Joey Swoll was hospitalized again last weekend for a heart-related issue, and this is not an isolated event. At 40 years old, he has now had multiple hospital visits dating back to 2023, and the pattern is becoming impossible to ignore.
In January 2023, Swoll reported feeling unwell and underwent an operation related to genetic irregularities in his heart. A year later, he said his doctor had cleared him, noting his heart was working better than ever and that he no longer needed medication. Not long after that, he went through a severe complication during a routine angiogram when a piece of medical equipment broke off and lodged in his heart, requiring doctors to cut into him and maneuver the fragment out of his arteries. He has since described developing PTSD from his cardiac procedures, writing:
“I have PTSD from multiple heart procedures over the years, including one that left me lying awake for 7 hours on the operating table as they tried to save my life. Hearing everything that they said or did while staring up completely helpless and praying.”
Given this history, and given his size, the conclusion is straightforward: he needs to get off PEDs. Maintaining that level of muscle mass is not something achievable on hormone replacement therapy alone, and anyone claiming otherwise is being dishonest about what they are actually taking.
Cardiac risk is tied directly to dose exposure, meaning either a high dose over a short period or a moderate dose sustained over many years can produce the same dangerous outcome. Swoll has reportedly been active in this space for over a decade, which puts him squarely in the high dose-exposure category regardless of what he is currently taking.
He is no longer a competing bodybuilder and has not competed in years, which removes any competitive justification for carrying this much size. The comments on his own post reflect this sentiment directly, with fans urging him to get off PEDs and prioritize his family and longevity over his physique. The response of his fiancée, asking people to mind their own business since he has supposedly already downsized, does not hold up well considering his public persona is built entirely around inserting himself into other people’s business, and visually, he does not appear meaningfully smaller.
Swoll has an enormous platform, a large following and significant influence in the fitness space. If he chose to downsize gracefully and speak openly about stepping back from excessive size, it could set a rare and valuable example in an industry that normally pushes in the opposite direction. Prioritizing cardiac health, reducing dosage and letting go of the attachment to size would not diminish him. It would likely save his life.
