The abstract discusses the potential heart health risks associated with psychedelic microdosing, specifically the risk of valvular heart disease (VHD) due to prolonged receptor activation. The use of psychedelics like LSD and psilocybin, which bind to the 5HT2B receptor, may lead to VHD when microdosed over many months to years. Medications with strong 5HT2B receptor binding affinity have been linked to VHD, with some cases resulting in heart surgery and death. Epidemiologic studies have shown an association between chronic dosing of psychedelics with 5HT2B affinity and VHD.Furthermore, recent randomized controlled trials evaluating LSD and psilocybin microdosing have not demonstrated significant antidepressant, anxiolytic, or pro-cognitive effects. In fact, the largest self-blinding RCT to date found equal improvement in both placebo and microdosing groups, suggesting that beneficial effects could be attributed to the placebo response.Given the lack of clear benefits from microdosing and the potential safety risk of VHD, caution is advised when considering prolonged and repeated microdosing. It is recommended to take breaks between microdosing intervals and to monitor heart health through routine echocardiography. This information is crucial for individuals considering microdosing psychedelics to be aware of the potential risks and make informed decisions about their use.