The heart is the organ most at risk from PED use, and we see early deaths occurring directly from cardiovascular incidents in young bodybuilders.
Why does this happen?
PEDs accelerate cardiovascular disease (CVD) by increasing thrombosis (abnormal blood clotting), atherosclerosis (plaque formation in blood vessels), hypertension, and cardiac remodeling. Much of this pathology is driven by anabolic steroids, but bodybuilders often use multiple drugs in combination, compounding the problem.
To excel in bodybuilding, we need to stay in the game for 10–15+ years, maintaining optimal health. Moreover, there is life after bodybuilding, and we want to avoid paying the ultimate price for our choices earlier than necessary.
The First Step: Assessment
Understanding how PEDs affect the heart allows us to determine appropriate monitoring for risks such as thrombosis, atherosclerosis, hypertension, and cardiac remodeling.
We recommend testing serum lab markers every 10-12 weeks, including a full lipid panel, CBC, and CMP. Specifically for PED users, further tests like homocysteine, hs-CRP, Apo-B, Ferritin, and Vitamin D are necessary to evaluate inflammation, oxidative stress, and vitamin/mineral excess and deficiency. This may lead to additional testing for specific genes that can increase the risk of CVD, such as Factor V Leiden or MTHFR gene.
Lab work alone is insufficient; we need to directly assess the heart for changes in size and function. Thus, we recommend a yearly echocardiogram, an ultrasound that maps the heart’s shape and function. Below, you can see a normal heart on the left and on the right, the remodeling induced by AAS use (Bond, 2022). The left ventricle (LV) wall
is thickened and the left atrium (LA) is dilated, leading to a lower ejection fraction (EF) i.e. less blood leaving the heart. An echo allows us to track the rate of change and make interventions accordingly.
To further assess atherosclerosis, a chest X-ray can determine the level of calcified plaque in coronary arteries, known as a Cardiac CT Calcium Score.
Additionally, at-home monitoring of resting heart rate and blood pressure is essential, as these are easy to measure and indicate how hard the heart is working. An increase in these variables suggests a need for further intervention.
What to Do About It?
Monitoring is like equipping your car with check engine lights. If a light comes on, we can make an intervention based on the vehicle’s needs.
The same principle applies to your health in bodybuilding. One individual might need a statin to manage high LDL, another might need blood pressure medication, while another might only need supplements to lower clotting factors.
This process is detailed in the Heart lecture in J3U Level 1. We guide you through understanding the necessary tests and then move to building interventions based on the findings. This includes not just what to take, but what to do—managing body fat, sleep, stress, cardio, etc., to make your bodybuilding more effective.
The J3U Heart lecture is crucial for safeguarding your long-term health in bodybuilding. This is the most comprehensive PED Heart Health Lecture available in the physique education world.
What You Will Learn:
- Managing risks of thrombosis, atherosclerosis, hypertension, and cardiac remodeling
- Understanding the impact of PEDs on heart health and altering stack design for harm reduction
- Interpreting serum labs, echocardiograms, and CT calcium scoring
- Lifestyle, nutrition, and training interventions for heart health
- Pharmaceutical interventions for heart health and disease prevention
Don’t miss this essential lecture to protect your heart and enhance your bodybuilding journey.
Check out J3U Level 1 HERE
Reference:
Bond P, Smit DL, de Ronde W. Anabolic-androgenic steroids: How do they work and what are the risks? Front Endocrinol (Lausanne). 2022 Dec 19;13:1059473. doi: 10.3389/fendo.2022.1059473. PMID: 36644692; PMCID: PMC9837614.
