Doctor-Overcautious?

[anavar_goblin]

Background​

• Male, 32, 5'11"
• LBM 190 LBS
• Weight 236
• Long-term resistance training background
• Currently in a fat-loss / recomp phase
• Down from 310lbs
• Total lost weight :74 lbs
• Bf%19

Training​

• 4–6 days/week hypertrophy
• Moderate–high volume
• Majority of working sets at 0–2 RIR with deload every 6 weeks
• Compounds + isolations
• Minimal cardio ( functional lifts)
• Deload labs (did not train within days of draw)
• Was in Trough levels

---

Nutrition (averages)​

• Protein: ~200–230 g/day
• Carbs: ~150–220 g/day
• Fat: ~60–80 g/day
• 1000 Calorie Caloric deficit
• Hydration 120 oz + daily

---

Current Stack / Regimen​

Hormonal / Peptides​

• Testosterone 350 ng/dl weekly
  Primobolan 400mg weekly
• Pinned 3 days weekly M-W-F
• 50mg Anavar split 25mg AM/PM

Daily:

• HGH: 6 IU/day (3 IU AM fasted, 3 IU pre-bed)
• 1mg BPC-157, 1mg GHK-Cu, 1mg TB-500, KPV
• 1mg Semax

Weekly:

• Retatrutide: 8 mg weekly

Medications​

• Telmisartan: 80 mg/day
• Amlodipine: 10 mg/day
• Methylene Blue: 20 mg/day
• Tanalafil 20mg every 3 days

Vitamin/Supplments​

Berberine 1200MG twice daily AM/PM
Vitamin D-3 & K-2 18000ui / 135mcg
Biotin 5000mg
inositol 500mg
Advanced Gamma E Complex (NOW) 2 softgels
NAC 600mg
Citrus Bergamont 12mg
Omega-3 fish oil:3000mg fish oil, 540 EPA, 360 DHA
Psyllium Husk 500mg
Tudca 500mg
Methyl Folate 1000mg + Methyl B12
Creatine Monohydrate 20 G split am/pm

For context, I have historically and possibly genetically low HDL; the highest it's ever been in the last 15 years is 26.

​

Category	Marker	08/15/2025	12/10/2025	Trend / Note
Liver	ALT	61	125	↑ ~2×
	AST	34	64	↑
	ALP	53	41	↓ low-normal
	Total Bilirubin	0.9	0.6	Normal
Lipids	Total Chol	89	164	↑
	LDL-C	40	130	↑ (borderline)
	HDL-C	25	19	↓ very low
	Triglycerides	137	77	↓ (improved)
Renal	Creatinine	0.93	0.76	Normal
	BUN/Cr Ratio	19	25	↑
	eGFR	112	122	Normal
Glucose / IR	Glucose	78	72	Normal
	Insulin	10.7	12.2	Slight ↑
	HOMA-IR	—	2.16	Mild IR
Hormones	Total Testosterone	418	>1500	↑↑
	Free Testosterone	9.1	>50	↑↑
	Estradiol	37.2	21.1	Normal
CBC	Hemoglobin	16.3	14.9	↓
	Hematocrit	49.3%	47.1%	↓ (normal)
	Platelets	292	424	High-normal
Thyroid	TSH	0.721	1.16	Normal
	Free T4	1.79	1.75	Normal
Other	PSA	—	0.6	Normal
	Vitamin D	32.5	26.8	↓ low

IGF-1 125 pre HGH 250 after HGH

---

Physician Assessment​

• Concerned about worsening liver enzymes
• Recommends liver imaging
• Flags very low HDL, elevated LDL
• Notes elevated BUN/Creatinine ratio
• Suggested coordinating the testosterone dose with the prescriber
• Follow-up in 4 weeks

---

Given:

• Normal bilirubin and albumin
• Low-normal ALP (no cholestasis pattern)
• Significant increase in androgen exposure
• Active fat loss
• Triglycerides improved, not worsened
• No clinical symptoms

Is the liver scan just preventive? I feel Great, no sides, energy is great, the only issue I see is low sleep, about 5 hours a night.

 

[Cyp180]

Would think about choline supp 800mg AD

 

[buck]

Does your Dr know about all the drugs you are taking.
Your levels aren't good but they don't scream major problem. I would drop the anavar and retest down the road.

 

[anavar_goblin]

Does your Dr know about all the drugs you are taking.
Your levels aren't good but they don't scream major problem. I would drop the anavar and retest down the road.

