Heart Enlargement on STEROIDS (its unavoidable)

Added: 2026-05-27

[00:00:00]All right, nerds. What's up? Um, this is going to be a fun one because we're going to be talking about the one basically unavoidable side effect when it comes to blasting gear. Um, which is enlargement of the heart. We're going to talk about left ventricular hypertrophy, LVH. You've probably heard of it. It's no fun apparently. Uh, how to not get it. And then we're going to talk about the types of heart enlargement. So, firstly, what is the left ventricular?

[00:00:25]Well, the heart has four chambers. if you guys [ __ ] up nth grade biology.

[00:00:30]And the left ventricular is the main pumping chamber. It receives the oxygenated blood from your lungs and pumps it out to the rest of your body.

[00:00:38]It is the most muscular chamber in the heart. If you have a brain, you've probably put together a muscular chamber, steroids, it must grow. Yes, every single heartbeat that is driven by your heart is an inherently stressful event. Okay.

[00:00:55]So, what does this have to do with LVH?

[00:00:57]Okay. Well, LVH is left ventricular hypertrophy. It's the hypertrophy of your left ventricular. It's basically the wall of your heart is thickening.

[00:01:07]Okay. This this isn't always a bad thing, right? This happens for a variety of reasons, but you have muscle cells in your hearts called cardiomyiocytes, and they have androgen receptors. And when you run androgens, they bind to the androen receptors on these cardiomyioytes and they trigger growth that causes the wall of your heart to hypertrophy to thicken. Okay?

[00:01:31]And this reduces how much space you have inside the chamber when you have pathological left ventricular hypertrophy. The key here is that you want the chamber of your heart in size to increase in proportionality to the thickness of your heart walls. You run into real issues when the walls are thickening, but the chamber is staying the same size because then the heart has to work harder. Okay, so that's all [ __ ] you know, fine and dandy and whatever, but how does steroids cause pathological LVH? That's the LVH we just talked about where you basically have enlargement of the heart walls without the actual chamber of the heart enlarging uh proportionally. Okay, this happens via a lot of mechanisms but the main one that is basically unavoidable is androgen receptor stimulation in your cardiomyioytes. Okay, this is causing direct cardiac muscle cell hypertrophy independent of blood pressure, independent of red blood cell mass, independent of hematology. This is unavoidable. Okay. Works the same way that steroids causing muscle growth in every other tissue in your body happens.

[00:02:37]Binds to the AR, upregulates mTor, upregulates protein synthesis. Congrats, your heart is bigger. Now, there's a lot of things that can also contribute to pathological LVH that are avoidable.

[00:02:49]One, increased blood pressure.

[00:02:51]Constantly having increased blood pressure forces the heart to work harder against resistance. You're basically resistance training your heart when you're living with high blood pressure.

[00:02:59]This is why maintaining proper hydration and checking your blood pressure is crucial because over time it will not only wear down your kidneys but it also causes your heart to grow. Crucial. This is arguably the biggest factor. Okay.

[00:03:12]Then increased blood cell mass. Having super high hematocrit, super [ __ ] up hematology basically is just you having thicker blood which also means your heart has to pump harder. Then uh direct myioardial toxicity. Now this is more compound dependent. There are certain compounds that cause cellular damage to cardiac tissue and cause fibrosis of your heart to a considerably disproportionate degree. Um the main steroid in this category is tindolone.

[00:03:41]If you stay away from tindalone, your chance of running into pathological LVH basically gets slashed in half. Along with that there is some data on nandelone showing it as unfavorable cardiac remodeling uh due to collagen deposition in your heart which can impact heart function. I will note here the nuance is that nandelone is one of the only compounds that's really been studied that extensively in this context of you know cardiammyiocy and heart growth. So it's possible a lot of other steroids do this and we just don't have data on it. But if you want to play things really safe, avoid trend and avoid nandelone. Really just avoid all 19 and you probably will be okay. Um, and if you guys have a brain, you probably know estrogen is cardiorotrotective. It's cardioctive.

[00:04:26]It's neural protective. It's renal protective. Every single organ system in your body requires estrogen. Crush your estrogen to the ground and run trend.

[00:04:33]Congratulations. Your heart is growing.

[00:04:37]So, pathological LVH versus physiological LVH. kind of already talked about this, but a lot of you guys kind of get these mixed up, so I'm going to go over it again. Um, so there's a concept known as athletes heart. This is basically where your heart is enlarging due to sustained aerobic exercise over years. Over the years, basically most athletes wind up with this. Um, it's basically where the thickness of the wall of your left ventricular wall is enlarging at the same time as your chamber. So the heart is getting bigger and more efficient. This is this is not a maladaption. This is an adaption that is catering to you uh being an athlete and requiring a high level of aerobic exercise for proper oxygen delivery.

[00:05:18]This is not bad at all. Um if you stop training and you drain, it completely reverses. Not a big deal at all. Seen endurance athletes all the time.

[00:05:27]Basically, the heart is functioning normally. Then there's pathological LVH.

[00:05:31]This is caused by pressure over overload, volume overload, or direct cardiac toxicity from things like tren.

[00:05:37]This is where the wall thickness is increasing but the chamber is not. Okay.

[00:05:42]So your diastolic function is becoming impaired and the heart is struggling to relax and fill properly. Often associated with fibrosis which is the scarring of the heart tissue. Basically increases your risk of [ __ ] everything like literally just literally speedrun to sudden cardiac death. Um kind of kind of is reversible. Um but once fibrosis of your heart has occurred, it's kind of GG's in terms of that's not going away. Um but yeah.

