Important Question for Swale?

[killiob]

I have a question for you Swale. I just got back my results from my bloodwork and my CPK level was high. The doctor said he is not worried about it at this moment, but he doesn't want it to get any worst, I haven't got my chest xray back but he said that he wouldn't be surprised if my heart was slightly enlarged. My question is would it be safe to continue use of AAS or should i stop, is it natural for AAS users to have slightly enlarged hearts and high CPK levels. Thanks for your info.


thanks
killiob

[MaxRep]

Originally Posted by killiob

I have a question for you Swale. I just got back my results from my bloodwork and my CPK level was high. The doctor said he is not worried about it at this moment, but he doesn't want it to get any worst, I haven't got my chest xray back but he said that he wouldn't be surprised if my heart was slightly enlarged. My question is would it be safe to continue use of AAS or should i stop, is it natural for AAS users to have slightly enlarged hearts and high CPK levels. Thanks for your info.


thanks
killiob

Killiob,
Weightlifting exercise alone can cause an enlarged heart and raised cpk levels.

In one study, I think done in Europe, which anti-steroid fanatics use to mislead people, a group of AAS using weightlifters all went through physical exams and results all came back showing them with enlarged hearts.

It was amazing how in that study there was no control group of weightlifters who never used AAS. Later studies corrected this flaw and found out... surprise, surprise... that weightlifters who never used AAS, also had enlarged hearts.

You can guess which study the media pounced on and which study was ignored by the general media.

Killiob, you may want to ask your doctor how much work he has done with high level athletes, specifically weightlifters or athletes who lift weights as one of the major components of their training.

MaxRep

[killiob]

Thanks MaxRep, actually my doctor said that it could be from my history of bodybuilding, I just assumed that it was because of the roids. I guess it really scared me, and I thought that I would be better off without roids. I got into bodybuilding to be healty and huge. I guess for right now I am going to take some time off and if my CPK levels go back down then I know the reason was the juice. It kind of dampened my bodybuilding dreams, but I guess going natural for now won't be bad, it will be harder work, but I am up for it.

thanks
killiob

Originally Posted by MaxRep

Killiob,
Weightlifting exercise alone can cause an enlarged heart and raised cpk levels.

In one study, I think done in Europe, which anti-steroid fanatics use to mislead people, a group of AAS using weightlifters all went through physical exams and results all came back showing them with enlarged hearts.

It was amazing how in that study there was no control group of weightlifters who never used AAS. Later studies corrected this flaw and found out... surprise, surprise... that weightlifters who never used AAS, also had enlarged hearts.

You can guess which study the media pounced on and which study was ignored by the general media.

Killiob, you may want to ask your doctor how much work he has done with high level athletes, specifically weightlifters or athletes who lift weights as one of the major components of their training.

MaxRep

[MaxRep]

Originally Posted by killiob

Thanks MaxRep, actually my doctor said that it could be from my history of bodybuilding, I just assumed that it was because of the roids. I guess it really scared me, and I thought that I would be better off without roids. I got into bodybuilding to be healty and huge. I guess for right now I am going to take some time off and if my CPK levels go back down then I know the reason was the juice. It kind of dampened my bodybuilding dreams, but I guess going natural for now won't be bad, it will be harder work, but I am up for it.

thanks
killiob

Killiob,
I think you're looking at this the wrong way. For a weightlifter to be overly concerned about an elevated CPK level doesn't make a lot of sense, of course your CPK levels will be elevated... simply due to working out. This is what I was saying before, there are literally hundreds of scientific studies showing elevated CPK levels due to strenuous exercise. If you want your cpk levels to go down, you'll need to stop going to the gym.

Or, if you want your creatine kinase (CPK) levels to go down, just take some extra Vit. E. (I am kind of joking and kind of not joking) See the following study.

MaxRep
__________________________________________________ ______________
1: Free Radic Biol Med. 2003 Jun 15;34(12):1575-88.
Effect of vitamin E and eccentric exercise on selected biomarkers of oxidative stress in young and elderly men.

Sacheck JM, Milbury PE, Cannon JG, Roubenoff R, Blumberg JB.

Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Tufts University, Boston, MA 02111, USA.

Muscle damage resulting from eccentric exercise provides a useful model of oxyradical-induced injury and can be used to examine age-related responses to oxidative stress. Sixteen young (26.4 +/- 3.3 years) and 16 older (71.1 +/- 4.0 years) healthy men were randomly assigned to 1000 IU/d vitamin E or placebo for 12 weeks and ran downhill for 45 min at 75% VO(2)max, once before and following supplementation. Blood samples were obtained before (baseline) and immediately postexercise (0 h), and at 6, 24, and 72 h postexercise to determine antioxidant status, muscle damage, lipid peroxidation, and DNA damage. Following exercise, young and older men experienced similar increases in serum creatine kinase (CK), F(2alpha)-isoprostanes (iPF(2alpha); p <.001) and malondialdehyde (MDA; p <.01), although iPF(2alpha) peaked at 72 h postexercise and MDA peaked at 0 h. Oxygen Radical Absorbance Capacity (ORAC) decreased at 72 h (p <.01) and correlated with the rise in iPF(2alpha), MDA, and CK in the young men (p <.05). Leukocyte 8-hydroxy-2'-deoxyguanosine (8-OHdG) was unaffected by exercise. Vitamin E decreased peak CK in young men, while in older men it decreased resting levels of iPF(2alpha) and suppressed the 24 h postexercise increases in iPF(2alpha) (p <.05). Thus, vitamin E supplementation induced modest changes eccentric exercise-induced oxidative stress, although differentially between the young and older subjects, while age had no direct influence on these responses among this group of physically fit subjects.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 12788477 [PubMed - indexed for MEDLINE]

