1 Year Heart Update

[Deleted member 106824]

Interesting dilemma. I’d do a low dose 1mg every 3 days on your case and see what E2 ends up at

Are you aware that's a higher dose than I've ever taken? My current dose is 1mg every 7 days (1mg/week) and before it was 1mg every 3.5 days (2mg/week) so 1mg every 3 days is 2.3mg/week

One problem is it varies so much. For example, I try to keep levels as constant as possible by dividing my 80mg Test into 4 days per week (so 20mg 4x/week).

Despite this, I have measured my E2 at 26, 17, 47, and 44 on that dose depending on when I measured (most of the time has been the day between doses though so very similar timing even).

Similarly, on that dosing schedule I have measured Total Test at 572, 285, 791, and 585 respectively.

Frankly, because I have tested so often I get to see these changes. I think most people test once and think that's their level and that's it. If my levels vary this much keeping things constant dividing it up 4x per week just think how much most guys' levels are changing throughout a week with their standard 1x/week protocol.

 

[nothuman]

Are you aware that's a higher dose than I've ever taken? My current dose is 1mg every 7 days (1mg/week) and before it was 1mg every 3.5 days (2mg/week) so 1mg every 3 days is 2.3mg/week



One problem is it varies so much. For example, I try to keep levels as constant as possible by dividing my 80mg Test into 4 days per week (so 20mg 4x/week).



Despite this, I have measured my E2 at 26, 17, 47, and 44 on that dose depending on when I measured (most of the time has been the day between doses though so very similar timing even).



Similarly, on that dosing schedule I have measured Total Test at 572, 285, 791, and 585 respectively.



Frankly, because I have tested so often I get to see these changes. I think most people test once and think that's their level and that's it. If my levels vary this much keeping things constant dividing it up 4x per week just think how much most guys' levels are changing throughout a week with their standard 1x/week protocol.

Oh misunderstood and thought you did 2mg per week. You would know how to play with it better than me since it’s your body

 

[Deleted member 106824]

No worries, yea the only thing I can really reduce it to is 0.5mg one time per week lol very minimal and hardly keeping labels stable. Happy to just come off of it from a physique and lipid panel standpoint but not happy about the health implications of elevated estradiol long term

 

[emeric delczeg]

Are you aware that's a higher dose than I've ever taken? My current dose is 1mg every 7 days (1mg/week) and before it was 1mg every 3.5 days (2mg/week) so 1mg every 3 days is 2.3mg/week

One problem is it varies so much. For example, I try to keep levels as constant as possible by dividing my 80mg Test into 4 days per week (so 20mg 4x/week).

Despite this, I have measured my E2 at 26, 17, 47, and 44 on that dose depending on when I measured (most of the time has been the day between doses though so very similar timing even).

Similarly, on that dosing schedule I have measured Total Test at 572, 285, 791, and 585 respectively.

Frankly, because I have tested so often I get to see these changes. I think most people test once and think that's their level and that's it. If my levels vary this much keeping things constant dividing it up 4x per week just think how much most guys' levels are changing throughout a week with their standard 1x/week protocol.

Try to have your test 12 to 14 hours after your last 20mg or 10mg each time, should be identical or just very small difference. Why don`t you give a try to the 10mg every day?

 

[emeric delczeg]

Are you aware that's a higher dose than I've ever taken? My current dose is 1mg every 7 days (1mg/week) and before it was 1mg every 3.5 days (2mg/week) so 1mg every 3 days is 2.3mg/week

One problem is it varies so much. For example, I try to keep levels as constant as possible by dividing my 80mg Test into 4 days per week (so 20mg 4x/week).

Despite this, I have measured my E2 at 26, 17, 47, and 44 on that dose depending on when I measured (most of the time has been the day between doses though so very similar timing even).

Similarly, on that dosing schedule I have measured Total Test at 572, 285, 791, and 585 respectively.

Frankly, because I have tested so often I get to see these changes. I think most people test once and think that's their level and that's it. If my levels vary this much keeping things constant dividing it up 4x per week just think how much most guys' levels are changing throughout a week with their standard 1x/week protocol.

