What may be the possible reasons why there seems to be a rash of sudden deaths in bodybuilders that are fairly young? In recent times, the deaths have ranged from people in their 20s to up to 50, 60 years of age. But when somebody dies, a man or a woman, when they die in their mid-20s, it's almost never a natural death.
In other words, it's always something that killed them. Usually, it's related to a cardiovascular catastrophe, such as a heart attack or stroke. I want to talk about possible ways to avoid that type of ending, what you can do.
A lot of this, a lot of what I'm discussing probably pertains more to bodybuilders that use performance-enhancing drugs or PEDs like anabolic steroids, growth hormone, and insulin. It's not that they use these drugs, it's that they use them in massive amounts. I mean, you look at the bodybuilders the steroid regimes used back then by people like Arnold Schwarzenegger and others were considered like baby stuff compared to what the guys use today.
I mean, that's why people like Arnold Schwarzenegger are still alive. If Arnold and his contemporary bodybuilders in the 70s had used or duplicated the drug regimes that are common with today's professional bodybuilders, I'd venture to say that most of these 70s bodybuilders would be dead. They would not be alive by now.
It would have caused so much damage, they would have died years ago. So that doesn't say much for today's bodybuilders. A medical study a couple years ago measured what they call the calcium score, which is the amount of calcium that accumulates in the arteries.
It's a harbinger for future heart attacks and strokes. They studied 14 elite professional bodybuilders. Of the 14 bodybuilders, 12 showed significant amounts of calcium buildup in their arteries, which means that they were like a fast train heading for a wall.
These guys, unless they changed something or did something drastic, most of them would sooner or later get either a heart attack or a stroke that may or may not kill them. It depends on the extent of the damage. But every time you get a heart attack, which is medically called a myocardial infarction, some part of the heart is dead.
It kills a portion of the cells in the heart, it's called necrosis. Even though you could survive it, you've caused permanent heart damage, so you want to avoid that. Now, the best way to avoid catastrophic events related to drug use is obvious common sense.
You don't want to use those drugs, or at least those dosages that are common today, because this is going to fall on deaf ears. A lot of the bodybuilders that compete today, they don't care. You could tell them all kinds of things.
I don't want to get into politics or anything like that, but it's similar to the vaccine situation where you could show people that are anti-vaxxers tons of evidence to show that the vaccines are safe and effective, but their preconceived notions, their confirmation bias will close them off. They won't, they don't hear it. They will not listen or believe any type of evidence-based information.
They're so firm in their belief, that belief could also be fatal for them. But as far as bodybuilders go, I mean, you know, a lot of them won't listen, but those who are more intelligent, those who value their health, those who want to live, let's say, years after their bodybuilding competition ends, should probably heed some of the advice I'm giving. And what I'm going to talk about is common blood tests that bodybuilders should undergo, and this doesn't just go for drug-using bodybuilders, this goes for any bodybuilder.
You know, it's not that bodybuilding is inherently bad for your health, but it's good to check up on your general health, because some of these things that show up in medical tests, you can't really feel, and they could be slowly causing damage in your body. You know, again, it's more so in drug-using bodybuilders, but it can happen in anybody. There could be genetic reasons, for example.
You could be doing everything right and carry genetic time bombs in your body that may not show up for a couple of years, but they could prove fatal. And by undergoing medical tests, you'll have a hedge against them and possibly be able to undergo some therapy that will prevent, again, catastrophic effects. So let's discuss some of the more common, let's say, preventative lab tests that every bodybuilder should consider, whether male or female.
And also, this is especially important, again, for anyone who's indulging in any type of performance-enhancing drug, especially anabolic steroids, insulin, growth hormone. Even if you're not taking the huge dosages, you should still undergo these tests. The greater the regime they're using as far as dosage, that's if using very high dosage or if you're using more dangerous steroids, like Trenbolone, for example.
Trenbolone is a very popular steroid, used to be sold as parabolin. But Trenbolone has not been manufactured by any legitimate drug company in years. All of it is underground lab stuff.
There's no guarantee of purity. There's no guarantee of dosing. And worst of all, Trenbolone has been shown in animal experiments that cause deleterious brain changes that can bring on horrible brain disease when you hit about maybe 60 years old, including Alzheimer's disease.
