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Using TRT with Heart Arrythmias - Risky?

How risky is trt with having heart arrhythmias? I have them since 10 years+, always when i am bit sick, have stress/anxiety or when i took ritalin/alcohol. It always stops as soon as i stand very still and stop breathing (or breathe less).
Also pushing out my stomach helps.
I have been to 2 different cardiologists to check my heart, they did ultrasonic and a test when i drove on a racing bike. I also wore a heart rate box for 24h, but no arrythmias occured.
Both doctors told me my heart is fine, and they could not see anything wrong.
How risky could trt be for me? I dont want to die from heart attack or stroke.

It depends on why you are considerinf TRT. If you actually have low test, it is actually better for your heart to be on it. Low test is not good for much of anything. If it’s a panic thing, TRT willnot liely have much effect one way or the other. Ritalin is a stimulant, Testosterone is not.

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I want to try trt mostly for body recomp. Training since 9 years. I was low t for the last 3-4yrs, always around 290-350ng/dl. No pump, bad recovery, no energy at training. Lost all of my muscles during this time, even with constant training. Now i am 27 and have a skinny fat body.
Since a few months i take finasteride and my test level has increased to 550-580.
Not really feeling better. My libido was always there, even with low test levels.
Its just that i cant cope with having such a shitty body and performance after many years of training. When i was young, 18-23yrs old, my body was very strong and i had nice physique.
I am to scared of taking a real test cycle, so i am thinking about going on a high end trt.

Just my opinion but going on TRT for life at 27 just for body recomp doesn’t seem like a good idea. If your libido is fine and you have no other issues I would try to get over your body issues. Sounds like you are just looking to get a TRT prescription to get jacked. What is high end TRT? TRT is minimal dose needed to relieve symptoms of Low T. Sounds more like you are looking for a low end cycle and want to justify it but getting a script and calling it TRT.

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I can pretty much promise you finasteride isn’t going to help. It’s just decreasing DHT which is making total T a little higher.

DHT is way stronger, so you’re probably going the wrong direction overall using fin.


So you’ve never been diagnosed with arrhythmia or had it captured diagnostically? Did you feel any arrhythmia during the tests? EKG will pick up alot so great sign they couldn’t see anything during that, the stress echo and what’s sounds like a 24 hr Holter test. Perhaps you are very sensitive to PVCs/PVAs and almost everyone has them over the course of 24 hours. Your description sounds like they are vagal nerve mediated and great that you’ve found a way to control them.

Google testosterone and beta-adrenoceptors. The beta-adrenoceptors in your heart are kinda important. Testosterone definitely affects function of the CNS. As @hardartery said, there’s an optimum Test level (too high or too low is bad). “Real” TRT (meaning keeping your peak and trough testosterone levels within physiologic range) when you are ready for the commitment would not be problematic and perhaps beneficial but save this message for a few years down the road when you reach that point of doing a “blast” which everyone (on here) seems to get to. DO NOT “blast” if you have arrhythmia or any defect in the electrical functioning of you heart. Bad stuff can and does happen.

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Another tool for the toolbelt in case any of you guys need it.


Vagal maneuvers cause increase in vagal tone, which has been shown to slow many types supraventricular tachycardia, such as atrial fibrillation (AF). However, the conversion of AF to sinus rhythm is usually not associated with vagal manuvers. Thus, AF is classically treated with medication and electrical cardioversion. Here, we present a 29-year-old male with no cardiovascular history and a low atherosclerotic risk profile who developed AF which converted into sinus rhythm immediately after a digital rectal exam. The patient remained asymptomatic after a 3-month follow-up. This implies that the digital rectal exam can be considered as an additional attempt to convert AF to sinus rhythm in AF patients.


You seriously need to ask yourself if you have an arrhythmia or if you suffer from panic attacks. If you need Ritalin (methylphenidate) it really doesn’t wind you up at all. (Just the opposite). If you don’t need it, some people really dig it as a recreational drug. The point I’m making is… if you aren’t really racing from the ritalin-- you need to consider the fact that you might be having recurrent panic attacks.

Go see a psychiatrist and/or your primary Doc and have him write you a script for klonopin. When you feel the way you describe, just take 1 pill and see if it calms you down and eliminates the arrhythmia.

