The Reason So Many Bodybuilders Die Early

The Numbers Keep Adding Up. Why?

A lot of relatively young competitive bodybuilders have died recently, but they’re only the latest in a long, grim line. Here’s why it might be happening.

It’s really weird, but I haven’t had all that much experience with death in my personal life. Sure, my parents died after relatively long lives, one close friend died of cancer, and two acquaintances committed suicide, but beyond that, I really haven’t had to contend with it all that much… yet.

However, when it comes to my professional life, it’s an altogether different matter. I know dozens of bodybuilders and assorted fitness people who’ve died early deaths from heart attacks. These are people I’d worked with, interviewed, or at least had conversations with.

There are so many of them that death could use them to put together a pretty formidable football team, complete with separate 11-man squads for offense and defense, along with a solid bench of second-stringers.

Sorry if that came off as flippant; I only wanted to convey that a disproportionate number of bodybuilders have died in the last 30 years, at least disproportionate to almost any equal, similarly-aged, random sampling of non-lifters in that same time period.

Their deaths are always unsettling to me, to say the least, but what’s almost as unsettling is that more often than not, I looked at them at some time in the past and gotten a sense that they weren’t long for this earth.

Maybe it was the ruddiness of their skin, their labored breathing, or the look that they were just going to pop – the victims of excess size, excess eating, excess drugs, excess everything – that made me sense that their hold on life was tenuous.

Why, if I could see it, couldn’t they? Or their friends or families?

I’ll leave those questions, along with any remembrances and tributes, to some other writer. Instead, what I want to discuss, what I want to analyze, is why most of them died so young. Was it, as most are quick to offer, steroids, or was it something else?

I have a theory. In fact, I have a couple of them. For starters, I suspect we can’t blame their premature deaths entirely on the actual steroids. Rather, it was largely the result of their stupendous body mass that was largely facilitated through the use of these drugs.

That may not sound like much of a distinction, but let me explain.

A House Too Big

Let me draw an analogy. Let’s say you live in a 1,500 square foot, one-story house with a furnace that kicks out about 50,000 BTUs – plenty to heat the place, even during the coldest nights. But then you start building onto the house, adding a family room one year and maybe a nursery the next.

You’ve still got the same furnace, though, only it has to force heat through a lot more cubic feet and through a lot more ducts that are perhaps too narrow for the new size of the house. Suddenly, it’s not as efficient as it once was. Then you get the wild idea to add on a rental apartment, still using the same furnace.

After a while, your nice, cozy 1,500 square foot house is now closer to 4,000 square feet with skinny ductwork. It’s not only inefficient, but it puts a constant strain on the furnace. Then one day, Rufus, your tenant, cranks the heat up to 90 degrees and the furnace finally blows, its capacities overextended.

I’m sure you can see what I’m getting at. I once read that it takes 10 times as many blood vessels to vascularize a pound of muscle as a pound of fat. If that’s true, then an obese truck driver with a body fat percentage around 35% probably has a better chance of living a long life than a bodybuilder who’s gradually added on around three to five times the muscle mass of an ordinary human.

Even if that number 10 regarding vascularization isn’t entirely accurate, the basic fact is true – muscle has a lot more capillaries in it than an equivalent amount of fat, and someone who’s carrying around 100 pounds more muscle mass than he did before he started lifting is putting a tremendous amount of strain on his heart.

Having the heart work that hard to oxygenate the body is, if you’ll tolerate another analogy, like a single horse pulling an 8-horse carriage.

Yes, having that much mass is a problem in itself, but we can’t deny that steroids themselves, in the ridiculous amounts used by most competitive bodybuilders, can also directly hurt the cardiovascular system in a number of other, insidious ways.

Bad Plumbing

Generally speaking, exercise causes blood vessels to release nitric oxide (NO), and that’s a good thing. NO is a chemical that relaxes arteries, and it plays a crucial role in regulating blood pressure and overall circulation.

However, when something interferes with the production of NO, a cascade of bad things start to happen. The blood vessels lose their elasticity and end up being physiologically close to a cheap garden hose that’s been left out in the sun too long. This increases the resistance against which the ticker struggles to pump blood.

All this resistance causes the walls of the heart to start to thicken, leaving insufficient space inside the chambers of the heart to handle the blood. It all adds up to decreased efficiency, and without intervention, it can lead to heart failure.

(As if all this wasn’t enough, this high blood pressure can also thicken and narrow the blood vessels that serve the kidneys, which causes waste to build up in the blood, along with the possibility of eventual kidney failure.)

So yeah, you guessed it. Anabolic steroids interfere with the production of NO, thereby increasing the chances of premature hardening of the arteries and all its implications. The drugs also accelerate the accumulation of arterial plaque.

