AAS and Cardiovascular/Pulmonary Function

[Michael Scally MD]

Tom Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology (EP.20)
Tom Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology (EP.20)

 

[Michael Scally MD]

Tom Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology (EP.20)
Tom Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology (EP.20)

Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation (EP.21)
Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation (EP.21)

 

[Mr.Oz]

Please look back at my post from around 2015 after I almost died. It's truly what happened to me and I actually had other tell me they were saved by my post because they were starting to have issues like I did with their tongue swelling and having sore place on each side where it was rubbing their teeth. Obviously the tongue is a muscle too so it was getting bigger like all my other muscles which my heart is one as well. This is almost 4 years since I almost died from my lungs filling with fluid due to my heart not functioning but only 15% injection fraction # and it was enlarged. I now forever have Congestive Heart Failure for the rest of my life and I am on disability permanently cause my condition affects all of me so severely. It robbed me of the man I was who could provide for his family and worked hard everyday to do that and now I can't even do small repairs around the house or on our cars which saved us so much money. I feel like a 90 year old man when I am only in my 40's. I am not pro or anti steroids I just know what happened to me and you also see so many bodybuilders and pro wrestlers die young from heart disease. I now have a defibrillator in my chest to save me if my heart goes too fast or too slow cause it also acts as a pacemaker as well. So just in whatever you do be careful cause my blood pressure was fine and I didn't know I was being damaged on the inside till it was too late. I came back on here to ask a question and saw this thread so I thought my input would be helpful. I promise you none of you want to have what happened to me happen to you. It steals every part of who and what you were prior to the heart problems and if I hadn't called 911 when I did I wouldn't have survived cause I barely lived through it as it was. Drowning on your own fluid while conscious is the worst thing ever and the incident haunts me still all the time and that has caused me anxiety and panic attacks. Here is the old thread where I explained everything when I got home from the hospital.

WARNING:ALMOST DIED
Discussion in 'Steroid Underground' started by Mr.Oz, Aug 24, 2015.


Thanks,
Mr.Oz

 

[Michael Scally MD]

Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation (EP.21)
Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation (EP.21)

Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins (EP.22)
Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins (EP.22)

 

[Michael Scally MD]

Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins (EP.22)
Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins (EP.22)

Tom Dayspring, M.D., FACP, FNLA – Part IV of V: statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain (EP.23)
Tom Dayspring, M.D., FACP, FNLA – Part IV of V: statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain (EP.23)

 

[Michael Scally MD]

Tom Dayspring, M.D., FACP, FNLA – Part IV of V: statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain (EP.23)
Tom Dayspring, M.D., FACP, FNLA – Part IV of V: statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain (EP.23)

Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more (EP.24)
Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more (EP.24)

 

[badrouter]

I've been a frequent visitor here over several years. Ended up starting a cycle in 2015 and...stayed on all the way through the end of September of this year. Never used TRT doses, either. 500 mg test/wk was about the lowest I went, often adding in other compunds like masteron and some orals (anavar, winny, a little dianabol and anadrol). Despite being 40, in shape (~10-13% bf) and with a fairly clean diet (good not great) I suffered a heart attack. Right artery ended up completely blocked, likely due to plaque breaking off, and I needed emergency surgery to put two stints in the right artery. Left artery was said to be 70% blocked. I spent five nights in the hospital and now take six medications every day.

This almost certainly is the result of my reckless steroid use. I don't post this seeking sympathy. And, again, I acknowledge that how I went about things is never recommended. But, I post it because I know there are folks on here like I was who figure that if they look and feel good, it's all good. Not so fast. Be careful.

 

[eryximachus]

I've been a frequent visitor here over several years. Ended up starting a cycle in 2015 and...stayed on all the way through the end of September of this year. Never used TRT doses, either. 500 mg test/wk was about the lowest I went, often adding in other compunds like masteron and some orals (anavar, winny, a little dianabol and anadrol). Despite being 40, in shape (~10-13% bf) and with a fairly clean diet (good not great) I suffered a heart attack. Right artery ended up completely blocked, likely due to plaque breaking off, and I needed emergency surgery to put two stints in the right artery. Left artery was said to be 70% blocked. I spent five nights in the hospital and now take six medications every day.

This almost certainly is the result of my reckless steroid use. I don't post this seeking sympathy. And, again, I acknowledge that how I went about things is never recommended. But, I post it because I know there are folks on here like I was who figure that if they look and feel good, it's all good. Not so fast. Be careful.

Three years is a long time.

Stay with us on this forum. We need more survivors to tell us how their life is going. Does exercise help? Have you switched to cardio? Particularly HIIT? Is life improving? I realize it's only a month.

