Help......Cardiac and test/trt

Ok. So after a month of a blast of 500mg cyp weekly, and 1 week of adding 100mg Deca I have to stop. I was sent to the Hosp on Friday morn from my Dr. because of heart palpitations and a bad EKG. Short story, no blockage but my heart is not pumping out the amount of volume of blood that it's supposed to. Called ejection fraction or EF. Normal is 65-75% Mine is at 25%. I also have a Bundle Branch Block, which is an electrical issue. Needless to say, the cardiac Dr's taking me off of lifting for now. I am NOT happy about this.

Just got home from the Hosp. with instructions to Stop using Cyp for TRT. So, Now my Question is....WHAT do I do? I have an appt. with my Urologist Friday for options, but what happens now that I can't take test for even TRT?? I was off of Cyp for 2 weeks and my test dropped to 281.

In this instance I would suggest talking to the doctors for advice on this. Maybe talk to an Endo as well if you are able to. I would not want to give you any advice that could make your situation worse and not many people on here happen to be cardiologists.

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Originally Posted by RangerDanger830

In this instance I would suggest talking to the doctors for advice on this. Maybe talk to an Endo as well if you are able to. I would not want to give you any advice that could make your situation worse and not many people on here happen to be cardiologists.

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I guess I'm wondering what if anything will bring my natty test back. I think HCG is a possibility (?) but after taking Cyp for TRT for years, I'm not producing any test correct? Should I treat like PCT and use other stuff??

Not really sure what my Urologist will say. Or an Endo? I don't have an Endo but can find one if that is a better option. This sucks.

My advice would just be to lower your dose. 400-500 ng/dl is on the low end of normal, so it won't be putting any added strain on your cardiovascular system.
What dose have you been using, and what were your test levels? Complete androgen depletion will cause heart disease as well.

How old are you?

I have been taking 200mg weekly for TRT, and blood test's have been between 820-1100 ng/dl over the last few years, other than as mentioned above, tet was 281 ng/dl and that was after no cyp for 2 weeks. I was on a 500 mg blast but that only lasted 4 weeks. Last pin was Thursday at 250mg.

I'm 51.

In this case the Dr. feels that the Test May have contributed to this heart issue, although mine is not a blockage, it's not pumping enuf. He won't diagnose the Test as the cause because he stated that there are No studies that can prove that Test is linked to cardiac issues. They are also looking at possibly a Virus or Stress related cause.

Agree with Bonaparte.

Did your doc's know that you were on a cycle or did they simply blame the test for everything?

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Originally Posted by kelkel

Agree with Bonaparte.

Did your doc's know that you were on a cycle or did they simply blame the test for everything?

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They did not know. I edited my post, they didn't blame Test on everything since they don't have studies that can prove it. But they must believe or think that is may have been a factor, he even referenced the "commercials" that are running now about..."Have you been takikng Test and suffered a heart attack..."

And I was under the impression that Test is "linked" to coronary Artery disease, not what I have? He also said that IM Inj is hard on the Kidneys ??

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Originally Posted by Warrior1700

And I was under the impression that Test is "linked" to coronary Artery disease, not what I have? He also said that IM Inj is hard on the Kidneys ??

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"Abuse" can be. Specifically to left ventricular hypertrophy. There are studies out there on that.
"Hard on the Kidneys" well so is half of any medication he prescribes. Jeez. Scare tactics.
Obviously take care of yourself but I'd be sure to get more opinions. Especially about coming off TRT. Re-read what Bona said.

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Originally Posted by kelkel

"Abuse" can be. Specifically to left ventricular hypertrophy. Re-read what Bona said.

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Would long term 200mg a week be considered "abuse" or would 4 weeks of 500mg be considered "abuse" ?

I know we are not doctors (I guess) and I don't expect "Medical Advice"...We are just talking here. Cuz I want to get opinions from you guys who know much more that I.

My Left ventricle is affected, but nothing said about Hypertrophy. Which he did mention could happen with Heavy long term lifting or even Marathon runners.

