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Cholesterol status
Total cholesterol
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Cholesterol is an essential fat (lipid) in the body. Although it has a bad reputation it has some important functions, including building cell membranes and producing a number of essential hormones including testosterone and oestradiol. Cholesterol is manufactured in the liver and also comes from the food we eat. Although there are a number of different types of cholesterol, the two main components of total cholesterol are HDL (high density lipoprotein) which is protective against heart disease and LDL (low density lipoprotein) which, in high levels, can contribute to cardiovascular disease. Your total cholesterol result on its own is of limited value in understanding your risk of heart disease; high levels of HDL cholesterol can cause a raised total cholesterol result but may actually be protective against heart disease. Equally, you can have a normal total cholesterol level but have low levels of protective HDL cholesterol. The most important factors are how much HDL and LDL cholesterol you have, and what proportion of your total cholesterol is made up of protective HDL cholesterol. We give a detailed breakdown of the components of your total cholesterol in the rest of this cholesterol profile.
LDL cholesterol
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LDL cholesterol (low-density lipoprotein) is a molecule made of lipids and proteins which transports cholesterol, triglycerides and other fats to various tissues throughout the body. Too much LDL cholesterol, commonly called 'bad cholesterol', can cause fatty deposits to accumulate inside artery walls, potentially leading to atherosclerosis and heart disease.
Non-HDL cholesterol
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Your total cholesterol is broken down into 2 main components; HDL (good) cholesterol and LDL (bad). There are more types of harmful cholesterol in your blood than just LDL - these include VLDL (very low-density lipoproteins) and other lipoproteins which are thought to be even more harmful than LDL cholesterol. Non-HDL cholesterol is calculated by subtracting your HDL cholesterol value from your total cholesterol. It therefore includes all the non-protective and potentially harmful cholesterol in your blood, not just LDL. As such, it is considered to be a better marker for cardiovascular risk than total cholesterol and LDL cholesterol. The recommended level of non-HDL cholesterol is below 4 mmol/L.
HDL cholesterol
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HDL cholesterol (high-density lipoprotein) is a molecule in the body which removes cholesterol from the bloodstream and transports it to the liver where it is broken down and removed from the body in bile. HDL cholesterol is commonly known as 'good cholesterol'.
Total cholesterol : HDL
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The cholesterol/HDL ratio is calculated by dividing your total cholesterol value by your HDL cholesterol level. It is used as a measure of cardiovascular risk because it gives a good insight into the proportion of your total cholesterol which is good (i.e. high-density lipoprotein HDL). Heart disease risk tools (such as QRisk) use the cholesterol/HDL ratio to calculate your risk of having a heart attack.
Triglycerides
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Triglycerides are a type of fat (lipid) that circulate in the blood. After you eat, your body converts excess calories (whether from fat or carbohydrates) into triglycerides which are then transported to cells to be stored as fat. Your body then releases triglycerides when required for energy.
Clotting status
Platelet count
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Platelets or clotting cells are the smallest type of blood cell. They are formed in the bone marrow and are important in blood clotting. When bleeding occurs, the platelets swell, clump together and form a sticky plug (a clot) which helps stop the bleeding.
MPV
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MPV, or Mean Platelet Volume, is a measurement of the average size of your platelets. Platelets are fragmented cells within the blood that aid the process of clot formation. MPV provides an indication of platelet production in your bone marrow.
Diabetes
HbA1c
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Haemoglobin A1c (HbA1c), also known as glycated haemoglobin, is a longer-term measure of glucose levels in your blood than a simple blood glucose test. Glucose attaches itself to the haemoglobin in your red blood cells, and as your cells live for around 12-16 weeks, it gives us a good indication of the average level of sugar in your blood over a 3-month period.
A raised HbA1c result points to diabetes or an increased risk of developing diabetes, which can have a significant impact on your lifespan and quality of life. Complications of uncontrolled diabetes include heart disease, kidney disease, eye problems, and vascular conditions. It can also contribute to mental health problems. And men with diabetes are three times more likely to have erectile dysfunction. Keeping your HbA1c within a normal range can help you reduce the risk of these conditions.