I would not worry to much about the total levels, the free is the one more important, you can have the total 500 and the free over 200. Some heavy users (over 800 mg/week) had total over 1800 and the free under 200.

The best way is to use very low dose of test with a supplement that acts as a ligands to the receptors , or intra-cellular and intra-nuclear sensors.

 

[emeric delczeg]

Agreed. I'd want the E2 at 20-35

Try to inject 10mg per day only, you will have last estrogen conversion, when you inject any amount of test 0.3% converts to estrogen, you need to inject every 24 hours 10mg, for 8 weeks non stop then check you estrogen level. It takes longer time to normalize estrogen levels then test levels, don`t worry if your estrogen level is not much lower after 3 weeks with 10mg, as I mentioned above it takes longer time then 3 weeks.

 

[Deleted member 106824]

Try to have your test 12 to 14 hours after your last 20mg or 10mg each time, should be identical or just very small difference. Why don`t you give a try to the 10mg every day?

Why would it be identical when measuring 12 hours after when it's been so sporadic consistently measuring 24hr after? It seems like my values vary quite a bit

I could go to 10mg every day, though to be honest my estrogen did not get any lower with more frequent injections (going from 1x/week to 4x/week injections) as many report is supposed to happen. I have been doing 4x/week for over 2 years now and my estrogen levels are just as high as when I was doing 1x/week

Do we have real scientific evidence that the frequent injections bring estrogen down? It seems to be something people say but I haven't seen the evidence for it.

 

[Deleted member 106824]

I would not worry to much about the total levels, the free is the one more important, you can have the total 500 and the free over 200. Some heavy users (over 800 mg/week) had total over 1800 and the free under 200.

True....given that my free test levels are quite high I could try coming off the Anastrazole while also dropping my TRT to 60-70mg so both my high Free Test and high Estradiol come down.

I would not worry to much about the total levels, the free is the one more important, you can have the total 500 and the free over 200. Some heavy users (over 800 mg/week) had total over 1800 and the free under 200.

The best way is to use very low dose of test with a supplement that acts as a ligands to the receptors , or intra-cellular and intra-nuclear sensors.

Do you have examples?

 

[emeric delczeg]

Why would it be identical when measuring 12 hours after when it's been so sporadic consistently measuring 24hr after? It seems like my values vary quite a bit

I could go to 10mg every day, though to be honest my estrogen did not get any lower with more frequent injections (going from 1x/week to 4x/week injections) as many report is supposed to happen. I have been doing 4x/week for over 2 years now and my estrogen levels are just as high as when I was doing 1x/week

Do we have real scientific evidence that the frequent injections bring estrogen down? It seems to be something people say but I haven't seen the evidence for it.

With test Cyp or Ananthate maximum test levels in the supraphysiological range where seen shortly 10 hours after injection.

 

[emeric delczeg]

True....given that my free test levels are quite high I could try coming off the Anastrazole while also dropping my TRT to 60-70mg so both my high Free Test and high Estradiol come down.



Do you have examples?

Yes one of them is Tony Freeman.

 

[Deleted member 106824]

Yes one of them is Tony Freeman.

What about Tony Freeman? lol I meant if you had any examples of "a supplement that acts as a ligands to the receptors , or intra-cellular and intra-nuclear sensors."

 

[hte]

Yo pumped340,

I could not reply to your PM, it says your message box is full... I'll my reply here so I don't lose all the text I wrote you:

-------------------------------------------------------------
Hi,

Thanks so much Pumped340.

I can find out more info from another one of our friends but for sure he was juicing (steroids) and another friend mentioned human growth hormone.

I know he had swollen feet and neck (he said some reaction to a supplement he was taking). He also was complaining about joint pain and taking something for that, probably the human growth hormone?

He as also drinking apparently and another buddy said you should not mix alcohol with this stuff.

