Thread: Test and your heart
11-27-2003, 03:55 PM #1
Test and your heart
Origanlly posted by Severed Ties
T and Your Ticker
The Positive Effects of Testosterone on the Heart
by Doug Kalman MS, RD
Steroids will cause your kidneys to implode, your heart to blow a ventricle, and your liver to squirt out of your arse, fly across the room, and knock the cat off the futon. We read it on the Internet and saw an after school special about it, so it must be true, right?
Actually, the more you learn about steroids, the more you come to realize that, like all drugs, there's a difference between their intelligent use and outright abuse. In this article, Doug Kalman takes a look at the effects of Testosterone on the heart. What he found may surprise you.
Over the years we've all heard the repeated mantra that anabolic steroids are bad for the heart. Some physicians will tell you that gear raises your risk of heart disease by lowering your good cholesterol (HDL) and raising your bad cholesterol (LDL). In fact, as some docs will tell you, steroids are known to even induce cardiac hypertrophy (enlargement of the heart). And since you can't flex your heart in an effort to woo women, who'd want that?
But, as in every story, there's more than one side. In fact, let it be said, the dangers of steroids are overstated and, hold onto your seats, may even be good for the heart. Let's examine some of the scientific studies on the positive effects of Testosterone on the heart.
What are the cardiovascular effects of steroids ?
Cardiologists at the Royal Prince Alfred Hospital in Australia recruited both juicing and non-juicing bodybuilders for a study. Each bodybuilder had various aspects of the heart measured (carotid intima-media thickness, arterial reactivity, left ventricular dimensions, etc.). These measurements indicate whether bodybuilding, steroid usage or both affect the function, size, shape and activity of the heart.
The doctors found some obvious and not so obvious results. Predictably, those bodybuilders who used steroids were physically stronger than those who didn't. What was surprising was that the use of steroids was not found to cause any significant changes or abnormalities of arterial structure or function.
In essence, when the bodybuilders (both groups) were compared with sedentary controls, any changes in heart function were common to bodybuilders. The take home message from this study is that bodybuilding itself can alter (not impair) arterial structure/function and that steroids do not appear to impair cardiac function. (1)
Does MRFIT need a T boost?
A famous cardiac study was published about 10 years ago. It soon became on ongoing study known as the Multiple Risk Factor Intervention Trial (MRFIT). The present study examined changes in Testosterone over 13 years in 66 men aged 41 to 61 years. The researchers determined if changes in total Testosterone are related to cardiovascular disease risk factors.
The average Testosterone levels at the beginning of the study were 751 ng/dl and decreased by 41 ng/dl. Men who smoked or exhibited Type A behavior were found to have even greater decreases in T levels. The change in Testosterone was also associated with an increase in triglyceride levels and a decrease in the good cholesterol (HDL).
The authors concluded that decreases in Testosterone levels as observed in men over time are associated with unfavorable heart disease risk. (2) Sounds to me like a good reason to get T support/replacement therapy in the middle age years!
In a similar study, researchers in Poland examined if Testosterone replacement therapy in aging men positively effected heart disease risk factors. Twenty-two men with low T levels received 200 mg of Testosterone enanthate every other week for one year. Throughout treatment, Testosterone, estradiol, total cholesterol, HDL and LDL were measured.
The researchers determined that T replacement returned both Testosterone and estradiol levels back to normal and acceptable levels. They also found that T replacement lowered cholesterol and LDL (the bad cholesterol) without altering HDL (the good cholesterol). Furthermore, there was no change in prostate function or size.
The take home message from this study is that T replacement doesn't appear to raise heart disease risk and it may actually lower your risk. (3) It appears that more physicians should be prescribing low dose Testosterone to middle age and aging men for both libido, muscle tone and for cardiac reasons.
What about younger men?
It's been long established that men have a higher risk of heart disease. One of the risk factors implicated is Testosterone. Reportedly, the recreational use of Testosterone can alter lipoprotein levels and, in fact, case reports exist describing bodybuilders who've abused steroids and have experienced heart disease or even sudden death. But the question remains, is the causal association one of truth or just an association?
To answer this, researchers at the University of North Texas recruited twelve competitive bodybuilders for a comprehensive evaluation of the cardiovascular effects of steroids. Six heavyweight steroid-using bodybuilders were compared with six heavyweight drug-free bodybuilders.
As expected, the heavy steroid users had lower total cholesterol and HDL levels as compared to the drug-free athletes. What was unexpected was that the steroid users also had significantly lower LDL (the bad cholesterol) and triglyceride levels as compared to the non-steroid users. In addition, the juicers also had lower apolipoprotein B levels (a marker for heart disease risk). Thus, the authors concluded that androgens do not appear to raise the risk of cardiovascular disease. (4) The take home message from this study is that the negative cardiac side effects of steroids are most likely overstated.
