It's important we take all this into perspective based on facts and not the blending of facts with the omission of facts. There are no published studies linking legit TRT, meaning 125 mg of testosterone weekly or less to heart failure, blood clots or any other detrimental outcome. (Unless you have a genetic predisposition to blood clots) To say low dose testosterone causes these issues, is to say that any healthy 20 year old is at risk for sudden death based on their bodies normal healthy testosterone levels. Think about teenagers who get massive spikes of test that end up developing gyno, yeah, gyno, from natural testosterone levels spiking and estrogen levels increasing to compensate. Same thing happens synthetically. If this were not true, than the drug testosterone, is the only bio identical drug known to man that causes unnatural bio identical side effects. Woman on birth control are at greater risk or at best the same risk level for blood clots, as men who are on TRT.
JM was on low dose testosterone, but the elephant in the room seems to be getting over looked. JM had a near fatal heart attack last year that severely damaged his heart, so much so that ever since JM had his heart attack, he was going against the medical community consensus regarding EF levels. "The effectiveness of implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden death in patients with an ejection fraction (EF) ≤35% and clinical heart failure is well established." JM admits openly that his EF was below the 35% threshold and he was scared to get an ICD Implanted. (Not blaming the guy, that has to be an insanely scary decision to make). My point is, JM didn't die suddenly because his test levels were between 800-1000 nanograms per deciliter, it's because JM had a heart that could give out at any moment, due to the massive damage he took from last year's heart attack. Not to mention the fact that JM had for absolute certain, a blood clotting disorder.
There is a list of risk factors for blood clots from the Mayo Clinic.
- Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs. JM was considered obese, as is everyone in this forum.
- Heart failure. This increases your risk of DVT and pulmonary embolism. Because people with heart failure have limited heart and lung function, the symptoms caused by even a small pulmonary embolism are more noticeable. (JM had an EF less than 35%, and his left ventricle was mainly dead. His words, not mine)
- Bowel diseases, such as Crohn's disease or ulcerative colitis, increase the risk of DVT. (JM had a more rare, more dangerous bowel disease than the ones listed.)
- Birth control pills (oral contraceptives) or hormone replacement therapy. Both can increase your blood's ability to clot. (Again, the risk for hormones is only noted because TRT and BC are not standard issue, people get over dosed prescriptions, or their bodies have over reactions to hormone replacement. If hormones are regulated to a natural level, these issues are not present.)
- A personal or family history of DVT or PE. If you or someone in your family has had one or both of these, you might be at greater risk of developing DVT. "Have a history of clots? You’re likely to get them again. One-third of people who get a DVT/PE will have another one within 10 years. Often, says Burgwinkle, this is because the blood clots form around the valves of a vein, which can damage it. In some cases, this can lead to multiple clots over time. More and more we're seeing that this can be more of a chronic disease, rather than an acute episode.”
- And the last one which we are speculating is Genetics. Some people inherit genetic risk factors or disorders, such as factor V Leiden, that make their blood clot more easily. An inherited disorder on its own might not cause blood clots unless combined with one or more other risk factors.
So if we set aside Genetics, JM still had 5 out of the 13 known causes of blood clots. If he did in fact have a genetic disorder, than he would have had half of the known risk factors associated with blood clots, that's alot of risk. To say that an other wise perfectly healthy human with no risk factors is rolling the dice from taking TRT, is going up up and away overboard.
On the other hand of this discussion, I get what some are worried about, trust me so am I. But the sad truth is, I know more people that die from diseases that they never should have had, lung cancer and never smoking, heart attacks with no drug use or other known risk factors, blood cancer, breast cancer, etc etc. Education and mitigation are essential to live a long life, and some how at the same time they are absolutely worthless. My advice for peace of mind would be to get genetic testing, know your family history, and do annual blood work. This goes for people on and off gear. Again I know far more people (not on gear) who have died preventable deaths because they never go to the doctor, than I do gym rats that get bloods done and see the doctor regularly.
We're all heart broken, JM was such a good guy that we all are reflecting on our own lives. I've done some amazing shit in my life, but I can promise you if I died tomorrow, no one here on this board would ever know. JM is and will forever be a legend. He transcended his influence and knowledge to people from all walks of Life. Unfortunately, life isn't fair, and if it was, JM would have lived forever.
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