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Heart Rate

XstarchildX

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Just a few comparisons from my donation history. Not sure if I really see too much of a trend/pattern.

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^^When my hemoglobin was in the 13's via the finger prick test, I had blood work done prior to donating on the same day and hemoglobin was 11.1. Just some food for thought.
 

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Stewie

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Your pulse pressure is a tad high (I didn't have time to average them out-- what I did calculated, it's in the 55-60mmHg +/-). An elevated PP is very much correlated with iron deficiency.

Here again. Iron deficiency is nothing one wants to fu#k with longterm.

Sadly the whole bodybuilding community pushes for over phlebotomizing, steering away from supplemental Fe, fear mongering slightly elevated HH.

Work diligently on getting your Fe levels up.
 

XstarchildX

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Your pulse pressure is a tad high (I didn't have time to average them out-- what I did calculated, it's in the 55-60mmHg +/-). An elevated PP is very much correlated with iron deficiency.

Here again. Iron deficiency is nothing one wants to fu#k with longterm.

Sadly the whole bodybuilding community pushes for over phlebotomizing, steering away from supplemental Fe, fear mongering slightly elevated HH.

Work diligently on getting your Fe levels up.
I appreciate your input, Stewie!

I have ferrous sulfate and supplemental iron. How would you recommend going about this? It's also good to note that I've been on omeprazole for about 5+ years for GERD and gastritis. I tried weening off and it was a giant rebound. I've read a couple studies where they feel PPI'S long term can make it hard to absorb iron via the digestive process.

Any input would be greatly appreciated. Last time I got my iron back in range, my crit was around 58%.
 

maldorf

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I've had the exact same thing as you, tachycardia (mine was over 100 though) probably caused by anxiety/stress. They put me on Bisoprolol (a bèta-blocker) and I've been fine ever since. No discernible side effects either.

Bisoprolol is a powerful drug and is what they use on me to keep my heart rate down. Mine at rest usually runs around 62 or so. It does make it a lot harder to get the rate up with exercise though and will limit your capacity. IMO taking the beta blocker is merely covering up the problem and not addressing the cause of the problem. If it really is psychological then I don't think that is a problem, but if you have a medical condition that is causing it then you are ignoring the problem and not treating it.
 

maldorf

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I appreciate your input, Stewie!

I have ferrous sulfate and supplemental iron. How would you recommend going about this? It's also good to note that I've been on omeprazole for about 5+ years for GERD and gastritis. I tried weening off and it was a giant rebound. I've read a couple studies where they feel PPI'S long term can make it hard to absorb iron via the digestive process.

Any input would be greatly appreciated. Last time I got my iron back in range, my crit was around 58%.

Since taking the PPI, have you had any really bad muscle cramping? I had that in my leg adductor muscles. It happened about 3 or 4 times, in the middle of the night when sleeping. One was so bad I went to the ER out of fear my electrolytes were messed up and I feared I might get arrhythmias. All my blood work came back normal. I stopped taking the PPI and switched to Famotidine and never had another cramp. Online I found many others had the same problem with PPIs.
 

XstarchildX

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Since taking the PPI, have you had any really bad muscle cramping? I had that in my leg adductor muscles. It happened about 3 or 4 times, in the middle of the night when sleeping. One was so bad I went to the ER out of fear my electrolytes were messed up and I feared I might get arrhythmias. All my blood work came back normal. I stopped taking the PPI and switched to Famotidine and never had another cramp. Online I found many others had the same problem with PPIs.
I don't get any straight up muscle cramps or charley horses, but I have noticed a lot more fasciculations lately (mostly in my calves and eyelid). It could certainly be the cause. Last round of labs showed all electrolytes in balance.
 

maldorf

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I don't get any straight up muscle cramps or charley horses, but I have noticed a lot more fasciculations lately (mostly in my calves and eyelid). It could certainly be the cause. Last round of labs showed all electrolytes in balance.

Id say then if you aren't having the bad cramps like me then you are ok. The PPI works better than the Pepcid I take so stay with that I would say unless those twitches are bothering you really bad.

I figured out that my gastro problem, eosinophilic esophagitis, was brought on by a combo of weight gain and drinking too much alcohol. Once I cut those down the problem got a lot better and I have even been able to lower my dose of Pepcid some.
 

jeroendebleser

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Bisoprolol is a powerful drug and is what they use on me to keep my heart rate down. Mine at rest usually runs around 62 or so. It does make it a lot harder to get the rate up with exercise though and will limit your capacity. IMO taking the beta blocker is merely covering up the problem and not addressing the cause of the problem. If it really is psychological then I don't think that is a problem, but if you have a medical condition that is causing it then you are ignoring the problem and not treating it.

