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Worst Heart Scan (Echo) To Date

  • Thread starter Deleted member 106824
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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.

Yes, my echos and MRIs have been substantially different. For example, in February of 2016 I had an echo showing 40% ejection fraction and 62mm LVEDD. In March of 2016 I had an MRI showing 55% ejection fraction and "mildly dilated right and left ventricle""left and right atrium normal in size".

So the discrepant echo vs MRI results have added to my confusion and frustration. Echos are much more common, much cheaper, and much simpler to perform. I do not know which is technically more accurate. Both, however, show LV enlargement

LVEDD on 5 MRIs: 267ml, 272ml, 241ml, 269ml, 285ml
RVEDD on 5 MRIs: N/A, 264ml, 255ml, 300ml, 331ml
EF on 5 MRIs: 50.7%, 49/49%, 55/54%, 47.8/40%, 59/56%

So as you can see, the last MRI had the best EF to date. This was after GotGame had told me to take Valsartan, so I assumed the notable increase was due to that. However, as you can also see, my volumes were the largest in the last MRI and therefore large volume + higher EF = massive stroke volumes (168/185ml).


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.

The paper you linked only showed CoQ10 + Selenium vs placebo....this doesn't demonstrate any reason why selenium + CoQ10 is beneficial over simply CoQ10 alone, or better yet Ubiquinol alone. Selenium is also not very difficult to get in the diet and/or a multivitamin. Looking at my blood work, normal selenium is noted to be 120-300. All four times I've tested it my levels have been 170-200.

This is the fish oil I take: https://www.amazon.com/gp/product/B000MXG1G2/ref=ppx_yo_dt_b_asin_title_o07_s00?ie=UTF8&psc=1 2 pills per day
Along with this ubiquinol https://www.amazon.com/gp/product/B073VK5TP4/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1 average of 1.5 pills per day


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 have inflammatory bowel disease(IBD....NOT the same as IBS). So certainly gut issues, no cure. I do what I can for it.

DHEA is usually low normal

I just finished a serious diet, so I'm sure thyroid levels were low. The diet is over so those will be naturally rising. I tried to get my levels tested but the lab fucked up the test so I have to redo them which I did this morning but I've been done dieting for a week now and eating a lot more, so it won't show how low they got. Regardless, thousands of people diet and have temporarily lower thyroid levels and it certainly isn't causing dilated cardiomyopathy. My FT3 levels are usually pretty normal.

I appreciate the input :)


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

I know what you're getting at and no I did not. All I can tell you is they ran genetic tests on me and I have no predispositions to cardiomyopathy. My brother had an echo that was completely normal. My father had an echo that was completely normal. I'd be very surprised if this was not in response to something I've taken (whether it be the AAS or excessive thyroid at one point).



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?

I don't think the anastrazole is responsible for any of this, no...even on it I keep my estrogen at a very normal level of 15-20. I also didn't start taking anastrazole with my TRT until 2017, well after this issue was present. Having said that, I don't think higher levels of say 30-50 are necessarily a big problem and I would like to drop it as it's just one more thing to keep track of.


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...

At this point I don't want to be injecting anything else into my body, especially something from a bodybuilding website lol. I do take fish oil though and would be open to Arjuna again.
 
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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.

No offense taken, I appreciate the input. As you know, between my IBD and the heart issue I'm pretty neurotic with health now and a hypochondriac. There is of course the possibility that my heart has more or less remained the same since 2015 when whatever damage occurred was done. This was the option I was thankful to accept after my last few....it seemed like my EF was decent and improved, and my dilation was present but stable. If this echo turned out the same as the ones in 2017-2018 I truly would have taken a break from testing for at least a few years and put it in the back of my mind (I admit I'd think about it at times, but I genuinely was feeling better about it). As I've said in the past, ironically I'm pretty relaxed with most other areas of my life....my new car got totaled and I shrugged it off. The health stuff gets me though and I (clearly) have the fear of (another) deteriorating condition on top of my IBD.

I've never taken GH or a lot of stims and never plan to. I have 0-2 cups of coffee per week but that will probably be dropped too. I am definitely open to stopping the TRT and likely need to to get my girl pregnant anyway.

