Helpful Medical Tests to Take as a Lifter – Part 1

Helpful Medical Test to Take as a Lifter (FI)

When it comes to weight lifting, the most important factors influencing your ability to gain strength, lose fat, and pack on muscle mass are consistent strength training, proper nutrition, adequate sleep/recovery, and even intelligent supplementation (like with whey protein and creatine). In order to determine whether you are making the best progress possible in the above categories though, it is helpful to gather data which can then be analyzed. Much of the data which can be used to examine the effectiveness of your workouts will come from your workout journal, and ideally you’re tracking your calories and macros as well, but those aren’t the only data sources you can collect from. A few specific medical and/or physical therapy tests can be helpful for the strength athlete to perform upon a reoccurring cycle, either annually or biannually, as these tests allow you to collect and analyze helpful medical knowledge about yourself which you otherwise might not know. Knowledge is power, and the more informed you are, the better choices you can make, in and out of the gym. In part 1 of this series, we’ll look at four different tests which can provide a wealth of data for any weightlifter and are relatively easy to do.

Testosterone Test

If you are a male lifter, getting your testosterone levels regularly checked is a crucial thing to do in today’s anti-androgenic environment which has an abundance of endocrine disruptors, such as those found in plastic productsphytoestrogens from food sources (such as soy), pesticides such as roundup, and even estrogenic gasoline exhaust fumes. In fact, researchers have measured that testosterone levels have declined consistently in a statistically significant way over the past twenty years, and the trend continues back more than just the past twenty years, but back to the initial widespread use of plastics, modern food production (which is heavily soy based), and in general post industrial revolution society. BPA, BPS, and BPF all are potent endrocrine disruptors, and over 90% or more of the population has detectable BPA levels in their urine according to the CDC (aka they’re everywhere). These endocrine disruptors along with phthalates, can have a major impact on your testosterone levels. BPS, BPA, BPF, and phthalates are found in thousands, if not millions, of plastic products and you probably come into contact with them everyday.

I point out all of the above evidence to show that plastic endocrine disruptors, phytoestrogens from food sources, and other anti-androgens CAN and DO have a real impact on men and women around the world, but considering testosterone levels are naturally much higher in men, like two orders of magnitude higher, the effect on men is more pronounced. Low testosterone levels in men can manifest themselves in a variety of symptoms, and these include:

  • Low sex drive
  • Fatigue
  • Decreased energy
  • Reduced muscle mass
  • Increased body fat
  • Erectile dysfunction
  • Trouble orgasming
  • Lower semen volume
  • Genital numbness
  • Mood issues/depression
  • Testicular shrinkage

Clearly all of these symptoms are bad, but in red are the potential low testosterone symptoms which weightlifters should be really concerned about, as it directly affects training ability and training results.

As a result of all the potential symptoms of low T above and the anti-androgen environment we live in today, it is critical that men get their testosterone levels checked frequently, especially at a young age (18+). For example, If you are 35 and start experiencing the effects of low testosterone and get your levels checked, they might come back in the mid-to-low range (270-400), but unless you have a prior test from your twenties showing your levels used to be much higher, the doctor might discount the idea that you have low testosterone levels, and offer no help. The range medical professionals use for “normal” testosterone levels is 270 to 1070 ng/Dl (nanograms per deciliter), but this range encompasses teenagers with raging hormones to ninety year old men whose T levels are at their all time low, obese to fit individuals, and men with existing hormonal issues to those with none. In modern society, testosterone levels decline consistently after peaking in a mans twenties, and while this is currently widely accepted scientifically, it might not be natural, as one study showed that there was no significant difference in testosterone levels between young or old rural Bolivian men. If you are young and test at 350 ng/Dl, you might be in the expected range per say, but those levels might be normal for a eighty year old man (in modern society), not a young man whose testosterone levels are still increasing.

Below are references on average testosterone for individual age groups as observed by two different studies.


