Worst Heart Scan (Echo) To Date

[Deleted member 106824]

Old Thread: https://www.professionalmuscle.com/forums/index.php?threads/1-year-heart-update.127409/page-25

Some of you have followed along. In 2014 at 23 years old I got an echo done, showed somewhat reduced ejection fraction (50%) and dilation (61mm). I was on my 2nd year of blasting and cruising at that point. So after 3 years of blasting and cruising I dropped down to just TRT (125mg) summer of 2015 and when I retested in the fall of 2015 it was worse (40% EF, 63mm dilation). I'm not very big. I was around 200lb at the time. I don't lift unusually heavy weights. I do not have thickening of my heart walls at all. late 2016 I started Valstartan (angiotensin receptor blocker). TRT was dropped to 80mg. New echo in 2017 showed ejection fraction up to 56% and dilation around 60mm. OK at least in the right direction. 2018 showed EF again around 55% and dilation at 61mm.

Bumped TRT back up to 120mg in spring of 2019. Fall of 2019 showed EF at 50% and dilation at 61mm. This is slightly worse but I figured within the margin of error. I almost didn't get an echo this year as I figured maybe I was just being too much of a hypochondriac and I should let it go. Well I got one, and EF is now down to 46% and dilation is the highest it's ever been at 63.1mm.

Results:

• The left ventricle is mildly dilated. Normal left ventricular wall thickness. There are no segmental wall motion abnormalities. Mildly decreased left ventricular ejection fraction. The left ventricular ejection fraction is 46% by 3D echocardiography.
• The estimated LV filling pressure is normal.
• The right ventricle is mildly dilated. There is normal function of the right ventricle.
• The left atrium is moderately dilated.
• The right atrium is mildly dilated.
• There is mild mitral valve leaflet thickening. There is flattening of the mitral leaflets without frank prolapse. There is mild mitral regurgitation.
• The aortic valve is trileaflet. There is trivial thickening of the aortic valve. There is trivial calcification of the aortic valve. There is normal excursion of the aortic valve. There is no aortic stenosis. There is trace aortic regurgitation.
• The tricuspid valve is normal. There is trace tricuspid regurgitation. The pulmonary artery systolic pressure is normal. PASP 25 mmHg.
• The inferior vena cava is dilated (diameter >21 mm) and decreases >50% in size with inspiration, suggesting an elevated right atrial pressure of 8 mmHg (range 5-10 mmHg).

"

There are some very intelligent doctors on this forum, I'm hoping to get some input here. I was very unimpressed with my new doctor. My last one was highly qualified and worked with professional athletes but left the hospital. This woman did not have a background with athletes and certainly not anyone who used AAS in the past. She said she recommends no one (even completely healthy individuals) lift heavy weights, at which point I knew we were not going to have a productive visit.

I just got these results, and after thinking maybe this was behind me and I had a normal EF and dilation for someone into fitness I think it's now pretty clear this is pathologic and not just physiologic. I'd love to hear some informed feedback and suggestions.

What I take:
-80mg Valsartan
-120mg TRT
-1mg Arimidex
-300mg Ubiquinol
-6g Citrulline
-3g fish oil
-1500mg BCM-95 Curcumin

I am going to drop TRT back down to 70-80mg with ED dosing. But to be honest I'm not seeing literature to support that TRT could be causing this, at all really. Would be great if I have my answer, and it does seem worse since bumping my TRT up to 120mg, but this just seems very unlikely to me to be the cause. My levels are just upper level of normal, with free test slightly above normal.

I am also wondering if a beta blocker would be useful at this point given their greater ability to reverse cardiac remodeling, but my HR and BP are already so low (100/64 and 45bpm at the office).

I am going to get a stress echo and VO2 max test done as well. My one in 2017 showed a normal response to exercise but my resting echo is showing a 10% lower EF than in 2017.