In a little more progressive study, researchers at the Albert Einstein College of Medicine in the Boogie Down Bronx (the BDB to those in the know) examined Testosterone as a possible therapy for cardiovascular disease. (5) The researchers note that T can be given in oral, injectable, pellet and transdermal delivery forms. It's noted that injections of Testosterone (100 to 200 mg every two weeks) in men with low levels of T will decrease total cholesterol and LDL while raising the HDL.
In fact, Testosterone therapy has been found to have antianginal effects (reduces chest pain). Low levels of Testosterone are also correlated with high blood pressure, specifically high systolic pressure. The researchers determined that returning T levels back to normal and even high-normal levels have positive cardiovascular effects and should be considered as an adjunctive treatment for maintaining muscle mass when someone has congestive heart failure.
Putting it all together
Strong research demonstrates that the risks of negative cardiovascular effects of steroids are overstated. In fact, a recent paper published in the Canadian Journal of Applied Physiology questioned the whole risk of using steroids. (6) Joey Antonio, Ph.D. and Chris Street MS, CSCS published strong data showing that the risks of steroid use are largely exaggerated, much like scare tactics used by your parents while you were a kid. Of course, it goes unsaid that abuse of anything will lead to unwanted consequences.
We know that as we age, circulating Testosterone levels naturally decrease. For most people the Testosterone decrease goes from high-normal to mid to low normal. Data shows that there's an inverse relationship between T levels and blood pressure as well as abdominal obesity (that paunch we see on so many middle age males).
Testosterone replacement lowers abdominal obesity and restores Testosterone back to normal levels. Restored Testosterone is correlated with better mood, better muscle tone, stronger sex drive, lower cardiovascular disease risks, stronger bones and better memory. It's important to note that while conservative use gives a pronounced positive health benefit, higher doses may not necessarily lead to further health benefits.
What to do
If you see your body composition changing (your gut starts looking like your Uncle Lester's), your strength or muscle tone diminishing despite your hard training and good diet, and your sex drive not matching up to TC's columns, have your Testosterone levels checked. The acceptable normal range for Testosterone to physicians is 300 mg/dl to 1100 mg/dl. Yes, that's a pretty wide range.
In the clinic, we see people with the complaints consistent with "andropause " (a term for male menopause) and/or increased cardiovascular risk having Testosterone levels between 300 mg/dl and 550 mg/dl. Bringing it up to the mid to high-normal level is what gives the health and "youthful" benefits. Traditionally 200 mg/dl of supplemental Testosterone given every one to two weeks improves body composition, lowers total cholesterol and LDL, while raising HDL.
It appears that supplemental T is a healthier and safer way to go than many of the drugs used to treat poor lipid profiles. The data presented in this article applies for males over 35, not those who are 18. If you think that you can benefit from Testosterone therapy look for physicians who market themselves as "anti-aging" or "longevity physicians" as well as the more progressive endocrinologists or cardiologists.
Long story short, used intelligently, Testosterone is good medicine!
About the author: Douglas S. Kalman MS, RD is a Director for Miami Research Associates (MiamiResearch.com) a leading pharmaceutical and nutrition research organization in Miami, Florida. Doug is also a national spokesperson for the American College of Sports Medicine and according to his latest test has high T levels. Doug can be reached at firstname.lastname@example.org.
1) Sader MA, Griffiths KA, McCredie RJ, et al. Androgenic anabolic steroids and arterial structure and function in male bodybuilders. J Am Coll Cardiol 2001;37(1):224-230.
2) Zmuda JM, Cauley JA, Kriska A, et al. Longitudinal relation between endogenous testosterone and cardiovascular disease risk factors in middle aged men. A 13 year follow-up of former Multiple Risk Factor Intervention Trial participants. Am J Epidemiol 1997;146(8):609-617.
3) Zgliczynski S, Ossowski M, Slowinska-Srednicka J, et al. Effect of testosterone replacement therapy on lipids and lipoproteins in hypogonadal and elderly men. Atherosclerosis 1996;121(1):35-43.
4) Diekerman RD, McConathy WJ, Zachariah NY. Testosterone, sex hormone-binding globulin, lipoproteins and vascular disease risk. J Cardiovasc Risk 1997;4(5-6):363-366.
5) Shapiro J, Christiana J, Frishman WH. Testosterone and other anabolic steroids as cardiovascular drugs. Am J Ther 1999;6(3):167-174.
6) Antonio J, Street C. Androgen use by athletes: A reevaluation of the health risks. Can J Appl Physiol 1996;21(6):421-440.
11-27-2003, 04:02 PM #2Senior Member
- Join Date
- Jul 2003
nice post JB
11-27-2003, 04:12 PM #3
Good post Johnny!
