Instant Blood Pressure Spike on Starting TRT

[ClashCityRocker]

Things aren't off to a good start, I'm afraid.

When I was examined by the endocrinologist last month, his office measured my blood pressure at 130/80. I'm typically about 128/78.

He started me on a relatively modest dose (0.4 mL/80 mg of Cypionate) once a week. I have primary hypogonadism, so my TT starting out was 465, with a FT of 6.8.

After my first dose, I felt a little revved up and had trouble sleeping. I decided for the next week I would split the dose (0.22 mL once every four days).

Well, I took the first dose of 0.22 mL and felt even more revved up. Today (3 days later) my BP is 141/93.

Nothing else has changed. No special stressors. Zero alcohol since starting TRT (before then, maybe 2 drinks a week). 5'9", 145 lbs. Lift 4 times a week; walk or hike on the other days.

The only other things I'm taking are 5mg of Creatine; vitamins C, D, & K; magnesium and zinc; and fish oil.

I'm obviously going to call the doctor before I take another dose, but does anybody have any perspectives or input?

 

[FunkOdyssey]

I'm obviously going to call the doctor before I take another dose, but does anybody have any perspectives or input?

It's pretty normal to see a transient increase in water retention and a transient increase in BP when you first start, before you adapt. Your baseline BP was already elevated, which gives you less headroom for these temporary effects. The "revved up" feeling is also temporary and will go away as you adapt.

You don't have to take your prescribed dose, if you're having trouble handling it at first. Feel free to take less if you need to. You can always increase later.

Caffeine makes everything that is bothering you worse, from the BP to the stimulation. Consider dropping it.

I had all the same problems you have at like 70 mg a week in the beginning, and I have since gone as high as 175 mg with no problem. This TRT thing is initially a big shock to your system but you will adjust to it given time.

 

[ClashCityRocker]

That all makes perfect sense. Thank you for the input.

I actually like the stimulated feeling, other than the sleep deprivation.

I used to be a caffeine fiend, but I've cut down to two strong cups of coffee before noon. Maybe this will be the impetus to get it off it for good.

Does dosing frequency have anything to do with these secondary effects? Would more frequent micro-dosing help?

 

[ClashCityRocker]

Doc answered promptly (that's nice). He said to cut back to 0.2 mL once a week.

Still wondering if it would be better to split it into 2 doses.

 

[Systemlord]

After my first dose, I felt a little revved up and had trouble sleeping.

Testosterone utilizes iron more to create more hemoglobin, hematocrit and RBC's.

Check ferritin and iron saturation.

How long did it take for these symptoms to appear after your injection?

I'm obviously going to call the doctor before I take another dose

I wouldn't expect answers as to why you're experiencing these symptoms from your endo as they receive no training, education for sex hormones in mainstream medical schools are operating outside their scope of medicine.

 

[Vince]

Things aren't off to a good start, I'm afraid.

When I was examined by the endocrinologist last month, his office measured my blood pressure at 130/80. I'm typically about 128/78.

He started me on a relatively modest dose (0.4 mL/80 mg of Cypionate) once a week. I have primary hypogonadism, so my TT starting out was 465, with a FT of 6.8.

After my first dose, I felt a little revved up and had trouble sleeping. I decided for the next week I would split the dose (0.22 mL once every four days).

Well, I took the first dose of 0.22 mL and felt even more revved up. Today (3 days later) my BP is 141/93.

Nothing else has changed. No special stressors. Zero alcohol since starting TRT (before then, maybe 2 drinks a week). 5'9", 145 lbs. Lift 4 times a week; walk or hike on the other days.

The only other things I'm taking are 5mg of Creatine; vitamins C, D, & K; magnesium and zinc; and fish oil.

I'm obviously going to call the doctor before I take another dose, but does anybody have any perspectives or input?

This thread may help

What high blood pressure meds are the most erection friendly? - Excel Male TRT Forum

My doctor keeps telling me my blood pressure is borderline high or a bit high side he first asked me to try and reduce my salt intake now talking about maybe putting me on some meds I've never taken any blood pressure meds before and really don't know much about the different...

www.excelmale.com

 

[ClashCityRocker]

How long did it take for these symptoms to appear after your injection?

It was somewhat subtle after the first shot. I felt energetic and giddy that day. But I also had a slight headache and trouble sleeping.

The day of the second shot, however (which was half the dose of he first shot), I felt as if I had taken a hit of meth (or what I imagine that must feel like). It was very pronounced.

I wouldn't expect answers as to why you're experiencing these symptoms from your endo as they receive no training, education for sex hormones in mainstream medical schools are operating outside their scope of medicine.

I will say the endo did answer my message through the patient portal quite quickly. But I do get a sense TTh is not a big part of his practice, and he's not steeped in the nuances that get discussed on this board. I'm very appreciative for the insights and help on this forum.

 

[Systemlord]

The day of the second shot, however (which was half the dose of he first shot), I felt as if I had taken a hit of meth (or what I imagine that must feel like).