[killiob]

I guess I did misunderstand what you were saying. So really I could be at the same place I am now without even taking roids this past year. Shit I shouldn't have sold all of my gear. Oh well, I guess I will just take a longer time off. It could be good for me. So in all reality would vitamin E help bring my CPK level back down. My doctor said everything else in my bloodwork was perfect, even my blood pressure was great. Thanks for the info MaxRep, I guess I shouldn't have freaked out, he even told me it could be because of my history of bodybuilding.

thanks
killiob

[MaxRep]

Originally Posted by killiob

I guess I did misunderstand what you were saying. So really I could be at the same place I am now without even taking roids this past year. Shit I shouldn't have sold all of my gear. Oh well, I guess I will just take a longer time off. It could be good for me. So in all reality would vitamin E help bring my CPK level back down. My doctor said everything else in my bloodwork was perfect, even my blood pressure was great. Thanks for the info MaxRep, I guess I shouldn't have freaked out, he even told me it could be because of my history of bodybuilding.

thanks
killiob

Killiob,
In general, strenuous exercise alone will raise cpk levels and over a long period of time, strenuous weightlifting alone, can enlarge your heart. Then you have to go into degree of enlargement, where specifically is the enlargement and is there also any damage to the heart.

When your Dr. said these things could be because of your bodybuilding, he was probably speaking only to your history of weightlifting and not of any steroid usage. So he apparently wasn't overly concerned simply because he knows weight lifters often exhibit these signs.

The above study only showed some benefit for young people, not older people. Which makes me suspect vit. E is only marginally effective.

Good luck,
MaxRep

[killiob]

I should be getting my chest xray back today or tomorrow, then I should know if it is enlarged and if there is any damage, I would think. Do they have to do a EKG to see if there is any damage in my heart.

thanks again
killiob

[SWALE]

That's really good work in this thread, MaxRep.

Weightlifting causes eccentric enlargement of the heart. It's building muscle to adapt to the load. Heart failure causes concentric enlargement, that is a very bad thing. You will need further imaging to discern the two, such as a Doppler (totally non-invasive).

An EKG would be part of any cardiac work-up.

Where AAS can cause concentric dilatation is when blood pressures are allowed to remain elevated over long periods of time.

[Cronk]

Originally Posted by killiob

I should be getting my chest xray back today or tomorrow, then I should know if it is enlarged and if there is any damage, I would think. Do they have to do a EKG to see if there is any damage in my heart.

thanks again
killiob

Killibob, a chest x-ray is in no way accurate as far as measuring the heart size or any degree of heart damage. As Swale mentioned, you would need an echocardiogram for both of these issues. An EKG would also possibly detect any heart muscle damage. The chest x-ray is a bullshit way to try to measure the size of the heart and MD offices use this test for a quick guide and also so that they can charge you for the x-ray. There is just no way possible for a doctor to accurately measure your heart size.

I perform echo's and this is what I notice. Endurance athletes that primarily utilize aerobic training methods tend to have slightly "dilated" hearts. The heart pump muscle appears minimally thin and the chamber size is slightly larger. But with strength training athletes that mostly utilize anaerobic training methods tend to have slightly "thickened" hearts. The muscular pump is thickened and the chamber size is slightly smaller than normal. Neither of these conditions are considered problematic.

cronk

[SWALE]

A CXR is a completely appropriate way to screen for an enlarged heart.

[bg65]

I had a post running with this exact same thing and Cronk had some very useful info and some cool studies performed...I just had an echo done which showed some hypertrophy but nothing unexpected for my size and workout history...

[Cronk]

Originally Posted by SWALE

A CXR is a completely appropriate way to screen for an enlarged heart.

I don't want to start any trouble here....especially with Swale. But I respectfully disagree with a chest x-ray being diagnosticaly acurate at measuring the heart size. Now before you get mad at me....let me explain myself. With a cxr, the camera is placed just above the chest wall. Then the distance from the camera to the chest wall is measured. So what you have here is a picture with an approximate "scale" of the heart size. This is a rudementary measurement at best. So what I'm getting at is this, if your heart is close to the surface of your skin..your heart looks huge on the cxr. And if the heart is placed deeper into the chest cavity..your heart will look smaller than it really is. This can and does lead to misdiagnosed enlarged or normal sized hearts. The best way to measure heart size and muscle wall thickness, other than to cut your chest open and physically measure, is by echocardiogram. The US waved penetrates the skin's surface and travels to the any object and then is redirected back to the transducer. The information derived from the returning echoes provides much information..including an acurate measurement of the heart.

Just about every time I perform an echo with the indication being "heart enlargement by chest x-ray", I prove the cxr wrong. So I'm sorry Swale but even though the current standard of practice to screen for an enlarged heart is via CXR, that don't mean it should be. You should know better than anyone that sometimes the current standard of care should be changed..and this, I feel, is one of those times.

Respectfully. Cronk

[SWALE]

Not "diagnostically accurate", I said for mere screening purposes. Big difference, which I am sure you are aware of.

We cannot send everyone for an echo--but oh if we could! There must be clinical suspicion as indication for further imaging studies.

I certainly agree with you on all points. There is a projection which occurs, easy to visualize as you imagine the X-ray beams passing though the chest and onto a screen behind. Now think of the heart being moved closer to the "projector", and how that would make the image larger on the screen behind the back, and vice versa.

[Millard Baker]

I don't want to confuse the issue, but I'm attaching a report that is skeptical of the absolute relation between resistance training and LV hypertrophy.

[Cronk]

Thank you Swale. And sorry for the misunderstanding.

And great read admin.