And then there’s the way anabolic steroids increase circulating sympathetic amine levels, which further constrict the blood vessels. Oh, and there’s also the anabolic-steroid activated increase in mineralcorticoid levels, which causes fluid retention. That means blood pressure can increase even further.

I left out one thing, though, and it’s the basis of my second theory on the premature deaths of steroid-abusing bodybuilders.

Can An Enlarged Prostate Kill You?

Many people, men and women alike, have heart attacks in the night or early morning, and this is certainly true of many steroid-using bodybuilders, too.

Cardiologists have long noted that humans are more susceptible to heart attacks just before waking up in the morning. It makes perfect sense. Cortisol levels are highest in the morning, and cortisol boosts blood pressure (along with blood sugar). Catecholamine levels also rise in the AM, leading to an increase in oxygen consumption while contributing to further constriction of blood vessels.

Add to that that platelets are particularly “sticky” in the morning, meaning they’re more apt to stick to the sides of blood vessels where they might cause a red blood cell traffic jam, resulting in a stroke or heart attack.

And this is all stuff that occurs in healthy people. Imagine how close you might be to falling off the mortal coil if you add in risk factors like stupendous body mass, already-compromised blood vessels, hypertension, and a heart with enlarged chambers.

This all ties into my second theory. All steroid users know that the drugs increase the production of red blood cells, which can further increase the chances of red blood cells getting into one of those life-threatening “traffic jams” in the blood vessels.

This is why keeping hematocrit (the measure of red blood cells in the blood) levels below a certain threshold is imperative (less than 50%). It also makes proper hydration crucial. Without enough water, the blood is even thicker, harder to pump (regardless of the aforementioned anabolic steroid-activated increase in fluid retention from elevated mineralcorticoid levels).

Here’s where we have to take into consideration a seemingly unrelated side effect of steroids – they increase the size of the prostate (BPH).

In the case of competitive bodybuilders, it’s probably a safe assumption that their prostates are as formidable as their muscle mass. In practical terms, it means they have to pee more. This might not be too much of a problem, except at night. Having to get up to urinate several times a night is not conducive to a good night’s sleep.

The natural response is to refrain from drinking water before they go to bed so they have a fighting chance of getting a good night’s sleep. That’s perfectly understandable, but as mentioned, dehydration, even minor dehydration, makes the blood thicker. Dehydration also negatively affects endothelial function. In fact, the authors of a 2016 study compared the effects of mild dehydration on endothelial function to that of smoking a cigarette.

And the level of dehydration required to do that is minor, less than 2%. To give you a frame of reference, 2% is around the threshold when people start feeling thirsty.

Add those last few facts together – the avoidance of fluids before and during the night so your sleep isn’t interrupted by the need to pee, along with the endothelial dysfunction and blood thickening caused by mild dehydration – and the words, “If I die before I wake, I pray the Lord my soul to take,” take on more significance than they might otherwise.

But You Just Said…

Here’s where I do a slight turnabout. Additional muscle mass is, in general, a healthful thing, as of course is resistance training in general. Weight training increases the production of NO, which leads to healthier blood vessels. In fact, research shows that there’s a negative relationship between muscle mass and cardiovascular disease – the more muscle you have, the less your chances are of developing heart diseases.

Furthermore, additional mass can help you weather a devastating disease. Consider the case of EAS founder and my old boss, Bill Phillips. He contracted COVID, was hospitalized, and spent a couple of months hooked up to a ventilator in an ICU, much of it in an induced coma, and he lost 70 pounds of body weight.

Had he not had that extra muscle mass, he would surely have died, because once you lose enough mass (it varies slightly from individual to individual), your body shuts down and dies, regardless of what else is going on.

All that being said, I’m talking about sane amounts of muscle mass and not the wretched excesses you see in most competitive bodybuilders. Granted, the early death of many of these steroid-abusing bodybuilders isn’t a certainty. Most probably won’t die in their fifties, forties, or even thirties. Heck, as dangerous as cigarette smoking is, only about 1 out of 5 of them will develop lung cancer.

Some steroid-using bodybuilders will monitor their hematocrit. Some will build up their respiratory systems along with their musculature. Some will drink plenty of fluids. And hopefully, some will know when enough is enough when it comes to adding size.

I’m not against the use of anabolic steroids. In fact, I think the use of modest amounts is either relatively harmless or, in some cases, can even improve health. I’m only against the bat-shit crazy doses used by so many competitive bodybuilders to achieve the body mass of a rhino, especially when they die as a result of those bat-shit crazy doses.




