T Nation

Ask Physiolojik Thread


Do you inject im?


@physioLojik I asked a question above and was wondering if you could give me your 0.02. My doc wants me to take saw palmetto to lower my DHT (have no idea what it is at and no symptoms of higher DHT except balding but that was before TRT). His thinking is if I lower conversion in turn would raise my total T. I personally didn’t think it would work that way, it would make sense with free T but not total to me, but I’m new at all this. Hope to get your opinion so I stop questioning my doc’s knowledge or know I need to start questioning even more. Thanks Doc.


I do inject IM. Shallow IM Delts with easy touch 28 gauge insulin needles.


So, I saw before that @physioLojik, you’re not a fan of AI use unless absolutely necessary. I even seem to recall you suggesting 10mg/day of Tamoxifen/Nolva in “ambitious” TRT instead of any low dose AI. Having done my research, I partly seem to get where you’re coming from (no “free lunch” with these AIs), but there’s a part that I cannot seem to get my head around. It’s the conflict of two facts(?) I cannot resolve.

  • Nolva acts as an anti-estrogen in the breast tissue, but acts as an estrogen agonist in other tissues.
  • gyno is the result of a seriously neglected rise in E levels in men. At least for me, moon face, lack of energy and motivation, etc. were already significantly present when my nipples were just itching a bit, but not swollen yet at all.

So, what’s the point I’m missing when I don’t understand why we should use a specific anti-gyno medication that does not(?) treat all the other side-effects that come sooner than gyno itself. (Or maybe even adding insult to injury being an E agonist elsewhere.)

Thanks in advance for helping me see more clearly here!


Nah man don’t worry about it, enjoy you’re holiday, I’ll annoy you about it when you get back lol.

I don’t think I’ve ever been in the Newark longue, but I have been in the quantas and Emirates longues before, I’ve gotten funny looks before though because I don’t dress sophisticated or quite look the part.


Alright I’m sorry to bother you on you’re holiday however something happened that I thought you and everyone on here should probably know about. So, I had a final exam coming up, one of the super important exams that determines what course I get into after school, goes towards a decent portion of my atar, which is the Aussie equiv to GPA/SAT scores or however they do it there. Anyway as a child I had ADHD, so I took amphetamines (prescription) to counteract the hyperactivity, I stopped taking them when I was about twelve due to certain adverse effects (extreme appetite suppression, certain ones made me borderline psychotic, however I ended up on Focalin (dexmethylphenidate), which had no side effects besides the appetite suppression, but as I got into lifting weights I decided to stop using it due to the appetite suppression so I got my doctor to wean me off. Now I still have a huge bottle of this stuff lying about, I’ll explain how this factors in soon. Now earlier you said you’d never judge me, but I’m sure you’ll judge me to the extreme with what I’m about to say.

To study more efficiently and for longer durations for the final exam, I took 5mgs of dexmethylphenidate the day before the exam. I would like to point out this is not something I do on a regular basis at all, maybe individual five times a year to help study for exams, and that’s just started this year. Due to anxiety, I couldn’t sleep that night (and I had gotten up early the morning prior), so studied through the night, but found myself getting very, VERY tired at around 4AM, considering I had to get up in two hours, I couldn’t risk going to sleep and not getting up, so I took 200mgs of caffeine (pill form), and my body HATES caffeine, I get diarrhea, tachycardia, heartburn (no point into going into mechanisms here, I’m sure you guys know why this happens with caffeine), and then three hours later before the exam I took another 5mgs of dexmethylphenidate as it helps me concentrate for hours on end (seriously when I’m not on it my attention span is so short I have to study in 15 minute increments). Anyhow, that morning due to anxiety about the exam and the stimulants in my system I had a full on panic attack, something that I’ve never had before and it SUCKED, there was pain in my chest, rapid heartbeat, I was nauseous (HR was already rapid due to the stimulants), I knew it was just a panic attack but I couldn’t help but freak out. Anyway, I got over it eventually and I went through the exam (which went well I think, I was anxious for nothing).

