Does TRT Really Cause Heart Attacks?

[Kayce]

Here’s the no-BS summary from the man himself, Dave Palumbo, on whether testosterone replacement therapy (TRT) actually increases heart attack risk.

Key Takeaways:​

• TRT Doesn’t Cause Heart Attacks Directly: Testosterone isn’t liver or kidney toxic. It can increase red blood cell count (thicker blood), but that alone won’t cause clots unless you already have a clotting disorder or a genetic predisposition.
• Plaque Is the Real Threat: The #1 cause of heart attacks is coronary artery plaque, which blocks blood flow. This is more tied to genetics, bad diet, and chronic inflammation than TRT use.
• Misleading Doctors: Many doctors wrongly blame TRT for heart risks without assessing other factors. Dave says it's usually genetics, poor diet, smoking, or uncontrolled high blood pressure that cause trouble — not moderate, clinical testosterone use.
• Get Proactive with Blood Work: Dave urges everyone on TRT (or any PEDs) to get cardiac CT calcium scores to check plaque buildup. No insurance? Doesn’t matter. Most imaging centers offer it for ~\$100.
• Manage Your Health Smartly: If you’re on TRT, monitor blood pressure, manage cholesterol, and if needed, donate blood if RBC count gets too high. Simple as that.

Bonus Wisdom from the Episode:​

• Masteron and Hair Loss? Not likely. Despite being “DHT-like,” it doesn’t convert from DHT and seems mild on the hairline compared to Test.
• Over 50? Still Train Hard: Older lifters don’t have to lighten weights. If you use good form and avoid ego lifting, keep pushing those compounds like squats and deads.
• Muscle Maturity Takes Time: Natural or not, Dave says the 10-year rule still applies — it takes about a decade to get that hard, dense look.
• Nick Walker is Back: Palumbo praises Nick for getting mentally back on track and leveraging his freak factor on social media again. Smart move — he’s a top contender for the 2025 Olympia and knows how to market himself.

Palumbo drops knowledge like always — no fluff, just experience and logic. Anyone on TRT or thinking about it should give this one a watch.

Full Video: Testosterone Causes HEART ATTACKS? – RXMuscle Ask Dave 7/2/25

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Let me know your thoughts — has your doc ever freaked out over your TRT bloods? Anyone done the cardiac CT scan yet? Let's talk health, not fear-mongering.