Re-read Bona, so am I presuming he means to cut back the TRT dose, say from 200mg to 100mg? Stay away from a blast? What about Deca?

This is obviously a serious issue for me and want to try to do the right thing but coming off of Test completely can't be good, and I don't wanna lose my Libido or energy and I am already dealing with some depression.

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Originally Posted by Warrior1700

Ok. So after a month of a blast of 500mg cyp weekly, and 1 week of adding 100mg Deca I have to stop. I was sent to the Hosp on Friday morn from my Dr. because of heart palpitations and a bad EKG. Short story, no blockage but my heart is not pumping out the amount of volume of blood that it's supposed to. Called ejection fraction or EF. Normal is 65-75% Mine is at 25%. I also have a Bundle Branch Block, which is an electrical issue. Needless to say, the cardiac Dr's taking me off of lifting for now. I am NOT happy about this.

Just got home from the Hosp. with instructions to Stop using Cyp for TRT. So, Now my Question is....WHAT do I do? I have an appt. with my Urologist Friday for options, but what happens now that I can't take test for even TRT?? I was off of Cyp for 2 weeks and my test dropped to 281.

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Most cardiologists will be content with an EF of 40-45%. I'm guessing they ran a stress echocardiogram? I also have left bundle branch block. I would work with my cardiologist as much as possible, but also consider that high estrogen and high hematocrit is a big concern here.
Keep a positive attitude, at one time my EF was @ 10% and I was eligible to be worked up for a heart transplant, but I've recovered.
As far as the lifting, if your heart is floppy/ enlarged and you have a conduction error (branch block), then you don't want to put your heart under a heavy workload....yet. I would expect that you'll recover with time....also in the future, when you lift, make sure to breathe. Holding your breath during heavy lifting combined with a low EF and a conduction error will REALLY stress your heart.
Again, work with your cardiologist, take notes, and voice.your concerns. The more educated you are, the less you will stress.
Best of luck and keep us updated.


EDIT: If they mention cardiac rehab, I highly recommend it. It will help you learn your limits while you are being monitored and at the same time you will be strengthening your heart. I went for 12 weeks and it made a HUGE difference.

Mayo considers 55% and above as normal. My EF was 40% the last time I had a stress echo, and I'm back lifting with my cardiologist's and GP's approval...and remember my EF was 10% once.
Also, I'm on TRT, albeit a poor one. My Dr. is being very cautious but was receptive to putting me on TRT, so hang in there.

Ejection fraction: What does it measure? - Mayo Clinic

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Originally Posted by Warrior1700

I have been taking 200mg weekly for TRT, and blood test's have been between 820-1100 ng/dl over the last few years, other than as mentioned above, tet was 281 ng/dl and that was after no cyp for 2 weeks. I was on a 500 mg blast but that only lasted 4 weeks. Last pin was Thursday at 250mg.

I'm 51.

In this case the Dr. feels that the Test May have contributed to this heart issue, although mine is not a blockage, it's not pumping enuf. He won't diagnose the Test as the cause because he stated that there are No studies that can prove that Test is linked to cardiac issues. They are also looking at possibly a Virus or Stress related cause.

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The diagnosis in my case was viral cardiomyopathy.

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Originally Posted by almostgone

Most cardiologists will be content with an EF of 40-45%. I'm guessing they ran a stress echocardiogram? I also have left bundle branch block. I would work with my cardiologist as much as possible, but also consider that high estrogen and high hematocrit is a big concern here.
Keep a positive attitude, at one time my EF was @ 10% and I was eligible to be worked up for a heart transplant, but I've recovered.
As far as the lifting, if your heart is floppy/ enlarged and you have a conduction error (branch block), then you don't want to put your heart under a heavy workload....yet. I would expect that you'll recover with time....also in the future, when you lift, make sure to breathe. Holding your breath during heavy lifting combined with a low EF and a conduction error will REALLY stress your heart.
Again, work with your cardiologist, take notes, and voice.your concerns. The more educated you are, the less you will stress.
Best of luck and keep us updated.