He does. He's not super stoked about how how my Test is. However he also knows I am doing great physically. Has expressed as far as trying to stay on top of everything that I'm doing better than probably 90% of his patients and to keep it up.

I'm at the end of my anavar cycle. So that will be stopping.

The raising of my LDL is an easy fix. I got tired of chicken and fish on my cut and have been slamming down quite a bit of red meat the last 2 months. Dropping back to 2 days a week I think I got it out of my system.

Outside of that as far as bad do you have any recommendations on what I could be improving? I'm open for suggestions. I'm finally getting back to a point where Im liking my body again and really don't want to mess myself up internally. Once I cut to 205 I'm hoping to bulk back to 225-230.

 

[BP_6]

To clarify the obvious. I am not your doctor nor would I ever want to give any medical advice above a doctor. However I do know that people's bloodwork who are training hard and on even reasonably dosed anabolics will have things a bit different. Taking that into account, I see absolutely nothing wrong with that bloodwork. In fact, I think it is pretty damn good. Only thing is you may want to add a vitamin D supplement.

Note, you aren't bringing your HDL up with anavar, I can tell you that much.

 

[buck]

Many studies show that very low LDL-C can be linked to shorter life spans. I don't find your cholesterol numbers bad. Check your apoB if you want to get a good idea of where you stand. That seems to be the better marker these days.
Plius i don't think you need to use as much anabolics as you are just to lose weight.

 

[anavar_goblin]

Many studies show that very low LDL-C can be linked to shorter life spans. I don't find your cholesterol numbers bad. Check your apoB if you want to get a good idea of where you stand. That seems to be the better marker these days.
Plius i don't think you need to use as much anabolics as you are just to lose weight.

Understood! Its something I've worried about with with or without I always been low in LDL-C with nothing moving the needle. As far as the anabolics. I was hypogonadl for 6 years before adding anything it's where the majority of the weight gain came from and I had a lot of muscle mass loss. Even the first blood work was me 3 months on enclomaphine at 50mg daily. My baseline was 204 for the large part of 6 years. Due to my age they didn't want me on testosterone.

 

[BP_6]

Many studies show that very low LDL-C can be linked to shorter life spans. I don't find your cholesterol numbers bad. Check your apoB if you want to get a good idea of where you stand. That seems to be the better marker these days.
Plius i don't think you need to use as much anabolics as you are just to lose weight.

Do you have these studies? I have never such one. There is this common misconception that higher cholesterol levels leads to a longer lifespan. Using that same data, you can say the same thing about blood pressure and blood glucose.

They get those numbers from people admitted to hospitals and who dies. Often very sick people where the sickness "like cancer for example" has cause them wasting which in turn has lowered their LDL. Along with their blood pressure and glucose.

 

[anavar_goblin]

To clarify the obvious. I am not your doctor nor would I ever want to give any medical advice above a doctor. However I do know that people's bloodwork who are training hard and on even reasonably dosed anabolics will have things a bit different. Taking that into account, I see absolutely nothing wrong with that bloodwork. In fact, I think it is pretty damn good. Only thing is you may want to add a vitamin D supplement.

Note, you aren't bringing your HDL up with anavar, I can tell you that much.

So the vitamin D I'm also supplementing at 18000 UI with little effect . I'm using nutricost. I've also used pharmacy prescribed with the same outcome.

 

[BP_6]

So the vitamin D I'm also supplementing at 18000 UI with little effect . I'm using nutricost. I've also used pharmacy prescribed with the same outcome.

Odd, when you say prescription, you are referring to Calcitriol .25mcg correct?

 

[buck]

Do you have these studies? I have never such one. There is this common misconception that higher cholesterol levels leads to a longer lifespan. Using that same data, you can say the same thing about blood pressure and blood glucose.

They get those numbers from people admitted to hospitals and who dies. Often very sick people where the sickness "like cancer for example" has cause them wasting which in turn has lowered their LDL. Along with their blood pressure and glucose.

Have you done any google searches specifically to search for low LDL and longevity?

 

[buck]

Just for starters some i have bookmarked. Hope i didn't double post any from different souses. My favorite is the one with 12.8 million showing the longest lifes spans have cholesterol levels around 220. And a couple hours of searching will show you even more if you care to look.

Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults - Scientific Reports

It is unclear whether associations between total cholesterol (TC) levels and all-cause mortality and the optimal TC ranges for lowest mortality vary by sex and age. 12,815,006 Korean adults underwent routine health examinations during 2001–2004, and were followed until 2013. During follow-up...

www.nature.com

Association between low density lipoprotein cholesterol and all-cause mortality: results from the NHANES 1999–2014 - Scientific Reports

The association between low density lipoprotein cholesterol (LDL-C) and all-cause mortality has been examined in many studies. However, inconsistent results and limitations still exist. We used the 1999–2014 National Health and Nutrition Examination Survey (NHANES) data with 19,034 people to...

www.nature.com

Meta-analysis says low LDL cholesterol may be associated with greater risk of cancer - PMC

pmc.ncbi.nlm.nih.gov

https://www.ahajournals.org/doi/10.1161/JAHA.121.023690

https://www.thelancet.com/journals/lancet/article/PIIS0140673601055532/abstract

LOW LDL CHOLESTEROL IS RELATED TO CANCER RISK - American College of Cardiology

www.acc.org

Low Cholesterol is Associated With Mortality From Stroke, Heart Disease, and Cancer: The Jichi Medical School Cohort Study - PMC

We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death. A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study ...

pmc.ncbi.nlm.nih.gov

Low cholesterol linked to higher all-cause death

<b><i>with slide</i></b> / Startling new data from the Honolulu Heart Program show that elderly men with the lowest cholesterol levels actually appear to face a higher risk of all-cause mortality over time. (Schatz IJ et al. <i>Lancet</i> 2001; 358: 351-55.)

www.medscape.com

https://www.thelancet.com/journals/lancet/article/PIIS0140673601055532/abstract

 

[anavar_goblin]

Odd, when you say prescription, you are referring to Calcitriol .25mcg correct?

colecalciferol 50,000 UI weekly for 3 months literally did nothing

 

[AIRBORNE DADDY]

Does your Dr know about all the drugs you are taking.
Your levels aren't good but they don't scream major problem. I would drop the anavar and retest down the road.

My buddy's liver enzymes went up 5x and I suspect anavar cuz he's only on tirz, a lower trt dose of cyp and glutathione.

 

[Photon]

Background​

• Male, 32, 5'11"
• LBM 190 LBS
• Weight 236
• Long-term resistance training background
• Currently in a fat-loss / recomp phase
• Down from 310lbs
• Total lost weight :74 lbs
• Bf%19

Training​

• 4–6 days/week hypertrophy
• Moderate–high volume
• Majority of working sets at 0–2 RIR with deload every 6 weeks
• Compounds + isolations
• Minimal cardio ( functional lifts)
• Deload labs (did not train within days of draw)
• Was in Trough levels

---

Nutrition (averages)​

• Protein: ~200–230 g/day
• Carbs: ~150–220 g/day
• Fat: ~60–80 g/day
• 1000 Calorie Caloric deficit
• Hydration 120 oz + daily

---

Current Stack / Regimen​

Hormonal / Peptides​

• Testosterone 350 ng/dl weekly
  Primobolan 400mg weekly
• Pinned 3 days weekly M-W-F
• 50mg Anavar split 25mg AM/PM

Daily:

• HGH: 6 IU/day (3 IU AM fasted, 3 IU pre-bed)
• 1mg BPC-157, 1mg GHK-Cu, 1mg TB-500, KPV
• 1mg Semax

Weekly:

• Retatrutide: 8 mg weekly

Medications​

• Telmisartan: 80 mg/day
• Amlodipine: 10 mg/day
• Methylene Blue: 20 mg/day
• Tanalafil 20mg every 3 days

Vitamin/Supplments​

Berberine 1200MG twice daily AM/PM
Vitamin D-3 & K-2 18000ui / 135mcg
Biotin 5000mg
inositol 500mg
Advanced Gamma E Complex (NOW) 2 softgels
NAC 600mg
Citrus Bergamont 12mg
Omega-3 fish oil:3000mg fish oil, 540 EPA, 360 DHA
Psyllium Husk 500mg
Tudca 500mg
Methyl Folate 1000mg + Methyl B12
Creatine Monohydrate 20 G split am/pm

For context, I have historically and possibly genetically low HDL; the highest it's ever been in the last 15 years is 26.

