Elevated BP and headaches.

[Rykertest]

Hello. 49, male, no other health issues. 4.5 months into TRT, lowered my dose a month ago due to some random heart palpitations, hemo and RBC were fine according to bloodwork. In .20 twice a week, down from .30 twice a week and started half a pill of arimidex as needed once a week. Yesterday I had a splitting headache at the base of my head. My allergies have been bad so I assumed it was that but I’ve had palpitations again. I checked my BP this morning and it was 139/99 which is very high for me. I feel kinda nauseous and have for a couple days. I plan to call my Dr when they open this morning but I feel the need to be very aggressive with this. I’m pounding the water but am unsure of what else I need to do. would donating blood help? What’s the best thing to do? Thank you.

 

[Blackhawk]

In .20 twice a week, down from .30 twice a week and started half a pill of arimidex as needed once a week.

Not enough info to make specific recommendations

When you post what you are taking, .2 and .3 means nothing without knowing what substance, what units and what concentration. Is that mg or ml? And what is the substance? Assuming testosterone, what ester, and what concentration? T comes in 100mg/mg, 200 mg/ml, 250 mg/ml... cypionate, enanthate, sustanon, undeconoate etc

And do you have labs related to your current situation? Get tested for your testosterone levels, estradiol, and a CBC for hemoglobin and hematocrit.

High BP and headaches can come from, high hematocrit, but it is not the only cause of headaches.

Adjusting doses and starting Arimidex without labs is folly.

 

[Rykertest]

.2 and .3?

This means nothing without knowing what substance, what units and what concentration.

Is that mg or ml? And what is the substance? Assuming testosterone, what ester, and wnat concentration?

Get tested for your testosterone levels, estradiol, and a CBC for hemoglobin and hematocrit.

High BP and headaches can come from, high hematocrit, but it is not the only cause of headaches.

Adjusting doses and starting Arimidex without labs is folly.

Nothing was done without labs. I had labs a month ago and the total and free numbers were very high so my Dr and I reduced the amount. Total was over 1500 and free was 38. My med is Test cyp, 200 mgs p ml. Repeat labs are scheduled for 3 weeks out to see how my adjusted dose affects numbers As I told my Dr I want both numbers lower.

 

[Blackhawk]

Nothing was done without labs. I had labs a month ago and the total and free numbers were very high so my Dr and I reduced the amount. Total was over 1500 and free was 38. My med is Test cyp, 200 mgs p ml. Repeat labs are scheduled for 3 weeks out to see how my adjusted dose affects numbers As I told my Dr I want both numbers lower.

Likewise, lab numbers need to be accompanied with reference ranges, Free T at 38 on the generic labcorp direct test is high (Yours probably is, due to the context of 1500). On Quest equilibrium dialysis it is middle of the range.

The total T over 1500 does imply high hematocrit. Apparently you didn't get this tested? Did you have a CBC done? And estradiol? If so, what E2 test?

So are you talking:

.3 ml of T cyp 200mg/ml = 60mg 2x/week for 120mg/week?

and

.2ml of 200 mg.ml - 40mg x2/ week for 80mg/week?

Lowering dose is a good move. It will take around 6-8 weeks for your blood T levels to drop from that change. You may feel like ass as your level drops, but have faith, it will improve in the long term.

If you do have high HGB/HCT, yes donating blood would be very good as long as ferritin is adequate, so get ferritin tested. Taking testosterone lowers ferritin because iof the extra redblood cellproduction due to hepcidin inhibition. Donating blood also lowers ferritin. Low ferritin is all too common for men on testosterone who donate too much blood.

If you do have high hematocrit, and don't dontate, expect it to take 6 months for your hematocrit to resolve naturally. Red blood cells live long, and that's about when they will have completely been replaced with new cells and level normalized

 

[sammmy]

What do you take for your allergies? Intranasal corticosteroid sprays that are sold over the counter can increase blood pressure as a side effect.

 

[Systemlord]

started half a pill of arimidex as needed once a week.

This is a lot of arimidex, knocking estrogen low can cause headaches, palpitations, high blood pressure and nausea.

All this this can be due to low estrogen.

I have found the use of Arimidex to trigger allergies I never had before or intensifies existing allergies. I had a mild allergic reaction to avocados my entire life, on Arimidex it intensifies and my eyes and nose swelled up shut and breathing became difficult, this doesn’t happen when I’m not taking an AI!

Arimidex can cause an allergic reaction in some people.

 

[Rykertest]

Likewise, lab numbers need to be accompanied with reference ranges, Free T at 38 on the generic labcorp direct test is high (Yours probably is, due to the context of 1500). On Quest equilibrium dialysis it is middle of the range.

The total T over 1500 does imply high hematocrit. Apparently you didn't get this tested? Did you have a CBC done? And estradiol? If so, what E2 test?