In my personal experience, when I went to professional school to get my Doctorate, I had several panic attacks and thought I was having a heart attack on multiple occasions. I had arrhythmias, tachycardia, shortness of breath, and the room was spinning-- amongst other symptoms. Never thought it was a panic attack.

However, I did have AFIB, and have always had it since I was a kid. When I went on testosterone, I was cured of AFIB. No idea why, not a clue, nobody seems to be able to explain this to me. But it just went away as if someone flipped a switch. (I started cardio about 4 weeks into my 200 mg/week TRT).

So, I apologize for the length of the post, however, I have had panic attacks, they suck, no I do not get them anymore, it was stress and pressure from school. Yes, I had AFIB, yes, it was cured-- or supressed.

However, now at 47 yo, my EKG has shown a right bundle branch block… it is probably congenital or something I developed. It doesn’t seem to impact my performance though. So be careful and make sure you hire competent physicians to treat you and do your checkup. Don’t let them cut corners because they are busy. A checkup without an EKG is a waste of time.

Good luck to you. Hope my experiences can help you find some answers.


Time for you to talk to a few cardiologists and get the heart thing figured out. Internet gurus are only as good as the info they get. Soooooo once thats on the table, I suggest you look for a competent, well known doc who is willing to take on your case. You are always a good candidate for TRT, but only the guy prescribing it to you is capable of making that call. The argument against it is as good as the argument for it. So you’re at a fork in the road or just a cliff fall away from a road. Either way, you can make it to the road to success by simply finding a Doc who would put his rep on your recovery. This means, make friends with a cardiologist. Get real time information. And find a competent TRT Doc.

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I’ve had an ablation for PVC’s. I still get occasional PVC’s here and there. I’ve even went into Afib when dehydrated while working out extremely hard. I’ve been on TRT for 6 years and at no point did I feel like the TRT effected my heart. My heart doctor (electrical) also said the TRT isn’t bad for the PVC’s or Afib.

This (and nothing but this).

I do like the idea of a digital/rectal cardioversion . I’ll have to see what the cardiologists at work think of that.

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The fact that the pt in question responded to DRE with a burst of vagal nerve activity implies that he found the experience, um, relaxing. Suggests to me this maneuver might work well for some populations, but not necessarily everyone.

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I am not looking this up, it sounds like it would involve a very long finger to get to the heart, or you’re saying that his heart and his anus are abnormally close to each other.

Actually you only need to rub the rectal wall a bit. It stimulates the vagal nerve. Which makes so much sense, I’ve had a few patients go into cardiac arrest on the toilet…we nurses get very nervous when an unstable patient says they gotta poop.

No hearts on this? Really.

Not being a dick on purpose, but you sure it’s arrhythmia?

In my mid 20’s (15 years ago, barf) I had a similar experience. Was in decent shape…heart would go crazy at random moments, tons of palpitations, felt like I was having heart attacks.

Went to the ER a bunch of times, they diagnosed me with having panic attacks. I thought they were nuts because “I didn’t have anything to be anxious about”.

Well…I was on Buproprion for depression, dextroamphetamine for ADD, was taking diet pills (remember Ephedra?) cause I was a gym junkie, and drinking coffee like it was water.

Turns out I was stimulating the fawk out of myself causing tachycardia and palpitations which led to panic attacks.

Went in for stress tests, EKG’s, wore halter monitors…nothing. Just an “irregular heartbeat”.

After a few years and a little digging I learned that I didn’t have depression, but actually suffered from generalized anxiety and a bit of social anxiety. Learned I could live without the ADD meds, and quit the diet pills.

Problems went away. Still have anxiety and use a Beta-Blocker to take care of the physical side effects of anxiety. Taking an SSRI to help as well.

Long story short…I had to chill on the stimulants and learned I actually had to get my head straight, not my heart. I still have palpitations when the anxiety flares up but nothing that worries me.

If I were in your shoes I’d ditch ALL stimulants including ADD meds. Take a break from coffee if you drink it. See a good cardiologist and get cleared. If still having symptoms maybe see a psychiatrist to see what they know. Can’t hurt.

I was certain back in the day that I didn’t have anxiety. I didn’t even know what anxiety was. Hindsight is 20/20…turns out I was swimming in it and the stimulants sent it into overdrive.