Left ventricle Hypertrophy

[Codster951]

Hello everyone, I’m a 34yr male and have been on Trt for about 4 years 100mg/week cyp. I recently have been heart palpitations and thought it was due to my hematocrit being high. Long story short I was recommended to a cardiologist and they just tested me and said I have a slightly enlarged heart with enlarged left ventricle!!!!! Can Trt cause this? Definitely has me worried! Also I have never taken any other steroids besides Trt.

 

[xqfq]

Did they do an echocardiogram? What did the cardiologist have to say? Did the cardiologist tell you your ejection fraction? Was it normal?

Edit: I just saw your post here: Trt and high BP/Hematocrit. High blood pressure can cause LVH. In your case, fixing your blood pressure should be your top priority.

You are in Stage 1 hypertension according to the latest guidelines. Your cardiologist should have recommended medication to reduce your blood pressure. Did they?

If I was you, I would take the medication and then figure out the root cause, hoping to reduce or eliminate the medication as I improved / found the underlying cause. You do not want to wait around with stage 1 hypertension.

This stuff is pretty complicated, but once hypertension is fixed the heart can sometimes remodel itself and you can "reverse" LVH. It depends though, and I'm not comfortable giving out much more of my thoughts than that -- your cardiologist should have talked to you about all of this.

There are also other causes for LVH that aren't high blood pressure. It's complicated though. In your case, you have hypertension so you should fix that no matter what.

 

[Codster951]

Did they do an echocardiogram? What did the cardiologist have to say? Did the cardiologist tell you your ejection fraction? Was it normal?

Edit: I just saw your post here: Trt and high BP/Hematocrit. High blood pressure can cause LVH. In your case, fixing your blood pressure should be your top priority.

You are in Stage 1 hypertension according to the latest guidelines. Your cardiologist should have recommended medication to reduce your blood pressure. Did they?

If I was you, I would take the medication and then figure out the root cause, hoping to reduce or eliminate the medication as I improved / found the underlying cause. You do not want to wait around with stage 1 hypertension.

This stuff is pretty complicated, but once hypertension is fixed the heart can sometimes remodel itself and you can "reverse" LVH. It depends though, and I'm not comfortable giving out much more of my thoughts than that -- your cardiologist should have talked to you about all of this.

There are also other causes for LVH that aren't high blood pressure. It's complicated though. In your case, you have hypertension so you should fix that no matter what.

He did not say anything about my BP and it was 136/92 today. He said he wanted me to wear a 24hr heart monitor and do some sort of echo? Today he made me lay on my left side and used like an ultrasound tool on my heart. They said I should hear back from then within 2 weeks.

 

[xqfq]

He did not say anything about my BP and it was 136/92 today. He said he wanted me to wear a 24hr heart monitor and do some sort of echo? Today he made me lay on my left side and used like an ultrasound tool on my heart. They said I should hear back from then within 2 weeks.

Based on your other post, I’m guessing these problems with blood pressure didn’t happen until you started TRT.

Has your BP been elevated like this for the past 4 years on TRT?

Do you have the following labs?:

Total testosterone, free testosterone, estradiol, SHBG, CBC?

If not, if I was in your shoes I would use discountedlabs.com to order them and get them. You can post them here for feedback. There may be something about your TRT that is causing this issue.

What is your current TRT protocol? How often do you inject (or apply cream/etc) and what amount?

——-
I know Doctor Thomas O’Connor knows a lot about these cardiovascular issues. You could schedule a consult with him, remotely even. If you can afford it it would be worth it:

https://www.testosteronology.com/

I am confident he has seen many cases like yours and would be able to talk to your primary and cardiologist.

 

[Vince]

Hello everyone, I’m a 34yr male and have been on Trt for about 4 years 100mg/week cyp. I recently have been heart palpitations and thought it was due to my hematocrit being high. Long story short I was recommended to a cardiologist and they just tested me and said I have a slightly enlarged heart with enlarged left ventricle!!!!! Can Trt cause this? Definitely has me worried! Also I have never taken any other steroids besides Trt.

Very high levels of testosterone can cause heart issues. If you're on using 100 mg of testosterone weekly, I would not be concerned of any heart issues at that low dose. I wonder if a good nitric oxide stack, Viagra and Cialis would help your blood circulation and your heart.

 

[Rain27]

[QUOTE = "Vince, post: 165175, miembro: 843"] Los niveles muy altos de testosterona pueden causar problemas cardíacos. Si usa 100 mg de testosterona semanalmente, no me preocuparía ningún problema cardíaco con esa dosis baja. Me pregunto si una buena acumulación de óxido nítrico, Viagra y Cialis ayudarían a la circulación sanguínea y al corazón. [/ CITA]
Vnce el dice que su hematrocrito estaba o esta elevado , creo recordar de la literatura que hematocrito elevado es una de las causas de hipertrofia del ventriculo.