You want to, if you're taking any of those kind of drugs, or again, large doses of steroids or growth hormone, insulin, that kind of thing, you want to undergo these tests more often. I would suggest, it might sound crazy, but I think you should undergo these tests every four weeks, about every, well, maybe five weeks. Every four to five weeks, bodybuilders, athletes on heavy drug regimes should undergo this blood testing.
It will catch stuff early. It will probably, very good chance of saving your life. So let's talk about some of these tests.
First and foremost, you have what they call the CBC, the complete blood cell count. It just tests, it's a blood test, obviously. It tests several components of the blood, such as erythrocytes, red blood cells which carry oxygen, white blood cells related to immune function, hemoglobin, which is the oxygen-carrying protein in the blood, hematocrit, which is the proportion of red blood cells to the fluid component.
In other words, hematocrit basically measures the thickness or viscosity of the blood, and also blood platelets, which is related to clotting factors. Hematocrit is very important for bodybuilders to check. Not that the other blood tests aren't important, but hematocrit is especially important because testosterone and other steroids are known to increase the hematocrit.
How they do this is, it has to do with the testosterone blocking the activity of a certain protein that controls iron uptake in the body, and testosterone kind of blocks that activity. So when you're on testosterone, or especially high testosterone, it doesn't even have to be high. It can happen during normal testosterone replacement therapy, which is relatively low doses of testosterone.
In about 50% of men, the hematocrit goes up. More common in men over 40, and when that happens, the thickness of the blood and those elevated hematocrit are usually above what they call maybe about 57 is the measure. If your hematocrit blood test shows a reading of 57 or more, you're at higher risk for strokes and heart attacks because thicker blood means a greater tendency to internal blood clotting, and the blood clots that form could travel, become a thrombus, it could block an artery in your heart, it could block an artery in your brain, cause a heart attack or stroke.
So you have to pay attention to hematocrit. The usual treatment for elevated hematocrit is phlebotomy, which is the donation of blood. When you donate blood, of course you're reducing immediately the viscosity or the thickness of the blood or the hematocrit.
So the hematocrit goes down, however, very few people know this, but there was a recent study that came out that showed that six months of aerobic exercise actually normalized elevated hematocrit in men on testosterone replacement therapy. And also, in many cases, the hematocrit automatically adjusts after a couple of months, even if it's elevated initially, it normally adjusts after a couple of months and comes down automatically. It doesn't happen all the time.
Now, if you're taking large amounts of testosterone, it might be a good idea to take a daily aspirin, a baby aspirin, 81 milligram aspirin. Aspirin works by inhibiting the aggregation of platelets. When platelets, these elements in the blood, when they stick together or aggregate, they form a clot and the aspirin will basically keep your blood thinner.
There's other possible natural ways, but I don't think they're that effective. That's about the most effective way. Again, this is called polycythemia, when the blood gets too thick.
Actually, it's actually about 53. In other words, if your hematocrit is over 53, you want to take some measures right away, at least the aspirin, and if you're feeling like headaches and symptoms, let's say fatigue, you might consider phlebotomy. It'll speed it up, or you could try and wait it out.
If you do aerobic exercise, within six months, the hematocrit will go back to normal. Another test is what they call the CMP, which stands for Comprehensive Metabolic Panel. It consists of 14 blood tests that's basically initial screening for total overall health.
Among these tests are tests for glucose. The blood glucose level, of course, is related to many things, but most importantly, diabetes. If you have your blood test done under fasting conditions and you show a blood glucose level of over 100, it could be indicative of either prediabetes or insulin insensitivity, or if it's 126 and over, that's full-blown diabetes.
You'd have to have a test done for hemoglobin A1C, which is a more definitive, and that's usually included in some of these blood tests. It's a more definitive test for long-term glucose control. Hemoglobin A1C looks at your blood glucose levels over several months, and you want to look for a level that's below 5.6. If it's over 5.7, 5.8, usually, again, it's indicative of diabetes.
You want to take measures. You want to probably maybe lose a lot of body fat, lose weight, adjust your diet, go on a lower carbohydrate intake. This will help prevent diabetes if any of these blood tests are abnormal.
