T Nation

Anabolics and Arrythmias

So ive searched through the archives and havent found anything relevant about steroids and arrythmias.My backround,40 this year 1st time cycle,am 7 weeks into 500mg weekly sustanon,adex.25.eod.

I have a previous history of occaisional episodes of irregular heart beats but have been to a cardioligist and had various tests(electrocardiogram,halter monitor,stress test etc…and my heart was found to be healthy(bit bigger than average but not relative to my build).Ive had arrythmias since about 3 weeks into the cycle,and the last 2 weeks theyve become more prevalent so ive decidedd to cut the cycle short.

im curious though,has anyone else experienced this?in all the side effects listed arrythmias isnt one mentioned. Im wondering if its the effect on the CNS that causes it or is it a direct effect on the heart?Interestingly the irregular beats are not during training but rather at night before i go to sleep when im lying quietly.

I take metapropolol(a beta blocker) to control the irregular beats but it does not seam to be as effective since on cycle.its a bummer because i would really like to continue the cycle and was considering another down the track.

Only thing I can say is that I have a friend with irregular heartbeats once in a long while, and he hasn’t seen any changes either way while cycling.

Just my 2 cents…I have A-FIB and have been on and off for 3 years no issues…you just need to be smart about it…

For me, AAS are fine and stims are fine, but higher dose AAS, with certain stims can cause me to have exertion arrythmia.

BBB

I get arrythmias always had them. I notice I especially get them if I’m not breathing properly I.E not taking proper breaths. always get slightly worse at start of cycle then seem to normalize.

[quote]h-man11 wrote:
I get arrythmias always had them. I notice I especially get them if I’m not breathing properly I.E not taking proper breaths. always get slightly worse at start of cycle then seem to normalize.[/quote]
interesting that they normalise during th cycle.mine seem to have gone the other way and got worse.My blood pressure in the 1st few weeks felt like it was through the roof(headaches veins iin temples bulging,when bending over felt like my eyes would pop out!) but that normalised and 2 weeks ago was tested and 120/80 which is as good as its ever been.im sitting quietly as i type this,quite relaxed yet still getting the odd one.usually might get a few a day,at the moment theyre as frequent as a few times (up to ten maybe)hourly.im just hoping its not some progressive problem…

Im no expert…but certain steroids can cause potassium wasting…I would get your k levels checked just to be safe. I had a allergy steroid shot (decadron/Kenalog) to help with my allergies and my K hasnt come up since. Doc says itll take a few months to get my body back to normal. IDK if its the same with anabolic steroids but getting your blood checked wouldnt hurt. ( Low potassium causes irregular heartbeats)

If he has an arrhythmia, it’s more likely that he has high potassium, especially since he uses a beta blocker.

Question 1: Are you using a combination hypertension therapy? (ie beta blocker+ace inhibitor, betablocker+thiazide diuretic, etc). If you are using an ace inhibitor, you are very likely to have high potassium levels. They cause potassium retention. As you cycle and work out, I’m guessing your diet is quite healthy, and healthy diets tend to have high potassium (protein powders and multivitamins add to the load, too). Potassium is released in high amounts during exercise, as well. If you have pathological potassium retention, this is going to build up your serum levels.

You need to get your blood work done asap. Hyperkalemia is a serious condition and can cause a rapid-onset heart attack without any prior risk factors. A hyperkalemia induced heart attack is harder to survive than an atherosclerotic-related one. I can’t give you advice on stopping your medication for a few days till it’s sorted because I can get in serious shit from the Royal College here in Canada for it, but go see your doc asap.