EDIT: If they mention cardiac rehab, I highly recommend it. It will help you learn your limits while you are being monitored and at the same time you will be strengthening your heart. I went for 12 weeks and it made a HUGE difference.

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Wow....~10%, ok so I'm a little bit more relieved. Thank you, great info, thanks for taking the time.

I have not had a stress Echo. I am supposed to start a min, 6 week Cardio Rehab some time soon (not sure if that will inc a stress Echo. I did have an Eecho in ER but not under stress (other than the stress of suddenly being hospitalized with a heart condition), ( and the stress of a few other recent situations) I have to followup with my cardiologist in a few days to hear the results of my cardio MRI. I do not know the size of my heart at this time nor if there is hypertrophy, or if it's floppy, but I presume with an Echo and Cath that they would know that?? Mine is a Left bundle branch block, I didn't mention the side before, as well as left ventricle low EF.

Believe me, I will do whatever it takes on my part to help this recovery process. I'll stay positive and I do ask a lot of questions and am writing some down for my follow up. I read a thread here and remember seeing about not holding your breath, which I think I may be guilty of at some point or another.

Last BW in April showed ultra sensitive E2 as 25 pg/ml, Hematocrit was 52%. A hematologist came to see me and said that my Platlets were on the low side. 90 I think. I asked her about the hematocrit and she said I was ok with 52%, however I did give blood a couple weeks ago and will again when eligible.

They gave no diagnosis for mine as of yet, but said viral or stress but leaning more with viral, may know more with MRI. Said they may not know the cause.

So back on TRT, can I ask what dose, were you completely off for awhile? Did you Dr.s attribute your cardiomyopathy to AAS at all?

Glad to hear that you recovered, and thanks again for the info. Helps a great deal. And thanks for the link. I'll keep you all posted.

Which now I ask, should I stay off of Adex since I am stopping the Test for now? What about HCG? Dump everything until I see the Urologist?

My TRT is a terrible, outdated protocol. I started TRT after all of the coronary issues. Work with your Drs. as much as possible to stay on TRT at a lower dose. Try to get them to at least keep you in range, even if it's the low end of normal. Low T and high E2 are not something you need right now.
It's been my experience that if you have coronary issues, it makes it a real PITA to get TRT prescribed. (I also had a biventricular pacemaker...can't really hide the scar).

Hang in there. You don't have an official diagnosis yet...right? My diagnosis was viral cardiomyopathy...possibly caused by Coxsackie B virus. I had bronchitis/ pneumonia and speculation was that it slid in while I was weak.

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Originally Posted by almostgone

Hang in there. You don't have an official diagnosis yet...right?

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Correct. I see the cardiologist on the 27th and hopefully get clearer info then. The Cardiac MRI will have been read. Thanks man. I'm hangin.

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Originally Posted by almostgone

possibly caused by Coxsackie B virus.

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Just re-read your post, I heard that name on discharge. (cuz I was like....Cox what?) Lol. Pretty sure they said I was negative for that. But are looking at other possible virus or auto-immune issue.

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Originally Posted by Warrior1700

Re-read Bona, so am I presuming he means to cut back the TRT dose, say from 200mg to 100mg? Stay away from a blast? What about Deca?

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Based on the test numbers you mentioned, I'd cut back to 80 mg weekly and see if that lands you at an average of 400-500 ng/dl. This would be best broken into 2 doses weekly that you could inject sub-Q.

And lose the Deca and HCG for now. You shouldn't need an AI either if your T levels are on the low end.

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Originally Posted by Bonaparte

Based on the test numbers you mentioned, I'd cut back to 80 mg weekly and see if that lands you at an average of 400-500 ng/dl. This would be best broken into 2 doses weekly that you could inject sub-Q.

And lose the Deca and HCG for now. You shouldn't need an AI either if your T levels are on the low end.

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I tried Sub Q before, wasn't a fan...that being said, that was at higher dose, 40mg Sub Q might be just fine for me.

