TRT increasing blood pressure?

[hankerata]

I've been on TRT through Defy for about two years, with great results. This is my protocol:

Test Cyp 200 mg/ml – 0.45 ml IM/SQ 2 times weekly
HCG 400 iu SQ 2 times weekly
Anastrozole 0.5 mg 2 times weekly

I am 41 y/o, 5'7", 190 pounds; work out, CrossFit-style, four to five times/week, with a pretty clean diet. I mention that to say that, while I could lean out a little, I'm not obese by many means.

For the last six months to a year, I've had persistently elevated blood pressure. One of my doctors suggested I start taking a low dose of Amlodipine daily, but before doing so, I'd like to try to bring my blood pressure down through lifestyle alternations. For that reason, I've decided to cut down my drinking to weekends only, and then just a two to three drinks on Saturdays and Sundays. I'm also going to mix in more cardio-intensive workouts and cut down on any non-alcohol sugars as well.

But I've begun to wonder if TRT itself is causing some of this elevation. Consultations with Dr. Google seem a bit mixed, but there are studies that suggest T can increase BP in obese men as well as in rats. Any opinions on whether I should suspect my TRT could be part of the cause, and if that's case, is it worth considering bringing down my T dosage a bit? Or do you think my BP is likely an issue I'd be dealing with now even if not on TRT?

Separately, for those of you on TRT and BP-lowering medication, can anyone provide feedback on whether they think being on BP drugs has been worth it and any recommendations on drugs themselves? As I said, my doc recommended Amlodipine, and she said it had few side effects. But then when I researched it, I saw gynecomastia is not uncommon -- which is of course a terrible side effect.

Thanks for your help.

 

[BigBamBoo]

I too and pretty fit...6’2”, 210lbs. Do not drink, smoke, use drugs, drink only water...no coffee, soda’s, workout 4-5 times a week, etc.

Prior to TRT I had very good BP. After being on TRT my BP became elevated.
I tried everything I could to lower it...stated taking magnesium, Q10, garlic, etc.

Once I stopped TRT my BP dropped substantially and continues to remain low.

Elevated BP was one of the reasons I stopped TRT....main reason was the negative sexual side effects TRT caused me.

I am 52 in a couple of months and currently take zero meds of any kinds.
The thought of having to take BP, cholesterol, heart, etc, meds does not excite me so I will do what it takes to not have to.

Good luck to you. Hope you find a way to manage it.

 

[Vince]

You should read over Gene's Nitric Oxide Stack. Increasing nitric oxide is a good way to lower blood pressure.

 

[Vince]

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[Nixter]

I've found BP to have a linear relation to trt dose. I'm down to 80mg/wk and BP is good, around 125/70 or so. I also struggle with trt related sexual sides.

 

[Nelson Vergel]

High Blood Pressure and Water Retention on Testosterone ( TRT ) | Testosterone Wisdom

TRT can cause water retention and high blood pressure during the first weeks of treatment. This article mentions ways to deal with that issue

www.testosteronewisdom.com

You do not say what your blood pressure before and after TRT is, your T level, your sensitive E2 and your height/weight.

I would reduce my T dose since I bet your total T is above 1300 ng/dL.

 

[slicktop]

I'm in a very similar situation. I'm 43, 5'9", 190 lbs. My work out though mainly revolves around heavy lifting right now. My blood pressure increased after starting TRT a few years ago. My doc wasn't worried about it, but I was consistently at that pre-hypertensive range of like 135-139 and I didn't like it since my whole life I ran under 120/80. I dropped my T3 medicine all together, didn't make a difference. Drank less coffee, didn't make a difference. Lowered my t dosage, didn't make a difference except I didn't feel as good, didn't perform quite as well in the gym. Ran more, didn't make a difference. Finally order some telmisartan from India and started taking that, now I'm back to where I was. I like telmisartan a lot; it has lots of benefits you may be interested in. It makes your body attack visceral fat which is an added bonus, and there's some evidence that it helps prevent Alzheimer's which runs in my family. It was a no-brainer for me. But honestly, you're going to get a lot of "your testosterone dose is too high" responses on here, which may be true... that's a big dose.

 

[Nelson Vergel]

We discuss losartan and telmisartan here

losartan excelmale.com - Google Search

 

[hankerata]

High Blood Pressure and Water Retention on Testosterone ( TRT ) | Testosterone Wisdom

TRT can cause water retention and high blood pressure during the first weeks of treatment. This article mentions ways to deal with that issue

www.testosteronewisdom.com

You do not say what your blood pressure before and after TRT is, your T level, your sensitive E2 and your height/weight.

I would reduce my T dose since I bet your total T is above 1300 ng/dL.