 

[xqfq]

[QUOTE = "Vince, post: 165175, miembro: 843"] Los niveles muy altos de testosterona pueden causar problemas cardíacos. Si usa 100 mg de testosterona semanalmente, no me preocuparía ningún problema cardíaco con esa dosis baja. Me pregunto si una buena acumulación de óxido nítrico, Viagra y Cialis ayudarían a la circulación sanguínea y al corazón. [/ CITA]
Vnce el dice que su hematrocrito estaba o esta elevado , creo recordar de la literatura que hematocrito elevado es una de las causas de hipertrofia del ventriculo.

In some men, elevated hematocrit can cause an increase in blood pressure. This increase in blood pressure, if sustained for long periods of time, can lead to LVH.

But there could be many other causes of his high blood pressure, which is why it’s important he share / get more lab work.

 

[Codster951]

Based on your other post, I’m guessing these problems with blood pressure didn’t happen until you started TRT.

Has your BP been elevated like this for the past 4 years on TRT?

Do you have the following labs?:

Total testosterone, free testosterone, estradiol, SHBG, CBC?

If not, if I was in your shoes I would use discountedlabs.com to order them and get them. You can post them here for feedback. There may be something about your TRT that is causing this issue.

What is your current TRT protocol? How often do you inject (or apply cream/etc) and what amount?

——-
I know Doctor Thomas O’Connor knows a lot about these cardiovascular issues. You could schedule a consult with him, remotely even. If you can afford it it would be worth it:

https://www.testosteronology.com/

I am confident he has seen many cases like yours and would be able to talk to your primary and cardiologist.

I take 100mg test cyp. weekly 1 shot
These are my current labs.
Cbc that was out of range:
MCH: 31.7 (post blood donation)
MCHC: 34.7
MO#: 0.51
Other test done.
Ferritin: 47 (post blood donation)
SHBG: 22.1
Estradiol: 28.1 (no AI)
Test Free: 19.2
Test Total: 822 (troft day)

 

[xqfq]

I take 100mg test cyp. weekly 1 shot
These are my current labs.
Cbc that was out of range:
MCH: 31.7 (post blood donation)
MCHC: 34.7
MO#: 0.51
Other test done.
Ferritin: 47 (post blood donation)
SHBG: 22.1
Estradiol: 28.1 (no AI)
Test Free: 19.2
Test Total: 822 (troft day)

Based on the Tru-T.org calculator, at your trough your free T is 30.08 ng/dL, with the theraputic range listed as 16-31 ng/dl. Filling in the blanks and assuming a 100 ng/dL-per day drop off and a once-a-week injection schedule, your peak total T could be 1422 ng/dL, with a free T (tru-t.org calculator) of 53.63 ng/dL.

So your dosage / injection schedule may be leaving you too high, or too high for your body. You may have room to reduce your dosage. You may want to discuss reducing your dose and increasing your injection frequency with your doctor, e.g. 3 times a week or every other day using a small insulin syringe. There are many threads on this forum about this - lots of good information.

Like 'free T', there is also 'free E2'. But it's harder to calculate. Using one spreadsheet, you free E2 at trough could be something like 0.8 pg/mL. According to Free Estradiol (Sensitive), the range for this might be 0.2 - 1.5 pg/mL in adult men. At your estimated peak of 1422 ng/dL total testosterone, your free E2 is likely well above the range as well. But I am not sure what the 'rule of thumb' for E2 increase with total T is, so I'd only be guessing here.

---

If you injected more frequently, say every day or every other day, it would be more easy to know where your numbers are because they would be more constant.

---

General tips for hypertension:

There are many lifestyle changes you can make that may reduce your hypertension. Here's a short video:

What I have heard works well:

* Increased magnesium - 400mg - 800mg/day, supplements usually needed. I take magnesium citrate 3x a day.
* Hit RDA of potassium, which is 4700mg/day.
* Potentially decrease sodium intake.
* Cardiovascular exercise.
* Improve sleep hygiene.

It's important to talk with your doctor before doing any of these (especially, IMO, the exercise)

But because I am guessing your hypertension didn't start until TRT, it's probably "secondary" to some effect of your TRT. Which is why it might make sense to increase your injection frequency and lower your dose.

Many people are apprehensive about taking blood pressure medication. If I was in your shoes, I would personally take any medication, have my blood pressure return to the healthy range, and then investigate underlying causes. For many, high blood pressure has no known cause. The good news is that there are many medications available to treat blood pressure, and they are cheap.

---

Please keep in mind that this is serious stuff, I'm not a doctor, and I'm just giving you my opinions here. I hope you can try and talk with Dr. Thomas O'Connor - I know he knows his stuff here.

 

[Codster951]

Yeah that test was taken the day before my injection day. The blood pressure and high hematocrit definitely are related to starting TRT. More frequent shots with insulin needles??? Sub q?? I was proscribed hydrochlorothiazide a while back but have been Skeptical in taking it.

 

[xqfq]

Yeah that test was taken the day before my injection day. The blood pressure and high hematocrit definitely are related to starting TRT. More frequent shots with insulin needles??? Sub q?? I was proscribed hydrochlorothiazide a while back but have been Skeptical in taking it.

