Maintaining a balanced diet, staying hydrated, moderating protein intake, and avoiding multiple stacked supplements are key preventive measures. Weight management through regular exercise and stress reduction further supports liver health.
Published Oct 12, 2025 | 7:00 AM ⚊ Updated Oct 12, 2025 | 7:00 AM
Varinder Singh Ghuman's sudden death has sparked concern over the growing number of cardiac-related deaths among seemingly fit, muscular athletes.
Synopsis: Regular medical check-ups are essential for bodybuilders to maintain heart health. Such evaluations help identify early signs of strain or dysfunction before they develop into serious complications.
The sudden death of 42-year-old bodybuilder and actor Varinder Singh Ghuman has sparked concern over the growing number of cardiac-related deaths among seemingly fit, muscular athletes.
Ghuman reportedly suffered a cardiac arrest during shoulder surgery at a private hospital in Amritsar, leaving the fitness community stunned and questioning the paradox of a powerful physique masking a fragile heart.
Behind the sculpted bodies and rigorous routines lies an unsettling reality: the human heart is often pushed to extremes in the pursuit of size and strength.
Excessive muscle mass, prolonged strain from high-intensity training, and the misuse of performance-enhancing substances can alter the body’s internal balance, burdening vital organs like the heart and liver.
What appears as health and vitality from the outside may, in fact, conceal a system under constant stress, one that can fail without warning.
According to Dr. Sanjay S Bhat, Senior Consultant Interventional Cardiologist at Aster CMI Hospital, Bengaluru, extreme muscle mass can place significant strain on the heart, even in otherwise healthy-looking bodybuilders.
“Excessive muscle mass increases blood volume and cardiac workload,” he told South First, adding that this chronic stress can lead to cardiac hypertrophy and fibrosis, conditions in which the heart muscle thickens and stiffens, reducing its efficiency.
He also highlighted the role of anabolic steroids, which are often used to accelerate muscle growth. “Steroids can promote heart muscle thickening, worsen cholesterol levels, and impair blood vessel function, driving up blood pressure and accelerating arterial plaque buildup,” Dr. Bhat said.
Coupled with high testosterone levels that can thicken the blood, these factors elevate the risk of arrhythmias, blood clots, heart attacks, and sudden cardiac events, even among young athletes.
Dr. Bhat emphasised that warning signs such as chest pain, shortness of breath, or dizziness should never be ignored, as they can indicate underlying cardiac stress that might otherwise go unnoticed.
Prevention and monitoring
Dr. Bhat emphasised that regular medical check-ups are essential for bodybuilders to maintain heart health. He recommended ECGs, echocardiograms, and routine blood work as part of ongoing monitoring. These evaluations would help identify early signs of strain or dysfunction before they develop into serious complications.
Alongside medical supervision, Dr. Bhat highlighted the importance of balanced training and nutrition. Structured exercise routines, adequate rest, and a diet that supports overall cardiovascular health can reduce undue stress on the body and help sustain long-term fitness.
He also stressed the need to avoid steroids and other performance-enhancing substances while managing stress effectively. “Bodybuilders must understand that looking muscular doesn’t automatically mean being healthy. By taking these precautions consistently, they can protect their hearts while continuing to train at high levels,” Dr. Bhat said.
High-protein diets and supplements like whey protein are popular among bodybuilders for muscle growth. The liver, essential for amino acid breakdown, ammonia detoxification, and protein synthesis, generally adapts well to moderate or high intake.
“In healthy individuals, moderate to high protein intake, around 1.6 to 2.2 grams per kilogram per day, is generally safe and does not harm the liver,” Dr. Thiagarajan Srinivasan, Senior Consultant and Director at the Institute of Liver Diseases, Transplant & HPB Surgery, told South First.
Problems arise when protein intake becomes excessive, over three to four grams per kilogram per day, or when there is a pre-existing liver condition. “In conditions such as fatty liver, hepatitis, or cirrhosis, the liver’s reduced detoxification capacity can lead to ammonia buildup and hepatic encephalopathy,” he explained.
Dr. Srinivasan also warned that “some commercial protein powders are adulterated with anabolic steroids or hepatotoxic additives, which have been linked to liver injury.”
Anabolic steroids, commonly misused to enhance muscle mass, pose additional risks. “When taken in high doses or for long periods, especially in oral 17-alpha-alkylated forms, steroids can be hepatotoxic, leading to cholestasis, hepatocellular injury, peliosis hepatis, or even liver tumors,” Dr. Srinivasan said.
He added that “injectable steroids pose less direct liver toxicity but may still contribute to systemic inflammation and metabolic stress.” Early warning signs include fatigue, abdominal discomfort, dark urine, pale stools, itching, or jaundice, he noted.
Fatty liver disease is increasingly common among athletes on high-calorie, high-protein diets. Dr. Thiagarajan Srinivasan said that while protein alone rarely causes fatty liver, excess calories and rapid weight gain from bulking diets or heavy supplement use can lead to fat buildup in the liver.
Early stages are often silent and reversible with diet and exercise, but if unchecked, they can progress to NASH, fibrosis, cirrhosis, or even liver cancer, he warned.
Regular monitoring is essential for bodybuilders and athletes who use supplements, follow high-protein diets, or have other risk factors such as obesity, diabetes, or alcohol use. Dr. Srinivasan advised routine liver function tests, including ALT, AST, ALP, GGT, bilirubin, albumin, and prothrombin time, to detect early liver injury.
Metabolic tests such as fasting glucose, lipid profile, and HbA1c can help assess the risk of fatty liver and related conditions. When abnormalities are found or the risk is high, imaging tests like ultrasound or FibroScan can detect fatty changes or fibrosis early.
He recommended that healthy supplement users undergo testing once a year, while those with higher risk factors should be checked every six months.
Maintaining a balanced diet, staying hydrated, moderating protein intake, and avoiding multiple stacked supplements are key preventive measures. Weight management through regular exercise and stress reduction further supports liver health.
If liver damage occurs, early lifestyle correction and medical guidance can often restore function. Dr. Srinivasan emphasized eliminating the cause, whether it is alcohol, anabolic steroids, or hepatotoxic supplements, and following a liver-friendly diet rich in fruits, vegetables, whole grains, and lean proteins.
With regular monitoring through liver function tests and imaging, along with medications or supplements like vitamin E as needed, bodybuilders can stay on top of their liver health and prevent long-term complications.
(Edited by Majnu Babu).