The autopsy revealed an enlarged heart, cardio vascular disease, and clogged arteries. They did not let me know the toxicology report (was pending at the time). I believe these are all side effects of these drugs. He was also on Xanax for anxiety problems that were there before he was juicing. I did not prob his family too much about this, because of all the pain and suffering we are going through.

The other thing I know is he got really sick about 8 months ago due to a virus and had a 107 fever. He did the Universal Soldier trick and took an ice bath to cool down. Recently, he went to the ER twice for high blood pressure. Another buddy, said that he was going to the doctor but not telling his doctor that he was juicing. His doctor did weigh him and said he put 25 pounds of muscle in 2 months, which is unheard of... the doctor must have known.

He was my best friend and was keeping this away from me, we all told him to not use this stuff and he didn't need it. We think his girlfriend and other pressures in life were causing him to do this. He told me a year ago he knew what he was doing, it was down to a science now, and would quit after he got a little bigger... he already looked like Van Damme, who is both of our heros.

I have been searching the forum top and bottom and can't find him. I PM'd Big A but did not hear back yet.

 

[Deleted member 106824]

Yo pumped340,

I could not reply to your PM, it says your message box is full... I'll my reply here so I don't lose all the text I wrote you:

-------------------------------------------------------------
Hi,

Thanks so much Pumped340.

I can find out more info from another one of our friends but for sure he was juicing (steroids) and another friend mentioned human growth hormone.

I know he had swollen feet and neck (he said some reaction to a supplement he was taking). He also was complaining about joint pain and taking something for that, probably the human growth hormone?

He as also drinking apparently and another buddy said you should not mix alcohol with this stuff.

The autopsy revealed an enlarged heart, cardio vascular disease, and clogged arteries. They did not let me know the toxicology report (was pending at the time). I believe these are all side effects of these drugs. He was also on Xanax for anxiety problems that were there before he was juicing. I did not prob his family too much about this, because of all the pain and suffering we are going through.

The other thing I know is he got really sick about 8 months ago due to a virus and had a 107 fever. He did the Universal Soldier trick and took an ice bath to cool down. Recently, he went to the ER twice for high blood pressure. Another buddy, said that he was going to the doctor but not telling his doctor that he was juicing. His doctor did weigh him and said he put 25 pounds of muscle in 2 months, which is unheard of... the doctor must have known.

He was my best friend and was keeping this away from me, we all told him to not use this stuff and he didn't need it. We think his girlfriend and other pressures in life were causing him to do this. He told me a year ago he knew what he was doing, it was down to a science now, and would quit after he got a little bigger... he already looked like Van Damme, who is both of our heros.

I have been searching the forum top and bottom and can't find him. I PM'd Big A but did not hear back yet.

I'm really sorry to hear that man. I too figured it wasn't too risky when I got started.

His blood pressure must have been disturbingly high if he had to go to the ER for it twice. That plus already having clogged arteries in his low 30s is surprising.

I wonder if he had a heart attack or went into cardiac arrest

 

[Deleted member 106824]

New echo. Sure wish GotGame was still around. In reality, I don't think it's worse but this cardiologist is head of the echo department and for some reason no one really ever brought to my attention other issues going on. Everything first was about my ejection fraction. Then I realized it was a poor ejection fraction not due to low volumes of fluid being ejected but due to dilation. So for the last few checks my focus has been on looking at the ejection fraction and dilation.

So again on this one and my last one my ejection fraction seems right around normal, 55%. Great. But now this doctor tells me I have mitral valve prolapse, and that he's surprised I've never been told that before. So that's one more thing I have to deal with.

Because of this, I started scanning every word of the report and I see "E/A ratio indicates Grade III diastolic filling, however spectral doppler waveforms are more suggestive of normal diastolic function".....why has no one told me this?? I looked back at my echo from Cleveland Clinic and my E/A ratio was high there as well. Even if another test is "suggestive" of normality I should still be told what this means. I have a fairly good background in medicine but the number of in depth tests some of these places run is considerably out of my wheelhouse and I wish I would have been told these things.

