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Worst Heart Scan (Echo) To Date

  • Thread starter Deleted member 106824
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D

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You don't think putting him in a state of testosterone deficiency by removing TRT would be worse for his heart?

This seems to be a point of significant disagreement. Most cardiologists don't know what to think about my TRT usage. Dr. O'Connor thinks I'll need to be on it forever. GotGame has suggested coming off of it before. You and others voiced concern that the low T would hurt me. I do not know.

I am, however, going to need to come off to try to get my girl pregnant in the next few months, at which point I was curious to see what I could get my natural levels to anyway....so it seems an apt time to try coming off and getting endogenous production restarted.


Yea but it certainly won't hurt to take them. They will aim to prevent things from getting worse. I don't think this is the time to be in money saving mode. Super high dose fish oil too (at least 4g omega 3's). And always take selenium (brazil nuts or supplement) with your Ubiquinol.

I agree it's not the time to be penny pinching. Man I think of the thousands and thousands I've spent over the years not just on the few years of gear but endless doctor appointments, loads and loads of health supplements, etc....wish I had stayed natural.

Why do you suggest the selenium with ubiquinol? I've not heard that one before. I definitely will continue to take ubiquinol, fish oil, curcumin, taurine, and citrulline as I do now. I could add back ribose and arjuna....I'll look into the studies again (feel free to post any you find promising). I just don't recall being impressed with those.



I think the best advice given thus far was to seek a second opinion from another cardiologist. I would suggest as soon as possible before it gets more serious and to not change anything (valarstan) without consulting your current (or 2nd also) cardiologist.

Since this began in 2014 I have seen a cardiac nurse practitioner, then a cardiologist at the same hospital, then a cardiologist who had a more athletic background at a renowned hospital, then a cardiologist with a very athletic background at an even more renowned hospital, then a new cardiologist when I moved, then another cardiologist when I moved again, and finally my current cardiologist I met this week....who will be referring me to a new attending cardiologist with a sports background. So that is to say I've seen one cardiac NP and 6 cardiologists over the last 5 years due to frequent moving. I have also consulted with Dr. Rand McClain, Dr. Thomas O'Connor, both known in the bodybuilding world as TRT docs. So 8+ different doctors at this point.

Hard to even summarize a general opinion there, on the whole up until this week the general opinion was that there likely was some legitimate pathological damage but it seems to have stabilized. Now the question is is it getting significantly worse.

The current cardiologist called me today to go over the echo in more detail. She did not seem to confidently have recommendations other than that she didn't think I should be on anastrazole long term (but admitted it's not the cause of the problems we're seeing here) and said we could try bumping up the Valsartan from the current 80mg per day to 120mg (80mg in the morning and 40mg at night), saying that in cardiomyopathy / heart failure patients they try to get the dose as high as is tolerated. This seemed like a hesitant / reserved recommendation on her part, with phrases like "if you're comfortable with it" "we could try it". And that a beta blocker is simply out of the question given my heart rate.
 
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Yes...as I said, echos can wildly vary because of factors like poor echo image quality. For instance, Palumbo said he experienced a huge variance in ejection fractions.

MRI is considered more of a gold standard...and your 2017 MRI showed a very solid, higher normal ejection fraction. What were your left atrium sizes on your MRI reports?

it did yes, with massive volumes though.

I'm attaching the full results of my 2017 MRI for you. Keep in mind 2017 was when I had my best echo results, so this is likely the best my MRI would have been as well and may have worsened similar to my echo results.
 

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MethodAir

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it did yes, with massive volumes though.

I'm attaching the full results of my 2017 MRI for you. Keep in mind 2017 was when I had my best echo results, so this is likely the best my MRI would have been as well and may have worsened similar to my echo results.

The MRI report states that your "left atrium and right atrium are within normal limits in size", as opposed to the 'moderate' left atrium dilatation reported on your recent echo.

The MRI report also states that your LV was moderately dilated, but importantly, with preserved ejection fraction. Whereas curiously, your recent echo stated mild LV dilatation, with mildly impaired ejection fraction.

Again, for peace of mind, I would start with another MRI asap and take it from there.
 

nothuman

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I agree with you 100%. I wouldn't skimp on supplements such as arjuna and ribose.

I find krill oil to be a lot better than fish oil. Blood work never seems to improve when using fish oil compared to krill oil. Is there a brand of fish oil you particularly use or like?

Why do you recommend using selenium with the Ubiquinol?


Krill seems to be better for lipids from my experiences but high dose fish oil has more omega 3's and that's what the heart and brain really need. Krill provides very little omega 3's. 3.5g and up omega 3s is where fish oil really shines. More seems to be better. Carlson, Viva, and Nordic Naturals are good fish oil brands.