In my case there wasn't really a cause other than the AAS I take but he should definitely get it all checked out before going on a bèta-blocker idd.
 

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I honestly don't even notice that it's high most of the time unless I take my pulse. I climbed the stairs faster than normal earlier just to see if it made me feel out of breath, and though I was breathing slightly harder than at rest, I certainly wasn't out of breath at all.

I was getting CVT's on and off for a couple weeks, but I've had these on and off all my life. When I was cruising for about 12 week, my HR during the day was in the upper 70's, which still isn't where it used to be, but a bit lower. Now that I'm on 500mg of test and 300mg of deca (2 weeks in) it's back up again.

Thanks for your input!

I unfortunately have a heart murmur so I pretty much can tell how slow/fast my pulse is at all times. It's a pretty shitty thing to live with so I am a bit more concerned with pulse more than the average person. My guess is you don't have anything serious to worry about but if you want to get checked out for peace of mind, that wouldn't be a bad thing at all.
 

nothuman

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Your pulse pressure is a tad high (I didn't have time to average them out-- what I did calculated, it's in the 55-60mmHg +/-). An elevated PP is very much correlated with iron deficiency.

Here again. Iron deficiency is nothing one wants to fu#k with longterm.

Sadly the whole bodybuilding community pushes for over phlebotomizing, steering away from supplemental Fe, fear mongering slightly elevated HH.

Work diligently on getting your Fe levels up.

Unfortunately the average doctor or hematologist puts the fear of god into our hearts when they see an elevated hematocrit. It's not a pleasant conversation.
 

nothuman

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I appreciate your input, Stewie!

I have ferrous sulfate and supplemental iron. How would you recommend going about this? It's also good to note that I've been on omeprazole for about 5+ years for GERD and gastritis. I tried weening off and it was a giant rebound. I've read a couple studies where they feel PPI'S long term can make it hard to absorb iron via the digestive process.

Any input would be greatly appreciated. Last time I got my iron back in range, my crit was around 58%.

Do you actually know whether you have low ferritin? I wouldn't just take ferrous sulfate without finding this out for sure. I've taken it before to get ferritin up and didn't get any sides, but I know some people have gotten sides on it.

Bummer you need to take the PPI. Hopefully you're getting things like calcium, Vitamin B, etc. checked to avoid deficiency.
 

XstarchildX

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Do you actually know whether you have low ferritin? I wouldn't just take ferrous sulfate without finding this out for sure. I've taken it before to get ferritin up and didn't get any sides, but I know some people have gotten sides on it.

Bummer you need to take the PPI. Hopefully you're getting things like calcium, Vitamin B, etc. checked to avoid deficiency.
Yeah, I definitely have low iron and ferritin. I didn't need to do TIBC labs this time as we had the same issue with MCV, MCHC, and RDW previously--all of which are indicative of iron depletion. These labs look exactly the same after a few donations (same cause last time).

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XstarchildX

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Took my first dose of iron today in the form of Ferrous Bisglycinate Chelate @ 29mg. Got a great night's sleep last night (8.5 hours) but woke up feeling foggy and breathless. Today is an off day with cardio only. I recently started brining cardio back in an attempt to help with my RHR.

Any other thoughts from anyone else?

Stewie, if you get a chance, can you look at the labs I posted above? From my experience, everything there points to iron deficiency without anemia. I appreciate all your help!
 

Stewie

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The issue with repeated phlebotomies, especially in the presence of iron deficiency revs up erythropoietic response, thus stimuli of more RBC production as a compensatory for the lack of oxygenated hemoglobin. This is a common theme for a host of individuals that experience a constant elevation of their HH that repeatedly phlebotomizing while on a cycle or TRT. Ultimately this becomes a viscous cycle leaving them in a quandary state, of 'what to do'.

Aside from iron loss during excessive phlebotomizing, we lose other trace minerals that are vital. There's not much for literature stating the potential for secondary deficiencies of other micronutrients (trace minerals) loss in routine therapeutic phlebotomies. So these questions are treading in the unknown without pulling specific blood markers. Under these circumstances, I'd suggest taking a good quality multivitamin with iron and zinc leading up to and after your phlebotomy. If by chance there is a copper deficiency, be sure to add copper to your zinc supplemention at a 10:1 ratio of zinc to copper.