He says he would be hesitant about me continuing testosterone. He says there isn't evidence of testosterone causing mitral valve prolapse, but as I read about it I found MVP can be caused by left ventricular issues.....so for all I know the AAS I used to use caused the LV issues which led to the MVP issues.

I'm only on 80mg TRT with 1mg adex so it's hard to imagine it's causing an issue but at the same time it is still above my normal level. I told him my plan was to run HCG but that would likely bring me from my current 7-800ng/dl up to 1000-1200 I would guess (never ran HCG before). I wanted to do that and bulk up another 10-15lb again but now I'm really unsure about that and wonder if I should just try to stop the TRT and go on just the HCG and Adex to get lower-normal test levels. Which would really suck mentally and physically but if it would get my heart functioning better it would be worth it.

 

[MKSuccess500]

That's really frustrating bud, sorry you're still dealing with this

 

[Deleted member 106824]

Apparently a beta blocker can be helpful for MVP but I believe it's just to control symptoms, not do anything to reverse it. And my BP and HR are already low to begin with.

 

[nothuman]

New echo. Sure wish GotGame was still around. In reality, I don't think it's worse but this cardiologist is head of the echo department and for some reason no one really ever brought to my attention other issues going on. Everything first was about my ejection fraction. Then I realized it was a poor ejection fraction not due to low volumes of fluid being ejected but due to dilation. So for the last few checks my focus has been on looking at the ejection fraction and dilation.

So again on this one and my last one my ejection fraction seems right around normal, 55%. Great. But now this doctor tells me I have mitral valve prolapse, and that he's surprised I've never been told that before. So that's one more thing I have to deal with.

Because of this, I started scanning every word of the report and I see "E/A ratio indicates Grade III diastolic filling, however spectral doppler waveforms are more suggestive of normal diastolic function".....why has no one told me this?? I looked back at my echo from Cleveland Clinic and my E/A ratio was high there as well. Even if another test is "suggestive" of normality I should still be told what this means. I have a fairly good background in medicine but the number of in depth tests some of these places run is considerably out of my wheelhouse and I wish I would have been told these things.

He says he would be hesitant about me continuing testosterone. He says there isn't evidence of testosterone causing mitral valve prolapse, but as I read about it I found MVP can be caused by left ventricular issues.....so for all I know the AAS I used to use caused the LV issues which led to the MVP issues.

I'm only on 80mg TRT with 1mg adex so it's hard to imagine it's causing an issue but at the same time it is still above my normal level. I told him my plan was to run HCG but that would likely bring me from my current 7-800ng/dl up to 1000-1200 I would guess (never ran HCG before). I wanted to do that and bulk up another 10-15lb again but now I'm really unsure about that and wonder if I should just try to stop the TRT and go on just the HCG and Adex to get lower-normal test levels. Which would really suck mentally and physically but if it would get my heart functioning better it would be worth it.

This leads me to think your issues might not be entirely steroid related because my heart problems, which I know for a fact were caused by steroids, are completely different than yours. I had heart enlargement in all the chambers, to the point my aortic root had to be operated on. My Left atrium and IVS are mildy enlarged still when they were small before I started the madness. You have none of those issues and obviously, my AAS use was far more extreme than yours was as you have said you were a light user.

Look, if there is any valve that you'd want to be leaking, it's the mitral valve. The fix for that is very minimally invasive nowadays if you need it. I think they just do a MitraClip or something like that. I have a leaky aortic valve, and I'd trade that for a leaky Mitral valve in a second.

E/A ratio is something I was able to personally improve. I had grade 1 diastolic dysfunction and now I don't. My E/A ratio lowered by 0.5. Nebivolol, Probenecid, Glycine/NAC in combination, and D-Ribose have been shown to improve E/A ratio according to science. They worked for me. I am not sure whether we have the same issue but I don't see much downside in trying a combo of those.

I really think if he is pointing fingers at 80mg weekly testosterone, you will once again be going down the wrong rabbit hole when you are trying to figure this out.