Any input is appreciated. I realize I am not going to die tomorrow with these results, but at 29 years old this is not trending well and I'm feeling pretty sick at the moment seeing this compared to 1-2 years ago.

 

[Bio]

I'm not going to attempt to comment on your situation but I do have a question. Why are you taking Arimidex?

 

[Deleted member 106824]

I'm not going to attempt to comment on your situation but I do have a question. Why are you taking Arimidex?

My estradiol is around 45 without it on 80mg of TRT, and around 50 without it while on 120mg TRT.

I am going to drop my TRT down to 70-80mg with every day dosing soon, and ideally that will put estradiol in the 30-40 range in which case I'd like to come off arimidex.

That will bring my total test to only around 500ng/dl....but I'm fine with that if it can improve my health at all.

Highly regret ever touching gear. When all is said and done I'll have maybe 0-5lb more muscle than if I stayed natural, and a lifetime of anxiety and regret from the consequences.

 

[Needmassquick]

I am sorry brother I hope someone here can help

 

[Bio]

45 to 50 is still in the normal range.

 

[Deleted member 106824]

45 to 50 is still in the normal range.

Normal EF is 55-70%. Normal Left Ventricular End Diastolic Dimension is <55mm. Mine are 46% and 63.1mm, respectively.

In the case of extremely conditioned endurance athletes you will sometimes see dilation to this extent and a resting EF at this level. I am not remotely a highly conditioned endurance athlete. And even in that population it's rare and on the extreme end.


Edit: Sorry, I thought you were referring to my ejection fraction. I just realized you're talking about estradiol. 45-50 is elevated on normal tests. I would agree though that it's not that high, and when I lower my TRT I would like to drop my arimidex as well.

 

[Luv2test]

Compared to most, I don’t know jack shit about cardiac issues like this, but from a gym bro/chat room aficionado, it sounds like there are not a lot of upsides to aromatase inhibitors. If you have a trt dr. who’s prescribing it, maybe you can have a conversation and consider dropping it. Probably wouldn’t fix all your problems, but instead of regressing, you may at least break even.

 

[MethodAir]

Old Thread: https://www.professionalmuscle.com/forums/index.php?threads/1-year-heart-update.127409/page-25

Some of you have followed along. In 2014 at 23 years old I got an echo done, showed somewhat reduced ejection fraction (50%) and dilation (61mm). I was on my 2nd year of blasting and cruising at that point. So after 3 years of blasting and cruising I dropped down to just TRT (125mg) summer of 2015 and when I retested in the fall of 2015 it was worse (40% EF, 63mm dilation). I'm not very big. I was around 200lb at the time. I don't lift unusually heavy weights. I do not have thickening of my heart walls at all. late 2016 I started Valstartan (angiotensin receptor blocker). TRT was dropped to 80mg. New echo in 2017 showed ejection fraction up to 56% and dilation around 60mm. OK at least in the right direction. 2018 showed EF again around 55% and dilation at 61mm.

Bumped TRT back up to 120mg in spring of 2019. Fall of 2019 showed EF at 50% and dilation at 61mm. This is slightly worse but I figured within the margin of error. I almost didn't get an echo this year as I figured maybe I was just being too much of a hypochondriac and I should let it go. Well I got one, and EF is now down to 46% and dilation is the highest it's ever been at 63.1mm.

Results:

• The left ventricle is mildly dilated. Normal left ventricular wall thickness. There are no segmental wall motion abnormalities. Mildly decreased left ventricular ejection fraction. The left ventricular ejection fraction is 46% by 3D echocardiography.
• The estimated LV filling pressure is normal.
• The right ventricle is mildly dilated. There is normal function of the right ventricle.
• The left atrium is moderately dilated.
• The right atrium is mildly dilated.
• There is mild mitral valve leaflet thickening. There is flattening of the mitral leaflets without frank prolapse. There is mild mitral regurgitation.
• The aortic valve is trileaflet. There is trivial thickening of the aortic valve. There is trivial calcification of the aortic valve. There is normal excursion of the aortic valve. There is no aortic stenosis. There is trace aortic regurgitation.
• The tricuspid valve is normal. There is trace tricuspid regurgitation. The pulmonary artery systolic pressure is normal. PASP 25 mmHg.
• The inferior vena cava is dilated (diameter >21 mm) and decreases >50% in size with inspiration, suggesting an elevated right atrial pressure of 8 mmHg (range 5-10 mmHg).

