Best meds to improve Ejection Fraction in TRT Users?

readalot said:

Bigorexia has a penalty and muscular obesity hard on your heart just like fat obesity.

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IronKnight said:

I'm slowly making some progress:
7 days into a prolonged fast, I've dropped ~10kg (mostly water, yes), and morning BP is consistently around 120/70 (last 3 days).
Waist is 114cm from 120cm before, and I'm using a bit of cold (not moving much, but minimally dressed) to speed up the fat loss process a bit, upper and middle abs visible (but not very defined yet) when flexing.

I am trying to reverse as much damage as possible via autophagy + will have another Echocardiogram at the end of the month to see where things are. Aiming for EF > 52, ~60 should be ideal, as >75 is also bad. Nebivolol alone should increase EF by 10%, but in 3 months:

Effect of nebivolol on left ventricular function in patients with chronic heart failure: a pilot study - PubMed

These data indicate that nebivolol might improve cardiac function in patients with reduced left ventricular function.

pubmed.ncbi.nlm.nih.gov

Prolonged fasting is also supposed to help with blood pressure and other things:

The Effects of Prolonged Water-Only Fasting and Refeeding on Markers of Cardiometabolic Risk

(1) Background: Cardiometabolic disease, including insulin resistance, hyperlipidemia, and hypertension, are major contributors to adverse health outcomes. Fasting has gained interest as a nonpharmacological therapeutic adjunct for these disorders. (2) ...

www.ncbi.nlm.nih.gov

Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects

Only few studies document longer periods of fasting in large cohorts including non-obese participants. The aim of this study was to document prospectively the safety and any changes in basic health and well-being indicators during Buchinger periodic fasting ...

www.ncbi.nlm.nih.gov

re Prolonged Fasting:
In my case, I'm using only ~3L water + 1 cup of bone broth / day (for electrolytes + easier transition into refeeding later)

BP Meds now: 2 x Dipperam 160+5 (160mg Valsartan + 5mg Amlodipine) + 2 x 5mg Nebivolol

After a lot of reading, I came accross this:

How To Maintain Cardiovascular Health While Bodybuilding

Maintaining cardiovascular health while bodybuilding should be one of your top priorities. The main cause of death among bodybuilders is heart disease.

moreplatesmoredates.com

Some interesting notes from there:
1) resting heart rate:
"A lot of guys are walking around with borderline tachycardia (resting heart rates over 100), which is super unhealthy.
Many argue that heart rate is not important as long as you are under 100 beats per minute, but the reality is that the lower your resting heart rate is, the better indicator it is of your health."
=> In this regard, 2 x 5mg Nebivolol is helping, half life is 12h, so I'm taking 5mg in the morning + 5mg 12 hours later.
My resting heart rate is now 60-70, whereas before it was 80-90, just watching TV on the couch.

2) better to avoid peaks above 120/80:
"You want your blood pressure to be no higher than 120/80 at all times, year-round.[...]
Most bodybuilders will brush off blood pressure readings slightly above 120/80 that aren't considered hypertensive, when they shouldn't."
=> Given the +15 BP daily increases vs. "first BP in the morning", I would have to wake up around 105/70 to accomplish this.
I was so happy my BP was finally 120/70 in the morning man, still lots of work to do

3) Astragalus supplementation
"has the ability to reduce blood pressure.[...]
It also reduces hardening of the arteries, cholesterol absorption and plaque build up.
[...]
It is also possible that it improves cardiac contractions, generally strengthening your heart and its ability to pump.
The reason I use it is because Astragalus is virtually the only compound that research shows can regenerate Kidneys, as well as greatly lower creatinine and raise GFR"
=> This was very interesting to me because I've read a lot about BP meds lowering GFR, whereas some people like Peter Attia suggest you should aim your GFR to be 105 in your 40s so you are OK in your 90s.
Additionally, I had a recent 95 GFR reading and subsequent 73 a couple of weeks after meds, so the kidneys seem to be getting a hit.

Some small clarifications to some previous comments:
- re body fat: I finally measured this properly via DEXA: 24% body fat
- re Free T: 32.41 pg/ml is my "through -1", the real through is lower. I also have only measured this once, should check it more.
- re does your cardiologist know about your TRT? => yes, I told him the first day, he didn't ask anything (although I showed him all my labs on the 1st visit, and he checked them but didn't comment on anything). He's not very cooperative and clearly unfamiliar with weightlifting fans, so I'll meet another one later this month.
- re HCT: I hadn't donated blood in 3 years and it was still at 51, I don't seem to have a problem with that. Also, donating didn't lower BP for me, at least not in a measurable way. Additionally, the *sartans seem to help in this regard.
- re exercise performance: I just want to beat my humble PRs in the gym, and any med that gets in the way will be ruled out
- re Ubiquinol supplementation: I strongly believe taking organic freeze-dried beef heart powder should be superior, as all the building blocks for the heart should be there, not just Ubiquinol. Time will tell

re BP supplements, I'm currently thinking in the direction of:
Magnessium, Citrulline malate
Omega 3, Astralagus (to improve GFR, but also lowers BP), Garlic (mainly for BP)

re BP Meds:
I would like to ditch Amlodipine as it seems to be giving me some stomach acid sides, and in general, CCBs are not great.
A decent exercise-compatible combo would be: 80mg Telmisartan + 2 x 5mg Nebivolol + ? mg Doxazosin
However, I'm not sure I'll be able to keep my BP < 120/80 like that, including daily peaks.
If that fails, a close 2nd would be:
2 x 160mg Valsartan + 2 x 5mg Nebivolol + ? mg Doxazosin
I'll discuss this proposed approach with the 2nd cardiologist and see what he says (I'll ask him to do the Echocardiogram first + share what has been tried so far later, so I'm not suggesting him for anything in particular)

Doxazosin should also help with EF on its own:
Doxazosin was associated with a significantly higher level of voluntary submaximal exercise and a favorable trend on left ventricular ejection fraction (increase of 9.8% of the baseline value vs 2.7% with placebo; p = NS)

Doxazosin for the treatment of chronic congestive heart failure: results of a randomized double-blind and placebo-controlled study - PubMed

In this study we evaluated the effects of once-daily administration of oral doxazosin in patients with chronic congestive heart failure (CHF). After a stabilization period of at least 2 weeks with digitalis and diuretics, 73 patients with chronic CHF were randomized to receive additionally...

pubmed.ncbi.nlm.nih.gov

Will update this thread as I know more & my experiment results come

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magnus68 said:

Do you find Nebivolol interferes with weightloss or cardio?

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mooseman109 said:

This forum will throw you under the buss if you take any BP meds. Ignore the bro science

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blood pressure

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