A raised HbA1c result points to diabetes or an increased risk of developing diabetes, which can have a significant impact on your lifespan and quality of life. Complications of uncontrolled diabetes include heart disease, kidney disease, eye problems, and vascular conditions. It can also contribute to mental health problems. And men with diabetes are three times more likely to have erectile dysfunction. Keeping your HbA1c within a normal range can help you reduce the risk of these conditions.
Hormones
Oestradiol
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Oestradiol is the strongest of the three oestrogens. It's labelled a female hormone but it's made in both the ovaries and testes. It's responsible for the growth of breast tissue, the female reproductive system, and male sexual function.
In pre-menopausal women, oestradiol levels vary throughout the monthly cycle, peaking just before ovulation. Levels are lowest after menopause when the ovaries stop producing eggs. Low oestradiol levels in women can cause many symptoms associated with the menopause, including hot flushes, night sweats, and changes in mood. It can also increase the risk of osteoporosis (a condition where the bones become less dense).
In men, oestradiol levels tend to increase slightly with age as testosterone levels decline. Too much oestradiol in men can contribute to fertility problems, gynecomastia (enlarged breast tissue), and erectile dysfunction.
Testosterone
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Testosterone is a hormone that causes male characteristics. For men, it helps to regulate sex drive and has a role in controlling bone mass, fat distribution, muscle mass, strength and the production of red blood cells and sperm. Testosterone is produced in the testicles of men and, in much smaller amounts, in the ovaries of women. Testosterone levels in men naturally decline after the age of 30, although lower than normal levels can occur at any age and can cause low libido, erectile dysfunction, difficulty in gaining and maintaining muscle mass and lack of energy. Although women have much lower amounts of testosterone than men, it is important for much the same reasons, playing a role in libido, the distribution of muscle and fat and the formation of red blood cells. All laboratories will slightly differ in the reference ranges they apply because they are based on the population they are testing. The normal range is set so that 95% of men will fall into it. For greater consistency, we use the guidance from the British Society for Sexual Medicine (BSSM) which advises that low testosterone can be diagnosed when testosterone is consistently below the reference range, and that levels below 12 nmol/L could also be considered low, especially in men who also report symptoms of low testosterone or who have low levels of free testosterone.
Iron status
Iron
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Iron is a mineral that is essential for life. It is a component of haemoglobin, a protein in our red blood cells that is responsible for transporting oxygen around our body. If we don't have enough iron, our haemoglobin levels fall and we can't get sufficient oxygen to our cells. This can cause symptoms which include fatigue, dizziness, and shortness of breath. Serum iron is a very transient reading and can be influenced by the amount of iron-rich food in your diet in the days before your blood test. For this reason, iron is rarely looked at on its own, and is interpreted alongside other markers in an iron status test.
Ferritin
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Ferritin is a protein which stores iron in your cells and tissues. Usually, the body incorporates iron into haemoglobin to be transported around the body, but when it has a surplus, it stores the remaining iron in ferritin for later use. Measuring ferritin levels gives us a good indication of the amount of iron stored in your body.
Kidney health
Urea
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Urea is a waste product produced by the body when it breaks down proteins in the liver. Once the urea is made, it is transported to the kidneys, which filter it out of the blood and remove it from the body in the form of urine. Measuring the levels of urea in the blood can therefore reflect how well both the liver and the kidneys, are functioning. It is important to note that even if one kidney is severely damaged but the other is functioning perfectly, results may still return as normal.
Creatinine
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Creatinine is a chemical waste molecule that is generated from normal muscle metabolism. Measurement of this is an indicator of the levels of other waste products in the body. Creatinine is also an accurate marker of kidney function, and may help in diagnosing kidney disease.
eGFR
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The estimated glomerular filtration rate (eGFR) assesses how well the kidneys are working by estimating the amount of blood filtered through the kidneys. The glomeruli are tiny filters in the kidneys responsible for removing waste products. If these filters do not do their job properly, kidney function can be impaired. The eGFR calculation is an estimate of actual glomerular filtration rate, calculated using your age, gender, ethnicity, and serum creatinine levels.
Liver health
ALP
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Alkaline phosphatase (ALP) is an enzyme found mainly in the liver and bones. Measuring it can indicate ongoing liver, gallbladder or bone disease.
