T Nation

Fear of Heart Attack on TRT Injections?

Anyone else have the nagging thought that you are going to have a heart attack while on TRT injections? If so what have you done to overcome the fear or do you still wrestle with it?

I’ve been on TRT less than 90 days and feel better than I did when I wasn’t, but I have this lingering fear that I’ll have a heart attack while doing cardio.

Read Abraham Morgentaler’s book Testosterone for Life. He discusses how TRT actually reduces your risk of heart attack and why people associate TRT with risks of heart attack.

Just remember, most of the anecdotal evidence against TRT is based on people abusing steroids to achieve supraphysiological levels and those levels are what put you at risk. Running a responsible TRT protocol actually lessens your risk of many health issues.


The myth is absolutely correct on this issue. So long as they monitor your blood levels as some can cause it to “thicken” you’ll be fine with responsible usage.

Ive read that unchecked e2 would cause more of a heart issue than the testosterone. As well as issue with your prostate.

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The studies showing increasing T causes heart disease / attacks are flawed. They took men with really low T and brought them to low t ranges. As was posted previously, there is more evidence to show low T issues cause a variety of diseases, including increased cardiovascular disease. you need to monitor your Hematocrit levels and if it starts getting too high, just give blood and it will knock it down. FWIW - my buddy is a cardiologist and often prescribes Androgel or other T-replacement therapies to his patients - independent of numbers (bases it on symptoms). He told me that he has seen almost no clinically adverse reactions to lipids

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Thanks for the responses! I’ve read the book “Testosterone For Life” and Jay Cambells book and I still have anxiety.

The main reason for the anxiety is because three days after my shot my chest pounds when I lay in bed and I have to take a sleep aid. I check my blood pressure 3 to 4 times a day now. Would blood pressure indicate blood thickening?

As far as checking my e2 is there a way to get it done without asking my doctor?


Order it at privatemdlabs.com. They use lab corp. Then go to retailmenot.com and enter privatemdlabs and you’ll find a coupon code for 15% off. A good one is hormone panel for females for $66.99. Just select MALE at checkout.

Or order the following. (Same as above but includes free test also)

Hormone Panel with F&T Testosterone LC/MS-MS

@jimgainz is your buddy in California? Info please if so.

Ambulance chasers i have had half a dozen doc tell me even at at 1200 nanograms , and active better than 250 couch potatoes, dont believe those commercials, i have ivc filter doc is so concerned about it moving maybe next year check if it moved, i will say if you have high bmi , on high test, over 1 gram weekly total over 35 take a 81mg baby aspirin twice daily with reduce risk greatly. Now of im on 1000mg test. 1000eq, weekly and 50mg anadrol definitely add aspirin.

If it doesn’t cause heart attacks why would I need to take aspirin?

thank you for the info!

He’s on a gram a week and that can cause high hematocrit and something with the RBC - on TRT dose, you don’t have to worry about it.

Some guys make too many red blood cells with higher T levels and HTC can be too high.
Aspirin makes blood cells more slippery so they flow better.
Avoid dehydration.
Fish oil is also a mild blood thinner.
Males should avoid vitamins with iron, save those for kids and cycling females. Avoid iron fortified foods: bread, pasta, cereals, flour etc.

Remember all of the testosterone heart attack adds from lawyers and how they stopped suddenly? A retrospective study of VA guy on TRT showed that they had 1/3rd less heart attacks and strokes. THE HEART ATTACK ADS STOPPED INSTANTLY. And we know that they were as a group would be poorly managed mostly without any estrogen management.

Post injection anxiety is a different beast. Have you injected T into veins? How/where do you inject?

“The main reason for the anxiety is because three days after my shot my chest pounds”

This was a big issue for me. It was pretty bad and what has limited me to only .5 mL a week. I know I need more. Closer to 1mL as I can get . I just couldn’t stand the anxiety.

I’ve mitigated it with .25mL subq injections twice a week. I believe my estrogen was spiking so high it was giving me panic attacks. I’ve finally talked my doctor into AI blocker and am taking it with my subq injection. If all it well I plan on increasing them together until I can dial it in.

After one dose of the AI I was creepily calm and happy. Very euphoric. Way less anxious. Hope it keeps up. Also been pissing like a race horse and I can see my tendons and veins in the back of my hands again. I’m guessing it’s helping with the bloating as well. Felt like I’ve been swimming in fluid.

Hope this helps ya. The subq injections are fucking money. I inject nto fat in the quads.

Thanks KSman! I inject into my left shoulder and don’t believe I’ve hit a vein. My doctor said that it was okay to inject there.

My doctor has me on .3mL twice a week and I’m thinking I should lower the dose. I have no idea about AI’s and not sure thats any road I want to walk down. I am still figuring out the injections! What do you mean subq?

He’s not in Cali. But I’m sure there are a multitude of doctors in CA that specialize in this. Check out YouTube and type in “ask the doc” and it will show a TRT doc located near LA who answers all sorts of questions about various protocols and dosing. I think his name is Rand McClain or something like that. He discusses T replacement in depth and dispels many of these issues regarding T and heart attacks.

Lower the dose and see how it goes. Regarding an AI - you need one. The fly in the ointment with testosterone replacement therapy is estrogen. Anxiety with TRT can be a common thing. I had to stop Androgel (2 pumps a day) because it made me so anxious - and this is from a guy that could pin half a 10,000 IU bottle of Test back in the 80’s at one time with no issues. Your anxiety is most likely caused by E2 spiking with the test. Get bloods and see if E2 is in the range of around 20. In the meantime I would lower your T dose a bit and pin 2x per week

Subq is subcutaneous injection. injecting into the fat. Slower release.

You do have a valid concern IF your hematocrit is high. I’ve been on TRT for 18 years and no matter what dose I take the level is always right at or just below max normal.

Here’s what I did - I went to a hematologist and told him my concerns. There are a number of factors other than one’s hematocrit which can cause a clot. Some are genetic and should definitely be checked. He ran a whole battery of tests and in the end he said that even with a high normal hematocrit level I had a very very low risk for a clot.

I asked about a low dose blood thinner. He said I would be more at risk of having a brain bleed than having a clot.

He said to stay hydrated, take a baby aspirin in the morning and evening, hefty amounts of fish oil and if I fly by all means wear compression socks.

Seems that you have not read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

It is important that E2 be optimized. Anastrozole is used to modulate E2 to a level where quality of life is better.

Elevated E2 leads to:

  • less libido
  • more fat
  • increased risk of endothelial dysfunction - arterial disease
  • reduced insulin sensitivity
  • increased risk of prostate problems
  • mood/depression problems

Low thyroid function reduces cellular metabolic rates leading to fat gain, increased cholesterol, low energy, lower body temperatures, mood problems, increased risk of lower insulin sensitivity and diabetes.

Suggest that you create a thread for your TRT and heath concerns, this thread is not good for that.