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Guide · Harm reduction

What blood tests should steroid users get in the UK?

If you use anabolic steroids, or are thinking about it, regular blood tests and blood pressure checks are how you see what they are doing to your body. This is what UK guidance for GPs recommends, what each test looks for, and where to get them.

Quick answer

UK primary-care guidance for people using anabolic steroids lists a full blood count (for haematocrit), cholesterol, liver function, kidney function and oestradiol, plus a blood pressure check. Testosterone with LH and FSH is for checking recovery after stopping, and HbA1c only if you use growth hormone.

  • Haematocrit above 0.52 in men: reduce or stop steroids and repeat. Above 0.60: urgent referral.
  • Your GP can order all of them free. Needle and syringe programmes and some NHS clinics help too.
  • This is for anabolic steroids, not corticosteroids like prednisolone.

The tests, and the levels doctors act on

From Essential blood testing in the patient using androgenic anabolic steroids, a 2024 UK guideline for primary care written by GPs, hospital specialists and drug treatment teams.[1]

TestWhyWhat the guidance says
Blood pressureAnabolic steroids can raise blood pressure, which strains the heart and kidneys.The guideline suggests measuring blood pressure alongside kidney tests. A pharmacy or GP surgery can check it free.
Full blood count (haematocrit)Steroids raise red blood cell production. Thicker blood raises the risk of clots, heart attack and stroke.Haematocrit above 0.52 in men: reduce or stop all anabolic steroids and repeat. Above 0.60: stop, and urgent referral to haematology.
Cholesterol (lipids)Low HDL and high LDL cholesterol raise the risk of heart disease. Oral steroids can lower HDL sharply.Repeat when off steroids if abnormal. Referral if, on repeat, cholesterol is above 9 mmol/L (or above 7.5 under age 30), non-HDL above 7.5, or triglycerides above 10 mmol/L. Every 10% fall in HDL raises coronary risk by about 13%.
Liver function (ALT)Oral steroids are often chemically altered to survive the liver, which can damage it. Heavy lifting also raises ALT.If ALT is below 3 times the upper limit, repeat 10 to 14 days after a break from heavy weightlifting before anything else.
Kidney function (urea and electrolytes)Can pick up kidney damage from high blood pressure.Creatinine is often raised by muscle mass, so eGFR can underestimate kidney function in bodybuilders (NICE NG203). A rise is repeated to check it isn't climbing.
OestradiolTestosterone converts to oestradiol, which can cause breast tissue growth (gynaecomastia) and changes in libido.Above 150 pmol/L is expected while using, and isn't a reason for referral on its own. The guideline advises against aromatase inhibitors.
Testosterone, LH and FSHShows whether your own testosterone production has recovered after stopping.Not needed while using testosterone, as it will be above the lab's range. After stopping: below 8 nmol/L with normal or low LH and FSH, repeat in 12 weeks; if rising, again in 8 to 12 weeks; referral to endocrinology only after about 24 weeks.
HbA1c (blood sugar)Growth hormone can raise blood sugar towards diabetes.Only if using growth hormone. Above 41 mmol/mol: stop growth hormone for 7 days and repeat.

Make a printable version for your situation with the steroid blood test checklist.

When to test

  1. Before any change. A baseline shows what is normal for you, so later results mean something.
  2. During use. Haematocrit, cholesterol, liver and blood pressure are where problems show. The guideline sets repeat times for abnormal results rather than a fixed schedule.[1]
  3. After stopping. Natural testosterone usually recovers within a year in men who used for under a year; US endocrine guidance suggests checking testosterone, LH and FSH every 1 to 3 months while it does.[2] In UK primary care, low testosterone is repeated at 12 weeks, and referred only after about 24 weeks.[1]

Where to get tested in the UK

WhereCostWorth knowing
Your GPFreeCan order every test here. Tell them what you use; it changes how results are read and stays confidential.
Needle and syringe programmesFreeNICE asks them to provide equipment and advice to people who inject steroids. Some offer health checks or can refer you.
NHS steroid clinicsFreeA few areas run them, such as the Edinburgh Steroid Clinic (NHS Lothian), which offers harm reduction and says nothing is added to your medical record.
Private labsAbout £60–£160Medichecks' Sports Hormone tests (£109, £159), Forth's Male Hormone (£89), Thriva's Testosterone Profile (from £62.10). Venous draws cost extra.
PharmacyOften freeBlood pressure checks.

NICE guidance on needle and syringe programmes covers people who inject image- and performance-enhancing drugs.[3] Public Health Wales and partners run ipedinfo.co.uk, with harm reduction information for people using or considering them.[4] The Edinburgh Steroid Clinic runs on Monday evenings.[5]

Why it matters more than you might think

Estimates of how many people in the UK use image- and performance-enhancing drugs range from around half a million to over a million, though these are expert estimates; the Crime Survey records far fewer and is thought to under-count.[1, 6] UK GPs report that around 1 in 5 men seen in primary care for low testosterone in one area had it because they had stopped anabolic steroids.[1]

Urgent symptoms

Chest pain, sudden breathlessness, weakness on one side of the body or slurred speech: call 999.

Questions

What blood tests should I get on steroids in the UK?

UK primary-care guidance (Gibbons et al., BJGP 2024) lists full blood count (haematocrit), cholesterol, liver function, kidney function and oestradiol, plus testosterone with LH and FSH to check recovery after stopping, and HbA1c if you use growth hormone. It also suggests a blood pressure check.

How often should steroid users get blood tests?

The UK guideline doesn't set a fixed schedule; it sets repeat times when a result is abnormal. Many people test before any change, during use and after stopping. US endocrine guidance suggests checking testosterone and LH/FSH every 1 to 3 months while recovering after stopping.

Is this the same as monitoring for prednisolone?

No. Prednisolone and other corticosteroids are a different family of medicines with their own monitoring. This page is about anabolic-androgenic steroids such as testosterone, nandrolone and trenbolone.

Will my GP report me?

The NHS says it is legal to possess anabolic steroids for personal use, and GPs keep what you tell them confidential. The 2024 guideline was written to help GPs care for people who use steroids.

Why is my haematocrit high?

Anabolic steroids raise red blood cell production. The UK guideline advises reducing or stopping all anabolic steroids and repeating the test if a man's haematocrit is above 0.52, and urgent referral above 0.60. Smoking and other conditions can also raise it.

Can a DNA test replace blood tests?

No. A DNA test reads variants you were born with; it can't show your haematocrit, cholesterol, liver or hormone levels, or how your body is coping.

Sources

  1. Gibbons SM et al. Essential blood testing in the patient using androgenic anabolic steroids: a clinical practice guideline for primary care. Br J Gen Pract 2024;74:187–90.
  2. Anawalt BD. Diagnosis and management of anabolic androgenic steroid use. J Clin Endocrinol Metab 2019;104:2490–500.
  3. NICE PH52. Needle and syringe programmes.
  4. Welsh Government: steroid abuse and ipedinfo.co.uk.
  5. NHS Lothian: Edinburgh Steroid Clinic.
  6. Full Fact: how many people use steroids for bodybuilding and image?
  7. NHS: anabolic steroid misuse.

For information only, not medical advice. GeneticEdge does not recommend or endorse anabolic steroid use, and no genetic test can tell you whether steroids are safe for you. Talk to a GP or pharmacist about your health. Last reviewed 30 October 2026.