Heart Palpitations on TRT? The cause?

[Krock]

This is great input and I appreciate it. BTW, The reason I have not rushed to the ER is that I don't have the associated signs and symptoms that would indicate heart attack or stroke and I have a hx of anxiety and panic attacks. I was actually in the ER weeks ago with abdominal pain (also have a hiatal hernia since 18yrs old) did an MRI with contrast as well as had them put a 12 lead ekg on me as I thought I had some heart flutters while there, everything was normal. Anyway, I go to see my family doc next Monday was the soonest and potentially may go to a cardiologist as well, have a referral but that takes a month to see this particular physicians so if I feel the need I may search out my own cardiologist as my insurance does not require a referral. Also need as orthopod now as I think as my bench press which is one of my favorites seems to be limited by my rotator cuff pain on both sides, which frustrates my ego as I had been setting PRs for the last few months. One thing I did add to my stack which I had taken on occasion is Nattokinase to thin out my blood a bit, it is a true blood thinner unlike other meds that stop coagulation but don't actually thin the blood. I have also started donating blood as my hematocrit was raised, although still normal. I don't drink frequently anymore and quit smoking many years ago (11) but occasionally I have to admit I will smoke a few cigarettes and drink some beers out on lake michigan when with friends. THAT is what really started this series of events about six weeks ago. Between the 8 beers over the course of a day and smoking I had major palpitations and what felt like afib or something as my heart was skipping beats. I do monitor blood pressure and it seems elevated at first reading may times i.e. 153/78 but than if I relax it drops to 136/72 ish....Also purchased a blood o2 sat meter to assure that looks normal which it does. Actually just worked out and heart feels great, I did skip the Arimidex 1/4 of a pill with my last injection. I inject twice weekly, Tuesdays and Fridays .75ml and sometimes I go slightly higher versus less based on what left in the 200 per/ml vile. Also, I think I am sensitive to the Arimidex as the 1/2 pill I was originally on per 150ml injection once weekly seemed to really put me mentally in bad place and it was hard to shake.

 

[TLR]

I have a history of anxiety also, and I think that probably contributes to it. I was at the gym when mine hit and I had some light headedness and a dull ache that developed afterwards so I went and got checked. Knock on wood I haven't had any in a while, and ironically i have been running a lower dose for awhile.

 

[Indy57]

First I will say that yes, I have spent most of the evening searching all the threads and reading but as some know, sometimes you just gotta hear it 'first hand'.

Starting today I started having a number of heart flutters with the slight accompanying lightheadeness. Both are random and short lived but have went on most of the day. For anyone that has experienced this you know its kinda spooky. However, there is no pain, fainting, etc... so haven't ran off to ER yet. Wife is a RN so will have her listen to my heart when she gets home form work.

My question is, can this be brought on by TRT? I've been under the car of Defy for years now and they have pretty much fine tuned me and I have been feeling great! My regiment hasn't changed for the most part.

.25ml SQ every other day of 200mg testosterone (very low SHBG)
.25mg Anastrozole 2x week
400iu HCG 2xweek

Have been on this for at least a year and have been good. Total T is always around 800, Estradoil around 25 and Hematocrit is controlled by blood donation.

So these palpitations have got me a bit spooked and I'm trying to narrow down IF this could be caused by my regiment. Only a couple of things have changed.

1) I started using a new BiPap for obstructive sleep apnea. My other was 11 years old, it still seemed to work but this new one works even better. i feel like I sleep better than I had with the old one. Been on it for about a month

2) I have been doing SQ injections in either the hip or upper/side thigh. However, to change things up the last week I started injecting in the abdomen (I have plenty of fat there).

3) Due to traveling, I have noticed I've had to do a number of my t injections in the evening instead of the usual mornings


I'm not due a blood work up from Defy for another 5 months because I just had one not too long ago. But I did purchase some tests through DiscountedLabs this evening but can't get them drawn until tomorrow and it will take a while to get the results back.

Thoughts?
Nick

When my E2 got super low my blood pressure was getting higher and higher and I had similar issues. I discontinued the arimidex and adjusted my dosage and my blood pressure dropped - get your E2. Checked if your below 20 is stop the ai

 

[xqfq]

If someone's looked at all of the more obvious markers (as is the case here) and can't figure anything out, one possibility could be low progesterone.

Women who are on HRT (post or perimenopausal) and are on a combination estrogen with progesterone[1] don't experience any change to their QT interval. But women who are on estrogen-only HRT experience an elongation of their QT interval. "Estrogen lengthens the QT interval.. and progesterone shortens the action potential."

One of the common symptoms of declining progesterone during menopause is heart palpations.

TRT without HCG reduces progesterone levels and even with HCG they may not be adequately restored or brought into balance with the man's estradiol level. This could mean a man could experience an elongated QT interval on TRT even with all of his numbers "in range" if progesterone was low relative to estrogen. Maybe. I don't know, but it's a possibility!

I'm doing more reading into the role of progesterone in men as well as self experimenting, which I'm going to chronicle in this thread.

