Very High Blood Pressure 1 mos into TRT

[Dean407]

Well, I have a problem...

Despite having a very clean diet and implementing as much as the "DASH" diet as possible my BP was always a bit high before TRT. I have been on BP meds for a couple of years now. On meds my BP is usually in the 130-140 range on top and 70-90 on the bottom.

I have a top of the line Omron BP machine which records the BP and have 6mos of date downloaded which I shared with my new Doc.

Unfortunately, I loaned my BP machine to my girlfriend for a few weeks. I was able to take it until this weekend about a month into TRT.

Now, by coincidence, I had been under a lot of stress, and felt bad but my BP was 173/103 when I first took it Saturday. I laid down and relaxed but it didn't go down much.

Now, a few days later and most of the stress resolved it is still high. My morning BP was 141/93 and just now at 7:30PM it was 159/94.

I have been under stress before and stress alone never had that kind of effect on my BP.

While I was working out Friday my heart felt like it was beating extra hard. Not faster, but harder/more forceful. My HR is still OK in the low to mid 60's.

I haven't seen my systolic BP over 150 except one other time after a lot of drinking and being dehydrated the next day.

My diastolic is usually in the low 90's not high 90's and I've only seen it in the 100's once before.

I can only conclude the testosterone is causing this. I do also feel very bloated. My weight has only gone up 2lbs since last month.

Keep in mind my BP is 159/94 while on my BP medicine. I can't imagine what it would be without it.

I did NOT take my shot which was due Monday evening.

My diet did not change at all.

Now that I think of it, right before I gave my machine to my GF, I checked my BP about an hour after going for a run. My BP has consistently been at it's absolute LOWEST after exercise for about 6 hours. I mean consistently in the sub 120/80 range. Usually 115/70 or thereabouts. I expected to see the same, but it was the first time in 2yrs that my BP was high after running then before running. I sorta recall thinking "I hope this isn't an indication of my TRT" and chalked it up to a fluke occurrence.

Sadly, it seems that my TRT treatment is jacking up my BP to unacceptable levels.

I wonder if a smaller dose would help this issue at all? I am literally just 1 month into my therapy. I'm on 50mg every 3.5 days.

 

[Megatron28]

Sounds like you have let your estradiol and/or hematocrit get too high.

What is your TRT protocol? And how often are you donating blood?

Do you have any blood work you can share?

If your BP gets about 179 systolic or 110 diastolic make sure you go to the emergency room.

P.S. A hot shower helps lower your BP. It is a nice thing to do before bedtime every night.

 

[Dean407]

Thanks for the reply. I'm doing 50mg every 3.5 days. How often should one donate blood? I just hit 30 days of being on TRT. My urologist never mentioned any of the meds talked about on here.

The only blood work he wanted me to have done was total testosterone 3 MONTHS after starting. I didn't think blood work after 1 month was necessary, so asked to get it 2 months after.

My 1st appointment with him was next Monday and I was going to talk to him then about the Aromatase inhibitor meds and add a bunch more tests to the blood work.

I am especially concerned about the hemocrit because I have had blood clots before which ended up a pulmonary embolism.

What i think i may do is call the urologists office tomorrow and explain what is going on and request several more tests be added to my bloodwork and I'll pick it up and get it done thursday.

Hemocrit and Estradiol Sensitive, total test and Free test at a minimum. Any other critical tests to get done in this lab?

I am questioning TRT quite a bit at this time. I don't do well even with butterfly needles and basic blood work. I have one decent thin vein in my left arm.

The biggest benefits I've had is the drastic change in recovery time after workouts and a mental clarity in the morning that is hard to describe. Haven't noticed much libido change compared to when my test was 346. There was some increase, but not too noticeable.

I think I will still get the blood work, but stop TRT for now before I get too deep into it. I will revisit it if/when I really feel I truly *need* it instead of want it.

I'll update here when I get any new info.

 

[Megatron28]

It isn't likely that your estradiol or hematocrit shot up that much on your protocol in only a month's time. But it is worth checking out.

You should donate blood every 56 days unless you have an iron deficiency problem. This is necessary for managing hematocrit.

It very well may be possible that your blood pressure is up simply due to the stress and anxiety you have been experiencing. But get the blood work done to make sure. And donate when your BP is low enough for them to accept you.

 

[Mprtz]

Consider taking some cialis before donating blood - it might lower your BP a bit and will also help make the phlebotomy easier.

 

[Dean407]

Instead of calling the Urologists office I decided to take a trip there. I didn't see the Urologist directly, but a nurse did take my BP and ask some questions then relay my lab requests to him.

He indicated to her that they make sense. However, he did not feel a Estradiol Sensitive was necessary at this point.