So after I got back home and decided to workout, now at this point I hadn’t eaten or had any significant amounts of fluid in about 20 hours, I’d been awake for around 36-40 hours but I wanted to work out anyway, so during the workout my heart rate was very, very high and I had a tightness in my chest, and towards the end during some curls I started feeling light headed, my HR became irregular and extremely fast (atrial fibrillation, this had never happened to me before) and I was like “shit, better go lie down”, the reason I didn’t check into a hospital was because if I did I’d have to come clean about what I’d done, and with my doctors that’s a last resort, if I’d had someone like you or a doctor that was open to monitoring me I wouldn’t been more comfortable with checking myself in. Anyway, I was in bed and my heart rate didn’t go down that much, during afib I believe it was well over two hundred, and then while in bed it was 120, but an hour in, while lying down, my heart started beating rapidly and irregularly again, I got up because I was like “that’s it, gotta check myself in”, I was nauseous, sweaty etc. So I got up and fell down, then got up again and sat down for a minute, and the heart rate went back to around 120BPM, still tachycardia, and my heart was beating HARD, like serious palpitations, I was almost sure I was going to die, so I sent out some texts to anyone who knew what I was doing telling them that it was no one’s fault but my own and for no one to blame themselves, that if anything bad happens to me I have few regrets etc. I lied in bed and kind of accepted the fact that this might be the end, but eventually after what seemed like an eternity the symptoms subsided, my heart rate is still elevated when I walk, but resting it’s no longer above 100bpm. Now I’ve decided I’m not going to use 200mg post cycle anymore, I’m just going to use what the doctors prescribe me regardless if I feel like shit or not, and I’m never using stimulants to help me study ever again. 200mg would probs get me to 900-1000ng/dl, and although I feel great up there, todays scare was too much.

Now, I’m sure it was synergy, the stims, the anxiety, the exercise, lack of food intake (and likely low blood sugar, the testosterone and previous brief use of nandrolone and oxandrolone, the lack of sleep, dehydration and stress), however I don’t want to risk something like this ever happening again, I’m going to be laying off exercise for a while too. I can’t rule out the risk of AAS induced heart damage given my bad luck previously, do I have dilated cardiomyopathy? Have I caused cardiac damage on a molecular level? Who knows, potentially for the first one and probably for the second one, unfortunately I won’t be able to find out, as I can’t go to a doctor and be all like “hey, I’ve used AAS”, which then goes back to my doctor giving me TRT, I get pulled off TRT and a whole new set of problems arise.

Anyway, today fucking sucked, if I stop posting or coming online just automatically assume something bad has happened to me. @physioLojik I don’t know you in person, therefore I don’t know whether you’d be concerned about this, probably not as you don’t know me in person, I’m just putting this out here because I feel like it’s important and I’m putting this out as a deterrent for anyone else who does stupid shit like this. I was aware of the potential side effects/ interactions of the two stimulants, I just figured “well it’ll be fine if it’s just once, and it’ll help me get a better ATAR which is worth it”. It’s strange the stupid and irresponsible things things some of us will do and justify accomplishing what we REALLY want, like getting into med school as an undergraduate. Anyway, to anyone reading this, judge away. Will I die soon? Potentially, I don’t know, it’d suck if I did that’s for sure. I’m not sure if I’ll ever be comfortable using non-prescription AAS again.

@alphagunner Whether this event was a consequence related to my blast there’ll never be a way to tell, however I do know that 17y/olds shouldn’t be having serious arrythmias from events like the one told above, considering there’s tons of kids my age who use METHamphetamine, drink to excess multiple times a week and they aren’t having any current heart troubles.


Bud the HSC can be a pretty stressful time. I occasionally dream that I am sitting those exams again, 30 years later, and can’t remember the subject matter well enough(even though I did at the time).
You sound like an intelligent young man and I predict you will do well. Many medical schools place a strong emphasis on interviews and I bet your knowledge would impress them.