I'm not (by any means!) saying this is likely to be the cause, but if you've exhausted other avenues and want something else to look at, it could be worth a look.

1. Or an estrogen + progestin (synthetic progesterone). Why Does My Heart Feeling Like it is Doing Hurdles?

----

Edit: I found this member of peakT who had great luck stopping his heart palpations with progesterone cream.

 

[Joe Sixpack]

RBC: 6.11/5.94
HMGLB: 17.6/16.7
HMTC: 51.4/50.6

This was before the blood donation right? Apparently the donation didn't help the palps?

 

[Maximus220rr]

I experienced that with high dosages of either testosterone or HCG. And a few of members here experienced the same. So yes it is possible they are being caused by your TRT regimen. Did they start after you commenced TRT?
Remember that HCG has a similar structure to FSH and for some people can cause hyperthyroidism symptoms. Example: before adding HCG to my regimen i used to take thyroid meds to optimize my thyroid. After adding HCG they were no longer necessary. Also HCG had a great impact on my DHEA-S levels so i had to greatly reduce my DHEA dosage.

What did u reduce your dhea to?

 

[HealthMan]

What did u reduce your dhea to?

From 50 to 10mg. I meant TSH not FSH

 

[Maximus220rr]

From 50 to 10mg. I meant TSH not FSH

U reduced dhea from 50 to 10mg?

 

[HealthMan]

U reduced dhea from 50 to 10mg?

Correct. HCG makes my DHEAS levels rise quite a bit so i dont need much

 

[jmzwy]

I would say it’s the dose. I had these on my first Defy protocol of 160 mg per week and 500 iu’s per week. After close attention to the dosages of both over time, it is my opinion that both meds contribute to the heart palpitations you experienced. Defy has been great and they are very professional, but in my humble lay opinion after a year of therapy, studying deeply on this science, and reading thousands of posts on this forum, my feeling is they just start people way too high. Yes I had very low levels pre-therapy (500 total T and 6.5 free T), but I am very sensitive to all types of medications. I am currently on 112 mg per week broken into daily doses; I do hcg right now at 250 iu’s 2x a week on back to back days ( admittedly though I have been all over the place with hcg; this med is way tougher than testosterone to handle in my opinion). No AI and no more DHEA. I feel excellent and feel like right now I am getting all the benefits from TRT with only very minimal sides and only occasionally (irritability sometimes from HCg and have minor chest water retention). I wish Defy would start people on lower doses; when my sides started, they wanted me to add AI, some additional supplements, etc. For me, after several back and forths with Defy, I just let the side effects be my guide - lowered dose substantially until sides disappeared (sides included lots of acne, massive face and chest water retention, flushed face, heart palpitations, and moodiness). I am finally getting the benefits of TRT I believe.

 

[fifty]

I would say it’s the dose. I had these on my first Defy protocol of 160 mg per week and 500 iu’s per week. After close attention to the dosages of both over time, it is my opinion that both meds contribute to the heart palpitations you experienced. Defy has been great and they are very professional, but in my humble lay opinion after a year of therapy, studying deeply on this science, and reading thousands of posts on this forum, my feeling is they just start people way too high. Yes I had very low levels pre-therapy (500 total T and 6.5 free T), but I am very sensitive to all types of medications. I am currently on 112 mg per week broken into daily doses; I do hcg right now at 250 iu’s 2x a week on back to back days ( admittedly though I have been all over the place with hcg; this med is way tougher than testosterone to handle in my opinion). No AI and no more DHEA. I feel excellent and feel like right now I am getting all the benefits from TRT with only very minimal sides and only occasionally (irritability sometimes from HCg and have minor chest water retention). I wish Defy would start people on lower doses; when my sides started, they wanted me to add AI, some additional supplements, etc. For me, after several back and forths with Defy, I just let the side effects be my guide - lowered dose substantially until sides disappeared (sides included lots of acne, massive face and chest water retention, flushed face, heart palpitations, and moodiness). I am finally getting the benefits of TRT I believe.

I agree

 

[Vtail]

General question - when you guys refer to palpitations, are you talking about irregular heartbeats or pounding heartbeats? Within the last few weeks I started experiencing pounding heartbeats after 7 months on TRT and almost 3 months on HCG. It's very annoying, but the heart rhythm feels steady with maybe a slightly higher rate. I think its stress related, but I've had stress (off and on) my entire life with no physical issues that I was aware of. Lately between family and work my stress levels have been high, so I'm thinking the TRT or HCG have made me more sensitive to the effects of stress. Bloods were done a few weeks ago and all was good. Similar to what others have said here, I'm also going to slowly lower my dose of TRT to see if I can find the least amount I need to feel good. Was currently on 60 mg T-Cyp E3.5D and 400 IU HCG E3.5D. My SHBG fluctuates between 30 and 35.

 

[jmzwy]

mine were a combo of flutters, pounding heart beats, and at times 'piercing' chest pain. They were all, for me at least, experienced within 24 hours of my injections.