As for you to be pushing 58%, I'd have say there's another driver behind this outside of androgenic stimuli. Hypoxic-hypoxia from undiagnosed sleep apnea is another stimulus of erythropoietic response. I would dig deeper into ruling out OSA. Or lack of sufficient hydration and or the combination of undiagnosed OSA. Hard to say with certainty. Nonetheless.

Here again, I suspect you may have mixed deficiencies. Generally MCV is elevated (macrocytic) in the presence of copper deficiency, as opposed to your microcytic status, although iron deficiency may over power showing signs of macrocytic. Although I would still consider asking your primary to assess the aforementioned immunoassays. The reasoning for my suggestions is that chronic digestive problems inconjunction with longterm use of PPI's and H2RA's can impede the absorption of copper, therefore hindering proper iron absorption. So it may be worthwhile to tease-out the possibility of a secondary deficiency is in place. Are you Rx'd the PPI's and was you diagnosed with GERD or similar? Or are you taking them primarily by your own decisions? If the latter, I'd suggest looking into substituting the PPI for betaine HCI and pepsin. If the former, I'd discuss the discontinuation of its use with your primary about switching to the use of betanie HCI/pepsin with each meal. Otherwise you may be facing an unbeatable battle to restore your Fe status.

A majority of the time it's not 'too much acid secretion', as most people (and clinicians) believe. Rather it's related to lowered acid secretion (hypochlorhydria) in those with heartburn, gastric distress, acid reflux. By suppressing gastric acid, this isn't fixing a problem, it's exacerbating a losing battle you're faced with. So yes, PPI's have been associated with impaired nutrient assimilation. As well, there's suggestive evidence that prolonged use of PPI's could potentially lead to acute kidney injury and acute interstitial nephritis. So, I'd reevaluate using a PPI.

There's some intriguing literature giving us fairly clear Information that iron deficiency acts as a prerequisite to a few different etiologies, e.g., cardiomyopathy (in more severe longterm cases), thrombosis risk through increased platelet aggregation- adhesion, cognitive impairment, impairment of our immune system, which is hypothesized to be a link between iron deficiency and some cancers. So, there's that.

You may need some reorganization of your diet not only for your GERD, as well interactions of food-food, nutrients, drugs that may inhibit sufficient iron absorption. Outside of vitamin C to enhance heme based iron absorption, as does Lysine. As for nonheme foods, Alpha-GPC has been noted to enhance nonheme base iron absorption. Vitamin A is dose dependent that can act paradoxically with iron absorption. Too high of dosages has been noted as being inhibitory, in contrast to lower doses seems to enhance uptake. The incredible edible egg can do damage on iron absorption, as does several other foods.

Ultimately in the end of all this gibberish. You really need to get to the root of why you've been struggling with regaining your Fe status.

No Celiac or Crohn's disease?
 

thethinker48

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Man, are we lucky to have Stewie [emoji846]

Sent from my Pixel XL using Tapatalk
 

XstarchildX

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The issue with repeated phlebotomies, especially in the presence of iron deficiency revs up erythropoietic response, thus stimuli of more RBC production as a compensatory for the lack of oxygenated hemoglobin. This is a common theme for a host of individuals that experience a constant elevation of their HH that repeatedly phlebotomizing while on a cycle or TRT. Ultimately this becomes a viscous cycle leaving them in a quandary state, of 'what to do'.

Aside from iron loss during excessive phlebotomizing, we lose other trace minerals that are vital. There's not much for literature stating the potential for secondary deficiencies of other micronutrients (trace minerals) loss in routine therapeutic phlebotomies. So these questions are treading in the unknown without pulling specific blood markers. Under these circumstances, I'd suggest taking a good quality multivitamin with iron and zinc leading up to and after your phlebotomy. If by chance there is a copper deficiency, be sure to add copper to your zinc supplemention at a 10:1 ratio of zinc to copper.

As for you to be pushing 58%, I'd have say there's another driver behind this outside of androgenic stimuli. Hypoxic-hypoxia from undiagnosed sleep apnea is another stimulus of erythropoietic response. I would dig deeper into ruling out OSA. Or lack of sufficient hydration and or the combination of undiagnosed OSA. Hard to say with certainty. Nonetheless.