ALT
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Alanine transferase (ALT) is an enzyme which is mostly found in the liver, but is also found in smaller amounts in the heart, muscles and the kidneys. If the liver is damaged, ALT is leaked into to bloodstream. As ALT is predominantly found in the liver, it is usually an accurate marker for liver inflammation and can indicate liver damage caused by alcohol, fatty liver, drugs or viruses (hepatitis).
Gamma GT
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Gamma GT, also known as gamma-glutamyl transferase (GGT), is a liver enzyme which is raised in liver and bile duct diseases. It is used in conjunction with ALP to distinguish between bone or liver disease. Gamma GT is also used to diagnose alcohol abuse as it is raised in 75% of long term drinkers.
Proteins
Total protein
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Total Protein represents the sum of the proteins albumin and globulin in your blood. Albumin and globulin have a range of functions including keeping blood within vessels, transporting nutrients and fighting infection. Abnormal levels can indicate malnutrition as well as a liver or kidney disorder.
Albumin
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Albumin is a protein which is made mainly in the liver. It helps to exert the osmotic pressure which holds water within the blood. It also helps carry nutrients and medications and other substances through the blood and is important for tissue growth and healing. Albumin also carries hormones around the body, therefore measuring the amount of albumin in the blood can help us calculate how much hormone is available to your tissues.
Globulin
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Globulin is an umbrella term for a set of different proteins that the immune system and the liver produce. Certain globulins bind with haemoglobin while others transport metals, such as iron, in the blood. Additionally, there is a certain type of globulin known as an immunoglobulin, (another name for an antibody) which helps to fight infection in the body.
Red blood cells
Haemoglobin
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Haemoglobin is a protein in red blood cells which carries oxygen around the body and gives the blood its red colour. This test measures the amount of haemoglobin in the blood and is a good measure of the blood's ability to carry oxygen around the body.
Haematocrit
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HCT (haematocrit) measures the amount of space (volume) within the blood that is taken up by red blood cells.
Red cell count
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Red Blood Cell (RBC) Count analyses the number of red blood cells in the blood. Red blood cells carry oxygen from the lungs to the rest of the body, where it can be used to fuel energy processes such as movement and respiration. They also carry carbon dioxide produced from cells back to the lungs so that it can be exhaled.
MCV
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MCV (mean corpuscular volume) reflects the average size of your red blood cells. This is important to measure, as it can indicate how much oxygen your cells are likely to be transporting around the body.
MCH
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MCH (mean corpuscular haemoglobin) measures the average amount of haemoglobin contained in one of your red blood cells.
MCHC
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MCHC (mean corpuscular haemoglobin concentration) is the average concentration of haemoglobin in your red blood cells. Haemoglobin is a molecule which allows red blood cells to transport oxygen around the body.
Thyroid hormones
TSH
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Thyroid stimulating hormone (TSH) is produced in the pituitary gland in order to regulate the production of thyroid hormones thyroxine (T4) and triiodothyronine (T3) by the thyroid gland. If thyroid hormones in the blood are low, then more TSH is produced to stimulate the thyroid gland to produce more of them. If thyroid hormone levels are high, then the pituitary produces less TSH to slow the production of thyroid hormones. If TSH is too high or too low, it normally signifies that there is a problem with the thyroid gland which is causing it to under or over produce thyroid hormones. Sometimes a disorder of the pituitary gland can also cause abnormal TSH levels.
Free thyroxine
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Thyroxine (T4) is one of two hormones produced by the thyroid gland. It works to speed up the rate of your metabolism. Most T4 is bound to carrier proteins in the blood - it is only the free, or unbound, T4 that is active in the body, which is measured in this test. Free T4 is the less active of the two main thyroid hormones. To have an impact on your cells it needs to convert to the more active T3 when your body needs it.
White blood cells
White cell count
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White Blood Cell (WBC) Count measures the number of white blood cells in the blood. White blood cells are key to your body's immune system. They fight infections and protect your body from foreign invaders such as harmful germs and bacteria. Additionally, they produce many antibodies and memory cells to protect you from further infections with the same germ.
Neutrophils
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Neutrophils are the most abundant type of white blood cell in the body and are responsible for helping your body fight infection. When a germ is initially detected by the body, neutrophils are the defence system which go out and attack the germ before any of your other white blood cells. When neutrophils are low you can be more vulnerable to illness and infection.