Thanks for sharing. And don't be a stranger. We need data points. Realism. Positive stories.

 

[hurricane]

Three years is a long time.

Stay with us on this forum. We need more survivors to tell us how their life is going. Does exercise help? Have you switched to cardio? Particularly HIIT? Is life improving? I realize it's only a month.

Thanks for sharing. And don't be a stranger. We need data points. Realism. Positive stories.

I myself don't plan on going anywhere.
Will continue and try to help where I can.
Sometimes it's hard reading about everyone using gear when I can't, but I believe I was put in this position for a reason.
To try and be a voice of reason and remind some of these members that things can go sideways very quickly.
It blows my mind to see the cycles these kids run just to be 200lbs.
Glad to see there's others on this board like myself.
I don't condone AAS use. I condone irresponsible AAS use. Which is the majority of users here.

 

[Michael Scally MD]

 

[hurricane]

Hey Doc good article but I'm confused a little. Since thiazides act as a diuretic to lower BP do you think BP meds aren't needed?
I only ask because is high BP solely caused by fluid retention?
I thought my meds such as coreg and amlodipine relax the blood vessels to help my BP and heart function.
And are diuretics safer then BP meds in general?
I've had to take diuretics in the past for my CHF and compartment syndrome and would hate to be on them long term.
Like I said very good read but it left me confused. lol.
I know you don't like to respond without studies(lol), but interested where you stand on thiazides as a first line medication of high BP.
Thanks Doc. Hope all is well.

 

[Michael Scally MD]

 

[hurricane]

I knew it. Another study. lol.
Pretty good clinical results for a prescription "fish oil".
Like the Doc said though I'd like to see another clinical trial on this.
Even as a addition to a statin medication. Luckily high cholesterol is one issue I don't have. Which is pretty odd at my weight.
I only take an arginine supplement and NutraBio protein.
Dr. Marieb gave the ok on the arginine.

 

[Michael Scally MD]

Hey Doc good article but I'm confused a little. Since thiazides act as a diuretic to lower BP do you think BP meds aren't needed?
I only ask because is high BP solely caused by fluid retention?
I thought my meds such as coreg and amlodipine relax the blood vessels to help my BP and heart function.
And are diuretics safer then BP meds in general?
I've had to take diuretics in the past for my CHF and compartment syndrome and would hate to be on them long term.
Like I said very good read but it left me confused. lol.
I know you don't like to respond without studies(lol), but interested where you stand on thiazides as a first line medication of high BP.
Thanks Doc. Hope all is well.

The thread helps explain why it is not the diuretic properties that lead to BP control.

 

[Michael Scally MD]

New Cholesterol Guidelines Make Room for Non-Statin Therapy and CAC Screening
https://www.tctmd.com/news/new-cholesterol-guidelines-make-room-non-statin-therapy-and-cac-screening%20/ https://www.ahajournals.org/journal/circ

In primary prevention, the ACC and AHA finally open the door to using CAC screening to help guide treatment decisions (class IIb indication). For those at intermediate risk—defined as those with a 10-year risk between 7.5% and 19.9%—and a CAC score of zero, treatment with statins may be withheld or delayed unless the patient smokes, has diabetes, or a strong family history of ASCVD. A CAC score of 1 to 100, on the other hand, tips the balance toward statin therapy. Other “risk-enhancing” factors, such as persistently elevated LDL cholesterol (≥ 160 mg/dL), a family history of ASCVD, metabolic syndrome, chronic kidney disease, and inflammatory disorders, among others, also suggest intermediate-risk patients should be started on statin therapy.


Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guidelines on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2018;Epub ahead of print. https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000625


Llyod-Jones DM, Braun LT, Ndumele CE, et al. Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease: a special report from the American Heart Association and American College of Cardiology. Circulation. 2018:Epub ahead of print. https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000638

 

[hurricane]

The thread helps explain why it is not the diuretic properties that lead to BP control.

OK re-read it and understand a little more regarding initial drops in plasma volume resulting in lower BP but rebounding with extended use.
Decreased Cardiac Output would also be a huge red flag imo. Or am I wrong?
Again great stuff and I think I decifered it a little better but for some reason this article confused my dumbass.
I do appreciate the reply Doc.