 

[S1W]

I would say it’s the dose. I had these on my first Defy protocol of 160 mg per week and 500 iu’s per week. After close attention to the dosages of both over time, it is my opinion that both meds contribute to the heart palpitations you experienced. Defy has been great and they are very professional, but in my humble lay opinion after a year of therapy, studying deeply on this science, and reading thousands of posts on this forum, my feeling is they just start people way too high. Yes I had very low levels pre-therapy (500 total T and 6.5 free T), but I am very sensitive to all types of medications. I am currently on 112 mg per week broken into daily doses; I do hcg right now at 250 iu’s 2x a week on back to back days ( admittedly though I have been all over the place with hcg; this med is way tougher than testosterone to handle in my opinion). No AI and no more DHEA. I feel excellent and feel like right now I am getting all the benefits from TRT with only very minimal sides and only occasionally (irritability sometimes from HCg and have minor chest water retention). I wish Defy would start people on lower doses; when my sides started, they wanted me to add AI, some additional supplements, etc. For me, after several back and forths with Defy, I just let the side effects be my guide - lowered dose substantially until sides disappeared (sides included lots of acne, massive face and chest water retention, flushed face, heart palpitations, and moodiness). I am finally getting the benefits of TRT I believe.

With your current dose of 112/week, do you feel that you need to inject daily to maximize benefits/minimize side effects?

Did you try a lower dose on a E3.5D schedule?

SHBG?

 

[jmzwy]

I switched to dailies for 2 reasons - to reduce hematocrit (as I saw that others possibly had succes with this), plus It made intuitive sense to Me.

Did not try 112 E3.5 days 2x a week. It very well may have worked.

 

[jmzwy]

SHBG per therapy was very high - 63.

Has slowly come down on its own to mid/high 30s while on TRT.

 

[Krock]

Quick note, I did more and more research since my last post and actually believe that part if not all of my issue is likely linked to magnesium deficiency. I am on PPIs for hiatal hernia for many, many years and have a hx of IBS which can affect absorption of minerals, and that is known to tank magnesium, and low magnesium is notorious for palpitations. I just mention this as whether you think it might be a particular hormone that is out of balance or something else, magnesium will not hurt you to try and very possibly help from what I have read and now experienced for the last few days. I went from bounding pulses and skipped beats at times to normal R&R. My only other new development is a horrible case of vertigo since last Thursday which I have definitely gotten from TRT when I first started but not since, so not quite sure what trigged this episode as I have this off and on over the years. On an additional note, my doctor does not seem to want to prescribe hcg...I am definitely not in touch nor have access to the lab values most of you other members seems to which is alarming.

 

[Krock]

so I accidentally took 1/4 of an arimidex versus the 1/8 of a .25 mg tablet and I feel less "up" than usual, a bit negative and palpitations after deadlifts and squats last night. Thought perhaps pre workout is contributing although I have used this brand for years (Altius) and doubt that was it as the palpitations occurred four hours after completing a workout. I am convinced that the Arimidex itself has some effect on me as I may be sensitive or the actual estradiol that it changes levels in is is the cause. Subsequently I took 400 milligrams of Magnesium and it faded the symptoms away in an hour or so. Placebo or did the magnesium help? Medically speaking there is a particular arrhythmia that magnesium is actually used for in the ER, Torsade des pointes and like two other types, I am not a doctor but I stayed at the Holiday Inn Express

 

[jmzwy]

I think you are in denial that your dose might be too high - it’s estradiol; no wait it’s magnesium; maybe it’s 1/8 too much of an Arimadex pill. D if you are drinking 8 beers and smoking cigarettes, I think you are just throwing your money away on TRT therapy. You’re basically ‘multiplying by zero’.... the most dialed in protocol won’t do anything if your life/health habits are crap. You sound like you are all over the place with everything.

 

[xqfq]

so I accidentally took 1/4 of an arimidex versus the 1/8 of a .25 mg tablet and I feel less "up" than usual, a bit negative and palpitations after deadlifts and squats last night. Thought perhaps pre workout is contributing although I have used this brand for years (Altius) and doubt that was it as the palpitations occurred four hours after completing a workout. I am convinced that the Arimidex itself has some effect on me as I may be sensitive or the actual estradiol that it changes levels in is is the cause. Subsequently I took 400 milligrams of Magnesium and it faded the symptoms away in an hour or so. Placebo or did the magnesium help? Medically speaking there is a particular arrhythmia that magnesium is actually used for in the ER, Torsade des pointes and like two other types, I am not a doctor but I stayed at the Holiday Inn Express

You mention your palpations started after drinking a larger amount of alcohol. I've read that alcohol can contribute to afib in some people. I'd stop drinking for a while to make sure it's unrelated. Did you buy the blood o2 sat meter (I'm guessing this is a pulse oximeter?) because you suspect sleep apnea?

As I'm sure you know, some guys get sleep apnea on TRT. You'd have to wear the meter while sleeping to get an indicator of sleep apnea, and even that (just blood O2 level) probably isn't sufficient to detect sleep apnea - but it could give you a clue for further investigation.

You also mention a history of anxiety / panic attacks? Did you have palpitations, etc prior to TRT?