  1. Arnaoutis G et al. The effect of hypohydration on endothelial function in young healthy adults. Eur J Nutr. 2017 Apr;56(3):1211-1217. PubMed.
  2. Baggish AL et al. **Cardiovascular Toxicity of Illicit Anabolic-Androgenic Steroid Use.**Circulation. 2017 May 23;135(21):1991-2002. PubMed.
  3. Wemyss-Holden SA et al. Steroid abuse in athletes; prostatic enlargement and bladder outflow obstruction – is there a relationship? Br J Urol. 1994 Oct;74(4):476-8. PubMed.
  4. Neto WK et al. Testosterone is key to increase the Muscle Capillary Density of Old and Trained Rats. J Morphol Sci. 2019;36:182-189.
  5. Srikanthan P et al. **Relation of Muscle Mass and Fat Mass to Cardiovascular Disease.**Am J Cardiol. 2016 Apr 15;117(8):1355-60. PubMed.

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Interesting article. I remember reading an article on here about bodybuilders needing conditioning. The author talked about how he had to stop and rest getting to his vehicle in a parking lot. Anyone could understand if that is the state of your body then your cardiovascular system is not good.

However, let’s address the elephant in the room on some influencers that recently died. I have 3 cousins all died under age of 50 in the past year. Only thing in common was something that was mandated on them within the past years. Just saying.


Please don’t be bringing that tinfoil hat stuff into these forums. My condolences, but your anecdotal stories have crap-all to do with scientific fact. I’m sure if we took a good look at the cousins’ lifestyles, we’d see plenty of warning signs.


TC: With all your insider knowledge, how much diuretics issues have you seen? We all know several top-level BBs that died suddenly in contest preparation mode. But what about today’s BB and exercise celebrities getting ripped for photo shoots — are they using them too?

Excellent article, lots of food for thought. Thats why I use an array of heart protecting supplements, with COQ10 heading the list.


A bit narrow minded don’t you think. There is a tidal wave of heart disease victims this year i heard from a doctor friend working in a hospital.


I don’t have first hand knowledge of that, but I suspect they are. All you need to do is look at them.

More anecdotal BS. The narrow-minded part is ASSUMING it’s from the vaccine and not the disease!


My wife is a Cardiac RN at a major transplant center. Everytime I ask the question, I get the same answer - lifestyle choices. Majority of the issues are cumulative lifestyle choices. Also, unfortunately there are those among us that did not win the genetic lottery. Or, may have won in an athletic or bodybuilding perspective, but not a cardiac. All you can do is lower the risk.

Nice article and I agree with it. 60 now, down to 205ish. Reducing the 18 inch arms 48 inch chest, no more 405 squats for reps and much more cardio. Hardest part is psychological. Will it help, who knows. I can only control what I can control.

By the way, keep these articles coming. Loved the walking at increased grade, helped my cardio immensely. Younger guys may not like it, but if they are lucky they will be looking at ways to keep working out at 60, 70, and beyond…


Vaccines are killing people. Don’t discount it because you were too weak to resist.


Brony James is anecdotal?

Well, being that it’s from a medical doctor in a hospital, i would say that his info is pretty reliable and worth noting. No need to insult others. Ignorance is bliss!

Why are you even reading thses articles nevermind posting? Havent you heard from your social media overlords that fitness and exercise is far right wing?


No, they only tell me that simp conspiracy theorists are usually right wing. I’ve yet to see any formative study — that acounts for ALL factors — prove anything on this front. Until then, it’s anecdotal water cooler talk, even if it comes from an MD.
And what are you doing here? Didn’t your Evangelical overlords tell you you could pray your way to good health!! :laughing: :rofl:


Riddle: What do you call the guy who graduated at the bottom of his class from medical school?
Answer: Doctor
Sounds like even your medical pal is assuming a lot.

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“No cause has been publicly identified for the incident, but sudden cardiac arrest – where the heart abruptly loses its rhythm and stops pumping blood – is the leading cause of sports-related deaths among competitive athletes in the U.S. and has been since long before COVID-19 or its vaccines existed.


Get your spiritual health in line and you will never have to worry about death


Interesting read TC. I am curious if the actual number of bodybuilders deaths are inline with the general population of insidious deaths that occur. I agree those juicing on a large scale cannot be healthy. It is in my opinion that moderation in many areas of life is the key. The human body is designed to be resilient but excess of just about anything can have negative consequences. The body can adapt but only to a point. I am 65 and am realizing I need to tame my workouts down some. I have been training as I am still
In my early 20s. I have been getting the work in but am totally exhausted the remainder of the day. In process of rebalancing

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What amount of steroids do any here consider moderate? @TC_Luoma I’m interested in your input on this if you have some and care to share.

Though I don’t know many, of the men that are my friends (including close ones) and acquaintances who use or used roids and confide in me, there is not one who hasn’t had mental or physical problems, not just problems from being too big, as discussed in the article. This isn’t to say all have problems because of my small sample.

Can we directly attribute the increase in bodybuilders’ deaths to steroids? I cannot say with certainty. Do I think they played a role? Absolutely.