Elevated blood volume vs elevated blood pressure?

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I am a new member to this forum and fairly recent (< 2 yr) TRT patient. I'm in my mid-forties and was diagnosed with with low T (approx 300 ng/dL) after experiencing ED and general lack of energy. I had been taking weekly injected T.Cypionate of a few stages of varying doses (100-400 mg/ml) and gauging alleviation of symptoms.

Since starting TRT the ED disappeared and the energy was restored. I was feeling phenomenal. During the course of treatment my T serum levels generally varied from 600 - 1200. Not going to lie but felt better on the higher end (more energy, stronger, and sexual while appearantly losing weight). I'm 6' tall at 195 lbs. I didn't actually lose weight but transformed fat to muscle weight. It's important to note that I was also taking B12 injection with T but eventually went to biweekly with that. Now they offer Lipotrophic B12.

Since the higher range of T level seemed to work best for me I started 500mg Grape Seed Extract to help keep DHT in check. I was also taking fish oil, multivitamins, and blended creatine powder pills (1,200 mg/day). I mainly took the creatine because I found it helped my recovery times.

I'm a fairly active guy working out 3-5 times a week consisting of alternate free weigh training and 2-6 miles brisk running.
Now the bad news, I think I hit a wall this summer. I got dehydrated this past summer that sent me to the ER. My blood pressure was elevated and had high blood count. I always drank lots of water daily but my have slipped up on my sodium and electrolyte replacement as confirmed by the blood work.

Since I have stopped all supplements and TRT and still struggling to get my overall feeling and normal blood pressure back. Also learned my hematocrit was elevated (61!) so I started therapeutic phlebotomy and daily grapefruit until it reached 45 but blood pressure is still out of wack (sometimes normal but most times elevated around 145/85) AND have a tense feeling in my neck and ringing in my left ear since the dehydration. I don't know if that is coincidence or consequential damage.

Waiting on X-ray results on my head & neck but it doesn't seem related to my blood pressure since when it bothers me most my pressure is sometimes perfectly normal. My doctor told me that it could be due to high blood volume not caused by high blood pressure or worse a vascular blockage. Another thing that crossed my mind is a pinched nerve or needing neck/spine adjustment.

So to my question: I read that elevated hematocrit is fairly common from TRT patients but elevated blood volume a cause of TRT? I'm concerned that I still feel like crap now that my hematocrit is under control. I do notice both blood pressure and ringing in ear and neck discomfort seem to get better after phlebotomy. Anyone else experiencing this or have ideas on what my problem could be now that my HCT is under control?

Thank you for taking the time to read this. Wherever I find answers I will post the diagnosis and hopefully a treatment.
Defy Medical TRT clinic doctor


New Member
Just an update since my initial post in 2015: my blood pressure finally normalized after getting my hematocrit under control by phlebotomies but it took a couple of months to stabilize. I ate more vegetables and drank fresh ginger lemon tea each night during the process as many recommended to treat high blood pressure. Also started to eat 1/2 grapefruit between a meal each day to keep hematocrit normal as others have suggested. It appears to be working as I have not had a high level nearly two years since.

Really scary stuff and hindsight 20/20 should have knew more about TRT treatment and stayed on top of my lab work. I literally stopped the TRT, B12, and supplements mentioned for about 3 months after that event.

I've since been back on all original treatment and supplements note before minus the creatine. I believe the mix of high heat running 3-5 x week, creative, and unchecked, elevated hemotocrit sent me into the tailspin. The neck & hearing issue as I stated before may have just been coincidence but is still present. Never diagnosed by Dr. after X-rays and MRI but hearing loss in one ear was confirmed but it's manageable and not worsening.
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New Member
One other thing to note during my TRT experience: I'm about 3 years in and still run often but now believe I've developed Compartment Syndrome in lower legs, particularly on my strong side. While the condition is typically rare, it appears to be a confirmed possible side effect of TRT. I hope to have a specialist Dr. confirm / advise on this soon. I understand it can be dangerous to tissues & nerves if physically pushed too far. Upon researching possible remedies short of lowering physical stress on lower legs, it appears surgery is 50/50 successful but a new Botox injections (yes, Botox) is 75% successful. Botox treatment for this is fairly new and not currently covered by most insurance plans.

I'm curious to know if anyone is experiencing this similar TRT journey. Thanks to this forum I've armed myself with invaluable knowledge and know I'm not alone in my quest for sustained or better male health.
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