"

There are some very intelligent doctors on this forum, I'm hoping to get some input here. I was very unimpressed with my new doctor. My last one was highly qualified and worked with professional athletes but left the hospital. This woman did not have a background with athletes and certainly not anyone who used AAS in the past. She said she recommends no one (even completely healthy individuals) lift heavy weights, at which point I knew we were not going to have a productive visit.

I just got these results, and after thinking maybe this was behind me and I had a normal EF and dilation for someone into fitness I think it's now pretty clear this is pathologic and not just physiologic. I'd love to hear some informed feedback and suggestions.

What I take:
-80mg Valsartan
-120mg TRT
-1mg Arimidex
-300mg Ubiquinol
-6g Citrulline
-3g fish oil
-1500mg BCM-95 Curcumin

I am going to drop TRT back down to 70-80mg with ED dosing. But to be honest I'm not seeing literature to support that TRT could be causing this, at all really. Would be great if I have my answer, and it does seem worse since bumping my TRT up to 120mg, but this just seems very unlikely to me to be the cause. My levels are just upper level of normal, with free test slightly above normal.

I am also wondering if a beta blocker would be useful at this point given their greater ability to reverse cardiac remodeling, but my HR and BP are already so low (100/64 and 45bpm at the office).

I am going to get a stress echo and VO2 max test done as well. My one in 2017 showed a normal response to exercise but my resting echo is showing a 10% lower EF than in 2017.

Any input is appreciated. I realize I am not going to die tomorrow with these results, but at 29 years old this is not trending well and I'm feeling pretty sick at the moment seeing this compared to 1-2 years ago.

What's your blood pressure typically? Trace and mild readings are common...I'd want to know what was causing moderate left atrium dilatation. Heart wall motion is good, a positive sign.

I'd get another echo with a different cardiologist to rule out any potential image/interpretation errors.

 

[gotgame]

i vaguely remember this conversation a year or more ago.

I mean look bro its nothing MAJOR as you had mentioned but it seems to be trending in a way id prefer it didnt. We could have a very scientific discussion about each finding and throw out a bunch of differentials and cite some papers but honestly bro... if this were my heart... id NOT throw more meds at it. If i was able to get off the TRT and meds I would. Id stop them. Do a real PCT. Id stay on the ubiquinol. In maybe a year id get a cardiac MRI or repeat echo.

Thats just what id do...i wouldnt try to justify the TRT and data or what meds do what. Id get a clean slate and rule things out one by one as needed.

If things are still trending down at that point id certainly get a cardiac MRI as that would allow me to pinpoint any issues if there are any. Then and only then would i throw some meds at it with very specific reasons not just kitchen sink approach.

not what u wanna hear i know... but you have a mix of findings some are likely nothing some may be nothing, some may be the development of something but i dunno.

 

[Reno911]

I'm sure you know this already but here's what I would be taking if I was in your situation.

Arjuna
(Life Extension Cardio Peak)

Ubiquinol
-200mg 2-3x daily

Ribose
-10 grams per day

Taurine
-2 grams per day

 

[M@NU]

i am also a bit hypochondric like you. My doc once told me there is a good tolerance margin with every echo done. 5% +- is not something to worry about...
do you have symptoms? how is your cardio regime? strong stimulant use?

 

[Deleted member 106824]

What's your blood pressure typically? Trace and mild readings are common...I'd want to know what was causing moderate left atrium dilatation. Heart wall motion is good, a positive sign.

