TRT and Heart Meds

Long time browser, now finally decided to make an account. The reason for this comes down to this post.
I feel like Im on the edge of making a big decision and could use some intelligent insight from you guys.

Suffering from a mild case of cardiomyopathy, in my early 30’s, working out the same way I did in my teens before I was diagnosed. The reason I call it a mild case is because I don’t notice my illness on a day to day basis physically. The only real time I notice anything of it is when my life is chaotic or intensly stressfull which is when my body shuts down completly.

Ironically I’ve had some of my best gym-years after I was diagnosed with the illness, with many big PRs in the big 3. Which I think just goes to show my current condition.
When Im at my best i can hit a 350lb bench PR and when Im at my worst im bedridden entirely, cant even walk on the beach/forest or even consider walking stairs.

The problem though and the reason for this post is that due to some of the meds they’ve put me on and the fact that I am still ill, I’ve lost a big chunk of my private and daily life.
My sexdrive & libido is pretty much gone which has strongly affected my relationship with my lady. Gone from being with each other once a day to maybe once a month at best and thats not because she doesnt want to, she tries to get with me, still, multiple times a week. I just cant make it to the occation due to not feeling it. Its like my brain and scrotum have been deattached.
I can sense how my personality just during the last year has changed a lot,I used to be a very lighthearted (no pun intended) guy, easy going and quick to make conversation. Now I find myself mostly blank staring during conversation. Many of my friends and family have commented on it. I try to make efforts reaching out to people but find it hard to maintain, I dont have that ‘edge’ in my life anymore.
Depression & fatigue comes and goes regularly and are now a permanent thing in my life which I have accepted and try to work around as best I can.

Originally I was tested for TRT by my docs, but ranking in the low pars, still above the scale I was not qualified, instead they put me on viagra and told me to hope for the best. Which was just shit and does not make up for anything.

So I’ve decided to make an attempt on TRT without them to regain some quality in my life.
Im currently on 3 diffrent meds being; metropolol (betablocker), Warfarin (bloodthinning) and Ramipril.
The warfarin, bloodthinner, being the only thing Im worried about. I’ve read that you can adjust your doses accordingly to make up for what the Test does to your bloodflow. Im wondering how fast it reacts though? And what are the chances of internal bleedings?
I’d be lying if I didnt say it scares me a bit.

Im considering 200-250g mg Test E e5d.

I could really use some insight or even thoughts from an outisde perspective on my situation. Pro’s, con’s, good or bad. Anything and everything goes.

Thanks,
Fronk.

Please take a few days to read these stickies:

  • advice for new guys read first
  • thyroid basics, check body temps and eval long term iodine intake from iodized salt, you need iodine
  • protocol for injections
  • finding a TRT doc

Post all of your lab work with ranges. Get and always retain labs from your doctors.

Your stress reactions suggest possible adrenal fatigue. Note comments about that in advice for new guys.

Before TRT, must have LH/FSH lab work, you cannot do that after you start TRT.

Labs:
TT
FT
E2
prolactin
AM cortisol
fasting total cholesterol
CBC
ALT/AST
fasting glucose
PSA
CRP - general inflammatory marker
Homocysteine - cardio specific inflammatory marker

Arterial disease stems from endothelial dysfunction, degradation of the one cell thick layer of cells that line the arteries. These are helpful:

  • high potency fish oil, nuts, flaxseed oil/meal
  • ample iodine
  • vit-D3 5000iu per day, 25,000 per day for first week
  • 25 mg DHEA, test DHEA-S later
  • high potency B-complex multi-vit with trace elements and iodine
  • vitamin C and other anit-oxidants
  • min aspirin
  • CoQ10, in 50mg Ubiquinol form
  • magnesium rick cal-mag supplement [If you get leg cramps it is probably a magnesium deficiency]
  • lower blood sugars
  • lower insulin
  • higher T levels
  • E2 near 22pg/ml, elevated is a problem!

NOTICE: Aspirin and fish oils will thin your blood and contra-indicated for Rx blood thinners !!! You wanted to get off of that.
NOTICE: The above may lower your BP and in combo with your Rx BP meds may take your BP too low - dizzy or fainting.

Ramipril - Wikipedia << ED

Blood pressure is largely determines by arterial elasticity and muscle tone. Getting your hormones right can restore the ability of the arterial muscles to relax after moving a pulse of blood along, which allows the artery to expand to receive the next surge, after which the muscles briefly contract. The problem is then the muscles will not relax.

Your weak spells: Have you checked your BP then? If low, that can explain things.

Thyroid problems can explain many of your symptoms. There is probably more going on other than low T. Low T is not the condition to fix, it is a symptom of some other thing[s].

Cardiomyopathy: Your heart is a muscle. You need good T and E2 levels to support a muscle that never rests. Problems can also occur from CoQ10 deficiencies which can be caused in some cases by statin drugs. CoQ10/ubiquinol can support the mitochondrial in your tissues and muscles that create the energy base for all cells in your body.

