I’d jump to underlying health ailment unrelated to TRT (that may have been exacerbated) because a physiologic dosages of testosterone shouldn’t cause atrial fibrillation within a regular individual
Say he’s on 100-200mg/wk, I highly doubt that’d be the sole cause of a-fib. A highly stressful lifestyle, anxiety (also induced by genetic/lifestyle factors), old age with underlying cardiovascular disease, being heinously overweight (one of the reasons why I reccomend being careful with some regarding TRT. If you’ve spent you’re entire life sedentary, it’s not like you’re suddenly going to change dietary/lifestyle habits suddenly etc, the sudden shift off homeostasis regarding an already frail/fragile body, the sudden upregulation of the sympathetic nervous system and bam… arrhythmia city… (imagine an incredibly stressed out individual, cortisol pumping out, systemic catecholamine release… the guy is sedentary, overweight, already residing in a systemically pro inflammatory state due to elevated circulating concentrations of pro inflammatory cytokines etc… he’s put on T, the CNS stimulation combined with all the other variables proves to be too much and BAM… Atrial fibrillation, such an individual should have been evaluated carefully prior to being put on)
That’s just my take on it, I highly doubt barring perhaps the notion of a cardiac defect/disease (aside from atherosclerosis) being present that TRT alone was the sole causation here.
However systemlord is highly biased regarding this situation, stipulating every single male with a TT below say 600 “certainly requires TRT” when they state the slightest symptom that may or may not have anything to do with T deficiency. If it ain’t broke… don’t try to fix it lol. If we look at his situation (chronically unhealthy, has been very overweight for a very long period of time… health aliments are racking up due to being in ill health for so long) TRT does seem to exacerbate (understandably) his issues, particularly regarding regulation of electrolyte balance, autonomic dysfunction etc. He doesn’t appear to want to take the sound advice that TRT aggravates/induces new issues over time (for him) and thus prior medical pathology needs to be dealt with before he can proceed (and I assume had he been healthy the would be able to handle far higher doses to boot… not complain of potassium imbalance, neuropathic pain etc on 5mg/day… wonders why this is happening with a HbA1c of like 8% (obvious clinical marker regarding the presence of diabetes mellitus)…)
I understand there is a notion of denial, and he will get PISSED off that I’m posting this, however it needs to be said and the sooner he can realise TRT isn’t the holy grail regarding fixing his issues (as he has banked EVERYTHING on the mere notion of testosterone replacement being the holy grail to all issues and appears reluctant or outright refuses to try anything else “X medication won’t work because I have side effects from all medications etc”.) If he doesn’t fix up his health status, these problems he’s experiencing will prove lethal… I’m sure there will end up being some kind of excuse as to why he can’t lose weight “but I’m eating healthily, exercising etc.” Most obese people say this to me, then when you see a normal, somewhat fit person actually push them in the gym they’re suddenly winded after running 200 metres at an adequate pace, or literally die from one set of squats. You analyse their diet and… they may be eating healthily, but macronutrient intake is off, their “salad” is literally doused with sugary dressings, overall caloric intake is at or well over maintenance