T Nation

Coronary Plaque with TRT?

Anyone worried about their heart on testosterone replacement therapy?

Testosterone started out as a miracle hormone for me in improving energy and muscle size/endurance not to mention libido. I couldn’t wait to lift weights at the gym after a long days work and go home after with energy for the wife and kids. My levels on Androgel were 750-1100 TT and 20 something Free T with 30 Estradiol for a year.
Felt great to feel great again.

Then the palpitations happened…then the random tachycardia happened…then I stopped cold turkey from side effects related to arrhythmias and anxiety from arrhythmias.
For a whole year I struggled with depression/anxiety, the worst feelings of no energy or enthusiasm…saw a psychiatrist and was prescribed antidepressant which I never took because of zombie side effects and no libido.
Finally connected with anti-aging clinic and got on clomid for a month and hcg another month. Felt great until I stopped and now I’m here…
Currently feeling OK for the last year, definitely not depressed or anxious, and total T is 490 nothing spectacular but definitely better than when it was in 100’s.
So testosterone has always been the hormone that made a huge positive difference in my life with better well being and energy…but then testosterone was correlated with hypersensitive episodes and some side effects like palpitations, low blood sugar, and random chest pains.

I’m still wondering if negative sides might have been due to lack of sleep, constant suppression of cortisol, low blood sugar ( T lowered my blood sugar at random times regardless of diet) or just the gel itself vs the injectable cypionate.

I’m very much so interested in getting back on T for energy and strength, but leary of negative sides. I read about guys taking T into there 80’s and 50 year old power lifters who’ve been on T replacement for decades. Those dudes look healthy. Maybe my body is just sensitive to exogenous hormones?

But the one thing that really pisses me off about testosterone replacement therapy and the main reason I’m hesitant to jump back on is this: clinical evidence points in 2 different directions as far as safety is concerned! Many doctors say to stay away while some say it’s good for men. What the heck?!
For example, the recent JAMA study showed a buildup of soft coronary plaque from TRT users vs placebo.

Other articles show a decrease in cardiovascular events in TRT users vs placebo, while some studies point to no difference at all. What the heck?

So for now, I may just wait until further studies are completed before jumping back on the testosterone train.

-Older Soldier

Warning I’m not speaking as a expert or a doctor. Feel free to talk to real one

It doesn’t make a lot of sense that TRT treatments would increase the size of your arteries, Yet cause them to shut blood flow off to your heart. Or even cause calcification as that takes years and year to do that. But it does cause an increase in the number of red blood cells. Making your blood thicker which is not a good thing if you already have coronary artery plaque build up. Of course that can be taken care of by donating blood.

Things your increased testosterone does that could cause a heart attack, but has nothing to do with testosterone’s effect on your hearts health.

More and more vigorous sex. I went it like an 18 year old one night all night. that was when I had my heart attack.

In other words it makes you want to be more vigorous. This is good for you, but if you you are not used to it, or your heart is on the edge of failure.

My cardiologist did not think trt was a big thing so I restarted using it when I got out of the hospital. With newly open coronary arteries, but a very damaged heart. months later that heart showed no signs of damage. My heart was normal, hearts do not make a habit of fully healing when seriously damage ( I was to stupid too know I was having a heart attack). The cardiologist was very happy for me and took me off half my drugs.

Anecdotal evidence tells me that trt treatment helped me recover. It wasn’t just the muscle you can see that grew stronger and the fat loss was good. Buy my experience is not a medical study

Some cardiologists are referring patients for TRT.

That’s good to hear. I just started injections and am constantly 2nd guessing my decision. I would love to hear from 80 year olds that were in trt for decades.

Some cardiologists are referring TRT patients because of TRT? Or referred to be put on TRT?

So suffice to say T may be a double edged sword for many? Like adding nitrous to an engine…can benefit performance but must be used wisely as to not redline

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This is why it’s important to not overdo it after first starting TRT, if your E2 was low for a prolonged period of time your joint and tendon health will heal at a slower rate than your muscles, by comparison muscle grow much faster. A lot of guys wonder why their joints hurt after a hard workout, this is why.

Some cardiologists are referring TRT patients because of TRT? Or referred to be put on TRT?

Referring to be put on TRT.

Yes I’ve read T improves ejection fraction and contractility. The intricacies of the human body are much more complex than this alone, though. Like exogenous T administration suppressing cortisol and increasing epinephrine which could hyper stimulate things and cause a cascade of events which affect the entire metabolic environment within the body.

Yeah you go a number of years were your muscles really are not strong enough to tear up your tendons. Then they just start responding to exercise like they hadn’t done it in years and the tendons can’t keep up. That hasn’t been a huge problem with me but I definitely noticed it

I understand. Maybe TRT is not for you.

It seems like it made you feel good again. If so personaly I think it’s worth the small risk. Though I don’t really think there is a risk.

Remember Dr. Crisler had a heart attack not to long ago. Apparently he recovered very quickly maybe due to trt. Would love to know what his labs looked like before he had the heart attack…

Just read about Crisler last year, interesting how quickly he recovered…