About to start TRT with a whole slew of problems

[JReinhal]

I am 36 years old, 215, exercise, eat well, etc. I get blood work done every year, each showing my testosterone falling lower and lower. These most recent results, which I had done a couple weeks ago (I can post if requested), showed a T level of 328. Using this, Ive been able to get a prescription for TRT with IMT.
Here are my concerns, I have been battling very high blood pressure. My primary care is the VA and as of last week they have put me on BP medication to try to control my BP that can get as high as 190/100. Im 3 days in on a beta blocker. Yesterday I had to go to the ER due to my BP hitting high levels again. While at the ER, they found I had high D-dimer levels which apparently is a biomarker used to detect clotting. They checked me for a lung clot which I did not have, then sent me on my way.
So, here I am with high BP which the VA and I are trying to correct, as well as a biomarker showing I have high clotting potential. Should I even introduce TRT into the mix at this time?
I know that's a lot of info and I apologize. Im just trying to sort this all out and I do not have a lot of knowledgeable sources.

 

[bonexyster]

You need to speak with a Dr from the trt clinic. Not a single bro on here is a dr. Keep that in mind bro science is not a 10 yr doctorate degree. Speak with your professional.

 

[methos0123]

My BP has decreased to normal and slightly below since on TRT...

 

[Megatron28]

Talk to your doc at IMT about managing your estradiol and hematocrit. If you can keep them under control your BP should be fine. For example, you may want to get a prescription for therapeutic phlebotomies.

I would stay on the lower end of the testosterone dosage though to avoid aromatization. Estradiol is the "enemy" for you. Perhaps you could target a TT around 600. But again, talk to your doc at IMT. They know what they are doing.

 

[JReinhal]

Talk to your doc at IMT about managing your estradiol and hematocrit. If you can keep them under control your BP should be fine. For example, you may want to get a prescription for therapeutic phlebotomies.

I would stay on the lower end of the testosterone dosage though to avoid aromatization. Estradiol is the "enemy" for you. Perhaps you could target a TT around 600. But again, talk to your doc at IMT. They know what they are doing.

To be honest, I wasn't aware I had access to a doctor via IMT. I thought it was basically just an advisor whom I could call and email. I will say that Ive had excellent dealings with IMT so far, specifically an individual named Daniel. With that said, I want to be 100% certain that Im not going to stroke out due to adding TRT into a system with high BP.

 

[methos0123]

To be honest, I wasn't aware I had access to a doctor via IMT. I thought it was basically just an advisor whom I could call and email. I will say that Ive had excellent dealings with IMT so far, specifically an individual named Daniel. With that said, I want to be 100% certain that Im not going to stroke out due to adding TRT into a system with high BP.

it's the high hematocrit that causes the strokes...too thick blood. You and your doc need to manage it through manipulation of dose, and or through phlebotomy.

 

[JReinhal]

it's the high hematocrit that causes the strokes...too thick blood. You and your doc need to manage it through manipulation of dose, and or through phlebotomy.

I agree. I may have to get a prescription though as Ive been turned away from a blood bank due to high BP

 

[JReinhal]

Here are some numbers form my most recent blood work (I have yet to start TRT):

RBC.......................6.4...............3.4-10.8
Hematocrit.............49.2 ............37.5-51.0 %
Testosterone..........329..............348-1197 ng/dL
Free Test...............8.3 ...............8.7-25.1 pg/mL
Hemoglobin A1c....5.7............... 4.8-5.6 %
DHEA-Sulfate .......171.4 ..........102.6-416.3 ug/dL
TSH ......................4.830 ...........0.450-4.500 uIU/mL
LH ........................2.8 ................1.7-8.6 mIU/mL
FSH......................3.4................ 1.5-12.4 mIU/mL
Prolactin .............10.8................4.0-15.2 ng/mL
Estradiol, Sen ......8 ...................3-70 pg/mL
SHGB .................15.3 ..............16.5-55.9 nmol/L

 

[Daniel_IMT_Staff]

A therapeutic phlebotomy prescription for high hematocrit when you are not above the range is not done typically. Donating blood is a preventative measure and great practice. Typically insurance companies won't cover therapeutic phlebotomies unless your hct is 60%+ (!)

 

[JReinhal]

A therapeutic phlebotomy prescription for high hematocrit when you are not above the range is not done typically. Donating blood is a preventative measure and great practice. Typically insurance companies won't cover therapeutic phlebotomies unless your hct is 60%+ (!)

So if Im turned away from donating due to high BP (196/103), as I was last week, Im SOL?

 

[Daniel_IMT_Staff]

If you want to treat the elevated hematocrit you can certainly donate blood to lower your hct. However that high BP makes you a ticking bomb for stroke/heart attack, treat the hypertension first. And you will be fine to donate blood soon. Also, if you would get 500ml drawn while your BP is that high it would be extremely dangerous.

 

[Megatron28]

BP meds work very well. Sometimes you just need to find the right one(s). Give it a chance to work.

 

[JReinhal]

Doctor has put me on two BP meds: a beta blocker and a calcium channel blocker. Hopefully these will be effective.

An odd question but here goes. Is there a way I can just pay for therapeutic phlebotomy? Circumvent insurance and just pay to have it done every 3 months or so?

 

[Mprtz]

Check with your local blood center. Mine charges about $100. I think you will still need a prescription and the blood center may make their own determination of medical necessity. Mine seems to consider "testosterone administration" a gray area.

 

[IMT staff]

You need to get your blood pressure meds dialed in before starting your program. Give me a call 866-206-9926 ext 101

Todd