Unfortunately arrhythmias, particularly a-fib, have been associated with AAS use and there are a number of case reports in which they do appear fairly conclusively to be the causative factor. This is just typical scare-mongering – there can be an association, although it must be remembered that it would seem to be very, very rare. A few sample case reports are listed below:

http://www.google.com/url?sa=t&source=web&cd=6&ved=0CCsQFjAF&url=http%3A%2F%2Fwww.elitefitness.com%2Fforum%2Fattachments%2Fchat-conversation%2F37910d1215966460-statistics-question-afib-aas-user.pdf&ei=jTAsTO3NF8KC8gbO9vyVDQ&usg=AFQjCNEpPEJ6Uw7Old1czrbFp1UeQlFzOA

http://www.icrj.ir/UI/Pblc/..\..\Files\AuthArts\1020+.PDF

[quote]FrozenNinja wrote:
Im no expert…but certain steroids can cause potassium wasting…I would get your k levels checked just to be safe. I had a allergy steroid shot (decadron/Kenalog) to help with my allergies and my K hasnt come up since. Doc says itll take a few months to get my body back to normal. IDK if its the same with anabolic steroids but getting your blood checked wouldnt hurt. ( Low potassium causes irregular heartbeats)[/quote]

…Except those are corticosteroids, not anabolic steroids. Completely different drugs.

BBB

I really appreciate the input folks,anytime your heart does wierd shit its pretty freaky.I wouldnt have commenced the cycle if i thought it would give me arrhythmias.I actually went off the metaprolol for over a year with my docs ok with minimal recurrance (ie maybe once or twice a week it would flip flop for a few beats then be back to normal)and my blood pressure was fine.

i started the betablocker back up to help counter the potential BP increase from the sustanon.initially there wasnt any issue with the arrythmias although about 3 weeks in i had a glass of champange as atoast to good news(literally just one) and had them that night so didnt have any more alcohol whilst on cycle).but the betablocker is the only med ive been prescribed no ace inhibitors or diuretics.

i had bloods done a few weeks ago and my potassium was 4.3-(the range is 3.5-5.1) so im assuming thats not an issue.actually most of my parameters were standard,iron haemaglobin etc.though my cholesterol was pretty bad-my LDL was 4.8 and my HDL was only 1.0 so need to sort that out.

also my ALT was 79 H range(5-40)and my eGFR was 69L(says below an eGFR between 60-80 ml/min/1.73m2 does not exclude the presence of chronic kidney disease. i dont know what that means but am having a follow up and holter monitor test done in the next few days.

On to the next thing if everything is normal.

Talk to your doc about switching off a beta blocker to an ACE inhibitor or diuretic (you’ll have to get bloodwork done 1 month after starting the meds, and every three months after that).

As you’ve probably noticed, beta blockers make you feel like shit. They give you trouble when you try to get your heart rate up, you can’t do cardio, etc…Just an overall shitty feeling.

Heart beat/rate has 0 to do with CNS fyi. Your heart produces its own electrical current to cause the contractions via the SA node. What were results from the stress test? Was it just an exercise tolerance test or did they do a stress echo? (if unsure did you just walk on a treadmill with an ekg hooked up to you or did you get pictures of your heart taken as well)

Also, Joey why are you suggesting diuretic? Mostly diuretics are for people in congestive heart failure to get any excess liquid out providing less stress on the heart, but will seemingly not do much in order to control an arrhythmia. And a beta blocker will make any type of exercising very difficult. Your heart rate will not go up to compensate for the increase in oxygen demand during exercise. Either of these do not seem like a viable option.

Give me a detailed report on your results from your tests. PM me it or post it here I dont care.

BMC

He’s saying he’s taking a beta-blocker right now, which is why I’m suggesting to talk to his doctor about getting on another BP medication instead of it.

As far as the thiazide diuretic goes, while its indicated for CHF, it’s also indicated for hypertension (although it’s usually indicated as a combination therapy with an ace inhibitor because it’s a relatively weak anti-hypertensive). If his hypertension isn’t too bad a diuretic alone will suffice.

If he’s having arrhythmias due to high potassium (which is not confirmed at this point), then switching to a different BP medication that doesn’t cause potassium retention (both beta-blockers and ace-inhibitors raise potassium, but a diuretic doesn’t) will in fact help out in that regard.