The feeling of being on meth isn't a benefit/side effect of TRT, you have something else going on that needs addressing.

 

[Vince]

Some studies have shown that blood pressure med "Losartan potassium". Help in building muscle, especially in the elderly.

 

[FunkOdyssey]

Doc answered promptly (that's nice). He said to cut back to 0.2 mL once a week.

Still wondering if it would be better to split it into 2 doses.

Dividing the same weekly dose into smaller, more frequent injections almost always reduces side effects compared to larger and less frequent injections. There are rare exceptions, but this is the rule.

 

[ClashCityRocker]

Some studies have shown that blood pressure med "Losartan potassium". Help in building muscle, especially in the elderly.

Yes, I read somewhere on here that it's a myostatin inhibitor. That would probably be the first one I'd ask about if it came to that.

I'm hoping a lower, more frequent dose will help me get through the transition period on T and hopefully avoid other drugs, at least as long as possible.

I asked the nurse at the endo clinic if blood pressure spikes were a normal part of the "onboarding." She said she didn't really know, because almost all of their patients came into it already on BP meds. That was kind of depressing. It doesn't really seem to be the optimization crowd at this practice.

 

[ClashCityRocker]

The feeling of being on meth isn't a benefit/side effect of TRT, you have something else going on that needs addressing.

It was so pronounced, I literally thought maybe something was wrong with the drugs I'd been given. But they came right from CVS, ha. .

For the record, I don't actually know what meth is like. But if it's wilder than that, it's not for me.

 

[FunkOdyssey]

I'm hoping a lower, more frequent dose will help me get through the transition period on T and hopefully avoid other drugs, at least as long as possible.

I would suggest something like 20 mg every other day to start with. If you still find that intolerable, go even lower. There are diminishing returns moving from every other day to daily with cypionate, but you can also try that if you're willing.

Run labs after 6+ weeks, note your progress with adaptation at that time, increase dose as needed to reach a therapeutic level, stay there several months, repeat as needed.

 

[Systemlord]

It was so pronounced, I literally thought maybe something was wrong with the drugs I'd been given.

Come to think of it, your symptoms sound a lot like ODing on anastrozole.

You weren't prescribed anastrozole were you?

 

[Vince]

Things aren't off to a good start, I'm afraid.

When I was examined by the endocrinologist last month, his office measured my blood pressure at 130/80. I'm typically about 128/78.

He started me on a relatively modest dose (0.4 mL/80 mg of Cypionate) once a week. I have primary hypogonadism, so my TT starting out was 465, with a FT of 6.8.

After my first dose, I felt a little revved up and had trouble sleeping. I decided for the next week I would split the dose (0.22 mL once every four days).

Well, I took the first dose of 0.22 mL and felt even more revved up. Today (3 days later) my BP is 141/93.

Nothing else has changed. No special stressors. Zero alcohol since starting TRT (before then, maybe 2 drinks a week). 5'9", 145 lbs. Lift 4 times a week; walk or hike on the other days.

The only other things I'm taking are 5mg of Creatine; vitamins C, D, & K; magnesium and zinc; and fish oil.

I'm obviously going to call the doctor before I take another dose, but does anybody have any perspectives or input?

TRT has never increased by blood pressure. Hopefully it's just a fluke and will go down. My last office visit my blood pressure was 105 over 60. Pretty low, normally my BP runs higher.

 

[Vince]

The NHS has a general guide that can tell you if your reading is within the normal range: Low blood pressure: under 89/59mmHg. Normal blood pressure: between 90/60 mmHg and 120/80 mmHg. High-normal blood pressure: between 120/80 mmHg and 140/90 mmHg - you may be at risk of high blood pressure in the future.

What causes low blood pressure and what are the symptoms?

Find out what leads to low blood pressure and how it’s measured and treated.

www.bhf.org.uk

 

[Systemlord]

TRT has never increased by blood pressure.

I made the mistake of continuing my beta-blocker after starting TRT and experienced low blood pressure that I treated with overloading on iron which increases blood pressure. I always knew I was using excessive amounts of iron to treat an unknown medical condition.

 

[SS1LE]

TRT has never increased by blood pressure. Hopefully it's just a fluke and will go down. My last office visit my blood pressure was 105 over 60. Pretty low, normally my BP runs higher.

Be careful with your diastolic in the 60's especially low 60s. the heart does not get enough oxygenated blood. I know you take daily tadalafil, but if you add viagra also it may be dipping into the 50s

 

[SS1LE]

To the OP, testosterone can spike your norepinephrine which will cause high bp. Which should normal out after a while.

 

[Vince]

Be careful with your diastolic in the 60's especially low 60s. the heart does not get enough oxygenated blood. I know you take daily tadalafil, but if you add viagra also it may be dipping into the 50s

Normally it runs much higher. I think I'm just too relaxed when I'm at a doctor's office.