11-27-2003, 04:20 PM #4
Thanks for sharing this info with us, top notch as usual
11-27-2003, 04:45 PM #5
11-27-2003, 05:16 PM #6
Great post Johnny!!!!
11-27-2003, 05:56 PM #7
11-27-2003, 06:14 PM #8Originally Posted by JohnnyB
11-27-2003, 07:11 PM #9
Super Great thread !!
11-28-2003, 02:47 AM #10
You do raise good points! But I will just comment that most of these studies are done using low test, and/or higher doses with duration dependency, or in people with hormone imbalances to begin with. But we also know that using higher doses with increased duration may have a negative impact on serum lipoprotein profiles. There are so many factors that we need to consider when relating test to lipid abnormalities, and especially when we try to evaluate what little studies have been done. It seems that most of the clinical trials showing test as being beneficial are mainly done in effort to show that having an imbalance in hormone levels is the negative aspect, and when we correct this imbalance, it does seem to be favorable. But I still question long term use, and especially high dose AAS treatment/use/abuse, often in combination with other AAS such as orals which seem to have a greater impact on lipid profiles. So yes, HRT with lower doses may be beneficial for those who have low/abnormal test levels. But we must consider dose, drugs used and duration as well. And believe me, I do think for the most parts that the ADE's associated with AAS use are overstated, and that the medical community in general could be better educated. But you raise another good question: and that is, what would be the effects of using low dose test or "cruizing" between cycles. We know that our test levels are decreased after cycles, and if having a subclinical test level is unfavorable, then could low dose test be for the most part void of lipid abnormalities between our more massive cycles? I don't know, and I still think more studies need to be conducted. You will find just as many studies showing negative effects as you will studies showing positive effects. But I will add that it is very important to evaluate these clinical trials carefully and always be aware of potential bias that may exist. And always ask yourself if these studies can apply to "our" population. Another thing to consider is that it may a good idea to monitor lipid levels while using AAS, as this will give the individual a better idea where they stand. But karma to you for bringing up these good points!
Last edited by ichabodcrane; 11-28-2003 at 02:52 AM.
11-28-2003, 03:19 AM #11
Nice post JB. You raised some good points Ichabod, seeing as most AAS users are taking substantially more 100mg-200mg/week of test, but it's always nice to hear about information that more or less supports the responsible use of AAS rather than the typical "if you use steroids ," "your head will fall off" load of crap that you always hear from everyone else. I would however like to see more studies/info on the effects that AAS have on blood lipid levels in normal, young, healthy adult males.
11-28-2003, 03:30 AM #12
That should have been "AS", not "AAS". It's late...
11-28-2003, 04:39 AM #13
11-28-2003, 06:32 AM #14
Interesting post JB.
11-28-2003, 08:44 AM #15
Being 48 and just starting AS I find this info fascinating. I will probably to to my Dr. at some time in the future to discuss HR therapy.
I cut and pasted the info for my "stack-o-stuff". Thanks.
11-28-2003, 10:25 AM #16
I'm on HRT and have seen these benifits, most if not all.
11-28-2003, 11:42 AM #17
Great article!!! Thanks! I too am on HRT and so far I love the benefits I am getting from it!
11-28-2003, 01:37 PM #18
I am not disputing the possibility that low dose test/HRT can be beneficial as far as lipid protective effects, as I do believe it is. But there does seem to be a dose related phenomena which turns for the worse with increased doses of androgens. I just wanted to point out that while low dose (~200mg/2week HRT) may show to be beneficial, it seems to worsen as we increase the dose, maybe even duration, and I didn't want people to think that just because they run 1g/wk of test, they souldn't have to worry about their lipid profiles. Lower dose test does seem to have coronary vasodilatory effects, which would be beneficial. Consider the incidence rates of CVD, which appears to be lower in women than men? Could it be hormone related? But like I said, there are many factors that come into play in lipid regulation, and there seems to be a delicate balance between hormones that helps regulate lipids. When we disrupt this balance, we provoke a change in lipid production/regulation.
I encourage people to do their lit searches.
Adams, Michael R.; Williams, J. Koudy; Kaplan, Jay R. Effects of Androgens on Coronary Artery Atherosclerosis and Atherosclerosis-Related Impairment of Vascular Responsiveness: Volume 15(5);May1995.pp 562-570
Last edited by ichabodcrane; 11-28-2003 at 01:40 PM.
11-29-2003, 01:03 PM #19Junior Member
- Join Date
- Apr 2003
- New York
as usual another great read..
11-29-2003, 01:29 PM #20
I totally agree with you at some point what is good for can become bad for you. Like food you can't live without it, if you abuse it and eat to much of it can cause health problems. The same with test, but it was interesting that drug free BBer's and juiced BBer's were checked for enlarged hearts, which is supposed to be one of the side effects of juicing and there was no difference.
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