Did you try the hydrochlorothiazide? Do you have a home BP monitor?

I can't go into all the details here of possible protocol changes for your HRT, but there are many threads here. I do subQ injections with an insulin syringe daily, which keeps my levels very stable. This gives me confidence that the levels that come back on my labs reflect reality - no 'surprises'.

 

[Codster951]

Did you try the hydrochlorothiazide? Do you have a home BP monitor?

I can't go into all the details here of possible protocol changes for your HRT, but there are many threads here. I do subQ injections with an insulin syringe daily, which keeps my levels very stable. This gives me confidence that the levels that come back on my labs reflect reality - no 'surprises'.

I haven’t given the medicine a fair chance. I have taken like a total of three days then I stopped. I definitely will look into more frequent injections. Also I do not have a BP monitor. Hopefully I can dial myself in and start feeling better.

 

[xqfq]

I haven’t given the medicine a fair chance. I have taken like a total of three days then I stopped. I definitely will look into more frequent injections. Also I do not have a BP monitor. Hopefully I can dial myself in and start feeling better.

There are many inexpensive home BP monitors available that are relatively reliable. I use this one from amazon:

Robot Check

I am surprised a doctor didn't tell you to start monitoring your blood pressure at home. Are you in the United States? I know some other countries have a higher threshold for what they consider high blood pressure.

 

[Codster951]

There are many inexpensive home BP monitors available that are relatively reliable. I use this one from amazon:

Robot Check

I am surprised a doctor didn't tell you to start monitoring your blood pressure at home. Are you in the United States? I know some other countries have a higher threshold for what they consider high blood pressure.

Yes I am in Southern California, the more reading I do I might start taking the hydrochlorothiazide, I definitely feel like I’m bloated and retaining more water than normal and I eat pretty good.

 

[SilverSurfer]

Yes I am in Southern California, the more reading I do I might start taking the hydrochlorothiazide, I definitely feel like I’m bloated and retaining more water than normal and I eat pretty good.

Yes I am in Southern California, the more reading I do I might start taking the hydrochlorothiazide, I definitely feel like I’m bloated and retaining more water than normal and I eat pretty good.

That’s a pretty benign med. if you notice you’re getting muscle cramps you’ll need additional potassium.

 

[Codster951]

That’s a pretty benign med. if you notice you’re getting muscle cramps you’ll need additional potassium.

Have you ever taken it? Any experience with it? All I hear is bad things about the med that it increases possible skin cancer.

 

[S1W]

To add to the discussion, and comparing the same exact total weekly dosages (120mg):

E3.5D injections had my peak TT just below 1500. Trough a few days later around 880. On that protocol, I had high HCT and noticed an increase in BP too. I don't even feel like I needed the HCT/BP numbers to confirm that there was a problem - I could FEEL it, my heart seemed to be working way harder than it used to during cardio, I would get splitting headaches in the gym when exerting myself, etc.

Now as a little experiment I'm running the same total weekly dose in daily injections. I will not have labs for a few more weeks, but I can say that BP is down and I no longer have that crazy heavy heart beating hard oh shit I'm gonna have a heart attack feeling, and the headaches in the gym are gone.

I hate to say it but it seems as if daily injections are healthier for me. I hate to say it because I'd prefer to just inject once or twice per week, but it's starting to seem like the writing is on the wall.

I plan to drop my dose a bit after I get labs, but wanted to try it this way to get an apples to apples comparison using the same total weekly dosage.

 

[Codster951]

This sounds exactly like the symptoms I am having besides the headaches. I definitely think I’m going to give the subq injections a try. Or at least injecting more frequently. Also I think I might drop my dose a little. 100mg a week doesn’t seem like a lot but I guess it is for me.

 

[S1W]

This sounds exactly like the symptoms I am having besides the headaches. I definitely think I’m going to give the subq injections a try. Or at least injecting more frequently. Also I think I might drop my dose a little. 100mg a week doesn’t seem like a lot but I guess it is for me.

With your SHBG and trough TT I bet your peak TT is pretty high after your 100mg injection.

If I were you, I would consider being aggressive/going full bore and trying daily injections and perhaps lower weekly dose a bit. In a way, dailies aren't as bad as you might think because you can use tiny pins (I use 30g 5/16" .3cc) and it only take seconds to do. In either case, dailies are certainly less concerning than heart problems.

Sticking to your current protocol and simply switching from IM to SubQ probably won't make any difference.

 

[Codster951]

With your SHBG and trough TT I bet your peak TT is pretty high after your 100mg injection.

If I were you, I would consider being aggressive/going full bore and trying daily injections and perhaps lower weekly dose a bit. In a way, dailies aren't as bad as you might think because you can use tiny pins (I use 30g 5/16" .3cc) and it only take seconds to do. In either case, dailies are certainly less concerning than heart problems.

Sticking to your current protocol and simply switching from IM to SubQ probably won't make any difference.

Do you do your injections IM or subq??