Also, you should know that taking large amounts of growth hormone basically raises the blood glucose level so high that if you take a blood test, it'll look like you have full-blown diabetes, but it's basically because the high levels of growth hormone interfere with insulin action. Of course, a lot of bodybuilders overcome this by taking insulin injections, which basically neutralizes the elevated blood glucose caused by growth hormone. By the way, some symptoms of elevated hematocrit, as I said, include headaches, higher blood pressure, and again, the cardiovascular risk factors.
Getting back to the comprehensive medical panel, it also tests for kidney function. Kidney function is also very important for bodybuilders on drugs because the drugs, the kidneys pretty hard. Most of the time you hear about liver problems with steroids, but a lot of people don't know the steroids can hit the kidneys very hard.
A lot of it has to do with elevated blood pressure that might occur when you're taking a massive steroid program. The kidneys themselves have a higher blood pressure than other organs in the body because the kidneys have to have a higher internal blood pressure to properly filter the blood. However, when you have overall systemic higher blood pressure, it adds to the normal elevated blood pressure in the kidney.
When that happens, the higher overall blood pressure starts to break down the filtering units of the kidney, the nephrons, and you could wind up having severe kidney disease, chronic kidney failure. You might even have to go on a kidney dialysis or you might sometimes, unfortunately, have to have a kidney transplant if things really get bad. There's a couple of cases where some bodybuilders had a genetic disease, like Flex Wheeler is a good example.
He had this genetic disease he didn't know about that basically put his kidneys at very great risk. Of course, when he took the drugs, it exacerbated the genetic abnormality he had, and eventually, Flex had to have a kidney transplant. So he didn't know he had it.
However, maybe if you take some of these kidney tests, I'm not sure if these kidney tests would even show that up. I think it would have to be some sort of imaging, probably CAT scans or MRI to figure out the kind of genetic, let's say structural abnormality that Flex had. It also happened to, oh God, I can't remember his name, the guy who was Mr. USA who recently died.
His name escapes me at the moment. He recently died. He also had the same disease, and as a matter of fact, that's one of the things that killed him because the kidney problems came back very strong and wound up causing his death years after he stopped using steroids, but he had some earlier kidney damage.
You have to also, very important again, his liver function test, what they call a liver panel measures various enzymes, AST, ALT, several others. I'll talk about this in a second, but you should also be aware that ALT and AST are liver enzymes, but they're also found in the heart and muscles, and a lot of doctors weren't aware of that who forgot their medical school biochemistry. If you come in and have a lab test and you show, let's say, an elevated ALT, they're going to think that you have liver problems, and they might even suggest having a liver biopsy.
In 99 out of 100 cases, however, the elevated ALT is not coming from the liver. It's coming from the muscles because every time you work out, you damage your muscles a little bit, and when you damage muscles, this ALT and AST, it's released into the blood. If you take a blood lab test within 48 hours after the workout, these enzymes are going to show up as elevated.
If a doctor doesn't know the difference, in other words, if he doesn't realize it's coming from muscle, again, he's going to think it's a liver problem and suggest a liver biopsy, which is completely abnormal because these enzymes, when they do get elevated from muscle damage, they never get elevated to the point that suggests liver damage. The best way to really ascertain that is to compare, let's say, ALT, AST to the other liver enzymes, which I'll talk about in a minute, particularly one particular liver enzyme, which is not affected by exercise and is a better indicator of true liver damage. Let's say if you've taken a lot of oral steroids, all oral steroids accumulate in the liver.
That's why they work. They're structured. Normally, when you take testosterone orally, the liver breaks it down right away in 40 minutes, but anabolic steroids, oral anabolic steroids, are structured to resist that breakdown, but they also, because of that, tend to accumulate in the liver, and they cause what they call chemical hepatitis, a swelling in the liver that impedes the bile ducts that basically transport bile to the gallbladder.
When that happens, the bile can overspill, cause symptoms like jaundice and destruction of hepatocytes, liver cells, which can lead to severe liver disease, like liver cirrhosis, and a worst-case scenario, liver cancer. So, what else there? The comprehensive, oh, electrolytes is also part of the comprehensive medical panel. This is stuff like potassium, magnesium, of course, sodium.
This is all important because a lot of times, bodybuilders will go on certain diets where, let's say they eliminate all this sodium, or let's say they're taking certain drugs, for example, potassium-retaining drugs like spironolactone, aldactone, which actually causes retention of potassium, and if you take a potassium supplement on top of that, it can cause severe heart problems. So it's very important to measure these electrolytes. Bodybuilders have taken diuretics.
