T Nation

Help Starting TRT - Heart Problems

Im a 27yo male from germany, 72kg, 178cm, good beard growth, thinning hair, bodyfat around 20%, training since 10 years, and noticed weakness and all the other low t symptoms 4-5 years ago. My total t back then was always around 7,5-8,5nmol/L. So i went to 4 different doctors, and only one of them prescribed me testosteron gel. But i never used it, because i was scared of starting trt at such a young age, and heard bad stuff about the gel. So the last years i made 0 progress at the gym, even though it is my biggest passion. Every time i’m in the gym, i have no pump or drive, feel anxious and can not increase my weights.
When I was 20 years old, I had made extreme progress in no time, now it is total different.
Now i startet finasteride 6 months ago (hairloss), and suddenly my t levels are a lot higher than the last 3 years. But i dont feel any better or stronger.
The other problem is that i have heart arrythmias (extra beats), specially when i am under stress.
I already went to 2 different cardiologist, and they told me my heart is healthy and there is no problem. Is this dangerous for my trt idea, and how risky is a higher T level with heart arrythmia?
Will there be a difference in building muscles with lower end t levels, in comparison to high end of the reference range? I heard some people say it doesnt matter if you are high or low, unless you are having supraphysiological levels.

These where the labs 1 year ago:
12,8nmol/l
Free T: 42.8pmol/l
shbg: 24,9nmol/l
fsh: 2,6u/l
lh: 2,4u/l
E2: 82pmol/l

And these are from today:
E2 126 pmol
shbg 26.9 nmol
total t 20.1 nmol
free androgen index fai 74.7

I wanna start self medication, with 150mg Enanthate e5d (subq injection) and a calorie reduced diet. I also have Arimidex on the hand, if i feel some increase in E2. Dosage would be 0,25mg 2 times per week. Do you guys think i could benefit from a trt, or would I have to go on a real cycle (250mg e5d) with my current values, to notice any improvement at all? btw sorry for my bad english

You need to add lab reference ranges.

Heart arrhythmia is when electrical impulses sent to the heart don’t function correctly, but there is nothing physically wrong with the heart.

As far as your TRT protocol, there is no reason to start out so high, you can slowly increase your dosage to reach the desired affect. The 150 every 5 days is a lot and not the same thing as 150mg per week, I would dial it down to 100-120 per week and split it up 1-2 times per week. I can tell you without a doubt that low-T isn’t healthy for the heart.

As far as the finasteride, get off it immediately, it’s an endocrine disruptor and some of the worst cases of Post Finasteride Syndrome see very high testosterone levels when compared to baseline levels. Some guys don’t get PFS until after they stop the drug.

Post-Finasteride Syndrome

Court let Merck hide secrets about a popular drug’s risks

Google post finasteride syndrome. It’s absolutely horrifying. You need to stop taking it. As for hair, I’m 33 and I’m starting trt so I’m not yet bald, but I will shave when it’s the case. Hair or not, it doesn’t matter. It’s all about confidence.

Immediately stop taking the finasteride for good as a very first step

I think you could realize some benefit, only one way to find out. The 150mg every five day dosing is fine. That averages out to around 210mg a week, which is a very common dose taken by 80-90% of those on TRT.

As others mentioned, I’d be very cautious with the finasteride.

Yes, when it comes to muscle, more is better, up to a point, and you won’t be going anywhere near those doses.

If you go off fin, and I hope you do, maybe make a post on propeciahelp.com asking the best way to wind it down. Stopping cold turkey might be a little risky.

I have the extra beats like you have as well. I even had an ablation done 5 or 6 years ago to get rid of the extra beats and it worked for a while but I seem to be getting them more and more these days. I’ve been on TRT for 6 years and I don’t think it effects the PVC’s (extra beats). One doesn’t have anything to do with the other. TRT won’t hurt you.

I will say this, if I’m dehydrated my PVC’s are way worse. Drink water but also drink electrolytes and lots of them. I drink Gatorade zero’s and they seem to really help.

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Add reference ranges to your originally post. It’s hard to compare the two sets of results as the tests aren’t really the same (for the most part) other than a few things.

Regardless… I agree with everyone else. Drop the finasteride. If your total T went up while on it it’s probably because less is being converted to DHT, or it’s just a coincidence

In general, 150mg every 5 days is totally fine.

Yeah, I guess I’ll chime in here and add that over the last couple years I have started having “extra beats” as well. I complained about it and was referred to a cardiologist who put a cardiac monitor on me for a couple weeks. It recorded both PVCs and PACs, with a burden of <1%. He then followed up with an echocardiogram, where my heart looks perfectly fine.

The cardiologist said that hearts aren’t morphologically perfect, and so long as the electrical wave doesn’t look bad (in whatever manner they can look bad to the doctors) and the burden is not high, and there are no other symptoms that would indicate a problematic arrhythmia, there is essentially nothing to be concerned about. Some people get them - even elite athletes. Many people have them and never know because they’re not OC like us. Think about how many people just sit around being slobs totally out of tune with their body. They have no idea what’s going on inside.

Stress and stimulants usually provoke these, by the way. I was told to limit any stress and lay off the coffee. Also, vagal nerve irritation can contribute. If your vagal tone seems unusual (BP issues, syncope easily, sensitive gag reflex) or you have poor gut health, clean those things up.

What he said above is very true about athletes getting PVC’s. Also the coffee, indigestion or gut problems, and stress all make the PVC’s worse. Alcohol can make them worse too. I drink a lot so I should know :slight_smile:

Thanks for you guys feedback. Here are the labs again, with reference ranges.

test from 2016
e2: 99 pmol/l everything below 195
total t: 7.8 nmol/l 9.3 - 34.6
free t: 28 pmol/l 15.8 - 83.8

Test from 2019:
e2: 82 pmol
lh 2.4 u/l 1.5 - 9
fsh 2.6 u/l 1 - 14
shbg: 24.9 nmol/l 13 - 71
total t: 12.8 nmol/l 9.3 - 34.6
free t: 42.8 pmol/l 15.8 - 82.8

From 2020:
e2: 126pmol/l everything below 195
shbg: 26.9 13 - 71
total t: 20.1nmol/l 9.3 - 34.6
free androgen index: 74.7 36 - 155

I dont know why you guys are so negative about finasteride. I would rather have a limp dick, than walking around with a bald head. Girls really hate bald guys, specially if they dont have a top tier bone structure. It would be totally over for me.
I looked at different studies, and they always write about 3-5% of guys getting side effects, but also almost the same amount from the placebo group. I will take this risk, because hair is so fucking important for me.

I am really scared of going on trt, because my labs seem normal and dont look like i have hypognadism. So in worst case, i could damage my natural production and get zero benefits from trt.
Its just that i dont feel masculine since a few years. It all started with a depression, and seems like since then my body and strenght went to shit.
I wanna feel like 19 again. Good pump, motivation, sweating and increasing strength. Im training the last few years without any muscle gains.

They may hate overweight balding guys, but muscle guys with shaved heads can pull a TON of ass

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I provided some links that should have made things very clear, there have been members who are in a living hell that makes being bald seem like a non issue.