I'd get another echo with a different cardiologist to rule out any potential image/interpretation errors.

Blood pressure is always low normal. Even when I was on gear I never had elevated BP.

This is excessive, but here are the results from every echo I've ever gotten. As you can see, my worst was 2015-2016. Things seemed to really improve in 2017-2018 once I went on Valsartan but now I'm back to my worst dilation ever and low ejection fraction despite still being on Valsartan:

1. Echo 10/28/2014:​

Weight: 200lb, BP: 116/56
Supplements: 500mg Test, 500mg EQ, 500mg NPP, 1mg Adex EOD, 0.5mg Prami EOD
EF: 50% (> 55)
LVEDD: 60mm (35-55)
LVESD: 45mm (28-38)
LV Wall Thickness: 9mm (6-11)
Septal Wall Thickness: 9mm (6-11)
LA Dimension: 37mm (20-37)
LA area: 28cm2 (9-23)
RA area: 20cm2 (8-20)
E/Em ratio: 2.96 (normal <8; intermediate 8-15; elevated LA pressure > 15)

2. Echo 9/25/2015:​

Weight: 194lb, BP: 110/69
Supplements: 125mg Test, 3g Acetyl L-Carnitine, 1130mg Hawthorn Berry, 200mg Ubiquinol, 2g Taurine, 300mg Magnesium Malate, 10g D-Ribose, 1440mg Abana
EF: 40% (> 55)
LVEDD: 63mm (35-55)
LVESD: 44mm (28-38)
LV Wall Thickness: 8mm (6-11)
Septal Wall Thickness: 7mm (6-11)
LA Dimension: 34mm (20-37)
LA area: 24cm2 (9-23)
RA area: 23cm2 (8-20)
E/Em ratio: 4.05 (normal <8; intermediate 8-15; elevated LA pressure > 15)

3. Echo 2/2/2016:​

Weight: 199lb, BP: 118/63
Supplements: 80mg Test, 6g l-citrulline, 1400mg Arjuna, 1200mg Pycnogenol
EF: 40% (> 55)
LVEDD: 62mm (35-55)
LVESD: 45mm (28-38)
LV Wall Thickness: 8mm (6-11)
Septal Wall Thickness: 8mm (6-11)
LA Dimension: 42mm (20-37)
LA area: 26cm2 (9-23)
RA area: 25cm2 (8-20)
E/Em ratio: 27.7 (normal <8; intermediate 8-15; elevated LA pressure > 15)
Aortic root dimension: 32mm
LV outflow systolic velocity integral: 15cm
RV systolic pressure: 21mmHg
Mitral E-peak: 83cm/sec
Mitral lateral annulus Em: 3

4. Echo 9/5/2017:​

Weight: 189lb, BP: 103/55
Supplements: 80mg Test, 2mg Anastrazole
EF: 56% (3D) EF > 52
LVEDD: 59mm (2D)
LVESD: 39mm (2D)
IVS, leaflet tips: 8mm (2D)
Posterior wall thickness: 12mm (2D)
Left ventricular mass: 233g (2D) 110g/m3
Global peak long strain: -22.5%
LV Stroke volume: 116ml (3D)
LV EDV: 206ml (3D) 97.5ml/m2
EDVi<=79
LV ESV: 90ml (3D) 42.6ml/m2
Max aortic dimension: 3.3cm 1.56 cm/m2
Left atrium diameter: 4.1cm (M-Mode)
Left atrial volume: 79ml (Simpson’s) 37ml/m2
LAVi<=34
Mitral annular lateral E/e’: 4.6
Mitral annular septal E/e’: 10.9
RV systolic tissue Doppler velocity: 14.4cm/s
Tricuspid annular displacement: 3.0cm
Estimated right ventricular systolic pressure: at least 17mmHg
Estimated right atrial pressure: 5mmHg
Peak pulmonary vein S/D ratio: 0.40
Inferior vena cava: 1.9cm, vessel decreases >50% with inspiration
Mitral valve pressure half time: 49msec
Peak mitral E/A ratio: 2.33
Average mitral E/e’ ratio: 7.8
Mitral flow deceleration time: 169msec
Aortic valve peak gradient: 6mmHg (peak velocity: 123.0cm/s)
LVOT diameter: 2.6cm
Pulmonic valve regurgitation: Mild (1+ - 2+)
Pulmonic valve peak gradient: 4mmHg
Aorta sinus: 3.3cm
Aorta sinotubular junction: 2.5cm
Mild ascending aorta: 3.1cm
LV Wall Thickness: 8mm (6-11)
Septal Wall Thickness: 8mm (6-11)
LA Dimension: 42mm (20-37)
LA area: 26cm2 (9-23)
RA area: 25cm2 (8-20)
E/Em ratio: 27.7 (normal <8; intermediate 8-15; elevated LA pressure > 15)
Aortic root dimension: 32mm
LV outflow systolic velocity integral: 15cm
RV systolic pressure: 21mmHg

