New to TRT and now high Hermatocrit and Blood Pressure

S

shrekitout

New member
Hi All

New to the forum and New to TRT (3 months in) - looking to get other members feedback etc.

Background: Male 44 with low T which came in at 277 on my first blood work - Hematocrit was 46.2 on first test with Estradiol at 25.4

Doctor prescribed: Test Cypionate Oil (grape seed) 0.5ml twice a week, Anastrozole 0.5MG Tablet twice per week, HCG 600iu twice per week (all done on Monday and Thursday morning) and then Clomiphene 25mg every day.

Results after 3 months - T levels now 1053, Estradiol 25.1 and Hematocrit now 54.8 .

So the TRT clinic said to me go donate blood asap to lower the Hermatocrit level and i went to Red Cross this week but then found my blood pressure is 151/110 so they would not accept me. I then decided to meet with my primary care doctor asap this week as I fly long distance travel for work and having hight HC level and High blood pressure adds a lot of risk re DVT. On meeting my primary care doctor she was 100% supportive on the program but referred me to a specialist TRT provider (not the clinic i went to - DO NOT POST LINKS TO OUTSIDE SITES) for a further discussion, 4 week wait till that happens. So in the meantime she has prescribed a low dose blood thinner of 10MG Lisinopril to bring my blood pressure under control.

My TRT Clinic is trying to get the network doctor to prescribe a Therapeutic Phlebotomy (blood letting) next week to help get the levels under control but have still not heard back from them - seems it will be early next week before they can give me the prescription to get this done and then need to go to the specific hospital in Mass.

TRT has totally changed my world and I am at pain in stopping the program (have not taken anything for 1 week now) but i am worried about the risk and impact to my day to day life if blood pressure like this. i went and purchased a good quality blood pressure monitor this week and after 2 days on 10MG Lisinopril today is was 151/98. Before TRT I could hardly walk after a squat day and in 3 months not only have I increased my 1RM by 15% I can actually get up and train the next day with passion, to many other benefits to list but the BIG RISK OF HIGH BLOOD pressure gets me here.

Questions?

  • Can you do a Therapeutic Phlebotomy with high blood pressure and being on a low dose Thiner?
  • Is the Clomiphene 25mg adding any benefit (not planning on any more kids and had the snip) - My primary care Doctor had no idea why i was on this and was against it.
  • HCG - does this add to the high blood pressure issue?
  • General thoughts and experience here from anyone like this?


thanks guys!

Shrek
 
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Welcome.

Why did your doctor prescribe Clomid? Not sure why you'd be on both test and Clomid.
What was your BP before TRT?
Are you overweight?
The BP meds will take more than 2 days to be fully effective. Keep monitoring your BP.
There shouldn't be any restrictions on a therapuedic phlebotomy.
Hcg shouldn't effect BP.

For now I'd stay 100% away from salt/sodium.

Sounds like you're on a good protocol minus the Clomid. You'll need to be diligent about keeping your hematocrit under control. BP of 151/110 is dangerous, but between meds and giving blood (and losing weight if that's applicable)you should be able to manage it and continue TRT.
 
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thanks Gainjin260 and Tbonexi for the quick replied.

BP was 130/85 before TRT weight was 249lbs. I am now 240lbs (lost 9 lbs) but more important lost 4 inches from my waist in 3 months. My body sharpe has changed for the better 100% and meant an entire new wardrobe of shirts/pants was needed. However I want to get to approx. 195lbs. In my younger days back in Australia when i was in the Army I was 180lbs (19-27 years old).

Re Clomid i has asked my clinic to confirm what is the "why" for this but have stopped this 100% now. Actually I have not taken my Test/Az at all now for 8 days as was so worried.

Do you think it is ok to get back on the meds of Test/Anastrozole/HCG 600iu OR wait until my Hermatocrit level is under control and re-introduce? i am talking to the clinic tomorrow on this but will be in the process of moving to the specialist my Primary care recommended as I am not happy with the service on this from my current provider. At the current place the DR works part time and is well "overally slow" to respond to anything - sometimes 5-9 days for a reply.

100% removing Clomid!

Cheers

Shrek
 
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Lisinopril isnt a blood thinner. It's BP medicine. I've been on it for 10 years now and it should not affect your ability to donate. Telling them that you are on a blood thinner probably will though. If it gets you lower number under 100 then you should be good to go at Red Cross. I had to get mine taken a few times once so they could get me under that threshold.

Once I figured out I had sleep apnea and got that treated my HCT levels plummeted. That might be something to consider. If you are suffocating yourself all night, every night, your RBC will be hard to keep down. But that's really the least of your worries if that's the case.
 
You might consider considerably reducing your testosterone dose (now 200mg per week, right?). Cut it in half until you get things sorted out and you will probably still have decent levels. Cut your Anastrozole in half as well. (these are just my suggestions, consult your doctor).

Your free T is probably way over range on your current regimen.

I had to reduce my dose from 200mg to (now) 120mg per week, but I still have an ongoing struggle with HCT.
 
thanks Mprtz - going to chat to my doctor about this exact subject - T level showed last month to be 1280 and this month to be 1053 so thinking my body is reacting to well too the 200mg per week?
 
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shrekitout said:
thanks Mprtz - going to chat to my doctor about this exact subject - T level showed last month to be 1280 and this month to be 1053 so thinking my body is reacting to well to the 200mg per week?
Click to expand...

My opinion: There is some value in starting out on a high dose. You can get some really dramatic changes and it can set your life on a whole new path.
I think of it as the honeymoon.

However, I think the majority of guys can not sustain a dose like 200mg/week in the long term. Having test levels out at the edge of what someone in some study had (who was probably younger) isn't necessarily what is natural for your body. And the body doesn't like to be pushed out of equilibrium.

In my case, I can't seem to absorb enough iron to replace the iron in the amount of blood I have to jettison to keep my HCT in range. Now I can't really afford to donate blood and I can't afford not to.

You're feeling the first part of this: you (like me) have a fairly strong erythropoietic reaction to testosterone. You will be able to get HCT back down with phlebotomy, but you might find that you can't keep it there without eventually running out of the iron-carrying blood protein ferritin.
 
Thanks IMT Staff

I am speaking to the doctor this week - do you think cutting to 100MG per week would be on the cards (twice a week - half a doze each time) both for Test/Anastrozole/HCG

thanks to all for the replies !!
 
Fwiw,

My BP was borderline high before TRT, and TRT put me in the high BP range. My estradiol levels are fine, so for me, it's the testosterone that's giving me high BP.

I'm on .8mg/week, and my trough test levels are in the mid 600's.

From the research I've done, testosterone can elevate BP in some people.

Not saying you shouldn't try to figure out if it's something else, but it may be just exogenous testosterone causing it.
 
Completed Therapeutic Phlebotomy and now Hematocrit is back down to 49.1 (the day after) - Blood pressure a little down as well (145/94) but need get the diastolic down to in the 80s. Going back to see my Primary care doctor today for the main reason of checking my blood pressure as i am not 100% the monitor i purchased is accurate.

As off today have not taken TRT for 3 weeks, want to get my blood pressure sorted so i know i dont have an underlying issue that TRT is compounding. Training the same but recovery sucks!
 
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