[00:06:14]Okay. So what makes certain compounds worse? So trimolone is the worst in cardiac remodeling data because it doesn't aromatize, highly androgen, raises matter significancy and has direct myioardial toxicity. And then I talked about deca here. Um and then some oral alkalated stuff. Really, anything that's going to absolutely rape your blood pressure is not going to be good or upregulate EPO to an extent that you can't control your hematocrit also not good honestly. Summary of this section here is stick to testosterone, testosterone derivatives and control your hematocrit and use DHTs and you're probably okay.

[00:06:49]Uh, is it dangerous? Does it does it impact life expectancy? Uh, yes, it does. This is I mean I don't even know what to tell you guys. If you guys get pathological LVH, you're probably not going to live a [ __ ] normal a normal lifespan. Okay? I don't know what to tell you. So, if that was surprising to you, like you actually could have been lobbomized in your sleep. Uh your heart isn't functioning properly. This puts you at risk for basically [ __ ] everything. Uh sudden cardiac death included, which it's what it sounds like. Uh, so we don't obviously have any like randomized control data studies on this because it's, you know, obviously [ __ ] unethical to give someone steroids, have them develop pathological LVH and then determine how long they're going to live. But, uh, yeah, it's probably not that [ __ ] good, bro. I level. Um, okay. Blood pressure.

[00:07:38]Okay, so you're probably wondering, well, how can I avoid this [ __ ] It sounds like it sounds like most of the stuff is avoidable. um besides the direct cardommyiocy growth via AR stimulation, right? Because I mean if I'm controlling blood pressure, it's not like I can prevent the steroids from binding to my heart. True. If we had steroids that only worked on uh pure non, you know, non-cardiac muscle tissue, you know, just your biceps, your triceps, your chest, whatever, uh I I'd be first in line to buy that [ __ ] I'd probably sell [ __ ] quarter inch of my dick to sell that [ __ ] to buy that [ __ ] U but we don't. Okay. So, assuming you're staying away from compounds like trin like nandrallone, sticking to testosterone and uh DHT derivatives, controlling your blood pressure with ARBs like Telmasardin, and using nivol to prevent your resting heart rate from being incredibly high, you're probably okay. Along with that, there is some direct evidence of telmardin reducing LVH in hypertensive patients and some data of nebol uh being able to prevent cardiac remodeling. So I suggest you to read the data yourself and draw your own conclusion. But if you really wanted to play things safe, you could in theory use telmaardinol year round even if you have completely normal blood pressure and resting heart rate to kind of aid in cardiac cardiac protection. Along with that there is data showing a plurinon the aldoststerone targeted diuretic can help prevent cardiac fibrosis. So basically the big three when it comes to protecting your heart are telmicardanol and a plurinon. You could in theory run these year round. Um I'm not going to lie, I kind of run them year round. I run telmardin um and a pluron pretty much year round for cardiac protection.

[00:09:16]It's not really needed. Um a lot of people would probably say it's overkill and that you should only use the ancillary if you have a reason to use the ancillary. Um and to them I say [ __ ] you. My Indian is three cents and it's probably pressed by some guy's toes. But I don't really care because I don't really want my heart growing. So there's that.

[00:09:36]um blood viscosity management. If you're struggling with hematocrit, drink more water. Um you could in theory use baby aspirin to reduce the platelets uh clotting together, but it's probably also going to melt your stomach lining.

[00:09:47]So bottom line here is if your hematocrit is out of control, driving elevated blood pressure, which is also going to drive cardiac cardiac growth.

[00:09:54]Um hydrate, please, or drop your gear.

[00:09:57]Compound selection. I've already talked about this before. Don't run tren. Avoid running tren for long periods of time.

[00:10:03]And if you're going to run trend, definitely use your [ __ ] ancillaries and control your blood pressure.

[00:10:08]Otherwise, like literal hall of shame spot waiting for you. Complete [ __ ] [ __ ] Um, regular zone 2 cardio. What it sounds like, do your zone 2 cardio.

[00:10:20]It It promotes physiological cardiac adaptation. If you're not doing cardio, your blood pressure is also probably going to be completely [ __ ] fried.

[00:10:27]Um, so, you know, the things kind of tie into each other here. Um, and then some supplements that can help. Omega-3, co-enzyme Q10, magnesium, but the main ones are obviously going to be tomosard and Abbyol, etc. The big three um components of LVH kind of regress. Um you've probably seen vigorous Steve had pretty bad pathological or not pretty bad, but he he had pathological LVH um that he was working on I think resolving and I I think it nearly it nearly resolved. There's a lot of bodybuilders who have had pathological LVH with minimal to no fibrosis and they've come off of gear and started using tomicard and indivol um and they're they're they seem to normalize. So something to be said for that. But I think overall here the bottom line of of this entire summary should be one control your blood pressure. Two stay properly hydrated.

[00:11:18]Three stay away from tin and nandelone.

[00:11:21]Uh four do your cardio every day zone two 25 30 minutes. Um and five if you're really that ultra worried about cardiac remodeling 40 milligrams tomosardin 5 milligrams nibbol 25 milligrams of pleon. handles basically every avenue of cardiac growth um and remodeling.

[00:11:40]So yeah, I I I I don't honestly think LVH is as big as a concern as most people think it is. Um it's really not that big of a deal. Probably most bodybuilders and people who use steroids have some amount of LVH. Whether it's pathological or physiological is kind of up to you. If you take care of yourself, it's probably pathological. Uh, if you don't do cardio, run trend, and you're just generally a chud, it's probably going to be pathological. Um, yeah. I mean, that's all there is to it.

[00:12:11]Be safe, chat. Drop video suggestions in the comments below. I'm going to try to get one of these videos out every day for the next until I [ __ ] die. So, there's that.