Stress reactions that have major mental and physical effects can be from Adrenal Fatigue, there is a good book with that title by Wilson that you can get at Amazon. Your cortisol lab results key into this.

You have a lot of reading in the stickies to digest. You have to manage your own health care.

I would talk to your cardiologist about switching your beta blocker to Bystolic which has less side effects. Also, find a doctor that will test all your hormone levels. Finding an open minded doctor that looks deeper than total T is a big hurdle. I wonder why your condition fluctuates so drastically. I’m not a doc, but that is not my understanding how a physical heart ailment would affect you. I could see that impact from rhythm issues, but not myopathy.

Just to clarify, warfarin does not “thin” the blood. It modifies the amount of time it takes for your blood to get to a certain stage in clot formation. The thickness of your blood is unchanged. So, with androgen therapy often means increases blood cells and increased blood proteins which do increase the viscosity and could change your INR. So INR testing should be done until the results stabilize and your phys will adjust the dose if necessary.

The improved ability of your blood to transport oxygen will help compensate for your reduced cardio output.

Were you asked to test your HR or BP before taking the metoprolol? You may be experiencing orthostatic hypotension and ED is a common side.

Just a thought.

My father-in-law is on heart meds, he also has low T. One of his doctors wanted to put him on TRT, but his cardiologist was worried about the spikes and valleys when on TRT. If you decided to go on TRT you may want to think about taking a much smaller dose more frequently. Maybe E2D or E3D.

200 to 250 mg E5D seem like a lot without even seeing where 80 or 100mg a week will take you.

Without a doubt I would heed the advice from KSman and get all the blood work / research

You might do some shopping around and find a good TRT doc in your area. If your at the bottom end of the range a good doctor may still prescribe TRT.

Good luck.

Thanks for the replies so far.

My condition has improved a lot the last year. Like I said in my original post I dont really notice it anymore apart from my private and daily life. Hence why I think TRT or more T could help improve my condition.

[quote] So INR testing should be done until the results stabilize and your phys will adjust the dose if necessary.

The improved ability of your blood to transport oxygen will help compensate for your reduced cardio output.

Were you asked to test your HR or BP before taking the metoprolol? You may be experiencing orthostatic hypotension and ED is a common side.[/quote]

I do test my INR every second to fourth week already, so thats not a problem. Yeah - initially my HR/BP was through the roof. Today its perfectly normal.

Heres some of my tests, if it helps anything;

150112
1140
B-Hemoglobin (Hb) 156 134-170 g/L
150112
1140
Erc-MCV 90 82-98 fL
150112
1140
P-Bilirubin, konj <2 <4 umol/L
150112
1140
P-Bilirubin 5 5-25 umol/L
150112
1140
P-ALP 0.85 0.60-1.8 ukat/L
150112
1140
P-GT 0.32 0.15-1.3 ukat/L
150112
1140
P-ASAT 0.58 0.25-0.75 ukat/L
150112
1140
P-ALAT 0.99 0.15-1.1 ukat/L
150112
1140
P-Pankreasamylas 0.57 0.15-1.1 ukat/L
150112
1140
P-Urat 264 230-480 umol/L
150112
1140
P-Albumin (imm) 39 36-48 g/L
150112
1140
P-Natrium 138 137-145 mmol/L
150112
1140
P-Urea 8.4* 3.2-8.1 mmol/L
150112
1140
P-Kreatinin (enz) 89 60-105 umol/L
150112
1140
P-Kalium 4.2 3.5-4.4 mmol/L
150112
1140
P-NT-proBNP 114* <100 ng/L
150112
1140
P-Troponin T <5 <15 ng/L

Is there anything I should be concerned with, in regards to blood thinners and test? Or will i be fairly “safe” if I keep my INR checked every week?

Please read my post from last year.

Heart disease begins with endothelial dysfunction. These nutrients and lab targets suggested last year are helpful.

Some added information for my case.

-age:
27-31

-height:
5ft 11in (182cm)

-waist:
29,92in (76cm)

-weight:
177lb (80kg)

-describe body and facial hair:
Quite hairy everywhere, some on the back (neck/lats/erectors), beginning to bald a whee bit on top, started already ~5yr ago, probebly then due to stress and bad diet. Had a period where it actually started to grow again and get thicker. Since its been pretty status quo.

-describe where you carry fat and how changed
Think most of my fat sticks to the legs and butt. Though Ive been fairly lean this past year.

-health conditions, symptoms [history]

[quote]Suffering from a mild case of cardiomyopathy, in my early 30’s, working out the same way I did in my teens before I was diagnosed. The reason I call it a mild case is because I don’t notice my illness on a day to day basis physically. The only real time I notice anything of it is when my life is chaotic or intensly stressfull which is when my body shuts down completly.