 

[Deleted member 106824]

This leads me to think your issues might not be entirely steroid related because my heart problems, which I know for a fact were caused by steroids, are completely different than yours. I had heart enlargement in all the chambers, to the point my aortic root had to be operated on. My Left atrium and IVS are mildy enlarged still when they were small before I started the madness. You have none of those issues and obviously, my AAS use was far more extreme than yours was as you have said you were a light user.

Look, if there is any valve that you'd want to be leaking, it's the mitral valve. The fix for that is very minimally invasive nowadays if you need it. I think they just do a MitraClip or something like that. I have a leaky aortic valve, and I'd trade that for a leaky Mitral valve in a second.

E/A ratio is something I was able to personally improve. I had grade 1 diastolic dysfunction and now I don't. My E/A ratio lowered by 0.5. Nebivolol, Probenecid, Glycine/NAC in combination, and D-Ribose have been shown to improve E/A ratio according to science. They worked for me. I am not sure whether we have the same issue but I don't see much downside in trying a combo of those.

I really think if he is pointing fingers at 80mg weekly testosterone, you will once again be going down the wrong rabbit hole when you are trying to figure this out.

Hey bud, I was not aware your aortic root had to be operated on specifically because of your steroid use....was that confirmed? And why did you have an echo done before your gear use? Is your left atrium the only thing that's currently enlarged?

My left atrium is dilated to some degree as are pretty much all of my chambers. None of them are thick, but all dilated. I also wonder about if my past thyroid use had anything to do with this....apparently Graves disease can lead to MVP and that's a condition where you have hyperthyroidism...I wonder if my 2-3 cuts of excessive T3 usage screwed me there.

What you said about the mitral valve is correct. It's not this HUGE issue at this point. Though for the record I believe they only do surgery with very extreme cases. It's just one more thing. I don't like to complain a lot, especially in person almost no one hears me complain, but man after years of GI disease, then finding out my EF was screwed, then finding out my heart was dilated, then after finally getting some minor improvements finding out there's another issue that for some reason no one ever told me about....just wears you down mentally after a while. OK rant over.


So they actually told you that your EA was a problem? What was your E/A ratio and what is it now? NO ONE ever mentioned E/A ratio to me. No doctors, no one I showed my echo too, nothing. It was 2.33 at Cleveland Clinic and I believe 2.5 this time. The most recent cardiologist says it appears my "volumes" are getting slightly better even though my 2D dimension is still the same more or less. Problem is these echos have all been with different people so there isn't consistency and sometimes they even have different items reported. If I had unlimited funds I would just get all these cardiologists I've worked with in a room together to get a clear picture of everything going on. You just can't get a comprehensive view when you have 20min with a doctor who has 30 other patients that day.

Do you happen to have any of the studies you mention showing those improvements in E/A ratio. Again it's just so weird to me that that report shows GRADE III diastolic dysfunction by E/A ratio but apparently normal function by some other method

To your last point...yea I just don't know man. I agree, I don't really believe this 80mg TRT is causing a major problem. BUT I will say that 700-800ng/dL is above my normal levels, and it causes it to always be that high rather than peaks and troughs seen in normal testosterone production, and to GotGame's point it's one of the only things I haven't tried. I feel like if I had a patient in my situation, and we said ok we're going to completely ignore muscle loss at this point, what would I recommend....I'd probably say try coming off and getting back normal production and see if the echo changes...and if it doesn't benefit then go back on the TRT. I am of course biased by not wanting the negative physical effects of coming off even with the dose being so low.

 

[nothuman]

Hey bud, I was not aware your aortic root had to be operated on specifically because of your steroid use....was that confirmed? And why did you have an echo done before your gear use? Is your left atrium the only thing that's currently enlarged?

My left atrium is dilated to some degree as are pretty much all of my chambers. None of them are thick, but all dilated. I also wonder about if my past thyroid use had anything to do with this....apparently Graves disease can lead to MVP and that's a condition where you have hyperthyroidism...I wonder if my 2-3 cuts of excessive T3 usage screwed me there.