Simon, D., Nahoul, K., & Charles M.A. (1996). Sex Hormones, Aging, Ethnicity and Insulin Sensivity in Men: An Overview of the TELECOM Study. In Vermeulen, A. & Oddens, and B. J. (Eds.), Androgens and the Aging Male (pp. 85-102). New York: Parthenon Publishing.


Vermeulen, A. (1996). Declining Androgens with Age: An Overview. In Vermeulen, A. & Oddens, & B. J. (Eds.), Androgens and the Aging Male (pp. 3-14). New York: Parthenon Publishing.

Getting testosterone levels checked on a regular schedule (annually, biannually, etc) is a great way to track how testosterone levels change as changes in diet, lifting habits, use of plastic products, etc occur and/or as you get older.

When checking your testosterone levels, it is important to order a blood test which measures total testosterone and free testosterone levels. Total testosterone encompasses SHGB bound testosterone, albumin bound testosterone, and free testosterone. The total testosterone level is important, but it is free testosterone levels which have the biggest impact on ones health.

There are a lot of different testing methods used to determine total and free testosterone levels, and honestly many of the different testing methods/calculations are inaccurate because measuring free testosterone is really difficult to do. To measure total testosterone levels, the ECLIA (Electrochemiluminescent Immunoassay) and LC/MS (liquid chromatography-mass spectrometry) methods are both great, with the LC/MS method the more accurate of the two methods. To measure free testosterone levels, there is the RIA Direct method, the Equilibrium Ultrafiltration method, and the calculated free testosterone method. Most free testosterone levels are determined the RIA Direct method, which is less precise than the Equilibrium Ultrafiltration method, but you can ignore all this because I am going to provide you with the best testosterone test currently available.

The “Testosterone, Free, Bioavailable and Total, LC/MS/MS” test from Quest Diagnostics (test code 14966) is one of the most accurate testosterone tests you can take. It measures total testosterone using the LC/MS method, and then using that very accurate total testosterone measurement, calculates the bioavailable and free testosterone levels. For the free testosterone for this specific test, it is ideal to have free testosterone levels on the upper end of the 46.0-224.0 pg/ml range and it is ideal to have bioavailable testosterone levels on the upper end of the 110.0-575.0 pg/ml range (if you are 18-69 years in age). More information on this test, including optimal testosterone levels for children, older men, and women, can be read here.

For further information on the subject, watch this video on testosterone levels by Elite Mens Guide.

DEXA Body Fat Percentage Scan

As a weightlifting, either through powerlifting, bodybuilding, olympic weightlifting, or strongman, it is critical to know the weight you’ll be competing at, and as a result, your lean body mass (LBM) and percent body fat (PBF) measurements are important to know and understand. As covered in our Ultimate Body Fat Testing Guide, The most accurate method currently available to determine your LBM and PBF is a DEXA scan. Dual-energy x-ray absorptiometry (DEXA, or DXA) scans were originally developed as a way to determine bone mineral density, and now DEXA scans are reguarily used to measure body composition.

The cool thing about DEXA scans is instead of calculating your LBM and PBF off of a few measurements, DEXA scan results are determined from thousands of x-ray scans, allowing DEXA scans to accurately determine overall, as well as regional, body fat, lean body mass, and bone mass percentages. The x-ray scans used in a DEXA scan are extremely low energy, and one scan is equivalent to ~1/20th the background radiation received by an average person over a normal day.

LBM and PBF measurements are helpful to take on an annual or biannual schedule because they can provide valuable information in regards to whether you are gaining/losing muscle and gaining/losing fat over time, which provides an objective viewpoint on whether recent lifting programs, nutritional strategies, and recovery methods you have pursued have been working. LBM and PBF data is also helpful for medical professionals because a high percent fat mass increases your mortality risk in old age (and likely at younger ages too).

For more information of DEXA scans, and other body fat testing methods, read our Ultimate Body Fat Testing Guide, and if a DEXA scan is too cost prohibitive, consider using a body fat caliper to track the change in your PBF over time.

