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Bodybuilder (60) gets heart enlargement after heavy testosterone cycle and experiment with stem cells

A 60-year-old American bodybuilder, who preparing for a competition with stem cell infusions and hefty doses of testosterone, has been diagnosed with heart enlargement. Internists affiliated with the Texas Tech University Health Science Center describe the remarkable case in BMJ Case Reports.

A bodybuilder of 60 years contacted a doctor because he had breathing difficulties. He breathed quickly and his heartbeat was increased.

The man, who was preparing for a competition, injected himself every 3 weeks with 200 milligrams of testosterone cypionate - officialy on medical grounds. In his medical file, the doctors read that the man secretly also used more testosterone. A month earlier his physician had advised him to stop, because the testosterone level of the bodyybuilder had increased to 2872 nanograms per deciliter. A year earlier it had been 388 nanograms per deciliter.

The doctors could not retrieve how much testosterone circulated at the moment in the man's body. The concentration in his blood was more than their equipment could measure.

Stem cells
The bodybuilder told that he was preparing for a competition. That is why he used such high doses of testosterone. In addition, he also used infusions with stem cells, on the advice of his coach.

In 2015, sports scientists at the University of Illinois published an animal study, in which they experimented with stem cells on mice. The mice, that had also been strength training, developed bigger and stronger muscles. [Med Sci Sports Exerc. 2015 Feb;47(2):315-25.]

After American physician Chris Centeno had read the study, he wrote in a blog that he expected pharmacological athletes to experiment with stem cells sooner or later. [ June 20, 2014]

"Mesenchymal stem cells from bone marrow or fat are easily obtained, isolated, or grown to bigger numbers", wrote Centeno. "They can be saved for future use via freezing. They would also be completely undetectable using current chemical based drug tests."

"In fact, it would take some sophistication to design a muscle biopsy test to detect this type of doping and if the cells were your own, doping may be undetectable with any certainty."

"The upshot? Will we see stem cell doping in body building or sports? I expect we will."

Back to the 60-year-old bodybuilder. Scans revealed the cause of his shortness of breath. His heart was enlarged, [cardiomegaly] and could no longer pump enough blood into the body. As a result, fluid accumulated in his lungs.

Bodybuilder (60) gets heart enlargement after heavy testosterone cycle and experiment with stem cells

Bodybuilder (60) gets heart enlargement after heavy testosterone cycle and experiment with stem cells

The ejection fraction has decreased with diseased heart enlargement. In healthy people it is somewhere between 50 and 65 percent. This was 25-30 percent for the 60-year-old bodybuilder.

The doctors prescribed a battery of drugs to the bodybuilder: "aspirin 81 mg daily, carvedilol 12.5 mg orally twice daily, digoxin 0.25 mg orally daily, valsartan 40 mg orally twice daily and furosemide 20 mg orally daily."

When they examined the man again after half a year, his ejection fraction was 50-55 percent. Moreover, his testosterone level was measurable again. It was at 346 nanograms per deciliter.

"Most patients reported to have adverse cardiac effects while consuming anabolic steroids have been young individuals with low risk for cardiovascular disease", writeb thew researchers. "The effect of anabolic steroids on older populations has not been well described, with the age range of case reports being 20-51 years."

"Older age groups may have an increased sensitivity to myocardial injury, which in turn may translate to noxious cardiovascular events in anabolic steroids users."

Bodybuilder (60) gets heart enlargement after heavy testosterone cycle and experiment with stem cells

Wild speculation
Myocardin, a a transcription factor that is expressed in smooth muscles and the heart muscle, lets mesenchymal stem cells develop into heart cells. [Physiol Rep. 2014 Feb 25;2(2):e00237.] [Stem Cells. 2008 Apr;26(4):1083-93.] There are indications that both testosterone [J Cell Physiol. 2017 Oct;232(10):2806-17.] and resistance training [Pflugers Arch. 2013 Sep;465(9):1317-25.] activates myocardin.

It is not impossible that the stem cells used by the bodybuilder have played a role in the development of his condition.

BMJ Case Rep. 2018 Jul 23;2018.

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