Nothuman,

Do you think 500mg of arjuna is a good dose? Swanson sells it at a good price. Do you like that brand?

I'd double that dose and Swanson seems to be solid.
 

nothuman

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This seems to be a point of significant disagreement. Most cardiologists don't know what to think about my TRT usage. Dr. O'Connor thinks I'll need to be on it forever. GotGame has suggested coming off of it before. You and others voiced concern that the low T would hurt me. I do not know.

I am, however, going to need to come off to try to get my girl pregnant in the next few months, at which point I was curious to see what I could get my natural levels to anyway....so it seems an apt time to try coming off and getting endogenous production restarted.




I agree it's not the time to be penny pinching. Man I think of the thousands and thousands I've spent over the years not just on the few years of gear but endless doctor appointments, loads and loads of health supplements, etc....wish I had stayed natural.

Why do you suggest the selenium with ubiquinol? I've not heard that one before. I definitely will continue to take ubiquinol, fish oil, curcumin, taurine, and citrulline as I do now. I could add back ribose and arjuna....I'll look into the studies again (feel free to post any you find promising). I just don't recall being impressed with those.

Just posted a link about the benefits of combining coq10 and selenium together up above.

I don't feel comfortable contradicting GotGame as he has helped me a lot over the years too, and I still plan to bug him at some point again about it, but I would be worried if you can't restore natural testosterone levels. We know that a T deficiency increases the risk of heart attacks. It's not hard to find evidence on that one. Anecdotally, many people on TRT seem to be fine getting their women pregnant. Dante's fertility protocol seems to be quite successful from what I hear (can't speak from personal experience though).

I hear you on the supplements. It adds up and it's discouraging to not see the improvements you are hoping for. I haven't seen echocardiogram improvements either yet, but I don't want to come off in case they are keeping things from getting worse. The studies on many of them seem pretty good though so there is zero negative risk of taking some of them.

I am more and more convinced eliminating grains is a huge help the more I listen to podcasts about gut health. Hormones are also huge. Have you checked your DHEA levels? A deficiency in that is very much bad for the heart. Thyroid (free T3) is too (as we have talked about before). I feel like you have a blind spot somewhere that you might never have been tested for. Tested for SIBO? A good functional medicine doctor would be your best bet at this point. Conventional cardiologists understand how to read heart tests but most of them can't tell you how to ultimately be healthier.
 

nothuman

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To clarify, I meant a functional medicine cardiologist would be your best bet. One who will understand the role of supplements and diet in addition to heart tests.
 

opietaylor

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here is a question for you...........did you ever have your heart checked BEFORE you started cycling. see what i'm getting at here.
 

gotgame

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You don't think putting him in a state of testosterone deficiency by removing TRT would be worse for his heart?

I am suggesting an otherwise healthy 29 yr old who is for some reason on TRT do a thorough PCT and restore natural production. I am not suggesting cutting off his balls and walking around in a perpetual state of hypogonadism.
 

gotgame

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Hey man, thanks for chiming in. I'm definitely willing to come off TRT if it will help. You were the one who recommended Valsartan a few years ago, and it was after that that things really seemed to improve (from two echos showing 40% to then being 55+%). You're suggesting coming off even the Valsartan now? That would definitely concern me given it's remodeling benefits.

As we discussed in another thread, my girl and I are going to be trying to get pregnant soon. So I would be fine with dropping my 120mg TRT to 80mg and then eventually just coming off and seeing if I could get restarted with a legit PCT. Is there any specific reason you think dropping TRT could help, or is it more of a "it's the only thing we haven't tried" sort of thing?

I have had 5 cardiac MRIs at this point. The last one I had was in 2017 which showed my best EF to date...LVEF 59% and RVEF 56%. But also my largest volumes to date...LVEDD 285ml and RVEDD 331ml.


You had 5 MRI's, numerous echos, you are concerned about every small variation in measurement with for as far as i can tell the slightly abnormal measurements arent producing a meaningful negative clinical response.

You could change a medication up and then get another echo and that will show a higher EF and you may suspect its the new med...or maybe 2 echos from now it will lower and it will show 2 more mm of dialation and there may be a new study showing the med doesnt work for that and you may be concerend about your E2 levels being out of range and producing another effect on the subendocardial region and getting some remodeling there.

Unless you have a real clinical reason to be on TRT as in you are not able to get your natural production back into range then i would suggest someone with your clinical history and personality be off TRT and all meds and start with a fresh clean slate. That way any future changes cannot be attributed to a particular med or supplement.