Sit and Rise Test

The sit and rise test (SRT) is a medical test developed by a team of Brazilian researchers which is an accurate predictor of all-cause mortality. High physical fitness levels of an individual are already inversely associated with an increased rate of all-cause mortality, and this test is an easy way to test the balance and musculoskeletal fitness of an individual. This test is primarily meant for older individuals, but considering it is so easy to take, and honestly can be done at home with the help of a friend after a quick review of the grading criteria, it’s another good test to take annually or biannually. Keeping track of your SRT score provides medical professionals a wealth of data, useful as you age or during/after you seriously ill/injured. Taken from the study:

The SRT assesses components of musculoskeletal fitness through evaluation of the subject’s ability to sit and rise from the floor, assigning a partial score for each of the two required actions. The SRT is administered on a non-slippery flat surface, in a minimal space of 2×2 m, with the subject standing barefoot and wearing clothing that did not restrict body movements. Before the SRT, the evaluator instructs the patient: “Without worrying about the speed of movement, try to sit and then to rise from the floor, using the minimum support that you believe is needed.” SRT partial scores begin with a maximum of 5 points, separately for sitting and rising. One point is subtracted for each support utilized, that is, hand, forearm, knee, or side of leg, and an additional 0.5 point is subtracted if the evaluator perceives an unsteady execution (partial loss of balance) occurring during the action. In addition, one point is subtracted if the subject placed one hand on the knee in order to sit or rise. Crossing the legs for either sitting or rising from the floor is allowed. If a score of 5 is not obtained, the evaluator provides some advice that might assist the subject to improve their SRT score in other attempts. The best score from all attempts in sitting and rising is used. In this context, a total of 11 possible separate scores in the range 0–5 were generated (0, 0.5, 1, … 4.5, 5) for each of sitting and rising from the floor.

The below video is from the research group, and it covers the SRT in depth.

The best possible score to get is a total of 10 (5 for sitting and 5 for rising), but a score of 7.5-9.5 is still good. If you’re really good, you’ll do a pistol squat down into a sitting position and a pistol squat back up, which would make your score technically above ten (but it’s still graded as a 10).

Resting Heart Rate Test

The resting heart rate test is very easy to do, and you have probably already learned how to do it at some point. The goal of the resting heart rate test is to determine your hearts beats per minute (BPM), which is an indicator of cardiovascular health, and their are a few ways to find out your heart rate.

A high resting heart rate is associated with increased cardiovascular risk, and even if you strength train consistently, it won’t do much to lower your resting heart rate. Cardiovascular exercise is a surefire way to improve cardiovascular function and as a result, likely lower your resting heart rate. The average heart rate range is between 60 and 100, but it is recommended to strive for a heart rate of 50 to 70. Those with impressive cardiovascular systems often have heart rates of 35-50!

The simplest method to determine your heart rate is to find your pulse and count the number of times your heart beats in 60 seconds. This number is your hearts BPM. A slightly faster method is to count the number of times your heart beats in 15 seconds instead of 60 seconds, and then multiply that heart beat value by 4 to find our your BPM. Some good places to find a pulse are the:

  • Inside of the wrist
  • Inside of the elbow
  • Side of the neck
  • Top of the foot

You can also use a heart rate monitor, either as a standalone device many older individuals or those with high blood pressure might own, you can use a cellphone application (though I’m not sure how accurate those are), or you can use fitness gear such as a Fitbit Charge, which perform the task admirably.

A heart rate test can be easily done daily, but again, taking and keeping track of these test annually or biannually provides you a wealth of data on whether your fitness levels are improving.

Knowledge is Power

Keep track of these four health metrics, plus four more you’ll read in part 2 of this series, and as a result reach a deeper level of understanding in terms of how your fitness levels and nutrition affect your general health. While it is not as critical for younger lifters (16-30) to take these tests, it is still helpful to take these tests on a consistent basis because the data you acquire from them will allow you to examine how specific health metrics have changed as you have gotten older and as you have increased in fitness.


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Stefan Burns

Stefan Burns

Fitness, nutrition, and powerlifting buff. Created Strength Cooperative as a way for hardworking, natural lifters to share advice on how THEY got results in the gym.
Stefan Burns

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