 

[Old]

New Cholesterol Guidelines Make Room for Non-Statin Therapy and CAC Screening
https://www.tctmd.com/news/new-cholesterol-guidelines-make-room-non-statin-therapy-and-cac-screening%20/ https://www.ahajournals.org/journal/circ

In primary prevention, the ACC and AHA finally open the door to using CAC screening to help guide treatment decisions (class IIb indication). For those at intermediate risk—defined as those with a 10-year risk between 7.5% and 19.9%—and a CAC score of zero, treatment with statins may be withheld or delayed unless the patient smokes, has diabetes, or a strong family history of ASCVD. A CAC score of 1 to 100, on the other hand, tips the balance toward statin therapy. Other “risk-enhancing” factors, such as persistently elevated LDL cholesterol (≥ 160 mg/dL), a family history of ASCVD, metabolic syndrome, chronic kidney disease, and inflammatory disorders, among others, also suggest intermediate-risk patients should be started on statin therapy.


Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guidelines on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2018;Epub ahead of print. https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000625


Llyod-Jones DM, Braun LT, Ndumele CE, et al. Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease: a special report from the American Heart Association and American College of Cardiology. Circulation. 2018:Epub ahead of print. https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000638

Wow, so they now accept CAC scoring after years of poo-pooing???

To Make Room for Non-Statin Therapy indirectly admits that statins aren't all they claim to be: both in efficacy and safety.

 

[Michael Scally MD]

Wow, so they now accept CAC scoring after years of poo-pooing???

To Make Room for Non-Statin Therapy indirectly admits that statins aren't all they claim to be: both in efficacy and safety.

I have not read and do not expect to read the entire guides, but it is interesting CAC is now included. I believe this is not based on RCT, but observational data. I do find CAC compelling. It was just a short time ago that many were downplaying CAC in the film 'Widowmaker'.

It was on Netflix. A shorter version is on YT.


Here is a review.

The Widowmaker
Review: ‘The Widowmaker,’ a Heart Care Documentary

By now the average health care consumer perhaps understands that treatment recommendations from a doctor may be influenced by research grants, financial interests and other personal entanglements. “The Widowmaker,” a documentary by Patrick Forbes, takes a lengthy look at that phenomenon as it relates to heart attacks, promoting the coronary calcium scan, a noninvasive procedure that faced years of resistance because the medical establishment preferred the surgically implanted stent. The film’s only problem is that it may leave you so skeptical that you’re not sure you’re getting the unbiased story on the scan, either.

…

 

[hurricane]

I have not read and do not expect to read the entire guides, but it is interesting CAC is now included. I believe this is not based on RCT, but observational data. I do find CAC compelling. It was just a short time ago that many were downplaying CAC in the film 'Widowmaker'.

It was on Netflix. A shorter version is on YT.


Here is a review.

The Widowmaker
Review: ‘The Widowmaker,’ a Heart Care Documentary

By now the average health care consumer perhaps understands that treatment recommendations from a doctor may be influenced by research grants, financial interests and other personal entanglements. “The Widowmaker,” a documentary by Patrick Forbes, takes a lengthy look at that phenomenon as it relates to heart attacks, promoting the coronary calcium scan, a noninvasive procedure that faced years of resistance because the medical establishment preferred the surgically implanted stent. The film’s only problem is that it may leave you so skeptical that you’re not sure you’re getting the unbiased story on the scan, either.

…

I've seen it. Loved it!

 

[Michael Scally MD]

Health Consequences of Androgenic Anabolic Steroids

Background - The lifetime prevalence of androgenic anabolic steroid abuse is estimated to be around 6% for men, but there is limited knowledge about the side effects of these drugs.

Objective - To investigate mortality and morbidity amongst users of androgenic anabolic steroids (AAS).

Methods - In this retrospective matched cohort study, 545 male subjects tested positive for AAS in Danish fitness centres during the period 3 January 2006 to 1 March 2018. Subjects were matched with 5450 male controls. In addition, 644 men who were sanctioned because they refused to submit to a doping test and 6440 controls were included as a replication cohort.

Results - Mortality was three times higher amongst users of AAS than amongst nonuser controls (hazard ratio 3.0, 95% CI 1.3–7.0). The median annual number of hospital contacts was 0.81 in the cohort of AAS users and 0.36 in the control cohort (P < 0.0001). Acne, gynaecomastia and erectile dysfunction affected more than 10% of the androgenic anabolic steroid users, and the prevalence of these disorders was significantly higher than in the control group (P < 0.0001). The results could be replicated in a similar cohort.

Conclusion - Androgenic anabolic steroid users have an increased risk of dying and significantly more hospital admissions than their nonuser peers. Side effects of AAS and their metabolites were highly prevalent. Given the high rate of androgenic anabolic steroid abuse, these side effects are of public health concern.

Horwitz H, Andersen JT, Dalhoff KP. Health consequences of androgenic anabolic steroids. J Intern Med. 2018. https://onlinelibrary.wiley.com/doi/abs/10.1111/joim.12850