In your opinion, a legit PCT while staying on the Valsartan and basic heart supplements like Ubiquinol, fish oil, etc would be the most reasonable action?


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.

Appreciate the clarification, and just to clarify myself, I have had inflammatory bowel disease since I was 20.

Symptom wise, i get occasional chest pressure or jolts but no test ever showed anything. Have worn a holter monitor for 2 weeks three separate times, showed nothing.

The only other symptom I could even mention is I seem to be out of breath easily at the start of exercise, yet no real exercise intolerance. What I mean is, I will walk up a flight of stairs and feel winded....but can do stairs as cardio for half an hour and only be at 110bpm or do sprints up stairs and feel a normal response to the exercise. As I mentioned earlier in the thread I went hiking with friends and almost immediately felt like I had labored breathing....yet an hour into hiking I was only at 80bpm while everyone else was at 100bpm. I guess another way to say it is I have no issues exercising, but my subjective effort seems harder and more labored at the initial low stages. Again my Vo2max was 49 in 2017 and I'll be doing another test soon.


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.

Well I hate to see you duck out GotGame, but I greatly appreciate you chiming in and stating your piece. I do understand what you're saying. It's kind of the only thing not tried. And to your point....if it works and my heart values look better, great. If it doesn't and my heart stays the same then I can go back on TRT.

To everyone resistant to me going off TRT, as GotGame admitted, I have not seen any evidence to indicate negative echocardiogram changes due to TRT. However, as far as I can recall the negative effects of low testosterone on the heart are also not so much related to dilated cardiomyopathy or my current issues but rather atherosclerotic issues (please correct me if I'm wrong). So while I certainly do not want to have chronically low test levels for years on end, I would think trying to restore my levels and going without TRT for a year may be useful. I'd love to find that dropping the TRT and AI improved my condition.

https://www.ncbi.nlm.nih.gov/pubmed/25632043
I wouldn't put a ton of stock into this study given it's just in rodents, but this showed suppressing DHT levels decreased cardiac dilation and improved LV dysfunction.
 

gotgame

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No offense taken, I appreciate the input. As you know, between my IBD and the heart issue I'm pretty neurotic with health now and a hypochondriac. There is of course the possibility that my heart has more or less remained the same since 2015 when whatever damage occurred was done. This was the option I was thankful to accept after my last few....it seemed like my EF was decent and improved, and my dilation was present but stable. If this echo turned out the same as the ones in 2017-2018 I truly would have taken a break from testing for at least a few years and put it in the back of my mind (I admit I'd think about it at times, but I genuinely was feeling better about it). As I've said in the past, ironically I'm pretty relaxed with most other areas of my life....my new car got totaled and I shrugged it off. The health stuff gets me though and I (clearly) have the fear of (another) deteriorating condition on top of my IBD.

I've never taken GH or a lot of stims and never plan to. I have 0-2 cups of coffee per week but that will probably be dropped too. I am definitely open to stopping the TRT and likely need to to get my girl pregnant anyway.

In your opinion, a legit PCT while staying on the Valsartan and basic heart supplements like Ubiquinol, fish oil, etc would be the most reasonable action?




Appreciate the clarification, and just to clarify myself, I have had inflammatory bowel disease since I was 20.

Symptom wise, i get occasional chest pressure or jolts but no test ever showed anything. Have worn a holter monitor for 2 weeks three separate times, showed nothing.

The only other symptom I could even mention is I seem to be out of breath easily at the start of exercise, yet no real exercise intolerance. What I mean is, I will walk up a flight of stairs and feel winded....but can do stairs as cardio for half an hour and only be at 110bpm or do sprints up stairs and feel a normal response to the exercise. As I mentioned earlier in the thread I went hiking with friends and almost immediately felt like I had labored breathing....yet an hour into hiking I was only at 80bpm while everyone else was at 100bpm. I guess another way to say it is I have no issues exercising, but my subjective effort seems harder and more labored at the initial low stages. Again my Vo2max was 49 in 2017 and I'll be doing another test soon.