Lymphocytes
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Lymphocytes are a type of white blood cell which fight bacterial and viral infections. They are the subset of white blood cells involved in the more specific response to infections, which can identify and differentiate between different foreign organisms that enter the body. As well as fighting infection, they produce antibodies and memory cells to help to prevent future infections from the same germ. Lymphocytes include T cells, B cells and natural killer cells.
Monocytes
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Monocytes are a type of white blood cell that surround and destroy germs and dead or damaged cells from the blood. The heat and swelling that you feel when a body part is inflamed, for example after a cut on your finger, is caused by the activities of these cells.
Eosinophils
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Eosinophils are a type of white blood cell that are responsible for removing parasitic infections and regulating inflammation to mark an infected site. They also play a role in allergy and in asthma.
Basophils
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Basophils are a type of white blood cell that protect your body from bacteria and parasites such as ticks. They also play a role in allergic reactions.
If you have periods
Tests with LH, FSH, or oestradiol
If you're taking your test to learn more about your fertility, take your test between days 2 and 5 of your menstrual cycle, or ideally day 3. Otherwise, for a general health check or if you're postmenopausal, you can take your test at any time.
In either case, it's important to log the date of your last period, and any other information regarding your periods or menopause status, in your MyMedichecks account right after taking your sample.
If you don't let us know the date of your last period, we'll interpret your result as though you took your test on day 3.
Special instructions
How to prepare for your test
Prepare for your Sports Hormone Blood Test by following these instructions. Take your sample between 6am and 10am. Take this test when any symptoms of short-term illness have settled. Take this test two to five days after the start of your period, ideally on day three. It can be taken any time if you do not have periods. Avoid heavy exercise for 48 hours beforehand. Avoid fatty foods for eight hours before your test, you do not need to fast. Stay well hydrated before your test. Do not take biotin supplements for two days before this test, discuss this with your doctor if it is prescribed. Hormonal contraception can affect the results of this test. Taking a break from this and waiting for your periods to restart before your blood test will give more accurate results. If you take thyroxine, you can take your medication as usual, either before or after your blood test. However, if you take desiccated thyroid extract (DTE) or liothyronine, it's best to take it after you've collected your sample. Please let us know in your supporting information if you take amiodarone or lithium as these can affect your thyroid function results.
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FAQs
Which hormones are included in a sports blood test?
We've included tests for the core performance hormones: testosterone, oestradiol, thyroid-stimulating hormone (TSH), and free thyroxine (FT4). Imbalances in these hormones can affect your body composition and ability to gain muscle, making it more difficult to get lean. They can also influence mood and motivation, making workouts seem harder than they need to be.
Why is this test for PEDs and steroid users?
Anyone taking any form of testosterone supplement needs to keep track of their general health, especially their red blood cells, liver function, and cholesterol levels. Taking anabolic steroids can cause you to make too many red blood cells, leading to stickier blood that's more prone to clotting. All steroids (but particularly oral steroids) can cause liver inflammation and abnormal cholesterol results where LDL (bad) cholesterol rises and HDL (good) cholesterol falls to below-normal levels.
Our approach to testing for people taking steroids is to reduce harm by helping to highlight the impact of steroid use on your health. Some abnormalities can revert to normal once you stop taking steroids, but others can cause lasting damage, especially if your cycles are long. In particular, hypogonadism, where the testicles shrink and can no longer produce enough testosterone for fertility, mood, and general well-being, is a common and sometimes lasting side-effect of supplementing with testosterone. Our doctors will not judge you, so please tell them as much as possible about your steroid use when you take this test. Read more in our blog: the effects of steroids on the body.
What is a Sports Hormone Blood Test?
Our Sports Hormone Blood Test is a venous blood test (where blood is drawn from a vein in your arm), which covers the main biomarkers a strength trainer would want to test. Our test is for steroid users, bodybuilders, and athletes looking to understand the factors that can influence their performance.
Does this test measure high levels of testosterone?
Most testosterone tests set an upper detection limit of 52 nmol/L. If your result is higher than this, the lab will attempt a second measurement to get an actual reading, providing there is enough sample volume available.