Here again, I suspect you may have mixed deficiencies. Generally MCV is elevated (macrocytic) in the presence of copper deficiency, as opposed to your microcytic status, although iron deficiency may over power showing signs of macrocytic. Although I would still consider asking your primary to assess the aforementioned immunoassays. The reasoning for my suggestions is that chronic digestive problems inconjunction with longterm use of PPI's and H2RA's can impede the absorption of copper, therefore hindering proper iron absorption. So it may be worthwhile to tease-out the possibility of a secondary deficiency is in place. Are you Rx'd the PPI's and was you diagnosed with GERD or similar? Or are you taking them primarily by your own decisions? If the latter, I'd suggest looking into substituting the PPI for betaine HCI and pepsin. If the former, I'd discuss the discontinuation of its use with your primary about switching to the use of betanie HCI/pepsin with each meal. Otherwise you may be facing an unbeatable battle to restore your Fe status.

A majority of the time it's not 'too much acid secretion', as most people (and clinicians) believe. Rather it's related to lowered acid secretion (hypochlorhydria) in those with heartburn, gastric distress, acid reflux. By suppressing gastric acid, this isn't fixing a problem, it's exacerbating a losing battle you're faced with. So yes, PPI's have been associated with impaired nutrient assimilation. As well, there's suggestive evidence that prolonged use of PPI's could potentially lead to acute kidney injury and acute interstitial nephritis. So, I'd reevaluate using a PPI.

There's some intriguing literature giving us fairly clear Information that iron deficiency acts as a prerequisite to a few different etiologies, e.g., cardiomyopathy (in more severe longterm cases), thrombosis risk through increased platelet aggregation- adhesion, cognitive impairment, impairment of our immune system, which is hypothesized to be a link between iron deficiency and some cancers. So, there's that.

You may need some reorganization of your diet not only for your GERD, as well interactions of food-food, nutrients, drugs that may inhibit sufficient iron absorption. Outside of vitamin C to enhance heme based iron absorption, as does Lysine. As for nonheme foods, Alpha-GPC has been noted to enhance nonheme base iron absorption. Vitamin A is dose dependent that can act paradoxically with iron absorption. Too high of dosages has been noted as being inhibitory, in contrast to lower doses seems to enhance uptake. The incredible edible egg can do damage on iron absorption, as does several other foods.

Ultimately in the end of all this gibberish. You really need to get to the root of why you've been struggling with regaining your Fe status.

No Celiac or Crohn's disease?
Stewie, I truly appreciate you taking the time to do this. When I visit my new PCP on Wednesday, I'm going to provide him with the information you so kindly took your time to supply me with. I'm hoping he'll be pulling a plethora of labs to really get to the root of this dilemma, and to hopefully figure out what's going on here.

As for the PPI, I had H Pylori many years back (which went undiagnosed at first because the original doctor did only the saliva test). I requested a new gastro and he referred me for both upper and lower endoscopies, during which they pulled a biopsy of my intestines. I tested positive for H pylori and had pretty decent damage going on due to GERD (which the H pylori would obviously cause). They didn't want me to come off the PPI, and since I felt great at the time, I never questioned it. I will certainly bring this up to my new doc.

OSA could also be a possibility, as some nights I do wake up many times throughout. When I was on tren for the first time a couple years ago, I recall waking up gasping on a couple occasions. It hasn't happened over the past year so I just 'assumed' I don't have OSA--which is actually quite ignorant of me to be honest. This could be as simple as getting a CPAP machine.

I definitely don't want to prolong this given the risk factors involved in long term iron depletion. I'm hoping he will also order me a 24 hour EKG or an echo just to make sure the old ticker is working properly. Having my HR so high really does cause anxiety, which in turn keeps the HR elevated. Another vicious cycle...

Thanks again for your help, Stewie!
 

Stewie

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Well, that's unfortunate with the infliction of H-pylori. Incidentally taking betaine possibly wouldn't fair well, especially if you have a peptic ulcer. At least to the best of my knowledge. Although I'd bounce it off your primary.

I wouldn't hesitate to have a full anemia panel pulled rather than going off of your indices alone. Yes, all arrows are pointing at iron deficiency. Tho for conclusive evidence, that panel would be helpful.

To track along side of that, being that you're taking a PPI (which could lessen the uptake of Fe) and there's the potential for unpleasant gastric pains associated with different forms of Fe. As well, even tho it was years ago, we would only hope that the H-pylori was eradicated with antibiotics and hoping there's no more H-pylori lingering around chowing up gastrointestinal Fe. This becomes an issue, if in the event the H-pylori hasn't been controlled. Bacteria thrives on iron, there's suggestive evidence that supplemental Fe, continues to feed the host. It's a losing battle.