So are you talking:

.3 ml of T cyp 200mg/ml = 60mg 2x/week for 120mg/week?

and

.2ml of 200 mg.ml - 40mg x2/ week for 80mg/week?

Lowering dose is a good move. It will take around 6-8 weeks for your blood T levels to drop from that change. You may feel like ass as your level drops, but have faith, it will improve in the long term.

If you do have high HGB/HCT, yes donating blood would be very good as long as ferritin is adequate, so get ferritin tested. Taking testosterone lowers ferritin because iof the extra redblood cellproduction due to hepcidin inhibition. Donating blood also lowers ferritin. Low ferritin is all too common for men on testosterone who donate too much blood.

If you do have high hematocrit, and don't dontate, expect it to take 6 months for your hematocrit to resolve naturally. Red blood cells live long, and that's about when they will have completely been replaced with new cells and level normalized

Thank you for your reply. Yes, labcorp was who ran my blood work and yes it was high.

I am currently on a lowered dose of .2ml of 200 mg twice a week for a total of 80mg/week. That’s been my new dose for almost 3 weeks. I don’t know if that dose is getting to the point where I don’t have a need for TRT or not. When I initially got tested, my total was fine, almost 600 if memory serves, but my free was low at 6, the bottom range being 6.8. My last blood work numbers were;

Labcorp RBC was at 5.85 4 weeks ago which is considered high and that is up from 5.53 previously which is not high. Range is 4.14-5.80

hematocrit was elevated slightly but not considered high at last blood draw. Went from 46.4-49.4. Range is 37.5-51.

Estradiol went from 21 to 63 and was considered high with a range of 7.6-42.6.

Ferratin has never been checked and I asked around to the friends and coworkers I know who use this same dr and he never checks that. Maybe he should or maybe he’s using some other marker to determine it’s not a concern at the time of a blood draw.

To answer the allergy question above, I was using Benadryl, 3-200mg Advil and earlier in the day I had used Allegra D 24 hour. The headache I had was at the base of my skull along with the ear/sinus pressure I had which was allergy related. This spring has killed me allergy wise. That location of headache was new to me and it was unsettling. I was supposed to take the arimidex with my shot yesterday but I didn’t. I do wonder if this is part of the problem because the last 3-4 weeks my allergies have been the worst they’ve been in a decade or more when I got 3 years of allergy shots. Horrible sneezing, sinus pressure, eyes itching, throat and ear itching, etc. I also did have some moderate nausea the last two nights. I was beginning to wonder if my allergy shots were wearing off but it came on with such a vengeance, now I wonder if it was the AI. I had hoped the lower dose of TRT would allow me to not need the AI long term. If I stopped the AI, how long until it’s out of my system so to speak?

I also had some mild knee pain. Kind of an ache at the base of both knees and I don’t normally have that. This started about a week ago.

I have an appt with my dr tomorrow and his nurse said he will most likely want me to donate asap. I’ve not donated blood in 20+ years so I figure I will.

im Replying from work on my phone so thank you for everyone’s assistance.

 

[Systemlord]

Ferratin has never been checked and I asked around to the friends and coworkers I know who use this same dr and he never checks that.

That’s not a good sign, higher exogenous testosterone uses more iron to create more hemoglobin, therefore is not uncommon see a significant reduction in ferritin.

Ferritin testing should be routine before initiating TRT and 3-6 months after starting T replacement therapy. I started TRT with iron saturation at 14% (20-55%) and iron at the bottom of the ranges, and had my doctors been properly educated, testing ferritin was the next logical step.

The vast majority of doctors and providers are out to lunch with regards to properly managing men on T replacement therapy. TRT is a field of medicine that’s a blindspot for a lot of doctors due to inadequate training.

 

[sammmy]

Allegra D contains a stimulant pseudoephedrine that can raise blood pressure. Nausea is not a sign of allergy but a sign of intestinal irritation, either from food, drug or from infection.

Have you typically had itchy throat and ear with your allergies before?

 

[Rykertest]

That’s not a good sign, higher exogenous testosterone uses more iron to create more hemoglobin, therefore is not uncommon see a significant reduction in ferritin.

Ferritin testing should be routine before initiating TRT and 3-6 months after starting T replacement therapy. I started TRT with iron saturation at 14% (20-55%) and iron at the bottom of the ranges, and had my doctors been properly educated, testing ferritin was the next logical step.

The vast majority of doctors and providers are out to lunch with regards to properly managing men on T replacement therapy. TRT is a field of medicine that’s a blindspot for a lot of doctors due to inadequate training.

I will ask him tomorrow if he can check that and see if I meet resistance. He seems like the type that will Check whatever I ask him too. The issue I then have is it’s 8-10 days before my lab work is back and I’m not inclined to deal with these palpitations and headaches for another couple weeks. Having never dealt with high BP or cardiac issues, I’ll readily admit this is very unnerving.