Well I hate to see you duck out GotGame, but I greatly appreciate you chiming in and stating your piece. I do understand what you're saying. It's kind of the only thing not tried. And to your point....if it works and my heart values look better, great. If it doesn't and my heart stays the same then I can go back on TRT.

To everyone resistant to me going off TRT, as GotGame admitted, I have not seen any evidence to indicate negative echocardiogram changes due to TRT. However, as far as I can recall the negative effects of low testosterone on the heart are also not so much related to dilated cardiomyopathy or my current issues but rather atherosclerotic issues (please correct me if I'm wrong). So while I certainly do not want to have chronically low test levels for years on end, I would think trying to restore my levels and going without TRT for a year may be useful. I'd love to find that dropping the TRT and AI improved my condition.

https://www.ncbi.nlm.nih.gov/pubmed/25632043
I wouldn't put a ton of stock into this study given it's just in rodents, but this showed suppressing DHT levels decreased cardiac dilation and improved LV dysfunction.

Your a good guy Pumped and i know you have concerns about this, in my opinion more so then is probably warranted given the findings and your symptoms.

Im not sure you need to be on TRT. Maybe you do...but given your concerns which are sometimes out of proportion to the actual findings( read hypochondriac) you are the type of person who does not need more things to worry or wonder about. If you stay on TRT..and you are trying to restore fertility and lets say you take HCG.. your next concerns ( hypothetically) will be the effect of HCG on the TRH receptor and increased thyroid activity on heart function and then relate that to your next cardiac scan and then we will be discussing that if your next scan comes back worse.

I think you are the kinda guy who should only be taking the minimum amount of meds/supplements. My recommendations for coming off TRT have more to do with that then anything medical to directly link TRT to cardiac issues. With you a less is more approach should be used.

Id try to restore natural test production and id stay on ubiquinol. I dont feel too strongly one way or the other about the ARB at this point. I dont think it could hurt but im also not convinced its needed in an otherwise healthy guy should shouldnt have many reasons to have abnormal remodeling. Our discussion last year is still valid from an academic standpoint on the -sartan recommendation.

You are not the type of person who i think at this point with your clinical history and personality should be throwing more meds/supplements into the mix chasing imaging measurements.


Again, to ward off any PM's from guys on TRT...i do not know of any studies linking true TRT doses to cardiac function issues and that is not what i am suggesting in my above discussions.

I really dont have much more I can contribute to this discussion. I will ofcourse always look at future imaging reports and comment when appropriate.
 

danieltx

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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.

I know what you're getting at and no I did not. All I can tell you is they ran genetic tests on me and I have no predispositions to cardiomyopathy. My brother had an echo that was completely normal. My father had an echo that was completely normal. I'd be very surprised if this was not in response to something I've taken (whether it be the AAS or excessive thyroid at one point).

The bigger point here is heart disease is the leading cause of death in the United States - the vast majority of those people never used PEDs and many had no genetic predispositions.

Blaming yourself for this is doing no favors to your mental or physical well-being.
 

KillerStack

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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...

Regarding the l-carnitine, recently I came across meldonium/mildronate sold as a "supplement" and decided to try it. Guys may recall that this is the Russian compound tennis player Sharapova tested positive for. She claimed she didn't notice it had been added to the banned list, she had been using it for 10 years. It is a heart failure drug in Russia and Eastern Europe. Tons of athletes were quickly popped for it, whole teams of hockey players and across all sports etc. It was claimed by some docs that it didn't enhance performance whatsoever, and it was only used to protect the heart of elite athletes undergoing hard training. Both of those comments might be wrong, why does a healthy athlete need heart protection from normal training and why would they take it if it wouldn't enhance performance? :D

Anyway, the interesting thing, to me, about this drug is the purported mechanism of action. It blocks the biosynthesis of carnitine in the heart and switches the metabolism from using fat as fuel to using carbs as fuel. This us thought to strengthen the heart as carbs are a more efficient fuel. At least that's how I understood the write-ups on the net. It's also supposed to enhance blood flow and nitric oxide or whatever.