Either way, he should get off the beta blocker. It’s a terrible option if you exercise at all. In my opinion, it’s a terrible option for anyone. Docs who still prescribe beta-blockers when there are better alternative treatments are living in the past.

And the reasoning behind asking about the results of the stress test… if his left ventricular function isnt normal… id suggest staying far away from diuretics with hypertension… And havent diuretics even been linked to causing arrhythmias?

But yes i agree with you. if he plans on exercising while on a beta blocker… he wont have much of a workout. Youll be getting next to no blood to compensate for the increased oxygen demand.

BMC

[quote]BMC85 wrote:
And the reasoning behind asking about the results of the stress test… if his left ventricular function isnt normal… id suggest staying far away from diuretics with hypertension… And havent diuretics even been linked to causing arrhythmias?

But yes i agree with you. if he plans on exercising while on a beta blocker… he wont have much of a workout. Youll be getting next to no blood to compensate for the increased oxygen demand.

BMC[/quote]

As far as I know, only the potassium-sparing class of diuretics have been linked to arrhythmias. Thiazides have proven pretty safe, although he may have some initial side effects with the body adjusting to the slightly reduced blood volume.

It’s all speculation without having examined the patient though. Can’t say if it’s contraindicated or not without the test results.

I guess we’ll never know the results.

BMC

hey guys,thanks for the informed input. been flat out with my work and havent been able to get online(not all of us sit in front of a monitor for a living)the stress test was done 4 years ago,no issues with left ventricle or any abnormalities.they only wired me up though,no images taken.The betablocker is prescribed purely for the arryhthmia,not for elevated blood pressure…

I wasnt having issues with the irregular beats at the start of the cycle,that really kicked in towards the 5th week.i wore a holter monitor 4 days ago for 24 hours and am waiting on the results for that,but typically i didnt seam to had much of an episode whilst wearing the device.the last few days ive been symtom free and its been about 3 weeks since my last sustanon shot(and around 2 since the last test prop shot,so wether thats coincidental or perhaps im one of the rare few that reacts with AA’S.

ive just started PCT(nolvadex standard protocol from th stickies)and am still training hard,strength hasnt dropped off as yet but am down abit in weight.all though i was only “on” for 7 weeks i must say apart from the obvious issue with the arrythmia(and thats not confirmed as being causitive from the gear)it was really abit of a letdown.After reading of 10kg increases from 250mg of sust(profile on meso-rx i believe)in a few months i thought the returns would be greater. .

i ate a shitload of good food(and some not so good)and trained my ass off,but really only probably gained a couple of kgs at the end of it all.I didnt really see ANY improvement in sex drive either,but did get quite pumped and some extra acne-so in all was quite a let down and most likely wont be venturing down that path again.still,at least i wont have to wonder what might have been if id never tried…

i will post the results of the holter monitor and anything else relevant though when i do get some results(am working in a ski resort in oz and the medical facilities arent much good for anything other than breaks and fractures!!

That’s usually the case when holter monitors are given. Usually no symptoms during the period you wear it. If you do still feel any palpitations or any symptoms at any point you can suggest to the doc to wear an event monitor (before you do, realize they will probably ask you wear it 3-4 weeks which can be quite a hassle, but more of a chance of the monitor to pick up the irregular beat)

And to your comment about the other fellows heart rate being normal while on cycle might be due to his heart rate being faster on cycle. Typically when your heart rate speeds up it gets into more of a sinus rhythm. I feel like my heart rate is slightly elevated than normal when on cycle so that may be the cause.

Do you notice any side effects with training while on the beta blocker? In my eyes it’d be a horrendous feeling.

Also as far as your disappointment with gear… Could be a few things… If youre an ectomorph you’d really be amazed as to how much food needs to be taken in order to gain desirable weight. Im talking mind boggling amounts of food… even while youre on gear. Another option would be that the gear wasnt legit. Regardless, theres always a reason for things like this to happen.

BMC