I May be way off base with this next comment, I 100% acknowledge it’s said from a place of ignorance. It Seems like donating ONCE to drop the BP and headache issues and then Address ferritin issues IF they arrive is my best bet. I view high BP as a more urgent matter than iron deficiency. Pleqse correct me if this is way off base.

 

[Rykertest]

Allegra D contains a stimulant pseudoephedrine that can raise blood pressure. Nausea is not a sign of allergy but a sign of intestinal irritation, either from food, drug or from infection.

Have you typically had itchy throat and ear with your allergies before?

This spring has been all my allergy symptoms elevated. Itchy throat, ears, eyes, sinus pressure, some sneezing, etc. the nausea showed up two nights ago and I’ve not had that. I eat pretty plain and have so for the past few weeks so nothing odd in my diet that could cause issues.

 

[Systemlord]

It Seems like donating ONCE to drop the BP and headache issues and then Address ferritin issues IF they arrive is my best bet.

If your palpitations and high blood pressure are from low iron, donating is the last thing you want to do! A donation can cut your ferritin in half.

When I have iron deficiency, nause, burning in the throat and eyes, sinus pressure and stuffiness was the norm. I also had three unnecessary sinus surgeries due to iron deficiency.

 

[Rykertest]

If your palpitations and high blood pressure are from low iron, donating is the last thing you want to do! A donation can cut your ferritin in half.

Geez, this is a shitty situation I find myself in. I can’t donate and can’t continue. So now what?

 

[Blackhawk]

I am currently on a lowered dose of .2ml of 200 mg twice a week for a total of 80mg/week... I don’t know if that dose is getting to the point where I don’t have a need for TRT or not.

I think Systemlord got you covered since I responded... Just add: Do not discount lower dose as useful. I may soon be reducing from 56mg/week because I am running a little high. Waiting for a second round lab tests because the high numbers seem a fluke. Different combo of esters, but total amount is comparable to 56mg of T cyp in a week. My total T has peak and trough of 700-1000, and free T equivalent to 22 on your Labcorp scale. Without TRT, Total T less than 300 and free T about 6.

N=1

 

[Rykertest]

If your palpitations and high blood pressure are from low iron, donating is the last thing you want to do! A donation can cut your ferritin in half.

When I have iron deficiency, nause, burning in the throat and eyes, sinus pressure and stuffiness was the norm. I also had three unnecessary sinus surgeries due to iron deficiency.

Do you have a history of iron deficiency?

 

[Systemlord]

Do you have a history of iron deficiency?

Yes, months into TRT my first endo ran a blood test, iron saturation 14% (ranges 20-55%) and iron one point from the very bottom of the ranges. If doctors had checked my ferritin, it would have been below range.

So I was reviewing these labs to help explain my symptoms, it was Dr. Saya of Defy Medical that caught it, due to the MCV at 80, bottomed of the range and had told me I likely had low iron.

2 weeks later, ferritin is 24, iron saturation, 12% and iron 42 or below range. I stopped TRT and got ferritin up to 128, without iron supplements, meaning via diet alone ferritin recovered, went back on TRT and months later ferritin is again 24 and iron, iron saturation low.

It was then my endocrinologist told me that someone on TRT uses up more iron than someone not on the T replacement and he recommended iron supplements which I take to this day.

 

[Fortunate]

I am betting on the AI as the source of the headache. The headache itself can raise your pressure. But, the reverse is also true: elevated blood pressure can cause headaches.

Let us know how your appointment goes.

 

[Rykertest]

I am betting on the AI as the source of the headache. The headache itself can raise your pressure. But, the reverse is also true: elevated blood pressure can cause headaches.

Let us know how your appointment goes.

Took my BP again this morning and it was 143/91. VERY high for me. I have a Dr appt in an hour and don’t have a clue what to do To resolve the issue. The pressure behind my eyes is very concerning.

 

[Fortunate]

Took my BP again this morning and it was 143/91. VERY high for me. I have a Dr appt in an hour and don’t have a clue what to do To resolve the issue. The pressure behind my eyes is very concerning.

Good idea seeing your doc.

It is somewhat common for females to get migraines around their menstrual cycle. It is believed that the headaches may be triggered by a drop in estrogen levels around their cycle. I see no reason why males may not have the same mechanism - ie, if you drop your levels quickly with an AI, might that trigger a headache? Seems plausible.

The pressure is a concern.

 

[sammmy]

The simplest thing to try is to stop using Allegra D with the pseudoephedrine stimulant in it - it can aggravate palpitations and high blood pressure. Its stronger cousin ephedrine is banned for that.

Get Allegra without the D.