I thought this might be mildly interesting, especially the carnitine connection.:)
What I noticed is I get low blood sugar easier, so perhaps it has increased carb metabolism. Perhaps feel a higher exercise tolerance as well. Who knows, this might be a protective compound for juicers as well, though I wouldn't dare to draw that conclusion automatically. The inventor of the drug was critical of the banning of it, said you shouldn't stop athletes from protecting their health, it's a human rights violation.:D
 

KillerStack

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Pumped, I know close to nothing about it, but I noticed you listed Pramipexole. How much of it did you use? All I remember is that and caber being potentially connected to heart issues. I don't mean to add to your worries, and there is probably no connectionin your case, but I do remember especially caber being warned about as being potentially harmful.
 

MethodAir

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Regarding the l-carnitine, recently I came across meldonium/mildronate sold as a "supplement" and decided to try it. Guys may recall that this is the Russian compound tennis player Sharapova tested positive for. She claimed she didn't notice it had been added to the banned list, she had been using it for 10 years. It is a heart failure drug in Russia and Eastern Europe. Tons of athletes were quickly popped for it, whole teams of hockey players and across all sports etc. It was claimed by some docs that it didn't enhance performance whatsoever, and it was only used to protect the heart of elite athletes undergoing hard training. Both of those comments might be wrong, why does a healthy athlete need heart protection from normal training and why would they take it if it wouldn't enhance performance? :D

Anyway, the interesting thing, to me, about this drug is the purported mechanism of action. It blocks the biosynthesis of carnitine in the heart and switches the metabolism from using fat as fuel to using carbs as fuel. This us thought to strengthen the heart as carbs are a more efficient fuel. At least that's how I understood the write-ups on the net. It's also supposed to enhance blood flow and nitric oxide or whatever.

I thought this might be mildly interesting, especially the carnitine connection.:)
What I noticed is I get low blood sugar easier, so perhaps it has increased carb metabolism. Perhaps feel a higher exercise tolerance as well. Who knows, this might be a protective compound for juicers as well, though I wouldn't dare to draw that conclusion automatically. The inventor of the drug was critical of the banning of it, said you shouldn't stop athletes from protecting their health, it's a human rights violation.:D

Interesting post. To your point, testosterone and AAS derivatives can significantly improve carb sensitivity...under some conditions, I feel they can be used as a cardiac protective/performance mechanism for recovery and training overload.
 

MethodAir

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Pumped, I know close to nothing about it, but I noticed you listed Pramipexole. How much of it did you use? All I remember is that and caber being potentially connected to heart issues. I don't mean to add to your worries, and there is probably no connectionin your case, but I do remember especially caber being warned about as being potentially harmful.

Yea, caber was loosely associated with heart valve complications I believe.
 

MethodAir

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Regarding the l-carnitine, recently I came across meldonium/mildronate sold as a "supplement" and decided to try it. Guys may recall that this is the Russian compound tennis player Sharapova tested positive for. She claimed she didn't notice it had been added to the banned list, she had been using it for 10 years. It is a heart failure drug in Russia and Eastern Europe. Tons of athletes were quickly popped for it, whole teams of hockey players and across all sports etc. It was claimed by some docs that it didn't enhance performance whatsoever, and it was only used to protect the heart of elite athletes undergoing hard training. Both of those comments might be wrong, why does a healthy athlete need heart protection from normal training and why would they take it if it wouldn't enhance performance? :D

Anyway, the interesting thing, to me, about this drug is the purported mechanism of action. It blocks the biosynthesis of carnitine in the heart and switches the metabolism from using fat as fuel to using carbs as fuel. This us thought to strengthen the heart as carbs are a more efficient fuel. At least that's how I understood the write-ups on the net. It's also supposed to enhance blood flow and nitric oxide or whatever.