I'll go in for labs tomorrow morning. A couple people from the office said he looked at my insurance and the blood tests could be expensive if I didn't meet my deductible. The labs are as follows:

Hematocrit
Testosterone, Free and Total
********* Panel, Basic
Thyroid Cascade Profile
Prolactin

Hopefully have the results in by Monday when I have an appointment for him.

I have to state that it's impressive how I was treated. The nurse saw me right away and attended to me well. My BP while there was 160/100. I have had a dull grade headache for a few days.

And for a specialist office charging a $45 co-pay, they didn't charge me ANYTHING which is rare in this day and age.

 

[Megatron28]

Take a look below at my signature. You can get cheap blood work at Private MD Labs. You usually get results back in a day or two.

If I were you I would get estradiol checked. Get a whole CBC too instead of just hematocrit. It doesn't cost that much more.

 

[Mprtz]

Why does the system appear to * out the word m_e_t_a_b_o_l_i_c?

 

[Megatron28]

Why does the system appear to * out the word m_e_t_a_b_o_l_i_c?

It just does. I asker about it a few months ago too.

 

[3J]

he need to put his ph balance in check..


800mg magnesium

900mg potassium

4 servings of coq10


take that daily.. that should drop you to normal levels..

my bp was sitting at 140/90.. unacceptable..

its now 124/80 regularly.. gets up to 130 sometimes but only when stressed or have had coffee..

 

[Dean407]

I have been taking Magnesium, Zinc, Vit D, and B Complex for about 2 months.

My BP just got down to an ok level. 128/79

Could having had blood taken helped?

 

[Megatron28]

I have been taking Magnesium, Zinc, Vit D, and B Complex for about 2 months.

My BP just got down to an ok level. 128/79

Could having had blood taken helped?

If your hematocrit was high, donating a pint of blood would have helped. It is harder for your heart to push thick blood.

 

[3J]

Yea that would make sense

 

[Dean407]

Well got some of the test results back:

Component Standard Range Your Value
HCT 36.6 - 51.9 % 51.8

So, YEP my blood was thick! I much better yesterday and back to normal today. I've had blood clots which turned into a pulmonary embolism before.

Right now my BP is 142/88. This morning 139/89.

Other results:

Component Standard Range Your Value
TSH 0.27 - 4.20 mcU/mL 1.94

My TSH a few months ago before treatment was 2.34 So, not much difference there.

Component Standard Range Your Value
Prolactin 4.0 - 15.2 ng/mL 6.0

Haven't had that done before, but looks ok.

The entire Me ta Bo lic panel results were all within 10% of the results from a few months ago.

I got these released very early this morning. Nothing on the Testosterone results yet.

My last injection was 8 days ago. I feel completely fine so far. The soreness in my feet is back though. I physically felt the blood thickness kicking in by the middle of the 3rd week of TRT; I started feeling bad.

I'm sure the HCT dropped but I wonder by how much? I meant to call the Urologist today and ask if I should be on blood thinners as a precaution. I got to busy and didn't get around to it. Guess I'll survive through Monday.

I'm very curious what my testosterone was at. Just as the good effects started to kick in, the bad effect kicked in.

 

[Dean407]

Well, saw the urologist. It didn't go well. Just yesterday I got a bill from them for the pathology of the biopsy and my out of pocket is $372. Had I known the biopsy would have ran me over $500 I wouldn't have had it done. As soon as I checked in they hassled me for payment even though I just got the bill yesterday.

Then I waited an hour past my appointment time for the Urologist to come in the room.

I told him it wasn't him but I was frustrated at the TRT not working out and not having known it would be so much money out of pocket for the biopsy. I asked him and the two nurses if they knew the cost of the procedure and they told me around $600. And that was accurate for the ultrasound part. However, the pathology bill was just south of $2500.

Anyway, on to he hematocrit. He basically said I had to donate blood. I then told him I wish he put the estradiol on the test and explained about the message board which is how I knew about the hematocrit, etc...mentioned how the estradiol can get too high and cause problems.

He said somewhat frustrated, "Well, HOW DO YOU FIX THAT?"

I told him through an AI like Arimidex from what I read.

Well, he had it. He said "That's WAY out there, if that's the case I'll refer you to an endo."

He really has no idea about TRT management. He just sticks guys on the patch and tests for testosterone every 3 months.

I kind of regrouped and told him it was more stuff then what I expected...which wasn't really the case since I read stuff here. But it was clearly beyond his comfort zone and he made me feel like I was some punk trying to score some drugs.

I told him I'd stop TRT for now and deal with it until it becomes more of an issue. I'll try to lose 20lbs and eat well to support my natural test production the most I can.

I found my local red cross center and will donate blood tomorrow to make cure my hematocrit is low enough.