There's been a couple of cases where they didn't undergo these lab tests. They took too many diuretics. It messed up their electrolytes so much that they wound up dying.
They wound up dying of either kidney failure or heart disease, heart failure, I should say. Of course, then you have the lipid panel. The lipid panel measures basically blood lipids or fats, such as low-density lipoprotein, high-density lipoprotein, and triglycerides.
LDL, or low-density lipoprotein, is often referred to as the bad cholesterol, which is a misnomer. It's not really bad. LDL cholesterol is the main transporter of cholesterol in the blood.
LDL is what transports cholesterol in your blood to the testes, where the cholesterol is converted through several enzymatic reactions into testosterone. As a matter of fact, studies have shown that people with naturally higher testosterone levels almost always have slightly elevated LDL. Normally, doctors want to see your LDL at 100 or less.
Anything over 100 is considered a harbinger for possible cardiovascular disease, but the truth is, LDL is only bad when it's oxidized. Oxidized LDL. If you take certain nutrients, certain antioxidants, you could keep your LDL from being oxidized.
I'm not saying it makes LDL harmless, but it certainly goes a long way to preventing As long as the LDL is not oxidized, it's not dangerous. That's the bottom line. Also, there's more sophisticated tests that measure what they call particle size.
For example, LDL, the large, fluffy LDL, is much less subject to oxidation than the small, dense LDL. What stimulates large, fluffy LDL? It turns out eating fat. Eating fat stimulates fluffy or more protective LDL.
Going on a low-fat or no-fat diet, coupled with a high-carbohydrate diet, stimulates small, dense LDL. That's the dangerous one. That's the one highly prone to oxidation.
LDL cholesterol, high-density lipoprotein, for years it's been considered protective against heart disease, cardiovascular disease. LDL is like a garbage man. It's made of mostly protein.
It's made in the liver, travels in the blood, latches on to excess cholesterol, carries it back to the liver. In medicine, it's called reverse transport. Carries it back to the liver, where the cholesterol is degraded into bile and then excreted.
This is the only way the body can get rid of excess cholesterol. Cholesterol, unlike fat, cannot be burned. This is the only way the body can get rid of it.
Now, there's a lot of myths about LDL, but the way to bring out ... Well, I should also point out, in relation to drugs, unfortunately, steroids, especially oral steroids, are very famous for lowering your LDL to almost untraceable levels. This is very bad, because it opens up the door to heart disease, especially if accompanied by an elevated LDL, and that's usually the metabolic picture of a person on high-dose oral steroids. Elevated LDL, low HDL.
Now, again, if your total cholesterol is also low, which it usually is in bodybuilders, because of their training and diet, it kind of neutralizes some of the effect, but not completely. The good news is that these LDL and LDL, these abnormal lipid values that occur when you're on steroids, when you get off them, they revert back to normal. That's the good news.
It's not a permanent effect. Triglycerides used to be considered not that dangerous, but now they know that triglycerides are basically a precursor for the production of low-density lipoprotein, so triglycerides are important to measure. Also, again, they should be below 100.
What raises triglycerides? Two things, mainly alcohol, excess alcohol intake, excess sugar intake. What lowers it? Exercise, not smoking, fish oil. Omega-3 fatty acids can lower elevated triglycerides anywhere from 40 to 60% without using any type of pharmaceutical drug.
As I said, high-dose testosterone and antibiotic steroids increase LDL, decrease and decrease HDL and triglycerides. I mentioned earlier the kidney tests. The usual kidney test is what they call the estimated glomerular filtration rate, EGFR.
You'll see it on the blood test. This measures the ability of the kidneys to filter the blood. I believe the cutoff point is 60.
If you have a reading above 60, if I remember correctly, the higher the reading, the better. In other words, if your EGF is lower than 60, you're probably heading for kidney disease. However, it's not a super specific value.
If you really want to know, people have come to me and have been worried about having it because they show elevated EGF levels. If you're dehydrated, for example, bodybuilders taking diuretics, if you don't drink enough fluid, you can have an artificially lowered EGF. It looks like you have kidney disease, but you don't.