You are not in sustained clinical heart failure at the moment. u do not need an AICD. Your MRI's showed good EF. We have discussed interobserver variablity with respect to echo reads. Many of those findings may not mean anything but you will worry about them until your next scan.

In my opinion..... and do not take this the wrong way bro...you should not be on any meds or supplement you do not need to be on. That would include TRT, cycling, GH, stims, etc.
 

warlock

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Krill seems to be better for lipids from my experiences but high dose fish oil has more omega 3's and that's what the heart and brain really need. Krill provides very little omega 3's. 3.5g and up omega 3s is where fish oil really shines. More seems to be better. Carlson, Viva, and Nordic Naturals are good fish oil brands.



I'd double that dose and Swanson seems to be solid.

Thanks nothuman. That study is gold and for such cheap supplement it seems like a no-brainer to me. I'm about to order some selenium now. Thanks

As far as the 3.5g of omega 3's, do you mean 3.5g combining both EPA and DHA? Or do you mean, if a pill of fish is 1000mg, take between 3 and 4 pills?
 

gotgame

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Just posted a link about the benefits of combining coq10 and selenium together up above.

I don't feel comfortable contradicting GotGame as he has helped me a lot over the years too, and I still plan to bug him at some point again about it, but I would be worried if you can't restore natural testosterone levels. We know that a T deficiency increases the risk of heart attacks. It's not hard to find evidence on that one. Anecdotally, many people on TRT seem to be fine getting their women pregnant. Dante's fertility protocol seems to be quite successful from what I hear (can't speak from personal experience though).

I hear you on the supplements. It adds up and it's discouraging to not see the improvements you are hoping for. I haven't seen echocardiogram improvements either yet, but I don't want to come off in case they are keeping things from getting worse. The studies on many of them seem pretty good though so there is zero negative risk of taking some of them.

I am more and more convinced eliminating grains is a huge help the more I listen to podcasts about gut health. Hormones are also huge. Have you checked your DHEA levels? A deficiency in that is very much bad for the heart. Thyroid (free T3) is too (as we have talked about before). I feel like you have a blind spot somewhere that you might never have been tested for. Tested for SIBO? A good functional medicine doctor would be your best bet at this point. Conventional cardiologists understand how to read heart tests but most of them can't tell you how to ultimately be healthier.

Always up for a good discussion with you my friend. I dont want Pumped to be walking around for years with a test level of like 30ng/dl.. that would be bad for many things including his heart. but if he is able to recover his natural levels for someone with his history and level of concerns i think a clean slate approach may be best.
 

gotgame

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Please note: When im talking about cardiac remodeling and using ARB's which i am a big fan of, as well as other meds. Most of my comments are with respect to weight training induced changes and AAS use. In this specific discussion we are talking about prior AAS use in a young patient without any comorbidities, that im aware of, who is as far as i can tell is asymptomatic, and on TRT at age 29 and has been for years. Patient has seen multiple " specialists" and had numerous imaging studies including cardiac MRI which i consider to be the gold standard ( i do cardiac imaging).

So when reading my above comments dont try to extrapolate that out to other clinical scenarios. In many guys TRT is a great choice. I am on TRT and i am not aware of any negative cardiac effects of legit TRT doses. However my recommendations above extend beyond just pubmed studies on TRT and cardiac effects for multiple reasons.
 

Bio

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Pumped and GotGame my earlier reference to why you (Pumped) were using Arimidex with TRT. I know the standards have changed but on some panels 45 to 50 is considered in range for estradiol. What I'm getting at is, estrogen has cardiovascular protective properties. Is there a chance that using an AI when you're in range or barely out of range had a negative effect on your heart/cardiovascular system?
 

nothuman

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Thanks nothuman. That study is gold and for such cheap supplement it seems like a no-brainer to me. I'm about to order some selenium now. Thanks

As far as the 3.5g of omega 3's, do you mean 3.5g combining both EPA and DHA? Or do you mean, if a pill of fish is 1000mg, take between 3 and 4 pills?

If 1 pill is 1g omega 3's, take 3 a day minimum for daily use (or more/less depending on your fish intake) or more if you want to take a more aggressive approach.
 

MethodAir

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Just posted a link about the benefits of combining coq10 and selenium together up above.

I don't feel comfortable contradicting GotGame as he has helped me a lot over the years too, and I still plan to bug him at some point again about it, but I would be worried if you can't restore natural testosterone levels. We know that a T deficiency increases the risk of heart attacks. It's not hard to find evidence on that one. Anecdotally, many people on TRT seem to be fine getting their women pregnant. Dante's fertility protocol seems to be quite successful from what I hear (can't speak from personal experience though).

