Testosterone-Induced Cardiomyopathy: Strong Muscles, Weak Heart

Doleeb, Sarah; Thohan, Vinay

doi:10.1016/s0735-1097(18)32911-5

Cited by 1 publication

(1 citation statement)

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“…Androgen anabolic steroids (AAS) are taken to increase muscle mass but have a wide range of well-documented complications4 affecting the endocrine system including impaired lipid profile5 and reduced fertility with low sperm count and abnormal sperm morphology 6. AAS have been associated with cholestatic jaundice,7 focal segmental glomerulosclerosis8 and cardiomyopathy 9. Testosterone supplementation can also have an erythropoeitic effect10 although in our case the patient had normal haemoglobin and haematocrit (without a presupplementation baseline for comparison), possibly because the supplementation was recent and the peak effect occurs at around 9–12 months, or as a result of superimposed suppression by systemic inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of T3 supplementation in a bodybuilder presenting with tachycardia and features of sepsis

Warner

Woodrow²,

Pal

2020

BMJ Case Rep

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A 25-year-old man presented generally unwell to the emergency department. Initial assessment identified systemic inflammatory response syndrome markers with an insect bite as a potential source of infection and he was treated for presumed sepsis. Tachycardia persisted and baseline thyroid function testing showed undetectable free thyroxine and thyroid-stimulating hormone (TSH), prompting further endocrine investigation. Triiodothyronine (T3) was markedly raised with normal TSH receptor antibodies, and the patient later confessed to supplementary testosterone and T3 use as part of bodybuilding activities. Following counselling, thyroid function normalised and the patient returned to his usual health. This case describes the diagnostic work up in a case of persistent tachycardia caused by T3 supplementation, demonstrating the potential for endocrine supplementation by bodybuilders which may be poorly understood and recognised by clinicians. T3 supplementation should be considered and a thorough drug history obtained in bodybuilders presenting with symptoms of thyrotoxicosis and deranged thyroid function tests.

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