4. Echo 9/5/2017 (Stress Echo):​

Weight: 189lb, BP: 120/76
Supplements: 80mg Test, 2mg Anastrazole
EF: 56% (vistual est. EF > 52
LVEDD: 61mm (2D)
Mitral annular lateral E/e’: 4.0
Mitral annular septal E/e’: 6.0
LV Rest: All scored segments are normal
LV Stress: All scored segments are nomral
RV systolic tissue Doppler velocity: 12.0cm/s
Mitral valve pressure half time: 43msec
Peak mitral E/A ratio: 1.77
Average mitral E/e’ ratio: 5.0
Mitral flow deceleration time: 147msec
Pulmonic valve regurgitation: Mild (1+ - 2+)

STRESS
Peak HR: 194bpm (100% MPHR)
Peak BP: 136/88mgHg
Rest ECG: Normal sinus rhythm
Stress ECG: Normal ST segment response and premature ventricular contraction
Left ventricular cavity size: Decreased with stress
Rest E/e’ average: 5.01
Stress E/e’ average: 6.11
Ischemia: Negative at 100% MPHR (13.7 METS)

5. Echo 10/23/2018:​

Weight: 194lb, BP: 98/68
Supplements: 80mg Test, 1mg Anastrazole
EF: 55% (biplane), 62% (2D)
RV Base: 4.08cm
RV Mid: 3.73cm
IVSd (2D): 0.98cm
LVPWd (2D): 1.07cm
LVIDd (2D): 6.01cm
LVIDs (2D): 3.97cm
Ao root diameter (2D): 3.4cm
Ascending aorta: 3.09cm
LA dimension (AP)(2D): 39.4mm
LA ESV BP (A/L) index: 41.26ml/m2
RA Area 4Ch: 19.34cm2
LV EDV SP 4Ch (MOD): 179.74ml
LV EDV SP 2Ch (MOD): 218.14ml
LV EDV BP: 199.2ml
LV ESV BP: 89.7ml
MV E-Wave Vmax: 0.9m/sec
MV deceleration time: 238.4msec
MV A-wave Vmax: 0.36m/sec
LV E:e’ lateral ratio: 4.01 ratio
LV average E:e’ ratio: 4.95 ratio
AV Vmax: 1.37m/sec
AV VTI: 29.93cm
AV peak gradient: 7.56mmHg
AV mean gradient: 4.73mmHg
LVOT diameter: 2.2cm
LVOT Vmax: 1m/sec
LVOT VTI: 19.6cm
LVOT peak gradient: 3.97mmHg
AVA (continuity VTI): 2.48cm2
Ascending Ao: 3.09cm
MVA (PHT): 3.18cm2
MV PHT: 69.14msec
Tricuspid TAPSE: 3.53cm
TR Vmax: 1.75m/sec
RAP: 15mmHg
RVSP: 29mmHg (may be underestimated dt insufficient envelope of the tricuspid regurgitant jet)
IVC diameter: 2.99cm
Pulmonic Valve Vmax: 0.95m/sec
Respiratory change in Inferior Vena Cava dimension: <50%
EDV (apical four chamber biplane): 180ml
ESV: 86ml
EDV (apical two chamber biplane): 218ml
ESV: 94
Subtle/mild bileaflet mitral valve prolapse with trace-mild regurgitation

