T Nation

Possible IVC Compression or Narrowing Slow Blood Return to the Heart

#1

I have hold off talking about this for as long as I can (denial), but the last 4 weeks I am having what I thought were just random palpitations and strong hot pumping (bloating) in the abdomen you get from changing dosages and swelling of both legs (edema). I also have pressure behind the cheek bones, vision changes, sinuses swelling up closed, hearing changes, teeth feel strange and numbness and tingling in the feet and hands.

My chronic cough is in full swing and has been treatment resistant for over a year, acid reflux has stumped doctors and is also treatment resistant for the same amount of time. According to doctors there is no reflux occurring.

I stopped TRT one week ago, the symptoms have subsided a little. My last blood labs as of 4/25 was 450 ng/dL which I shouldn’t be having trouble and I have pushed higher without symptoms in the last 6 months.

Dr. Saya has suggested I see a vascular surgeon/cardiologist as soon as possible. I have an appointment Friday with a vascular surgeon and am worried if I’m not on TRT, he will be unable to find anything wrong since the symptoms are less when not injecting testosterone.

Dr. Saya threw around some big words that have hit me hard, IVC (inferior vena cava) or Aortic embolism do to plaque buildup narrowing the aortic valve could be causing these symptoms. I have always had these symptoms when changing dosages which resolved after 6 weeks, but are happening at all time now even after a week of no testosterone.

Been in and out of the ER for more than a week, legs swelling what looks like edema and throbbing sensation in legs probably do to edema affecting blood flow, now I’m noticing throbbing pain in my lower back and chest pains on both sides. New symptoms continue to present themselves the more time pases.

Now looking back 4 years ago when testosterone suddenly decrease over a years time, I now left wondering if the cause of low testosterone is back to finish the job.

I had a colonoscopy yesterday and a small cyst was removed, but everything looks fine, healthy gut. Monday I’m getting an ultrasound of the kidneys and Friday to see a vascular surgeon to see what is going on with my circulatory system.

I have always struggled on TRT, never really finding a range where I feel normal for long, maybe whatever is happening is the reason why.


Iron deficiency without anemia
HGB 15.4 g/dL 14.0 - 18.0 g/dL
HCT 46.5 % 42.0 - 52.0 %
RBC 5.72 Mill/mcL 4.70 - 6.10 Mill/mcL
Platelets 269 x1000/mcL 130 - 400 x1000/mcL
MCV 81.3 fL 80.0 - 94.0 fL
MCH Low 26.9 pg/cell 27.0 - 35.0 pg/cell = average mass of hemoglobin is small.

Iron 40 mcg/dL 59 - 158 mcg/dL
Iron saturation 12 % 20 - 50 %
Total Iron Binding Capacity 498 mcg/dL 250 - 425 mcg/dL
Vitamin D 12 ng/mL30 - 100 ng/mL
Potassium 3.3 mEq/L 3.5 - 5.0 mEq/L

#2

What’s you’re RHR (do you notice tachycardia upon rest, as in, a resting heart rate above 100BPM)

do you have hypotension (esp in supine position) but hypotension in general

What’s HCT/RBC count? Platelets?

Finally (well there’s others, just super super super super super super rare), (and most concerning potential cause of IFC syndrome) would be a tumour on the kidney, renal cell carcinoma/adenoma) I assume that’s why you’re getting a kidney ultrasound

Anyway sorry to hear about this, tis real shit I’d imagine

You’re iron/vit D is low, as is potassium. Low potassium can contribute to arrythmias (as can high blood pottasium) #torsadesdepointes #ventricularfibrillation. Iron deficiency anaemia can make heart palpitations worse and/or bring them on. But D is required for optimal bone density, hormonal output and more (I mean…you’re on TRT so the hormonal output isnt particularly important)

#3

CBC labs are below midrange, platelets is 272. Heart rate and BP are slightly elevated and the most consistent, 140-160 at times with HRT 85-101. Sometimes BP drops down suddenly (118/68), then quickly bounces back to 140-160.