He basically pushed me back to my General Practitioner and we didn't even make an appointment. I left it off that I'd make an appointment if someone changed in the future.

No testosterone test results back yet.

 

[Dean407]

I went to Red Cross to donate blood to drop my Hematocrit. I couldn't donate because they only use an 18g needle and cannot use a butterfly needle. I have one vein that can easily be accessed in my left arm and it's a thin vein in the middle of my arm. The nurse (?) asking me questions told me they needed to use the vein in the inside joint of the arm...which I no longer have. Chemotherapy 20yrs ago required me to have a mediport put it as the chemo destroyed my veins.

So, now I need to call my GP and see if he can write a script to the blood lab to do a therapeutic blood draw.

Since I started running again my BP has been very good for me. Just now 135/75 and this morning 128/77.

 

[Megatron28]

Well, saw the urologist. It didn't go well. Just yesterday I got a bill from them for the pathology of the biopsy and my out of pocket is $372. Had I known the biopsy would have ran me over $500 I wouldn't have had it done. As soon as I checked in they hassled me for payment even though I just got the bill yesterday.

Then I waited an hour past my appointment time for the Urologist to come in the room.

I told him it wasn't him but I was frustrated at the TRT not working out and not having known it would be so much money out of pocket for the biopsy. I asked him and the two nurses if they knew the cost of the procedure and they told me around $600. And that was accurate for the ultrasound part. However, the pathology bill was just south of $2500.

Anyway, on to he hematocrit. He basically said I had to donate blood. I then told him I wish he put the estradiol on the test and explained about the message board which is how I knew about the hematocrit, etc...mentioned how the estradiol can get too high and cause problems.

He said somewhat frustrated, "Well, HOW DO YOU FIX THAT?"

I told him through an AI like Arimidex from what I read.

Well, he had it. He said "That's WAY out there, if that's the case I'll refer you to an endo."

He really has no idea about TRT management. He just sticks guys on the patch and tests for testosterone every 3 months.

I kind of regrouped and told him it was more stuff then what I expected...which wasn't really the case since I read stuff here. But it was clearly beyond his comfort zone and he made me feel like I was some punk trying to score some drugs.

I told him I'd stop TRT for now and deal with it until it becomes more of an issue. I'll try to lose 20lbs and eat well to support my natural test production the most I can.

I found my local red cross center and will donate blood tomorrow to make cure my hematocrit is low enough.

He basically pushed me back to my General Practitioner and we didn't even make an appointment. I left it off that I'd make an appointment if someone changed in the future.

No testosterone test results back yet.

You need a new doctor. I would encourage you to employ the Compounding Pharmacy strategy for finding a doc. Also, don't be so confrontational with docs. Using the Socratic method will serve you a lot better. You could have said some thing like, "Hey doc, I was reading about TRT and I came across something about testosterone aromatizing into estradiol. Can you tell me about how that works? Doc blabs ... Oh, so we should monitor estradiol then? ... Say, what if it gets too high, what can you do about that? Doc blabs... Oh, that gets me thinking. I read about some drugs that inhibit aromatization. Have you had to prescribe that to anyone on TRT?

It works a lot better when you lead them to the right answer rather than confronting them with stuff you read on a forum. Showing them medical studies works well too.

So are you going to get back on TRT? Dropping cold turkey is a really be idea.

 

[Megatron28]

I went to Red Cross to donate blood to drop my Hematocrit. I couldn't donate because they only use an 18g needle and cannot use a butterfly needle. I have one vein that can easily be accessed in my left arm and it's a thin vein in the middle of my arm. The nurse (?) asking me questions told me they needed to use the vein in the inside joint of the arm...which I no longer have. Chemotherapy 20yrs ago required me to have a mediport put it as the chemo destroyed my veins.

So, now I need to call my GP and see if he can write a script to the blood lab to do a therapeutic blood draw.

Since I started running again my BP has been very good for me. Just now 135/75 and this morning 128/77.

If you stopped TRT it will come down on its own slowly. You are not in the danger zone. Ask your doc, but you may be able to wait it out and skip the donation.

But if you do get back on TRT you may require a prescription for therapeutic phlebotomies.

 

[buildingpaul]

If your hematocrit was high, donating a pint of blood would have helped. It is harder for your heart to push thick blood.

This may sound a bit silly but when I have my bloods done they take 4ml......Always feel dizzy and strange afterwards. To have 1 pint of blood taken I cant imagine how I would feel. Is it common to feel weak/dizzy after donating blood?

 

[Megatron28]

This may sound a bit silly but when I have my bloods done they take 4ml......Always feel dizzy and strange afterwards. To have 1 pint of blood taken I cant imagine how I would feel. Is it common to feel weak/dizzy after donating blood?

Sounds psychological. Unless you are very small.