I thought this might be mildly interesting, especially the carnitine connection.:)
What I noticed is I get low blood sugar easier, so perhaps it has increased carb metabolism. Perhaps feel a higher exercise tolerance as well. Who knows, this might be a protective compound for juicers as well, though I wouldn't dare to draw that conclusion automatically. The inventor of the drug was critical of the banning of it, said you shouldn't stop athletes from protecting their health, it's a human rights violation.:D

Interestingly, the cardiologist Dr. Sinatra recommends the simple sugar d-ribose and l-carnitine for cardiac purposes. The im carnitine route is going to make it a lot more bio-available of course. I suspect they both have a place.
 

nothuman

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Regarding the l-carnitine, recently I came across meldonium/mildronate sold as a "supplement" and decided to try it. Guys may recall that this is the Russian compound tennis player Sharapova tested positive for. She claimed she didn't notice it had been added to the banned list, she had been using it for 10 years. It is a heart failure drug in Russia and Eastern Europe. Tons of athletes were quickly popped for it, whole teams of hockey players and across all sports etc. It was claimed by some docs that it didn't enhance performance whatsoever, and it was only used to protect the heart of elite athletes undergoing hard training. Both of those comments might be wrong, why does a healthy athlete need heart protection from normal training and why would they take it if it wouldn't enhance performance? :D

Anyway, the interesting thing, to me, about this drug is the purported mechanism of action. It blocks the biosynthesis of carnitine in the heart and switches the metabolism from using fat as fuel to using carbs as fuel. This us thought to strengthen the heart as carbs are a more efficient fuel. At least that's how I understood the write-ups on the net. It's also supposed to enhance blood flow and nitric oxide or whatever.

I thought this might be mildly interesting, especially the carnitine connection.:)
What I noticed is I get low blood sugar easier, so perhaps it has increased carb metabolism. Perhaps feel a higher exercise tolerance as well. Who knows, this might be a protective compound for juicers as well, though I wouldn't dare to draw that conclusion automatically. The inventor of the drug was critical of the banning of it, said you shouldn't stop athletes from protecting their health, it's a human rights violation.:D

Interesting stuff. I have also seen it being sold on Russian online pharmacies and was curious about it because of Sharapova.
 
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I appreciate that GotGame and understand where you're coming from, thanks again :)

Pumped, I know close to nothing about it, but I noticed you listed Pramipexole. How much of it did you use? All I remember is that and caber being potentially connected to heart issues. I don't mean to add to your worries, and there is probably no connectionin your case, but I do remember especially caber being warned about as being potentially harmful.

I used it for a brief period about 5-6 years when I was on 19-nors
 

nothuman

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I want to post this link that I PM'd you so others can benefit.



Updated (1/2020) heart failure protocol might include:
  • 5,000 mg of D-ribose powder 3 times daily (15,000 mg total per day)
  • 3,000 mg a day of taurine (a low-cost supplement)
  • 200-600 mg of ubiquinol (dose can be based on blood test results)
  • 250-500 mg a day of nicotinamide riboside
  • 500 mg a day of magnesium
  • 1,000 mg a day of carnosine
  • Senolytic protocol of your choice
 

Knight9

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I want to post this link that I PM'd you so others can benefit.



Updated (1/2020) heart failure protocol might include:
  • 5,000 mg of D-ribose powder 3 times daily (15,000 mg total per day)
  • 3,000 mg a day of taurine (a low-cost supplement)
  • 200-600 mg of ubiquinol (dose can be based on blood test results)
  • 250-500 mg a day of nicotinamide riboside
  • 500 mg a day of magnesium
  • 1,000 mg a day of carnosine
  • Senolytic protocol of your choice
Mag Glycinate would be my suggestion. If Taurate just provides Taurine...then it's probably not warranted due to Glycinates optimal absorption rate. Threonate is great too but more for brain health.
No curcumin or astaxanthin? Did we omit Arjuna, Pycnogenol, Cardiovascular garlic extract formula? Im asking because Im sincerely wondering how some of what you listed pertains but some of what I mentioned doesn't?

What senolytic protocols are options?
 

nothuman

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Mag Glycinate would be my suggestion. If Taurate just provides Taurine...then it's probably not warranted due to Glycinates optimal absorption rate. Threonate is great too but more for brain health.
No curcumin or astaxanthin? Did we omit Arjuna, Pycnogenol, Cardiovascular garlic extract formula? Im asking because Im sincerely wondering how some of what you listed pertains but some of what I mentioned doesn't?