It's because you're dehydrated. If you really want to know if you're having kidney problems, you have to have another test done, which is the most accurate way, especially for guys on drugs. It's called cystatin C. Cystatin C will tell you your true kidney function.
There's another one called creatine clearance rate, which is a measure of the excretion of creatinine, which is the byproduct of creatine metabolism. That remains usually stable. However, if you have that test done, let's say two days after you start a creatine load, taking 30 grams of creatine, it might be falsely elevated again, making a doctor who's not familiar with nutrition, he'll suggest that you're heading for kidney failure.
So you've got to be careful because it's not really dangerous. If you're not sure, get the cystatin C and you will know. Now, I mentioned the liver test, ALTST, they're not really definitive as far as showing liver problems.
If you want to know a more definitive enzyme, liver enzyme, you look at a test called gamma glutamyl transpeptidase that found the liver cells, and again, it changes when you have liver problems. There's another test called alkaline phosphatase. The ratio between alkaline phosphatase and GGT can tell you, give you a true picture of whether you're having liver damage from the steroids, which can lead to, again, chemical hepatitis, cirrhosis, tumors, or even possibly pancreatic cancer.
So this is an early warning sign, especially for those taking large amounts of oral steroids. If you have a blood test and your liver enzymes, especially GGT and alkaline phosphatase, if they're elevated, that means your liver is under severe stress, my suggestion would be to get off oral steroids immediately. Get off them because you're definitely hurting your liver.
And if you stay on them extended times, you could wind up with liver failure. Of course, there's total testosterone. You know, that's just standard, of course.
When you're taking steroids or when you're taking testosterone replacement therapy, your testosterone is either going to be in mid-normal or elevated. If you're taking large amounts of anabolic steroids, it'll be above the range, so the range is like 300 to 1,000. Your testosterone will be so high, it'll be above the range.
You know, it has an upper limit of usually between 1,000 and 1,500 nanograms per deciliter of blood. So, you know, again, they say that having elevated testosterone above the normal range, it's kind of unknown territory. They think it could be dangerous for health in the long run.
It's best for health to keep your testosterone in the midpoint to the high range as long as it's within the normal range. So high range normal would be something like 800. If you have an 800 testosterone level, that's great for building muscle.
You don't need any testosterone replacement therapy. There's a couple of other hormone tests you might want to look at, what they call high sensitivity estrogen. That's important to somebody who's taking testosterone because about 8% of testosterone is converted into estrogen through the action of the aromatase enzyme.
It's a big controversy with estrogen tests, you know, the ultra-sensitive estradiol test because they used to think that if you had an estrogen level of over 30, it was considered high. And, you know, then they would put you on, let's say, anti-aromatase drugs like aromadix. But we now know that having slightly higher estrogen levels, even up to 60, 65, is not dangerous.
It's not causing any problems. If you go to a doctor and, you know, he tests your high sensitivity estrogen, and let's say you show up 35, he wants to put you on an aromatase blocker, my suggestion is don't do it because you need a certain amount of estrogen for health. Recent studies show that estrogen also is important for the activity of satellite cells, which are muscle stem cells heavily involved in muscle repair and growth.
So you never want to cut estrogen down. When you take aromatase blockers, you cut as much as 90% of your estrogen off. So I also suggest taking tests for DHT, which is dehydrotestosterone, a major byproduct of testosterone metabolism.
DHT is actually more active than testosterone at the androgen receptor in all tissues except for muscle. And muscle DHT is rapidly broken down by enzymes. But DHT, elevated DHT, is associated with such effects as male pattern baldness, possible prostate problems, and acne.
So you want to know your DHT. Another test for body bulge would possibly be prolactin. Prolactin is especially affected by heavy growth hormone use.
And the problem with prolactin is elevated prolactin can cause gynecomastia, male breast formation just like estrogen, and it also can cause erectile dysfunction, where it's pretty bad. Also, if you're taking a growth hormone, you also want to know your IGF-1, insulin-like growth factor test. It's produced by the liver, and if you have low IGF-1, it'll impede muscle growth.
However, people that work out regularly almost never have low IGF-1, whether they're on steroids or not. As a matter of fact, IGF-1, one of the great things it does manage the effects of growth hormones in your body. IGF-1 and GH together promote normal growth of tissues and bones.
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