Ironically I’ve had some of my best gym-years after I was diagnosed with the illness, with many big PRs in the big 3. Which I think just goes to show my current condition.
When Im at my best i can hit a 350lb bench PR and when Im at my worst im bedridden entirely, cant even walk on the beach/forest or even consider walking stairs.

The problem though and the reason for this post is that due to some of the meds they’ve put me on and the fact that I am still ill, I’ve lost a big chunk of my private and daily life.
My sexdrive & libido is pretty much gone which has strongly affected my relationship with my lady. Gone from being with each other once a day to maybe once a month at best and thats not because she doesnt want to, she tries to get with me, still, multiple times a week. I just cant make it to the occation due to not feeling it. Its like my brain and scrotum have been deattached.
I can sense how my personality just during the last year has changed a lot,I used to be a very lighthearted (no pun intended) guy, easy going and quick to make conversation. Now I find myself mostly blank staring during conversation. Many of my friends and family have commented on it. I try to make efforts reaching out to people but find it hard to maintain, I dont have that ‘edge’ in my life anymore.
Depression & fatigue comes and goes regularly and are now a permanent thing in my life which I have accepted and try to work around as best I can.

Originally I was tested for TRT by my docs, but ranking in the low pars, still above the scale I was not qualified, instead they put me on viagra and told me to hope for the best. Which was just shit and does not make up for anything.

So I’ve decided to make an attempt on TRT without them to regain some quality in my life.
Im currently on 3 diffrent meds being; metropolol (betablocker), Warfarin (bloodthinning) and Ramipril.
The warfarin, bloodthinner, being the only thing Im worried about. I’ve read that you can adjust your doses accordingly to make up for what the Test does to your bloodflow. Im wondering how fast it reacts though? And what are the chances of internal bleedings?
I’d be lying if I didnt say it scares me a bit.

Im considering 200-250g mg Test E e5d. [/quote]

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
In my early youth I did try a mild T/deca-cycle. Nothing fancy or advanced. Thats about it I think.
Apart from the 3 meds my cardiologist has me on, mentioned above.

-lab results with ranges
Dont have access to any apart from the ones in the previous post.

[quote]
150112
1140
B-Hemoglobin (Hb) 156 134-170 g/L
150112
1140
Erc-MCV 90 82-98 fL
150112
1140
P-Bilirubin, konj <2 <4 umol/L
150112
1140
P-Bilirubin 5 5-25 umol/L
150112
1140
P-ALP 0.85 0.60-1.8 ukat/L
150112
1140
P-GT 0.32 0.15-1.3 ukat/L
150112
1140
P-ASAT 0.58 0.25-0.75 ukat/L
150112
1140
P-ALAT 0.99 0.15-1.1 ukat/L
150112
1140
P-Pankreasamylas 0.57 0.15-1.1 ukat/L
150112
1140
P-Urat 264 230-480 umol/L
150112
1140
P-Albumin (imm) 39 36-48 g/L
150112
1140
P-Natrium 138 137-145 mmol/L
150112
1140
P-Urea 8.4* 3.2-8.1 mmol/L
150112
1140
P-Kreatinin (enz) 89 60-105 umol/L
150112
1140
P-Kalium 4.2 3.5-4.4 mmol/L
150112
1140
P-NT-proBNP 114* <100 ng/L
150112
1140
P-Troponin T <5 <15 ng/L [/quote]

-describe diet [some create substantial damage with starvation diets]
Lean meat, root vegetables, eggs, salmon, brown rice, salads, olive oil, almonds, fruit, red meat.
Supps; Vitamin D, Multivitamin, Omega 3, D-ribose, Creatine, ZMA, Q10.

-describe training [some ruin there hormones by over training]
3-6 sessions a week. Just recently as my condition has been getting better, Ive been upping my training.

-testes ache, ever, with a fever?
No.

-how have morning wood and nocturnal erections changed
Throughout my condition my morning wood went from being a constant pretty much all my life, to never ever again, since my condition bloomed. I havent had a morning wood since probebly ~3 years back.

"The only real time I notice anything of it is when my life is chaotic or intensely stressful which is when my body shuts down completely. "

This sounds like adrenal fatigue and related events.

You could have some combined problems going on.

Please read the thyroid basics sticky and find references to:

  • stress
  • cortisol
  • rT3
  • illnesses, accidents, inflammation, surgeries
  • adrenal fatigue
  • Wilson’s book [suggest that you read]

From last August: "Stress reactions that have major mental and physical effects can be from Adrenal Fatigue, there is a good book with that title by Wilson that you can get at Amazon. Your cortisol lab results key into this. "

I again direct you to consider the nutrients that I suggested before AND CoQ10 [Ubiquinol].

Make sure that thyroid function is as optimal as you can manage.

I’m going to go against everyone here and let you know that the heart meds you’re taking are what’s causing the problem with your T and your libido. You don’t need TRT you need to quit the beta blockers.

Flame away.