I have been had multiple tests, EKG’s, CT scans, X-ray and neither shows anything. When I mentioned this to my GP, he asked if they performed an scans of my midsection, which I replied no, only head and ultrasound on my legs looking for clots.

#4

Which aspect(s) of CBC is low? Do you have a deficient amount of mature red blood cells?

A systolic BP of 140-160 isn’t good in itself and will cause increased cardiac output, as will anaemia, IVC syndrome etc.

If you’re HR is randomly hitting 160 I’d call that cause for concern. If you’re like me (which I hope you aren’t), you may have some sort of autonomic dysfunction (if you find out IVC syndrome isn’t the cause), autonomic dysfunction is a fucking pain in the ass at times. Beta blockers are the only thing that I’ve found to help… At the consequence of mildly fucked up glucose tolerance lol

Look into POTS and IST. Testosterone itself upregulates beta adrenergic receptors (among many other receptors), thus increasing sensitivity to catecholamine release, hence why some dudes on gear and trt complain of heart palpitations (dude on here in pharma was running test/Dbol and had a RHR of like 120+)! Obviously over time downregulation occurs to some extent, however in those particularly sensitive this can be an issue.

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#5

I’m requiring more and more testosterone to maintain 500 ng/dL as time goes on, probably do to long term iron deficiency. If I attempt to go back to 500, these symptoms force me to stop.

Iron deficiency without anemia
HGB 15.4 g/dL 14.0 - 18.0 g/dL
HCT 46.5 % 42.0 - 52.0 %
RBC 5.72 Mill/mcL 4.70 - 6.10 Mill/mcL
Platelets 269 x1000/mcL 130 - 400 x1000/mcL
MCV 81.3 fL 80.0 - 94.0 fL
MCH Low 26.9 pg/cell 27.0 - 35.0 pg/cell = average mass of hemoglobin is small.

Current Iron labs
Iron 40 mcg/dL 59 - 158 mcg/dL
Iron saturation 12 % 20 - 50 %
Total Iron Binding Capacity 498 mcg/dL 250 - 425 mcg/dL
Feritin 24 ng/mL 25 - 336 ng/mL
25-hydroxy Vitamin D 12 ng/mL30 - 100 ng/mL
Vitamin D, 25-Hydroxy, D2 <4 ng/mL ng/mL
VIT B12 261 pg/mL 200 - 910 pg/mL
Potassium 3.3 mEq/L 3.5 - 5.0 mEq/L
Calcium 9.1 mg/dL 8.5 - 10.7 mg/dL
Folate 8.8 ng/mL >=5.4 ng/mL
ALT 23 U/L <=63 U/L
Alkaline Phosphatase 91 U/L <=125 U/L
Bilirubin, Total 1.1 mg/dL <=1.0 mg/dL

4 weeks after starting of TRT - Iron labs
Iron 61 mcg/dL 59 - 158 mcg/dL
Total Iron Binding Capacity 425 mcg/dL 250 - 425 mcg/dL
Iron saturation 14 % 20 - 50 %
RBC 5.37 Mill/mcL 4.70 - 6.10 Mill/mcL
HGB 16.0 g/dL 14.0 - 18.0 g/dL
HCT 46.0 % 42.0 - 52.0 %
MCV 85.7 fL 80.0 - 94.0 fL red blood cell volume = healthy
MCH 29.8 pg/cell 27.0 - 35.0 pg/cell mass of hemoglobin = healthy

#6

Any numbers on Vit B12, folate, or calcium? Done a zinc assay test? The Vit D is brutally low, did they test D1,25 as well?

#7

No zinc and no Vitamin D1. The rest added. RA factor is negative.

#8

Good luck, they’ll get to the bottom of it.

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#9

Sorry to hear about this brother. Hope you get it figured out.

As far as the iron goes, I remember you cut out steak a while back. Any chance this is contributing to the iron taking a dive?

