Should I Be Worried About My Blood Pressure On TRT?

[Strengthandlibido]

I'm hypertensive with blood pressure usually measuring about 130/90, but my PCP hasn't put me on any medication. I started TRT a week ago with low dosing. Wondering how cautiously I should proceed here.

 

[Systemlord]

I'm hypertensive with blood pressure usually measuring about 130/90, but my PCP hasn't put me on any medication. I started TRT a week ago with low dosing.

As you said you just started TRT a week ago, there is alot going on under the surface. You are beginning to supress your natural T production and on top of that the cypionate is slowly building up in your system.

On top of all that you're having hormonal fluctuations thet are affecting your body and various ways. This is likely the reason for a slightly higher than normal blood pressure.

What does your TRT protocol look like?

 

[Strengthandlibido]

As you said you just started TRT a week ago, there is alot going on under the surface. You are beginning to supress your natural T production and on top of that the cypionate is slowly building up in your system.

On top of all that you're having hormonal fluctuations thet are affecting your body and various ways. This is likely the reason for a slightly higher than normal blood pressure.

What does your TRT protocol look like?

My blood pressure has hovered around those numbers for years. I'm worried about it getting worse.

I'm on 10 mg testosterone cypionate, IM, QD.

But I was self medicated for a couple of years after I turned 40, about six years ago. I blasted and cruised for most of that time, then tried a low dose toward the end; 25 mg TC EOD (87.5 mg/week) back then (2018) got me:

Testosterone, T LC/MS/MS... 779, 250-1100 ng/dL
Testosterone, Free... 261.5, 35.0-155.0 pg/mL
Free T, calculated-V... 26.3 ng/dL Free & Bioavailable Testosterone calculator
Estradiol, Ultra LC/MS/MS... 54, < or = 29 pg/mL
SHBG... 13, 10-50 nmol/L

And here are labs from last month:

Testosterone, T... 312 ng/dL, 264-916
Free Testosterone... 6.6 pg/mL, 6.8-21.5
Free T, calculated-V... 6.4 ng/mL Free & Bioavailable Testosterone calculator
Dihydrotestosterone... 38 ng/dL, 30-85
SHBG... 31.5 nmol/L, 16.5-55.9
Estradiol, Sensitive... 10.5 pg/mL, 8.0-35.0
LH... 2.5 mIU/mL, 1.7-8.6
Prolactin... 3.6 ng/mL, 4.0-15.2

 

[rifter]

Unless I'm missing something, I would think that your "self-medicated" protocol from 2018 was more appropriate for cardio protection than your current protocol given your free T and estradiol levels in your current bloodwork - both of which are cardioprotective within physiological ranges. However, there are far more educated members here who would do that analysis better justice than I ever could.

Either way, in my mind, blood pressure and hypotension should be addressed irrespective of whether the individual is on TRT or not, or what protocol for that matter. Sure there are drugs out there that apparently cause an increase in blood pressure and are commonly used in a HRT setting, but testosterone in a normalized range should not have a deleterious effect. Exogenous testosterone has been known to increase RBC, but I wouldn't immediately think this would translate into increased blood pressure (at least not from my experience).

I'm sure you've taken a look at diet and lifestyle as main contributors to increased blood pressure? I'm also sure your PCP would be happy to prescribe lisinopril or other medications if the topic was revisited with him.

 

[Strengthandlibido]

Unless I'm missing something, I would think that your "self-medicated" protocol from 2018 was more appropriate for cardio protection than your current protocol given your free T and estradiol levels in your current bloodwork - both of which are cardioprotective within physiological ranges. However, there are far more educated members here who would do that analysis better justice than I ever could.

Just FYI: That latest bloodwork is a month before I started injections again. I've been injecting only 10 days as of today. So that bloodwork was years of me taking nothing. I get my first TRT bloodwork in late January.

 

[VacationMan]

You really should get your BP under control, regardless of TRT. Most PCPs will start you out on HCTZ (a diuretic) and you'll soon find out that's not going to work very well. Get your PCP to prescribe an ARB - it's the least likely class of BP drug to have any adverse side effects.

Besides controlling blood pressure, your kidneys will thank you as well.

 

[Gman86]

Yup, I 2nd an ARB. Just started Telmisartan myself today actually. Some people say that it’s beneficial for any guy using exogenous anabolics, regardless if they need help with BP or not. But if ur looking for BP control, look no further than Telmisartan. It can also help decrease water weight and HCT levels, which are two other common issues with guys on HRT.

 

[Strengthandlibido]

I just switched my PCP, partly because of availability (my doctor and others are booked out till March) and partly because I just want to try barking up a different tree in terms of responsiveness to my concerns. I'll ask about lisinopril, ARBs, and Telmisartan.

 

[VacationMan]

I just switched my PCP, partly because of availability (my doctor and others are booked out till March) and partly because I just want to try barking up a different tree in terms of responsiveness to my concerns. I'll ask about lisinopril, ARBs, and Telmisartan.

FWIW, I'm taking the generic form of Benecar (called Olmesartan). Next visit with my PCP (on the 30th), I'm going to ask about going to generic Mycartis (Telmisartan).

 

[drkelp]

I am not a doctor, and this is not advice. Do your own research and or consult a specialist further. I will say hibiscus has been helpful to me in this regard. Seems like it takes most of 3 weeks to really do its thing. YMMV

 

[AndyPandy66]

@drkelp: Regarding hibiscus, is that cold brewed or boiled? My Egyptian husband says they use it in Egypt for this, but the hibiscus has to be steeped in cold water to have the best effects. I'm curious how you prepared yours, and roughly how many points did it lower your BP?

 

[tbone182]

Good morning group, I have been on TRT for about 3 months now. Im using a very lose dose. 60mg a week divided into two injections 30mg Monday and 30mg Thursdays.
With out TRT my blood pressure is 130/74 on average, when on TRT at 60mg a week my blood pressure is at 155/90 on average. Why is such a low dose causing me high BP??

My endo put me on BP meds , amlodipine 5mg daily and has done nothing for my BP and gives me crappy side effects like ankle swelling and facial flushing.

 

[Cataceous]

Good morning group, I have been on TRT for about 3 months now. Im using a very lose dose. 60mg a week divided into two injections 30mg Monday and 30mg Thursdays.
With out TRT my blood pressure is 130/74 on average, when on TRT at 60mg a week my blood pressure is at 155/90 on average. Why is such a low dose causing me high BP??
...

It's hard to say anything definitive without lab work. One possibility is that you are still getting fairly high peak testosterone. Even with a typical absorption rate, cypionate injected twice-weekly can result in serum testosterone peaks that are 50% over the troughs. For example, on that protocol I would expect my peak testosterone to be around 900 ng/dL with a trough around 600. If your physiology is attuned to a daily peak of 500 ng/dL then forcing it to 900 could indeed cause problems. On the other hand, your clearance rate for testosterone is likely to be higher than mine, so the numbers may not be as dramatic. Bottom line: get some lab work done so you can see what's going on. At a minimum measure total testosterone, estradiol and SHBG. Measuring free testosterone by equilibrium dialysis is also a good idea.

It may make sense to try spreading out the dose by injecting 3, 3.5 or 7 times a week. The more often you inject, the smaller the testosterone peaks.