​

Category	Marker	08/15/2025	12/10/2025	Trend / Note
Liver	ALT	61	125	↑ ~2×
	AST	34	64	↑
	ALP	53	41	↓ low-normal
	Total Bilirubin	0.9	0.6	Normal
Lipids	Total Chol	89	164	↑
	LDL-C	40	130	↑ (borderline)
	HDL-C	25	19	↓ very low
	Triglycerides	137	77	↓ (improved)
Renal	Creatinine	0.93	0.76	Normal
	BUN/Cr Ratio	19	25	↑
	eGFR	112	122	Normal
Glucose / IR	Glucose	78	72	Normal
	Insulin	10.7	12.2	Slight ↑
	HOMA-IR	—	2.16	Mild IR
Hormones	Total Testosterone	418	>1500	↑↑
	Free Testosterone	9.1	>50	↑↑
	Estradiol	37.2	21.1	Normal
CBC	Hemoglobin	16.3	14.9	↓
	Hematocrit	49.3%	47.1%	↓ (normal)
	Platelets	292	424	High-normal
Thyroid	TSH	0.721	1.16	Normal
	Free T4	1.79	1.75	Normal
Other	PSA	—	0.6	Normal
	Vitamin D	32.5	26.8	↓ low

IGF-1 125 pre HGH 250 after HGH

---

Physician Assessment​

• Concerned about worsening liver enzymes
• Recommends liver imaging
• Flags very low HDL, elevated LDL
• Notes elevated BUN/Creatinine ratio
• Suggested coordinating the testosterone dose with the prescriber
• Follow-up in 4 weeks

---

Given:

• Normal bilirubin and albumin
• Low-normal ALP (no cholestasis pattern)
• Significant increase in androgen exposure
• Active fat loss
• Triglycerides improved, not worsened
• No clinical symptoms

Is the liver scan just preventive? I feel Great, no sides, energy is great, the only issue I see is low sleep, about 5 hours a night.

Your liver markers doubled, any doctor would be puzzled. Drop the orals and double your tudca and nac intake. Then retake labs.

 

[Jucuvog]

First of all good job on your weight loss progress.

Liver enzymes are bit high for what you're taking, how long are you planning to stay on cycle for? Good idea would be to drop orals.


But the liver markers are nothing to be overly concerned about if you're planning to come off/PCT, the liver is very resilient and can handle short term stress quite well. Doctors will be concerned about anything outside of the normal range, it's their job after all.

 

[RockyP]

These labs aren’t anything to get excited about. The LFTs are likely part training effect and part gear related. The ALT spike may be due to primo so I’d watch that if you run it again. If you run anavar again might be good to check in on your Cystatin C levels (can be harsh on kidneys in some) as well as ggt to see if it’s having any actual impact on liver. Also good to track your hsCRP. otherwise those labs aren’t too bad at all given the compounds you’re on. Of course I’d advocate for using a statin and ezetimibe at the very least while on a cycle with DHT’s but some might consider that overkill. Really no reason to just let the LDL run wild. 8-12 weeks of LDL over 100 and HDL under 30 is clinically relevant for plaque buildup.

 

[buck]

I had elevated liver enzyme levels for 30 years (although not 2x the top) and no Dr cared. Training and eating a high protein diet and gear can do that. When i eat more then 1.25gr/lb+ pf protein these days my levels go over the top of the range. And i am not on any big doses of gear.The same enzyme that is a by product of protein digestion is the same enzyme that they test for in the blood for liver damage.

 

[anavar_goblin]

Your liver markers doubled, any doctor would be puzzled. Drop the orals and double your tudca and nac intake. Then retake labs.

Great tip and will do! I'm at the end of my anavar cycle anyways. Planning on continuing primo for the next 8 weeks.

 

[anavar_goblin]

First of all good job on your weight loss progress.

Liver enzymes are bit high for what you're taking, how long are you planning to stay on cycle for? Good idea would be to drop orals.


But the liver markers are nothing to be overly concerned about if you're planning to come off/PCT, the liver is very resilient and can handle short term stress quite well. Doctors will be concerned about anything outside of the normal range, it's their job after all.

Thank you!! I've tracked every morsel, macro and have really made sure training has been a priority. Being on testosterone made a world of difference. I'm ending my anavar cycle in a few days and then 8 more weeks on primo. PTC isn't much of a concern. I'm hypogonadl so I'm on TRT for life. I'll eventually drop down to 150mg/200mg for cruise I don't seem to aromatize it a ton and no issues with my hematocrit.