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#10

The first 6 months on TRT were amazing, after that things started to change slowly and beginning in april things accelerated quickly towards where I am now. I remember the first several months on TRT I had these strange sensation in my lower extremities that are now out of control, there was no stopping what’s happening now.

Something else was already broken and it just took longer to present itself. Something is causing massive fluid retention within my body, kidneys failure, heart failure, hypothyroidism and even venous insufficiency could be the cause.

It could be more than one thing, whatever it is it may very well be why testosterone declined in the first place.

I stopped eating steak because for some reason I lost my appetite probably by whatever is causing this edema, edema = severe loss of appetite.

The question is what came first, the edema or loss of appetite…

#11

Is the edema generalised in the legs or would you say it’s around the lower legs/ankles?

#12

The legs, abdomen jaw and face. I can feel the pressure behind my cheek bones. Based on the locations of edema it points to kidney disease. If true this could cause circulatory problems and excess water/salt gather around the body disrupting blood flow.

It has been going downhill fast in the last 4 weeks.

#13

Damnit man this is horrible. I hope you find a solution and heal up ASAP. I’m sure you will. Hang in there brother.

Stay positive and try to meditate wherever possible.

#14

Thanks enackers, looking a getting a full work up soon. Whatever it is I’ll deal with it.

What doesn’t kill you makes you stronger.

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#15

Yes sir!

“Get After It”

-Jocko

#16

sorry for the short response. lets go straight to the point. for record im not a doctor. if i was you:

VIT B12 261 pg/mL 200 - 910 pg/mL - for your age its low. would eat grass fed cow liver twice a week. or inject b12!
Vitamin D, 25-Hydroxy, D2 <4 ng/mL ng/mL 10k UI /day for 2 months, then 2 times a week.
you also need K2 vitamin (actually its a phytonutrient)
Potassium 3.3 mEq/L 3.5 - 5.0 mEq/L - you are low potassium cause lack of magnesium. would take MAGNESIUM MALATE 1000 MG 3 times / day.

Betaine hydrochloride with pepsin - whith every main meals !

regards.

#17

I wouldn’t be surprised if I had other deficiencies, the cause of these deficiencies is what concerns me. Kidney disease can cause imbalances in vitamins D and others.

#18

You have mentioned in the past you are overweight. Are you obese?

Maybe it’s heart disease and you’re gearing up for a heart attack. I’ve read in the weeks before an attack, symptoms manifest.

This sucks systemlord. Keep posted.

#19

Kidneys check out and are alright, next is checking the heart and aortic valve. I believe the latter is the problem which narrows in obese patients causing circulatory problems causing blood to back up.

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#20

Kidneys turned out alright. I had an ultrasound today of my midsection (Inferior Vena Cava) that was particularly sore and stiff near the area where the ultrasound tech was probing, she was cute I might add.

This is the area where I constantly feel like blood is backing up all throughout the day (as I type) peaking at night causing the throbbing sensation throughout my lower back, legs and feet.

New symptoms are lower back pain is a new development which follows the throbbing in the legs and now a puslitory numbness in hands and bottom of feet without any TRT for 2 weeks.

I’m a little worried about not getting a diagnosis from these Kaiser doctors, I expect them to find something and believe it to not be a serious problem. My symptoms say otherwise as I need these symptoms to end as this is the longest 6 weeks of my life.

I even feel my heart struggling with the backflow of blood, it feels like nuts and bolts passing through my heart at times and I don’t particularly like these sensations because they stop my in my tracts and interrupt my life.

I believe whatever is happening was the cause of my low testosterone diagnosis and it’s just causing more problems years afterwards.

I am 230 lbs which isn’t terrible unless you know the men in my family are very lean 6ft. 160 lbs. On 24mg EOD for 4 weeks I went from 240 lbs ->230 lbs without any exercise, was having trouble during the last two weeks that lead up to the week of hell.