I hear you on the supplements. It adds up and it's discouraging to not see the improvements you are hoping for. I haven't seen echocardiogram improvements either yet, but I don't want to come off in case they are keeping things from getting worse. The studies on many of them seem pretty good though so there is zero negative risk of taking some of them.

I am more and more convinced eliminating grains is a huge help the more I listen to podcasts about gut health. Hormones are also huge. Have you checked your DHEA levels? A deficiency in that is very much bad for the heart. Thyroid (free T3) is too (as we have talked about before). I feel like you have a blind spot somewhere that you might never have been tested for. Tested for SIBO? A good functional medicine doctor would be your best bet at this point. Conventional cardiologists understand how to read heart tests but most of them can't tell you how to ultimately be healthier.

I agree with @nothuman , the findings do not warrant dropping TRT...

I'd add injectable carnitine and syntheselen to the mix, in addition to the arjuna and fish oil etc...
 

MethodAir

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Just curious, how would syntheselen help in this case?

The cardiologist Stephen Sinatra states:

"The 'awesome foursome', consisting of coenzyme Q10 (CoQ10), L-carnitine, D-ribose, and magnesium, individually and collectively help increase energy, or ATP, production in your body by supporting mitochondria within cells"

Syntheselen contains: Magnesium Aspartate, Potassium Aspartate, Heptaminol HCL, Adenosine Triphosphate (ATP), Uridine Triphosphate, Sodium Selenite, Cyanacobalamin (B12)
 

Reno911

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here is a question for you...........did you ever have your heart checked BEFORE you started cycling. see what i'm getting at here.

Was wondering the same thing. Not sure it's been mentioned in this thread or other ones discussing his condition.
 

Sides

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This seems to be a point of significant disagreement. Most cardiologists don't know what to think about my TRT usage. Dr. O'Connor thinks I'll need to be on it forever. GotGame has suggested coming off of it before. You and others voiced concern that the low T would hurt me. I do not know.

I am, however, going to need to come off to try to get my girl pregnant in the next few months, at which point I was curious to see what I could get my natural levels to anyway....so it seems an apt time to try coming off and getting endogenous production restarted.

I just wanted to note, as others have, that you don't need to come off TRT to get your girl pregnant. I and many other men have restored fertility while staying on TRT doses and adding HCG and HMG or FSH. And I am a 52-year-old man who has been on test and other anabolic steroids for over 28 years now, while you are much younger and you have been on test for a much shorter period of time. Age and duration of testosterone or other AAS use seem to be the biggest factors in how quickly you can recover your fertility:


Personally, I went from being azoospermatic to 7 million total motile sperm count by adding HCG for 7 months, then added HMG for 4 months to raise my sperm count to 31 million by the time my wife and I did IVF. And I stayed on test the entire time. If you look at Figure 1 in the study I posted above, I did much better than would have been expected of a man of my age and duration of testosterone usage by staying ON test and adding in HCG and HMG, than most of those men did by going OFF test and adding in HCG/SERM's, as comparatively few of those men even reached a total motile sperm count of 5 million.

Of course, how HCG and HMG/FSH would effect your cardiac health is unknown. But compared to the known cardiac risks of having low testosterone, personally I would prefer to stay on TRT and add in HCG and HMG/FSH rather than go off.

Just a personal opinion and thought, and I wish you all the best with your current situation.
 

gotgame

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Pumped and GotGame my earlier reference to why you (Pumped) were using Arimidex with TRT. I know the standards have changed but on some panels 45 to 50 is considered in range for estradiol. What I'm getting at is, estrogen has cardiovascular protective properties. Is there a chance that using an AI when you're in range or barely out of range had a negative effect on your heart/cardiovascular system?

Thats was i was sorta getting to in a prior post... but i left out the word AI because i didnt proof read. I was saying that next thing you know we will be going down the rabbit hole of will an AI result in decreased local estrogen effects and result in some study showing negative effects in the subendocardial vasculature. I dont think it would but that will be the next concern among other things.

Ill bow out here. Ill leave it as I dont know of any studies showing negative TRT effects on the heart but due to the above mentioned reasons in my other posts i think we will be right back here either 6 months from now or next year again brainstorming some more over variabilities in measurements and the more you add to the mix the more challenging it will be figure out what is going on.

Due to the nature of this board guys inherently want to stay on TRT and take supplements. Sometimes you need to say do i REALLY need to be on TRT. If you dont know the answer to that then maybe take a step back and see if you can recover...at least if you are 29 and not if your 60.
 

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