Know that the HSC is not the be all of everything, its importance will sink into the background, in the future regardless of how well you perform.

Ride it out, and see how you go. Just say you don’t do as well as you hoped, there are still plenty of ways of getting into to medicine.


Find a good cardiologist that can be involved in your regular Care.

You cant just let shit slide when you have those symptoms. Don’t give up on life. Life is precious and you are here for a reason.


First and foremost I am really sorry this has happened to you. I completely understand how terrifying it is. (Welcome to my world.)


You chemically induced a cardiac event and want to blame bodybuilding? Wait! What?

You will be fine! You just need to sober up.

Sometimes we learn just enough to be dangerous, and reading/learning from a books is great. But, nothing replaces experience. I believe Physio has already told you, you are too worried about this.
Are you going to die? Yep! Someday. Will it be from a cardio infarction (or whatever) caused by AAS maybe, maybe not. Might get struck by lightning tomorrow, or run over by a bus. Point is… don’t be so worried about dying you forget about living. It was one event, consider it a hard lesson learned and don’t be that stupid again!


I appreciate the kind sentiment, I never gave up on life, the acceptance just happens to be something that happens whenever I belive I’m in a near death situation (has happened a few times, once with an allergic reaction, other times they were related to injuries that I was sure were going to kill me at the time they occured). I may seek out help from a cardiologist, however I do believe it to be an isolated event caused by synergistic factors (mainly involving my high level of stupidity). It’s strange, many people say that the human has a very strong will to live in a life or death situation, I tend to just accept the situation for what it is. It’s happened about four times in my life (times when I thought, “well shit, I’m going to die today, oh well”, and each time I’ve had the same reaction. I should clarify I’m not depressed or suicidal, it just seems to be the way I react to the immidiate realization that my death could be imminent. I had an ECG recently (about three months ago) and everything came out normal, I doubt i’ve develoepd serious enough structural changes since then for it to be picked up, the presence of acute drug induced cardiotoxicity is more likely the culprit here. I could have a faulty electrical pathway, if that was the case it would definately need to be addressed.

Well it’s just that I’m not sure what to blame, surely the bodybuilding can’t have HELPED!

I actually worry about these things too, the second one because over the past month I’ve almost been run over twice (falling off bike in the middle of the road, people leave empty glass bottles on the roads sometimes), so I’d say the worrying is more justified on that cause though. I must say though, as I’ve gotten older my anxiety appears to have gotten progressively worse, I need to look into meditation and other ways to start coping better.

Definately, I’m aware it was the epitomy of teenage stupidity (although on the bright side I think I aced the exam), however this would’ve happened with or without the help, the ‘help’ def adds a few percentage to the grade, and there’s a big difference between say a 90% and a 93%, that being said I’m not willing to put myself at risk like that again. The funny thing is, I knew what I was doing had the potential to be dangerous, yet I did it anyway, it’s funny how ambition can cloud one’s judgement. I’ve never responded well to caffine, a shot of expresso in the morning to wake me up will always give me an upset stomach, tachycardia and jitteryness, however it does it’s job, it wakes me up (hence why I drink coffee on occasion), the dexmethylphenidate… well there’s no excuse for that, due to the fact I have legitimate ADHD (and fairly bad too), I do have a legitimate reason to take them, if I went to a doctor and requested to be put back on them I could likely be given a script for them fulltime, however due to the adverse effects they’ve always had on me I’ll pass. I knew the combination of the two were a bad idea, however given that I hadn’t slept in around 36 hours come exam time I didn’t want to risk falling asleep in my exam, that would be an absolute nightmare. Either way I can’t justify what I did, it was wildly irresponsible, I thought I was above the stupid decisions I see many teenagers do on a daily basis, but apparently not. It’ll take a while for me to forgive myself for this. I do believe the cardiac event was a synergistic factor of extreme anxiety (as my anxiety persisted after the exam, once I get myself extremely worked up it doesn’t just go away even if the factor making me anxious dissapears), what my body would consider to be a mild overdose of caffine, given the nausea, jitteryness, tachycardia, diarreah and whatnot and the dexmethylphenidate. The prior low dose AAS use probably does play a small role as data shows use of supratherapeutic doses of anabolic steroids does potentially predispose one to an increased risk of arrythmias. Now whether or not I have a heart defect or undiagnosed hypertrophic cardiomyopathy? Not a single person in my immidiate family has died of a heart attack, had a lethal arrythmia, cardiomyopathy or other issue with their heart, therefore if I did happen to develop HCM it’d likely be soley due to AAS use. Although I was looking at some more recent studies and the cardiac manifestations caused by long term high dose AAS use in most studies appear to be sub-clinical (not all that important), however the case reports are what scare me, while genetic predispositions cannot be factored in, I’ll always be scared when I see a case report of a 22 y/o coming in with congestive heart failure, or a news report (typically scare tactics) or a kid dropping dead suddenly from supposed AAS use.

