Conversation with HRT Stroke / Heart Attack Patient

[CraigWatts]

Wanted to share this conversation (without revealing his name for obvious reasons) with a guy I sent messages to on Facebook. A few months back I was seeing a lot of ads for Testosterone Replacement Therapy lawsuits on Facebook. I was getting in heated debates with people in the comments area calling the attorneys "vultures" etc. I was thoroughly convinced that if you monitor your hematocrit (i erroneously called it hemoglobin below), you would avoid such things. And that the only guys who had problems were the ones who weren't being properly monitored.

One guy commented that he'd been on on Androgel /HRT for something like 13 years and in that time he'd had both a heart attack and a stroke. So I sent him an email directly to test my theory. I'd love everyones input on what he says:

Me: Hi - saw your post on the testosterone advertisement. Do you mind me asking what your T levels were at for the majority of your time on Androgel? Specifically when you had your stroke and heart attack? I know the range is 300 to 1100 roughly. Thanks.

Him: My level was approx 600 +/- before the Heart Attack. It was a little under 500 prior to the Stroke. My dose was halved after the Heart Attack. Are you on it?

Me: Not yet. Was anyone monitoring your hemoglobin on a regular basis? I have a theory that nobody needs to have HA or strokes on Testosterone if their doctor is actually paying attention.

Him: Sorry to bust your theory ... Tested every 3 months. Was never high, nor even high-normal. I actually got a lot more care than normal I think because I work in the medical field. I am a Respiratory Care Practitioner.

Me: The devil is always in the details. Wish I knew what the details were so I could determine if its too dangerous for me to go on Testosterone therapy . If there was something about your situation that might have been avoided, or done differently, that is what everyone should be trying to figure out I think. If not, then everyone is at risk of bad results.

Him: My Heart Attack was not normal. None of the usuals signs/symptoms... No diaphoretic, no chest pain, my BP was slightly elevated at 148/78, Heart Rate 80. My wrists ached, just like the ache of a strained muscle. I was told my face was 'gray'. It wasn't until I was hooked up to a monitor while having an EKG, that the diagnosis was confirmed. I was at work at the time. Had I been home, I probably would have popped a couple Motrins & laid down. I would have woken up, probably w/ a few 100 less brain cells. My Right Coronary Artery (Dominant) was more than 90% occluded.

Me: How are you supposed to know your arteries are clogging? It blows me away that this isn't the #1 aim of heart doctors. Developing a technology that clearly monitors arterial plaque long before it becomes an issue, and tracks your evolution over time. There's no reason this crap should catch anyone by surprise.

Him: Many have proposed that a 'full body scan' once per year by CT Scan, be part of one's insurance plan. Those opposed state it would cost too much. Proponents argue (rightly so ...) finding problems before they become anything, would save Ins. companies millions & millions of dollars & the patients/clients they serve a lot of grief!

Me: Not sure a full body CT scan can identify microscopic buildup of plaques on arterial walls, but its probably better than nothing.

Him: No, it wont pick up small percentages of blockage, but it will identify abnormalities (blockages) or narrowing. At that point a Cardiologist can do their procedure. The main reason, CT Scans aren't done routinely/on a year basis, is not because of MDs, but Insurance Companies. The cost of a CT Scan of one section of the body, say the abdomen, is astronomical. The cost of a Scan of an entire body -prohibitive! The argument is - if an entire body scan does find something that is, worse case, deadly, then there has been justification. But the opposite can also be true too. Multiple scans on multiple people, with negative results. If the procedure/practice becomes standard, then Insurance Premiums will become affordable only to the elite.

(weeks later)
Me: Well my T level went all the way from 296 to 885 on a microdose of Clomid (12mg). Normal dose is 50mg.

(this response cracked me up from someone on HRT for 13 years, and working in the medical field)
Him: I'm not familiar w/ 'Clomid'. Is it a new Testosterone replacement product?

(later)
Me: If you had to guess, what would *you* say is the cause of your heart attack and stroke. If you had to guess. Since you say your hemoglobin and testosterone levels were not out of range.

Him: Honestly, have thought a lot about both occurrences, the whys for each , etc.. I don't know ...

