a low testosterone at that point means it has not, and that is an endocrinology conversation rather than a reason to start again.
Not directly. A testosterone level shows what reached your bloodstream, which can suggest an underdosed or mislabelled product, but it is not proof and it says nothing about contaminants or sterility.
114 biomarkers in one venous draw, at 103 UK clinics or at home, with a report written with your disclosure in mind. Confidential, no referral, no judgement.
Before TRT · Testosterone · Athletes · Men's health · Find a clinic
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