What about any AI's or HCG at this point.??

Just got back from Urologist. He is keeping me on Test @ 150m every 2 weeks. Re-asses in a month. He said that my hemoglobin and hematocrit are too high. They started coming down since in the Hosp from their BW. So he said I am back to "in range" so he is keeping me on it.

Now, what about AI or HCG still....and should I wait till my heart recovers before implementing any Deca? I would like to try 50 mg to keep my neck arthritis at bay. It was working at 100mg per week.

HI everyone. it's been awhile since I have posted or even been on this site. Been struggling with what they are calling Cardiomyopathy. The last time I posted my EF after leaving the Hosp back in May of 2014 was about 30% as indicated by a Cardiac MRI. I have had 2 Echos since and a Heart monitor once. The monitor came back normal, the latest Echo is indicating that my EF is now about 45%. It was 40% one year ago. I am going to have an Exercise VO2 stress test soon for a base line.

Update on my TRT. I was taking TRT for awhile per my Urologist and last Nov 2015, my total test was over 1100. My PCP took me off in fear that it was too high and because of my Cardiomyopathy.

BW in March indicated total test was 254ng/dl and free test was .60ng/dl. My latest BW in April indicate that my Total test is now 172ng/dl and SHBG is 31nmol/L. I have been feeling like crap. Fatigued, no libido, no energy at all, no erections at all, no overnight or morning wood. Now, I will say that I have been on 25mg of Carvedilol 2x day and 20mg Lisinopril 1x day and 20mg Atorvastatin 1x day. I jsut started seeing another urologist to get back onto TRT. He wants to try Testo Pells as he is not a fan of IM since he says it's hard on the Kidneys. I'm not so sure after reading about Testo Pells that I am a fan of those.

Suggestions?

In the meantime, until I get started back on TRT, I have 2 months worth of HCG. Would it be of any benefit at this time to start HCG therapy?

Thank you.

I'm like to know more about why he took you off TRT. Specifically how a normal testosterone level (yes, yours could have been lowered) would exacerbate cardiomyopathy?

HCG over time will do two things. Since it is a form of TRT (HCG Mono) it will raise your T levels assuming there are no primary issues. Second, over time it will suppress LH levels.

Pellets would be last on the list of treatments. There are doc's out there that like these due to the billing received from insurance for the implantation of the pellets. $$$$$ Look into Aveed.

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Originally Posted by kelkel

I'm like to know more about why he took you off TRT. Specifically how a normal testosterone level (yes, yours could have been lowered) would exacerbate cardiomyopathy?

HCG over time will do two things. Since it is a form of TRT (HCG Mono) it will raise your T levels assuming there are no primary issues. Second, over time it will suppress LH levels.

Pellets would be last on the list of treatments. There are doc's out there that like these due to the billing received from insurance for the implantation of the pellets. $$$$$ Look into Aveed.

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Well, initially back in My 2014 when this first began, my Original Cardiologist took me off because they think the TRT was an issue. Then after getting out of the Hosp and eventually seeing my urologist, he put me back on at a lower dose.

More recently I had to stop seeing my Urologist because of Insurance change. Then I asked my PCP to manage my TRT. That's when in November 2015 when my BW came back at 1100 she took me off completely because from the beginning of all this, all the Drs. involved in my care in 2014 (including my PCP, cardiologist...etc) were and still are under the belief that the TRT, for lack of any other cause, caused my Cardiomyopathy. So I have gone to a new Urologist, the guy who wants to try the pellets, to get back on TRT.

I'd rather go back on IM, but before I get back on TRT as it has been taking awhile , my T levels continue to plummet so I thought I would use up my HCG until I get back on TRT. I'm also curious to know if my T levels will ever start to increase naturally without TRT and if so how long after being off of TRT?

So would there be any benefit to use the HCG that I have to help restore some nattie size and T production?

It can do both, but at the same time will begin (over time) to suppress any restoration of endogenous pituitary function.