What you said about the mitral valve is correct. It's not this HUGE issue at this point. Though for the record I believe they only do surgery with very extreme cases. It's just one more thing. I don't like to complain a lot, especially in person almost no one hears me complain, but man after years of GI disease, then finding out my EF was screwed, then finding out my heart was dilated, then after finally getting some minor improvements finding out there's another issue that for some reason no one ever told me about....just wears you down mentally after a while. OK rant over.


So they actually told you that your EA was a problem? What was your E/A ratio and what is it now? NO ONE ever mentioned E/A ratio to me. No doctors, no one I showed my echo too, nothing. It was 2.33 at Cleveland Clinic and I believe 2.5 this time. The most recent cardiologist says it appears my "volumes" are getting slightly better even though my 2D dimension is still the same more or less. Problem is these echos have all been with different people so there isn't consistency and sometimes they even have different items reported. If I had unlimited funds I would just get all these cardiologists I've worked with in a room together to get a clear picture of everything going on. You just can't get a comprehensive view when you have 20min with a doctor who has 30 other patients that day.

Do you happen to have any of the studies you mention showing those improvements in E/A ratio. Again it's just so weird to me that that report shows GRADE III diastolic dysfunction by E/A ratio but apparently normal function by some other method

To your last point...yea I just don't know man. I agree, I don't really believe this 80mg TRT is causing a major problem. BUT I will say that 700-800ng/dL is above my normal levels, and it causes it to always be that high rather than peaks and troughs seen in normal testosterone production, and to GotGame's point it's one of the only things I haven't tried. I feel like if I had a patient in my situation, and we said ok we're going to completely ignore muscle loss at this point, what would I recommend....I'd probably say try coming off and getting back normal production and see if the echo changes...and if it doesn't benefit then go back on the TRT. I am of course biased by not wanting the negative physical effects of coming off even with the dose being so low.

Oh I thought everyone knew about my aortic root lol. Yea, over 4 years ago, I was under the operating table getting my aortic root replaced. I had a scary feeling one day about how unhealthy I was being and had a panic attack, thinking I was having a heart attack (I wasn't obviously) so I went to the ER. That's when they did the echo. That's how I became so obsessive about heart health. I was a big tren/test/hgh user, rarely taking breaks and staying on too long. Hypertension 24/7, eating like shit too much, etc. Completely self inflicted. Been doing damage control ever since while still trying to look big and lean. Been successful at it which is good. The worst part is I look better now than I did then (eating better is a big part of that).

My left atrium is only mildly dilated, but the atrial volume index is normal, so it isn't an issue. Essentially, all my heart measurements are high end of normal range or just above, but my ejection fraction is 65%. In fact, it was 60 but I improved it. I noticed when I am on gh, even a low dose, my left atrium and IVS measure bigger. I am off gh now and I have a follow up echo in a few weeks myself.

No, they never said a damn word about E/A or grade 1 diastolic dysfunction. But it was written on the report and I had to frantically research everything about it on my own since they were no help. grade 1 is extremely common and everyone gets it as they age. still, I refused to accept that shit so I took it upon myself to improve it, which I did. Went from 1.3 to 0.8...Hopefully didn't go back up since.

I am curious, how is your cardio? Are you in very good fitness shape or do you feel it should be better? maybe get the nt-proBNP blood test to see where you're at. Hopefully it's low for some peace of mind.

I wouldn't know enough about the thyroid stuff to comment there.

I really can relate strongly to you not getting all the info you want from all these cardiologists. I've had the exact same problem. They will tell me nothing is too bad (just to monitor my valve leak) but then I'll see the report after I leave and have 100 questions about what I am seeing. By then, it's not like I can go back and ask. It's extremely frustrating. I am going to see a new cardiologist who is big on wellness and not just western, which is exactly what I need.

