He was given a dose of furosemide 40 mg intravenous, started on diltiazem and heparin drip. An echocardiogram was obtained, which showed: Increased left ventricular cavity size with normal thickness and severely reduced systolic function, global hypokinesis, and dilated atria. Left ventricular ejection fraction was 15%–20% (Figure ). Diltiazem was switched to amiodarone drip later as he developed hypotension. Heart catheterization showed normal coronaries (Figure , and an initial diagnosis of non-ischemic cardiomyopathy with congestive heart failure was made. Further workup showed normal thyroid hormone, anti-nuclear antibody, iron studies, negative JAK-2, and elevated erythropoietin (Table 1). Lisinopril, spironolactone, metoprolol was started, and diuresis was continued. He had persistent symptomatic atrial fibrillation and underwent cryo-balloon isolation of all four pulmonary veins. After the voltage map documented isolation of all four pulmonary veins, patient was still in atrial fibrillation and was cardioverted to normal sinus rhythm using a one-time 360 joule shock. Subsequently, programmed stimulation during isoproterenol infusion failed to show any evidence of atrial fibrillation or flutter. He tolerated the procedure with no immediate complications. Medical records obtained from his hematologist’s office mentioned that he was using intramuscular injections of testosterone cypionate for more than 18 years for bodybuilding. Testosterone levels 3 years ago was 1761 ng/dl. On further questioning, he admitted using testosterone shots and tamoxifen and raloxifene for many years, the last use being 1 month ago. Laboratories showed total testosterone 2060 ng/dl (250–1100 ng/dl); free testosterone 810.5 pg/ml (46–224 pg/ml). He was discharged on lisinopril 2.5 mg daily, spironolactone 25 mg daily, metoprolol 12.5 mg twice a day, apixaban 5 mg twice a day post-ablation (to prevent the risk of stroke and thromboembolism from left atrial manipulation during the procedure, his CHADSVASc score was 1), amiodarone 200 mg daily. He was also referred to the cardiac rehab program. In addition, he was advised to stop AAS use.
Also see Table 3.
Too bad they didnt dig deeper on the 18 year history and more detailed case history of AAS use. Simple as what was listed above or more compounds over time? LCMS for TT plus accurate methods for fT would have been nice. So much that could be learned that is missed since AAS use pushed underground. TOT protocols have a bright side as they will give us additional data on TRT+ effects under medical supervision.
I’m 5’9", 165lbs (when carbed up). My first 8 years of training were focused on powerlifting, I totalled 450/347/550 at a fairly fat bodyweight of 210lbs. ( Bench 157.5 kg - YouTube). I accumulated so many injuries doing idiotic stuff (lifting too heavy too often) that my joints could no longer handle the strain of heavy weights. I shifted my focus to bodybuilding, so right now I don’t even lift heavy: I chase maximum mind-muscle connection with more isolation, slower tempo and lighter weights.
As far as dieting, I’m currently on Lyle Mcdonald’s UD 2.0: Today and yesterday were low calories days, basically about a pound of chicken with non-starchy veggies, protein powder, fish oil and a multi. Saturday was higher in carbs but still low fat, about 300g carbs from pasta and bread.
I’m trying to get as lean as I can to reduce the likelihood of any potential aromatization when I get on test.
You can find pictures attached here:
You’re lean - props! You also had some pretty respectable PRs in your powerlifting days.
While you’ve certainly got muscle mass, but I would like to believe you’re still able to put on a good bit of muscle naturally. I only say this because 5’9 at 165 is a relatively light weight and I’d imagine you’re able to do more with your natural genetics before going into AAS. My intent isn’t to steer you away from AAS, I’m just advocating for the safer route - which is to get near max genetic potential before cycling or going on BnC.
This being said, there is some research to support single blasts having a long-term effect. There is also anecdotal experience from a good number of people who have done simple test cycles and had good results. Some people (@hankthetank89) don’t believe in steroid cycles, and others (@RT_Nomad) do; I would attribute this to their own experiences, YMMV.
If you cycle off without issue, you may not need to BnC. If you lose nearly all gains in your post-cycle, then you may be better suited to BnC… I would recommend your cruise to be at a TRT dose (around 200mg/wk).
As for your concerns with having a Dr. - I don’t believe you need to worry. Get your pharma grade T, get some 27ga 1/2" or 1" needles, alcohol swabs, and run subcutaneous or intramuscular injections. These aren’t as big a deal as you think they are (this was a big concern of mine before starting TRT).
What’s the worst that can happen on a single cycle of 500mg test ?
My issue right now is mainly psychological and I’m aware of it: lifting weights is the single thing I care about in life, much more than my professional career actually (I only work 10h/week). Due to my competitive nature, I would be very sad staying at that level (or progressing very slowly). It’s pretty pathetic IMO that my life revolves around bodybuilding, yet I cannot compete.
I definitely agree that I can still gain mass naturally, especially in areas (like arms) where my mind-muscle connection can still improve (I actually now believe in shit like pump/mind muscle connection/targeting different areas of a muscle that I used to laugh at in my powerlifting days ). The thing is I have the ambition of being a competitive bodybuilder. Without claiming to step on the olympia, I want to make the most out of that journey: being the best I can be and I’m afraid if I wait too long to get on AAS then it will be too late (I’m already 28).
I think it’s important to watch out for how long those professional bodybuilders tend to live… They take a LUDICROUS amount of drugs, and are lucky enough to have the genetics that actually respond to them.
A thread worth looking over. (he’s 19 and has been training for 2.5 years in the first picture)
This guy went on to win the NY Pro and you can tell from the very first picture that he had genetics to support such aspirations. I don’t want to tell you not to, but I think it’s worthwhile to consider the life-consuming consequences of chasing stage victories. If you balloon up on your first cycle, when you go on, then it may seem more reasonable to dedicate effort to stage competitions.
You respond really well then go on to abuse AAS more and more?
Your heart responds to AAS juat like other muscles but not a easy to track. Also consider impact on CNS and brain. Make sure you get regular blood work and heart surveillance (ekg and echos regularly) if you decide to go this route. Great you are researching now instead of going in blind and unprepared.
My initial advice is to get a good career (and like it). Competitive bodybuilding is expensive, unless you have a sponsor. I never was good enough to acquire a sponsor.
Your next challenge is to find a reliable source for quality AAS. IMO, you need much more than just testosterone. I was fortunate to have very good sources over my 3 decade competitive time for pharmaceutical grade AAS and other competitive medications.
Actually, the main reason why I had to stop powerlifting was a nasty quad tendonitis I developed from heavy squats. I’ve been struggling with rehab for the last few years, it’s getting better but very slowly. I think it’s obvious which leg is injured from this pic:
If you want to give AAS a go, I would suggest 300mg/wk of testosterone and 200mg/wk of Deca.
Give it a 8 week run. Assuming both products are pharmaceutical grade, if you have a reasonable amount of good genetics to compete at a fairly high level, you will make noticeable improvement in 8 weeks. Your delts should start to visually dominate your upper body.
If you don’t respond well, IMO you have an uphill battle to become a reasonably good competitor. In other words, the health risk may not justify the reward.
Any reason for stacking with Deca, as opposed to the usually recommended test-only cycle ?
I’d actually do this and post pictures post-cycle. If I don’t respond well I’ll just accept that competitive bodybuilding is not for me and move on!