6. Echo 11/8/2019:​

Weight: 201lb
Supplements: 80mg Test, 1mg Anastrazole
EF: 50% (3D echocardiography)
Average global longitudinal peak systolic strain: -17.0%
Right ventricle: 2.4cm?
Right ventricular S’: 12.10cm/s
Inferior vena cava: Dilated (>21mm) and decreases >50% in size with inspiration
Suggests elevated right atrial pressure of 8mmHg (range 5-10mmHg)
Wall Scoring, score index: 1.00
LVIDD: 6.11cm
LVIDS: 4.57cm
IVS: 0.73cm
PW: 0.81cm
LV mass: 190.6g
LVIDD Index: 2.84 cm/m2
LV relative wall thickness: 0.27cm
LV mass index: 88.7g/m2
FS: 25%
MV Peak E Vel: 72cm/s
E/A ratio: 2.25
LV E’ lateral velocity: 17cm/s
E/E’ SEPTAL: 6
MV Peak A Vel: 32cm/s
E wave deceleration time: 282msec
LV E’ septal velocity: 13cm/s
E/E’ lateral: 4
E/E’ ratio: 4.89
Tricuspid valve peak velocity: 206cm/s
RV S’: 12.1cm/s
Tapse: 2.4cm
LA size: 3.8cm
LA volume: 82ml
LA volume index: 38mL/m2
MV stenosis pressure ½ time: 82ms
MV valve area p ½ method: 2.68cm2
TV rest pulmonary artery pressure: 25mmHg
TR PEAK GRADIENT: 17mmHg
Aorta sinus Valsalva: 3.91cm
Proximal aorta: 3.2cm
Aorta sinus indexed: 1.82cm
Aorta prox indexed: 1.49cm
Inferior vena cava, right atrium pressure: 8mmHg

7. Echo 8/12/2020:​

Weight: 184.8lb, BP: 100/64
Supplements: 120mg Test, 1mg Anastrazole, 6g citrulline malate, 1g taurine, 300mg ubiquinol, 3g fish oil
EF: 46% (3D echocardiography)
Average global longitudinal peak systolic strain: -16.7%
Right ventricle: 2.8cm
Right ventricular S’: 12.90cm/s
Inferior vena cava: Dilated (>21mm) and decreases >50% in size with inspiration
Suggests elevated right atrial pressure of 8mmHg (range 5-10mmHg)
Wall Scoring, score index: 1.00
LVIDD: 6.31cm
LVIDS: 4.86cm
IVS: 0.67cm
PW: 0.64cm
LV mass: 167.73g
LVIDD Index: 3 cm/m2
LV relative wall thickness: 0.2cm
LV mass index: 79.9g/m2
FS: 23%
MV Peak E Vel: 67cm/s
E/A ratio: 3.05
LV E’ lateral velocity: 18cm/s
E/E’ SEPTAL: 6
MV Peak A Vel: 22cm/s
E wave deceleration time: 232msec
LV E’ septal velocity: 11cm/s
E/E’ lateral: 4
E/E’ ratio: 4.91
Tricuspid valve peak velocity: 206cm/s
RV S’: 12.9cm/s
Tapse: 2.8cm
LA size: 3.8cm
LA volume: 97ml
LA volume index: 46mL/m2
TV rest pulmonary artery pressure: 25mmHg
TR PEAK GRADIENT: 17mmHg
Aorta sinus Valsalva: 3.59cm
Proximal aorta: 3.3cm
Aorta sinus indexed: 1.71cm
Aorta prox indexed: 1.57cm
Inferior vena cava, right atrium pressure: 8mmHg

 

[Deleted member 106824]

I'm sure you know this already but here's what I would be taking if I was in your situation.

