Experiences with TRT and Atrial Fibrillation (AFib)?

[YiL]

Hey everyone,


I’m a TRT user here on the forum, and I’ve been on testosterone replacement therapy (started on 2x75mg and dropped to 2x60mg) for a while now (dec 2025). Recently, I’ve experienced two significant episodes of atrial fibrillation (AFib) since starting TRT, which has me a bit concerned. I’m wondering if any of you have come across similar issues or have knowledge about potential links between TRT and AFib.


Has anyone else on TRT dealt with AFib or heart rhythm problems? What were your experiences, and did you find any ways to manage it? I’d love to hear your thoughts, insights, or any studies/articles you’ve seen on this topic. Let’s brainstorm together—maybe we can share some useful info!


Thanks in advance for your input. Appreciate the community here.

 

[SonhoDourado]

How did you determine Afib was occurring? I’ve dealt with anxiety for years and I don’t use meds to combat it as I don’t liked feeling doped, While going low carb a few months ago got some pretty bad anxiety and a few occurrences of palpitations and skipped beats. Got an echo performed and a holster monitor for a 48hr window, No afib detected and normal sinus rhythm found minus a few PCVs. I was very concerned as the palpitations scared me, to the point I went to the ER for the first time ever! Better safe than sorry though. That got the ball rolling for the aforementioned testing and future cardiac follow up!

Afib has a few unique properties, Usually you will have both an erratic rate and rhythm. Some people report RHR upwards of 150 BPM with a very erratic beat pattern. This is something that won’t always present on a EKG if it’s transient. That’s why an echo and holter monitor should be the next steps. The echo will you a good idea if there is anything structural wise going on with your heart. The holter will detect all beats, HR, arrhythmia if present, as well a journal of all perceived irregularities. Make sure to make note of any occurrences and activities happening when it occurred.

So if you haven’t already you absolutely want to get checked out asap. If you get another feeling of Afib or detect elevated HR last longer than an hour it may be a good idea to visit the ER. Regardless of what’s found a follow up with cardiology is paramount.

Wish you the best sir, please take care of yourself and keep us posted on any results pertaining the condition.

 

[YiL]

Been sent to first heart care twice in 13 days both times with afib episodes of 12 hours which eventually converted back normal by itself. The echo is plannend on Thursday.

 

[SonhoDourado]

Been sent to first heart care twice in 13 days both times with afib episodes of 12 hours which eventually converted back normal by itself. The echo is plannend on Thursday.

Ok, so you’ve confirmed Afib. Holter is the next step once the echo is complete. A full work up with cardiology should follow IMHO. They’re gonna want to see if any potential triggers beyond the TRT are causing this as it’s transient yet when presenting the length of time is significant.

The echo will tell what the next steps are depending on the findings. If something isn’t functioning properly in the heart itself the echo should detect it. Best of luck to you sir, keep your head up!

 

[YiL]

Thank you @SonhoDourado, I appreciate the time you took to read along.

Ive had three holters before onetime for 24 hours and two times for 72 hours, nothing detected in the past two years. I think (and hope of course) the echo won’t show anything significant which can explain the afib….

Nobody can answer my question regarding continuing or stopping trt…….. lowering the dosage maybe?

 

[nawot]

Hey YiL,

unfortunately I do not have any knowledge or experience about afib related to TRT. While reading here and in other forums I never came across anything about it.

I am interested in the outcome, though, since I started TRT about the same time as you but apart from feeling absolutely great I do not have any sides (yet).

All the best to you!!

 

[YiL]

@nawot

Great to hear you’re feeling absolutely great! I’m really happy for you because I know how it feels!! I’ve skipped 2 times now after the second afib, but starting to feel worse and worse, sleep got terrible fast as f#ck

What dosage do you use? Did you find your sweet spot?

 

[nawot]

@nawot

Great to hear you’re feeling absolutely great! I’m really happy for you because I know how it feels!! I’ve skipped 2 times now after the second afib, but starting to feel worse and worse, sleep got terrible fast as f#ck

What dosage do you use? Did you find your sweet spot?

I am now at 50mg test c EOD, which might actually be considered TRT+, but it works great for me so far.

I was quite overweight until 2023 (120+kg at 1,78m) and from January 2024 I did peptides only while working out until end of last year. I build good muscle while loosing fat but in the end I noticed that recomposition stagnated at around 95kg, so I decided to start cutting with GLP1s and introduced TRT for muscle preservation. So far that is working well and I feel amazing. The work outs have gotten significantly better since starting the TRT.

For the dosage and intervals I used steroidplanner.com. That helped significantly because it gives a release rate in mg/day for all the substances and esters. When my current vial of Cypionat is finished I'll try Decanoat to see if it gives even more balanced levels while pinning EOD and if that can actually be felt.

What did the doctors in the hospital say about the TRT and the afib? Did they recommend to stop it?

An idea could be to check (micro) nutrient deficiencies. I had my gut checked last year and it turned out that there was something wrong, so I was prescribed specific supplements for that because the fucked digestion lead to kind of malnutrition of certain nutrients. A couple of years ago I did a prolonged fasting and for that I also had to add supplements after three weeks because there can be serious heart issues if the wrong nutrient becomes deficient in your body. I can't remember which it was, unfortunately.

All other possible causes I really have no clue about, except for the usual suspects that cause metabolic syndrome and heart issues, like bad diet, lack of sports, drinking, smoking, overweight, etc, but I guess that doesn't apply to you.
I really hope that someone will be able to help you.

 

[jonny82]

Hi, I can only tell you that before testosterone replacement therapy, I suffered from extrasystoles, since I started they have decreaase Indeed, almost completely disappeared , Although to be honest it is no longer a therapy, because I have been on 300 mg per week for several months

 

[YiL]

The doctors in the hospital had zero to less info about afib/trt combi…… they did not advised to stop, but acknowledged trt might trigger the afib.

All bloodwork was fine, great diet, no alcohol, no smoking, no overweight…..

Maybe I’m the unlucky one. Wish I could go up to 300 to blast once in a while, but terrified it will kill me :|

Thank you for all the input guys, really appreciate it!!

 

[OldGHGuy]

I haven't seen you reference ANY bloodwork results. This is a MUST if you are going to be on TRT. Therefore, I am assuming you are doing TRT on your own, because any doctor prescribing TRT would have done bloodwork (and cardiovascular testing such as simple BP) BEFORE prescribing to make sure you are a proper candidate.

Get bloodwork done - there are plenty of posts on here explaining what you need to test for.
Check BP.
Make sure you are adequately hydrated and getting enough electrolytes/sodium.
Are you doing any cardio? Smoker? Alcohol? Excessive caffeine?

Being on TRT is EXCELLENT for health but it brings with it responsibilities.

 

[YiL]

Nope absolutely not on my own. Before getting my prescription I was at 8nmol and SHBG at 15. I had all bloodwork done before starting, including all health check ups. Never had heart issues before.

With all the bloodwork results I managed to get a prescription from Doctrinus (see steroid underground).

I know my diet is on point! I don’t drink or smoke, don’t drink coffee neither, never had BP problems! Daily cardio on a bike! Target of 10.000 steps per day is easily achieved

My next bloodwork appointment was set in March, 3 months after start TRT. But somehow the afib episode ruined it.

 

[jasonsta]

There are millions of people who suffer from tachycardia. I had several episodes in the past that were treated with medication, and eventually I underwent a radiofrequency ablation procedure — a very common operation for this condition.