question from a user
Would you advise a 49 y/o man with documented low T but also a long (>10yr) history of extensive PVCs (every 3rd to 5th beat) to avoid TRT? My PVCs have no presentation and I only know they’re happening if I take my pulse. I weight-lift 3-5 days per week without any issue or lightheadedness. PVCs tend to go away when doing cardio if that makes a difference. I see a cardiologist once per year who has done several complete work ups (ekg, sonograms) but based on the results, feels they’re currently not a concern. I’m worried I could exacerbate this condition with TRT and am hesitant to start despite having the prescription. I’m otherwise a healthy dude.
AlphaMD's Answer
PVCs are typically ideopathic, which basically is medical speak for "I dunno what is causing them". It sounds like your cardiologist has said the same. They tend to be more severe with release of catecholamines (epinephrine, norepinephrine). These are better known as adrenaline and are obviously related to stress, anxiety, and poor sleep. Other stimulants will make PVCs worse as well, such as caffeine, nicotine, etc.
PVCs are benign, and do not increase the risk of arrhythmia. They can be scary, and annoying, but they are (as your cardiologist said) "not a concern".
Testosterone has shown no evidence of causing or worsening PVCs. There was a very recent study which showed the increased risk of atrial fibrillation with testosterone, though the study was done in men in the age group that typically develops a-fib (55-75yo). Also, the mechanism that causes fibrillation and PVCs is different.
Specifically regarding PVCs, there are no studies that show testosterone increases their prevalence. In fact, there are a few studies show that low testosterone causes PVCs and TRT decreases PVCs. These were animal studies, but still, worth mentioning.
As I am not your doctor, I cannot say whether TRT would be right for you, but I can say that your PVCs will not worsen with TRT, and that there is a possibility they may improve or resolve on it.
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