Blood tests and TRT: what 'get your bloods done' actually means

What did @konlan_james actually say?

Konlan describes hitting a testosterone level of 161 ng/dL after roughly three years of using anabolic steroids without breaks or post-cycle therapy. He frames 400 to 900 ng/dL as a normal range and lists what he actually felt at that level: extreme post-workout soreness, difficulty holding muscle, a dead sex drive, persistent anxiety, and a strange paradox where he was simultaneously motivated to keep training. His closing line is the most important one: "I'll see you for the rest of my life because I never bounced back."

He is not selling a product here. He is sharing a cautionary account of suppression-induced hypogonadism, apparently permanent, caused by prolonged exogenous androgen use. That framing matters when evaluating what he got right and what deserves more precision.

Does the science back this up?

Mostly, yes. The symptom cluster he describes is clinically consistent with severe hypogonadism, and the mechanism behind it, suppression of the hypothalamic-pituitary-gonadal (HPG) axis from chronic anabolic steroid use, is well-documented.

The HPG axis depends on pulsatile GnRH signaling from the hypothalamus to drive LH and FSH secretion, which in turn tells the testes to produce testosterone. Prolonged exogenous androgen use suppresses this feedback loop. In some men, particularly after years of use without recovery periods, that suppression does not fully reverse. Rahnema et al. (2014, Fertility and Sterility) specifically described anabolic steroid-induced hypogonadism (ASIH) as a recognized clinical entity where Leydig cell function can remain impaired long after cessation.

His reported symptoms map onto what the literature predicts. Bhasin et al. (2001, New England Journal of Medicine) demonstrated dose-dependent relationships between testosterone levels and muscle protein synthesis, fat-free mass retention, and sexual function. At 161 ng/dL, you would expect all three to drop significantly. The anxiety piece is also supported: low testosterone has been associated with increased psychological distress in men, per Zarrouf et al. (2009, Journal of Psychiatric Practice).

What did they get wrong (or right)?

His normal range of 400 to 900 ng/dL is a reasonable lay approximation but slightly imprecise. Most major labs and the American Urological Association peg normal adult male total testosterone between 300 and 1000 ng/dL, with 300 being the common clinical threshold for diagnosing hypogonadism. Calling 160 "pretty damn low" is accurate regardless of which range you use, so this is a minor quibble, not a real error.

What he gets right, and deserves credit for, is not oversimplifying recovery. He does not say "just do PCT and you'll be fine." He says he never bounced back. That honesty is more clinically accurate than most gym content on this topic. Coward et al. (2013, Journal of Urology) found a significant increase in hypogonadism diagnoses among men with prior anabolic steroid use, consistent with his outcome.

What he underplays is the variability. Some men do recover HPG axis function after cessation, particularly younger men with shorter use histories. His case appears to represent a worst-case trajectory, which is real but not universal. Presenting it as the inevitable outcome for anyone who uses steroids would be an overreach, though he stops short of explicitly making that claim.

What should you actually know?

If you are experiencing symptoms like the ones Konlan describes, a single testosterone number tells you only part of the story. Clinicians evaluating for hypogonadism should also look at LH and FSH levels, which can tell you whether the problem is primary (testes not responding) or secondary (HPG axis not signaling). In ASIH, LH and FSH are typically suppressed, not elevated, because the axis has not recovered.

• Total testosterone below 300 ng/dL on two morning fasting samples is the standard diagnostic threshold per Endocrine Society guidelines (Bhasin et al., 2018, Journal of Clinical Endocrinology and Metabolism).
• Symptoms alone are not enough to diagnose hypogonadism. Labs are required.
• Prior anabolic steroid use should be disclosed to your prescribing clinician. It changes the clinical picture entirely, including what treatment options are appropriate.
• Self-diagnosing from a TikTok symptom list and starting testosterone without bloodwork is how people make the suppression problem significantly worse.

His sign-off, "Gear. Bloods. Check. Be smart," is the most medically sound thing in the video. Get labs before making any decisions about your hormones.