Overall I’m very dissapointed in myself, however I expected a much larger flaming when posting this, I’m still waiting for the responses ridiculing me for my unintelligent decision made here.

I’m aware of this, but the pressure for me to get great marks is enorumous, although the pressure is founded entirely by me. It’s important to me that I get into med school, although what kind of endocrinologist will I be if I make these godawful decisions myself, only time will tell


No judgement at all bro.

I can tell you from experience, that TRT has drastically increased my reaction to stimulants.

Maybe its because Test increases dopamine, and those drugs specifically dump dopamine into your receptors.

Obviously, don’t do that again. but you already know that.

Either way, I have had similar increased HR on stims. Do you have any medication you can take for anxiety? I try to avoid stims now, and if I do caffeine, I do like 50-100mg. Although I have been avoiding now since I know it affects e2.


Sorry to hear what you have been through. Must have been an extremely frightening experience… I’d defo give it some time to get over but as you mentioned there are shit loads of people in the world who abuse drugs and they survive the experience. You do not drink or take recreational drugs so you may well never have this happen again as long as you avoid these stimulants.

I personally did a lot is silly shit when I was young even though I had an autoimmune disease and really should have been looking after myself. Went to the Glastonbury festival one year and tool a load of bass speed and completely lost the plot for three days and nights. My friends thought had completely lost my mind and would never come out of it. Did not sleep for three nights and had psychosis.

All I’m trying to say is we all do stuff we regret but, you’ll get through this and learn from the experience. You’ll be stronger in the long run!

Keep your chin up :wink:


Good to know you felt like you aced the exam. Stay relaxed and keep up the good work.


I have noticed this too.


Yeh, I def over reacted a tad. Although the experience was far from fun, it happened again today, only for about a minute though, however I believe it’s more related to a panic attack than anything, as the sudden increases in heart rate seem to be directly correlated to episodes of me experiencing extreme anxiety, I seriously doubt I have a heart problem, the chance of me legitimately having an issue with my heart after using 250mgs of test (only enough to get me up to around 1500ng/dl MAX mind you), the total duration of my nandrolone use I don’t even think topped three weeks and the oxandrolone (both agents were used a while ago) was only for slightly less than five weeks, therefore if I do have an issue with my heart it’d be a congenital issue, which is impossible as I was checked as a baby and recently (a few months ago, post nandrolone and oxandrolone use though) and nothing abnormal was picked up. I enjoy bodybuilding too much to give it up, I will use again, however I don’t intend on using again without being monitered by a doctor, which in Australia it might be near impossible to find someone willing to moniter me. After I get my next set of bloods on my TRT dose and evaluate where I’m at I may up the dose to 200mg/wk forever, it depends how I’m feeling and where I’m at, I don’t know what I’ll do about the anxiety though, it’s extreme at times, I feel like a gigantic wuss and I can’t control it when it takes over.