Me: Maybe its possible you were out of range for a period of time ? 13 years is a long time to be on HRT. Then again maybe men are *supposed* to have lower testosterone as they get older, or they end up with these things.

Him: It's not that men are supposed to have a lower T_level, it's that some men drop faster & more than others. Normally, T-level begins to drop after the age of 30, some more than others. I didn't notice the changes in my body right away, but over a long time... Months to years. No matter how much I worked out, over time I was losing muscle mass & gaining weight/fat. And I knew how to workout to be in the shape II wanted/needed to have, from years of playing Lacrosse & skiing the Downhill. Not immediately, but over time I was developing 'Man boobs' & my libido was taking a huge dip. The time period was late 40's to just over 50. That's what prompted me to talk with my PCP. CBC's aren't the only tests routinely ordered. Chem Panels, PSA's, Cholesterol, a wide variety of tests, which are routinely ordered Q 6-months for me. And I have the option of adding that which I am additionally curious about.

---------------------

So I dont know what to make of all that. Didnt even push his Test to higher than 600 ... so he wasn't joyriding the whole time, thats for sure. And his hemoglobin (Hematocrit I hope he knew I meant....) was never high ... and never even normal-high. Yet he has a stroke and a heart attack while on Androgel (or equiv) for 13 years.

Any thoughts?

[clarky.]

I don't think it had anything to do with his hrt he did have bloods done evert 3 months and all was well if it was high for a long time then yes. Could it just be one of thoughs thing ? Could it be a family thing ?. I've never heard of trt blocking arteries.

[Beethoven]

I wonder if this guy would have had a slip and fall where he would have needed a hip replacement. Would TRT have been the culprit? I did notice he had elevated BP. Lots of people have heart attacks every day, I dont know that TRT would have anything to do with it.

[Chauffeur]

What was his diet and exercise routine looking like? Seems pretty relevant.

[Baxter35]

Heart disease runs rampant in this country primarily due to poor diet and exercise. Most men on trt are just regular guys who don't take care of their health pre trt and still don't take care of it post trt. Of course there will be guys on trt having heart attacks, but they would probably have had them either way. Honestly, if these same guys chose not to start trt and had heart attacks later on, they'd probably still try to blame their doctors claiming it was their doctors fault for NOT putting them on trt that caused the heart attack. People just like to pass blame no matter what the circumstance.

[kelkel]

Heart disease runs rampant in this country primarily due to poor diet and exercise. Most men on trt are just regular guys who don't take care of their health pre trt and still don't take care of it post trt. Of course there will be guys on trt having heart attacks, but they would probably have had them either way. Honestly, if these same guys chose not to start trt and had heart attacks later on, they'd probably still try to blame their doctors claiming it was their doctors fault for NOT putting them on trt that caused the heart attack. People just like to pass blame no matter what the circumstance.

Exactly. Blame testosterone . Worked for Lyle Alzado.

[Bonaparte]

So a guy in his 60s who was on hrt happened to have a heart attack. What does this have to do with testosterone ? Old guys have heart attacks all the time. It was from a narrowed coronary artery (from decades of poor cholesterol and arterial inflammation, not a spontaneous blood clot caused by hrt complications).

[Beethoven]

Unless he's using one of those ambulance chasers to get some money. Just because he's in the medical profession really might not make that much difference. I've seen RN's on their break smoking cigarettes, obese and the rest. Proper nutrition is the most important. Heart disease has been pretty rampant in this country well before the TRT got popular.

[fireeater49]

Think we all agree that family hx, exercise regimen, diet, and possible external factors like stress all could have contributed to it. I am not saying that if you go on TRT you will not have a heart attack but if you do AND you follow all the general health recommendations I personally feel it will be greatly in your favor in not having an AMI. Cigarettes are another possible factor (lifestyle choices) and I am curious what his estradiol count was in relationship to his test levels. Studies have shown correlation between ratios AND OR high or low levels can contribute to cardiovascular issues Interesting dialogue but so many other factors to definitely rule that long term HRT contributed to his heart attack.

FYI if your cardiac enzymes count are elevated by just a little then one could say that one had a heart attack. IMHO its a accumulation of several items not just 2 or 3 items. Just saying.