Arjuna
(Life Extension Cardio Peak)

Ubiquinol
-200mg 2-3x daily

Ribose
-10 grams per day

Taurine
-2 grams per day

Thanks, yea I still take Taurine and Ubiquinol. I used to take Ribose and Arjuna. Never noticed a benefit from any of these unfortunately.

i am also a bit hypochondric like you. My doc once told me there is a good tolerance margin with every echo done. 5% +- is not something to worry about...
do you have symptoms? how is your cardio regime? strong stimulant use?

Yea but given I was up to 55-56% and now 46% I'd say that's a legitimate decrease.

Symptoms: Occasional chest pressure and jolts at rest. Doesn't seem to be related as far as I can tell. That's about it. Cardio is HIIT a couple of times per week. No stimulant use aside from 1 cup of coffee 1-2x per week. Never used many stimulants other than a few diets with too much T3 back in 2013-2014, which I regret.

VO2 max was 49 when tested in 2017. I'm going to get another one done soon to see how it compares. For those who don't know, 49 is slightly above average for my age but nothing special. My exercise tolerance seems fine. It's strange, at the start of cardio I feel out of breath...like from going up stairs, but then I can do a full cardio session and feel normal and have a low HR compared to my friends when doing similar activity. For example a bunch of us went hiking recently and after an hour everyone was right around 100bpm while I was only at 80bpm, yet at the start of the hike I felt mildly winded. Consistent theme for me.

 

[Deleted member 106824]

i vaguely remember this conversation a year or more ago.

I mean look bro its nothing MAJOR as you had mentioned but it seems to be trending in a way id prefer it didnt. We could have a very scientific discussion about each finding and throw out a bunch of differentials and cite some papers but honestly bro... if this were my heart... id NOT throw more meds at it. If i was able to get off the TRT and meds I would. Id stop them. Do a real PCT. Id stay on the ubiquinol. In maybe a year id get a cardiac MRI or repeat echo.

Thats just what id do...i wouldnt try to justify the TRT and data or what meds do what. Id get a clean slate and rule things out one by one as needed.

If things are still trending down at that point id certainly get a cardiac MRI as that would allow me to pinpoint any issues if there are any. Then and only then would i throw some meds at it with very specific reasons not just kitchen sink approach.

not what u wanna hear i know... but you have a mix of findings some are likely nothing some may be nothing, some may be the development of something but i dunno.

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.

 

[nothuman]

i vaguely remember this conversation a year or more ago.

I mean look bro its nothing MAJOR as you had mentioned but it seems to be trending in a way id prefer it didnt. We could have a very scientific discussion about each finding and throw out a bunch of differentials and cite some papers but honestly bro... if this were my heart... id NOT throw more meds at it. If i was able to get off the TRT and meds I would. Id stop them. Do a real PCT. Id stay on the ubiquinol. In maybe a year id get a cardiac MRI or repeat echo.

Thats just what id do...i wouldnt try to justify the TRT and data or what meds do what. Id get a clean slate and rule things out one by one as needed.

If things are still trending down at that point id certainly get a cardiac MRI as that would allow me to pinpoint any issues if there are any. Then and only then would i throw some meds at it with very specific reasons not just kitchen sink approach.

not what u wanna hear i know... but you have a mix of findings some are likely nothing some may be nothing, some may be the development of something but i dunno.

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

 

[nothuman]

Thanks, yea I still take Taurine and Ubiquinol. I used to take Ribose and Arjuna. Never noticed a benefit from any of these unfortunately.

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.

 

[warlock]

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 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?

 

[warlock]

Nothuman,

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

 

[RoyHobbs]

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.

 

[MethodAir]

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.

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?