What senolytic protocols are options?

That is copied from Life Extension. I don't know why they decided to include the ones they did instead of you ones you listed. I'd say they're all helpful and important though.
 

Kaladryn

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I would definitely recommend 10mg/day maximum for sure of medically monitored TRT, blasting and/or 'high trt' isn't worth it with heart issues. I'd find a good cardiologist if you don't already have one and confirm that recommendation also, he might want you to go off completely. Focus your diet and training on cardiovascular health.
 

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I would definitely recommend 10mg/day maximum for sure of medically monitored TRT, blasting and/or 'high trt' isn't worth it with heart issues. I'd find a good cardiologist if you don't already have one and confirm that recommendation also, he might want you to go off completely. Focus your diet and training on cardiovascular health.

Do you think there's a legitimate medical reason a good cardiologist would want him off completely? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512682/ it looks like all of the evidence points to testosterone not being implicated in heart problems
 
D

Deleted member 106824

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I would definitely recommend 10mg/day maximum for sure of medically monitored TRT, blasting and/or 'high trt' isn't worth it with heart issues. I'd find a good cardiologist if you don't already have one and confirm that recommendation also, he might want you to go off completely. Focus your diet and training on cardiovascular health.

I'm interested in trying out the 10mg/day method. I haven't blasted in over 5 years now. Most of that 5 years has been 80mg broken up into 4x20mg, with about 1.5 years of it being at 120mg (4x30mg, where it is currently). 120mg + 1mg adex has me at 800-1000 total and free T over the limit and E2 around 15-20. 80mg + 1mg adex has me at 700-800 total and free test upper normal, E2 around 15-20. 80mg with no AI has me only at 500 or so, with E2 around 40-45. So I'd be interested to see if I feel any difference with 10-12mg ED and no AI. I'd guess still around 500-600 total and maybe mid to upper mid free test.

Would also hopefully make the transition to coming off a bit easier.
 
D

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Just wanted to mention this here. I went to a urologist to get HCG and get started on a fertility protocol. He said it wasn't his area (.....?) so he referred me to an endocrinologist. I guess the endo learned about my background and called me on his cell, just chatted for an hour. Literally the first doctor I've ever talked to in the last 10 years that wasn't from a bodybuilding forum who was incredibly knowledgeable in this area. We went back and forth on the various studies, my blood work and history, he's on TRT and knows Dr. Thomas O'Connor (said he's seen as a little bit of an outcast among traditional docs but how that doesn't mean he's not right), told me to text him with any questions and he would help me get in sooner with any of the doctors at this hospital if needed. Felt like I was talking to GotGame with his knowledge lol.

In any case, he went over the various protocols to restore fertility and it's a lot of what we discussed in another thread on here. As far as the heart condition, his stance is that there's no evidence it could be related to the TRT. He said there would be concerns if blood pressure was high, if Hb/Hct was high, if I had sleep apnea from it, etc as those are ways TRT could indirectly potentially cause a cardiomyopathy but all of those have been normal for me except minor sleep issues in the past. He mentioned that perhaps (with obviously no way to prove it) some mild sleep apnea in the past, or inflammation from my inflammatory bowel disease could play a role in the cardiomyopathy, or it could be a variant of normal, or simply idiopathic...of course speculative at this point and no way to prove anything.

This doesn't change much, the plan is still to lower my dose and eventually come off at least for a period of time as GotGame suggested (if for no other reason than to get pregnant) but I thought people reading along might be interested in this.
 

Sides

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Just wanted to mention this here. I went to a urologist to get HCG and get started on a fertility protocol. He said it wasn't his area (.....?) so he referred me to an endocrinologist. I guess the endo learned about my background and called me on his cell, just chatted for an hour. Literally the first doctor I've ever talked to in the last 10 years that wasn't from a bodybuilding forum who was incredibly knowledgeable in this area. We went back and forth on the various studies, my blood work and history, he's on TRT and knows Dr. Thomas O'Connor (said he's seen as a little bit of an outcast among traditional docs but how that doesn't mean he's not right), told me to text him with any questions and he would help me get in sooner with any of the doctors at this hospital if needed. Felt like I was talking to GotGame with his knowledge lol.