 

[Deleted member 106824]

Oh I thought everyone knew about my aortic root lol. Yea, over 4 years ago, I was under the operating table getting my aortic root replaced. I had a scary feeling one day about how unhealthy I was being and had a panic attack, thinking I was having a heart attack (I wasn't obviously) so I went to the ER. That's when they did the echo. That's how I became so obsessive about heart health. I was a big tren/test/hgh user, rarely taking breaks and staying on too long. Hypertension 24/7, eating like shit too much, etc. Completely self inflicted. Been doing damage control ever since while still trying to look big and lean. Been successful at it which is good. The worst part is I look better now than I did then (eating better is a big part of that).

My left atrium is only mildly dilated, but the atrial volume index is normal, so it isn't an issue. Essentially, all my heart measurements are high end of normal range or just above, but my ejection fraction is 65%. In fact, it was 60 but I improved it. I noticed when I am on gh, even a low dose, my left atrium and IVS measure bigger. I am off gh now and I have a follow up echo in a few weeks myself.

No, they never said a damn word about E/A or grade 1 diastolic dysfunction. But it was written on the report and I had to frantically research everything about it on my own since they were no help. grade 1 is extremely common and everyone gets it as they age. still, I refused to accept that shit so I took it upon myself to improve it, which I did. Went from 1.3 to 0.8...Hopefully didn't go back up since.

I am curious, how is your cardio? Are you in very good fitness shape or do you feel it should be better? maybe get the nt-proBNP blood test to see where you're at. Hopefully it's low for some peace of mind.

I wouldn't know enough about the thyroid stuff to comment there.

I really can relate strongly to you not getting all the info you want from all these cardiologists. I've had the exact same problem. They will tell me nothing is too bad (just to monitor my valve leak) but then I'll see the report after I leave and have 100 questions about what I am seeing. By then, it's not like I can go back and ask. It's extremely frustrating. I am going to see a new cardiologist who is big on wellness and not just western, which is exactly what I need.

I knew generally but I don't think I ever knew the entire history.

Yea there definitely seems to be a correlation between GH use and heart size. I've seen some studies indicating GH helping with the GI issues I have but I'd be way too scared to risk it messing with my heart.

I'm a little confused about your E/A numbers. This is just from Wikipedia:
-Normal diastolic function (E > A)
-Impaired relaxation (E:A reversal i.e. E is < A)
-Pseudonormal (E:A ratio appears normal)
-Restrictive filling (E:A ratio often > 2)

If you were at 1.3 that seems to indicate things were normal. And if you're now at 0.8 that seems to indicate an issue (impaired relaxation). Mine is the opposite end with >2 so "restrictive filling" according to this even though my "spectral doppler waveforms are more suggestive of normal diastolic function". Am I missing something with your numbers?

Regarding my cardio: I do 2hr of cardio per week. Typically that is about 1.5hr of LISS (130bpm) and one session of HIIT. This involves 10 all-out 15sec sprints on a bike. This gets me up to about 170bpm. At Cleveland Clinic last year my VO2 Max was 49. I feel like doing much more would just make my heart larger (as you know, extreme athletes tend to have more cardiac issues, more atrial fibrillation, and larger hearts).

I haven't gotten nt-ProBNP but I've gotten BNP tested numerous times and it's ranged from 4-25 (<100 being normal) so thus far that hasn't been an issue.

Yea. It's frustrating. I understand...the way the medical system is set up these doctors can't be spending an hour with one patient, but when it comes to something like the heart we're going to have a ton of questions especially if we're well read. And like you said, you see the report and then have a ton of questions. I'm going to see a men's health doctor who sort of has a specialty practice geared toward men who have used gear and want to optimize their health. We have an hour long consultation next week. As I've mentioned in this thread before I've worked with Dr. Rand McClain and while I like him I think he's too quick to brush things off. Always telling me my heart is totally normal for an athlete when it's clearly not. This new doctor is very serious about getting men to optimal health post AAS use so I'm hoping he has some answers for me. I'd love to start HCG and get my test a little higher if it's not going to make my problems worse but my heart health is my main concern. Will update everyone about what he says.