Where I'm going. If your panels do (which I'm very certain they will) show a diagnosis of iron deficiency, I'd would discuss with your primary about doing iron infusions. Because you're not 'anemic' per se, this idea may get shot down. If it does, I wouldn't hesitate to get a second opinion from a hematologist or gastroenterologist.

If by chance you do have undiagnosed OSA and you use corrective measures, compliance and adherence of CPAP therapy, as well to dropping to the lowest dose of TRT, you may actually have anemia, by definition.


Good luck!
 
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XstarchildX

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Well, that's unfortunate with the infliction of H-pylori. Incidentally taking betaine possibly wouldn't fair well, especially if you have a peptic ulcer. At least to the best of my knowledge. Although I'd bounce it off your primary.

I wouldn't hesitate to have a full anemia panel pulled rather than going off of your indices alone. Yes, all arrows are pointing at iron deficiency. Tho for conclusive evidence, that panel would be helpful.

To track along side of that, being that you're taking a PPI (which could lessen the uptake of Fe) and there's the potential for unpleasant gastric pains associated with different forms of Fe. As well, even tho it was years ago, we would only hope that the H-pylori was eradicated with antibiotics and hoping there's no more H-pylori lingering around chowing up gastrointestinal Fe. This becomes an issue, if in the event the H-pylori hasn't been controlled. Bacteria thrives on iron, there's suggestive evidence that supplemental Fe, continues to feed the host. It's a losing battle.

Where I'm going. If your panels do (which I'm very certain they will) show a diagnosis of iron deficiency, I'd would discuss with your primary about doing iron infusions. Because you're not 'anemic' per se, this idea may get shot down. If it does, I wouldn't hesitate to get a second opinion from a hematologist or gastroenterologist.

If by chance you do have undiagnosed OSA and you use corrective measures, compliance and adherence of CPAP therapy, as well to dropping to the lowest dose of TRT, you may actually have anemia, by definition.


Good luck!
Come to think of it, it is possible that I either never fully eradicated the h pylori, or it somehow reinfected my system. I do get occasional bouts of nausea for no apparent reason, and have lately had a bit of a gnawing/burning sensation in the middle of my abdomen, but it feels rather deep, as if it's near my spine (I recall having this sensation when I was originally diagnosed). I'll also bring this up to my PCP.

I've read many studies that have shown PPI's to block absorption of iron and other trace minerals, so it would be nice to get off the drug. I made a couple of attempts and had some pretty bad rebound reflux that made falling asleep pretty much impossible. I'm hoping I can fight through it if need be. I'm going to have to if they want to retest for h pylori via a breath or stool test as these PPI's will greatly diminish the accuracy of those tests...

The anemia panel would be ideal. My prior primary only did CBC and then TIBC, transferrin saturation, and followed up with another CBC claiming that if the CBC looks good, everything else is good. I'm not sure I 100% agreed with his methodology, but he was making an effort to help, so I appreciated it nonetheless.

This truly is a sticky situation, and I can't keep going on like this. I really have to force myself to get moving in the gym. I can still get some pretty great sessions in, but prior to and after, I am pretty much exhausted. It's made work quite difficult too. I'm in a brain fog a lot of the day, and since my RHR has been elevated, my anxiety and panic attacks are starting to pop up again. I do live video presentations in front of anywhere from 50-80 people a pop at around 20-25 sessions a week, so you can only imagine how this is affecting me. I had a full blown panic attack last week during one and somehow managed to keep it together without looking like a total idiot... I can only imagine what my HR was during those 25 minutes lol.

Once again, I really appreciate all your knowledge bombs. It will definitely help as I move forward in this process!
 

Stewie

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In a rush with the ole ball-and-chain doing some black Friday madness shopping, I'll try my best to hit on this a bit more, hopefully.

Nonetheless. Look into glycine and glutamine and it's relationship with H-pylori. Also, there's suggestive evidence that glycine helps tame down platelet aggregation. Which may be pivotal under the circumstances.
 

XstarchildX

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Met with my new primary today. Really cool dude. He was open about my self TRT and didn't judge me for anything. He knew a decent amount about it as well (much more than any PCP I've met). We did an EKG in office which looked good and my HR was around 92bpm. He ordered the following:

Thyroid labs
lipid panel
Sleep study
stress test
stool test (for h pylori which I had many years ago)

Also took me off the PPI and switched me to an H2 blocker.

He thinks the HR is partially anxiety related so going to get some CBT as well.

I'll keep everyone posted.
 

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