In any case, he went over the various protocols to restore fertility and it's a lot of what we discussed in another thread on here. As far as the heart condition, his stance is that there's no evidence it could be related to the TRT. He said there would be concerns if blood pressure was high, if Hb/Hct was high, if I had sleep apnea from it, etc as those are ways TRT could indirectly potentially cause a cardiomyopathy but all of those have been normal for me except minor sleep issues in the past. He mentioned that perhaps (with obviously no way to prove it) some mild sleep apnea in the past, or inflammation from my inflammatory bowel disease could play a role in the cardiomyopathy, or it could be a variant of normal, or simply idiopathic...of course speculative at this point and no way to prove anything.

This doesn't change much, the plan is still to lower my dose and eventually come off at least for a period of time as GotGame suggested (if for no other reason than to get pregnant) but I thought people reading along might be interested in this.

Damn, how lucky are you. You found the mythical rainbow unicorn...a doctor (endo) who actually really knows something about our world, and better, wants to apply that knowledge. A very rare thing. I'm so envious. That's great, and I hope he can help you.

FWIW, I've had a phone consult with Dr O'Connor, and while he's well-intentioned, I found him to be too much of a salesman...but then, after all, he is running a business, isn't he? And the name of the game is to make money. So I can't blame him, but even so I was disappointed when he had no special knowledge to share beyond "100mg every 5 days."

And my endocrinologist is Dr Shalender Bhasin, of the famous 600mg test studies. And while I expected great things of him, he just wants to put me on the same 100mg per week cookie cutter protocol that everyone else from the non-TRT world is on. So I've been very disappointed with doctors who you would think would know something about our world.

And yet I keep on hoping for answers...But I hope you are fortunate enough to find the answers for you.
 
D

Deleted member 106824

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Damn, how lucky are you. You found the mythical rainbow unicorn...a doctor (endo) who actually really knows something about our world, and better, wants to apply that knowledge. A very rare thing. I'm so envious. That's great, and I hope he can help you.

FWIW, I've had a phone consult with Dr O'Connor, and while he's well-intentioned, I found him to be too much of a salesman...but then, after all, he is running a business, isn't he? And the name of the game is to make money. So I can't blame him, but even so I was disappointed when he had no special knowledge to share beyond "100mg every 5 days."

And my endocrinologist is Dr Shalender Bhasin, of the famous 600mg test studies. And while I expected great things of him, he just wants to put me on the same 100mg per week cookie cutter protocol that everyone else from the non-TRT world is on. So I've been very disappointed with doctors who you would think would know something about our world.

And yet I keep on hoping for answers...But I hope you are fortunate enough to find the answers for you.

I was definitely grateful to be talking with him and now seem to have him in my corner, we'll see what comes of it.

At the same time, I don't think you or I are going to find answers beyond what we can find online through the studies and what guys like GotGame can tell us. We all have access to the same info (some like GotGame just know a lot more of it and have formally studied it), and as this new doc I met and Dr. O'Connor would tell you we simply don't have data on a lot of this stuff. For example, this endo I spoke with mentioned how clomid would likely speed things up in terms of recovery, but he will often just taper guys' test down (said the fastest way would be to just drop it but no patient wants to do that) and take a long time to get them back online because technically the guidelines don't recommend clomid and it's off label use. That is to say, a lot of these guys have the same limited evidence we're aware of in terms of the studies and after that it's just based on what they have seen in their own practice. I don't know if I would see it as a negative that Dr. O'Connor or Dr. Bhasin starts most men on the same dosage, assuming they then follow up with blood work and make adjustments as necessary based on results.

I too find Dr. O'Connor a little salesy, definitely cocky in terms of his intelligence and knowledge when talking to him 1 on 1, but I'd rather have someone who knows their stuff and is cocky in a situation like this over someone more humble but less informed (if I had to choose between the two). At the end of the day it is definitely a business and it behooves them to make their medical acumen seem very specialized.
 

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