Nelson,

I do not have specific numbers for BP prior to and in the first months of being on TRT. As I recall generally, my BP was slightly elevated prior to taking TRT, then came down to normal, and in the last nine months has been elevated, much higher than it was pre-TRT.

My height 5'7, 190 pounds. My last labs were in December. Total T at trough was 733, with Free T at 20.3. My Estradiol Sensitive was 28.4.

 

[slicktop]

We discuss losartan and telmisartan here

losartan excelmale.com - Google Search

calf cramps!!!! OMG... Nelson, you're a peach. I've been trying to figure out where they came from. Thanks for the link! Now you have me thinking....

 

[gerardo]

I've found BP to have a linear relation to trt dose. I'm down to 80mg/wk and BP is good, around 125/70 or so. I also struggle with trt related sexual sides.

Did you measure your hematocrit?

 

[Ozzieville]

I'm taking Irbesartan for elevated blood pressure - the lowest prescription dose of 75 mg. There's some evidence Irbesartan is good for erection health (Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome - PubMed). It makes sense, as lower BP = less restricted blood flow. There seems to be plenty of evidence that high BP is bad for your sex life.

 

[hankerata]

Guys,

Thanks for the feedback on this. For now, I'm going to try reducing T from 0.45 ml/2x per week to 0.4 ml/2x per week. I'm also going to mix in daily 5mg Cialis.

If I don't see any improvement in three to four weeks, I'll introduce a low dose of losartan or telmisartan. But my goal is to avoid BP medication if I can.

I'll report back here in a month or so. Thanks again.

 

[Golfboy307]

I had mildly elevated BP before starting TRT (age 47 at the time). Healthy lifestyle, long time runner. TRT didn't make it go up anymore, but I am on a current does of 90mg - 100mg per week text cyp. (divided by 3 doses). I have had good luck with Lisinopril, an ACE inhibitor. I was on a diuretic for a good long time, but dropped it last year. Hated the sides from the water pill.

 

[Nelson Vergel]

One thing I forgot to mention: Anastrozole can decrease endothelial function. That can cause increased blood pressure. Of course, this study used daily AI.

The ASCO Post

Have you tried going without anastrozole for 4 weeks? (It is a drug with long half life, so it takes time to leave your system).

 

[Nelson Vergel]

"
The study found that small- and large-artery elasticity, measured via EndoPAT testing, was reduced among case patients compared to control persons, even after adjustment for differences in systolic blood pressure, resulting in a significantly lower EdoPAT ratio for case patients (0.8 vs 2.7) ― an indication of endothelial dysfunction (P < .00101).

The vast majority of participants who had increased cardiac risk, as determined on the basis of EndoPAT ratio levels, would not have been considered at risk on the basis of Framingham Risk Scores, she noted.


Vascular function did not seem to differ with respect to whether women had received chemotherapy, radiation, or had left- or right-sided cancer. Among the AIs, anastrozole was associated with a significantly greater reduction in large-artery elasticity in comparison with exemestane and letrozole. "There was no association between length of time on an AI and EndoPAT ratio," she said.

Not surprisingly, median estradiol levels were significantly lower in AI-treated women compared to control persons (2 vs 15 pg/mL)."

Aromatase Inhibitors: Is Cancer Benefit Worth Cardiac Risk?

A new study of endothelial dysfunction in breast cancer patients prompts this question, especially in the context of long-term use.

www.medscape.com

 

[Nelson Vergel]

TRT and high BP Pulse

I am on 100mg cipionate and .25mg anastrozole. Recently I was diagnoses little high BP with 130/90 average pulse always above 90. So my GP prescribed me 2.5mg Lisinopril to bring the BP down. Is anybody here on ACE inhibitor Lisinopril for high BP? Bad Thing is even my Bp came down with...

www.excelmale.com

Oestradiol improves arterial endothelial function in healthy men receiving testosterone - PubMed

In healthy young men, oestradiol supplementation is associated with enhanced arterial endothelial function, a key marker of vascular health.

pubmed.ncbi.nlm.nih.gov

 

[ryan98366]

hankerata,​

You are 41. That is an age many men get on BP meds. Does blood pressure problems run in your family?

#2 - sounds like you were doing some drinking which is huge in elevated BP. People usually under report how many drinks they have.

My suggestion is blame the alcohol vs the TRT.
Go no alcohol for 90 days and then check your BP.

 

[drkelp]

Always consult your physician of course. My bp tries to climb occasionally, lots of water, and hibiscus or "Rosellica" has made a significant difference. But that's just me.

 

[Smokey]

You should read over Gene's Nitric Oxide Stack. Increasing nitric oxide is a good way to lower blood pressure.

I tried his stack. WAY too many pills and I became very dehydrated. Kidneys hurt etc.