Becoming Hypertensive. Doctor Blaming TRT

Been on Test Cyp for 3 years. 46 years old. In the last year blood pressure has been rising from 120/80 to 145/95. As a result my doctor (hemotologist/oncologist) has been reducing my Test cyp incrementally, and I get the know he is becoming uncomfortable keeping me on Test Cyp at all. He has reduced me from 150mg/week to 120mg (I split it into 2 weekly injections). My Total Test was 1000ish (at 150mg) now down to 750-850 with the reductions - which I am cool with, but worried about him ceasing treatment altogether.

Can anyone offer some TRT educated advice for me? He’s not a TRT guy - but less so are my other doctors. I’ve read both that TRT can cause Hypertension and heard from others that it doesn’t.


How has your diet, exercise, bodyweight, and bodyfat changed in the last year?

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I came off blood pressure medication last year. Blood pressure ran sub 125/ Then I started trt. My blood pressure tolerated 100mg week meaning about 130-140. When I increased to 124mg week. It increased blood pressure went up to 150-170. So I restarted my cozzar 100mg for blood pressure. Now it’s 110-130. Diet is good. Caffeine never effected my blood pressure. Only stupid people at work seems to increase it. I won’t be asking for a test dose decrease. As notice and over all improvement in my new dose. I’d rather just take the blood pressure pill.

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TRT did increase my BP. Taking Losartan now to help. Don’t take Lisinopril, it increases SHBG.

Others have no issue with increasing BP, some do. But it shouldn’t be progressively getting bad. It should have leveled off.

Are you watching your CBC? Maybe your H/H is high.

My blood pressure increased on TRT, the reason had more to do with potassium becoming low on TRT. Pre-TRT my potassium was on the higher end at 4.7 (3.5-5.0), on TRT it decreased to 3.8 and after 2.5 years decreased to 3.4 which landed my in the emergency room with crazy high blood pressure, cramping, bloating and leg swelling.

TRT also took my iron deficiency to the next level, the potassium is enough to increase blood pressure, iron deficiency can also cause the heart to work harder. Wherever you are working with doctors who are unfamiliar with TRT, you will always be operating in the dark and often chasing your own tail.

We really need to see all of your biomarkers to be sure your protocol is correct for you. We need SHBG and estrogen numbers.

Doctors seem to blame TRT for everything when there is something they cannot explain, people who are not on TRT become hypertensive. The truth is there are numerous things that can cause hypertension, stress, poor sleep etc.

Yes, a bit. I’ve gained 15-20 lbs - but off of the best shape of my life. Last year at this time I was pretty cut at an unsustainable 190 lbs. I am in good shape at 200. I am now at 210 - so just a little overweight (6’4"). Less excercise and have gone from full on Keto to super-lazy Keto diet (extra carbs here and there). Thing is, Prior to the last year and a half I was at 220-230lbs and 120 over 80 solid for decades.

If you were getting consistently good readings previously, including the first few years you were on TRT, then I wouldn’t necessarily blame TRT.

Like the guys are saying, hypertension/polycythemia aren’t uncommon on TRT, but if the issue has only been on the rise for the last year, I’d be more inclined to blame a decrease in exercise and increase in bodyfat (even if you used to carry more fat previously) because that’s just not a good combination in any case.

Get some easy cardio in a few days a week and see how you feel. There’s also the possibility that the higher reading were flukes. If your body’s trend was good numbers for decades and then you get 1-2 unusual readings in a short period of time, I wouldn’t be super-quick to make drastic changes to the medication.

Wow - great feedback and quick! Actually, since I posted this earlier today, I visited my general practitioner. She put me on Lorsartan (as @anon10035199 suggested). She did offer Lisinopril first but I saw your post, so I got her to change it. Thanks!

@systemlord - I don’t have many recent hormone markers. My E2 is usually around 30-40 - I have a hard time getting that (I get my anastrozole from a peptide shop online) because my TRT prescribing doctor is a hemo/oncologist - and he will not prescribe arimidex (because it’s a breast cancer med, nearly ridiculed me out of his office for asking), nor does he see the need to test for estrogen, but he does test it on occassion to humor me and I secretly take my peptide anastrozole. I am pretty sure I over-respond to anastrozole - I take 3 drops per injection (2x weekly) to keep me in the 30-40 range. Is there a special name for the SHBG that I should ask for? I see him next week so I can add it on to my other tests then.

My CBC is checked every month to every few months (by my oncologist), and I am always riding high H/H, but I have a standing order to get phlebotomies when I need them - I can’t donate blood like normal people because I am on chemotherapy - so my blood is poison. :wink:

I plan to get back on my exercise regimen soon (cardio and weight training). I have several nerve ablations I am having done in 2 weeks, then I hope to be able to move more freely. My general practitioner did mention that she didn’t suspect that my weight was a contributing factor, but suggested lowering my salt intake, and try to get better sleep so I will try that too. I currently require ambien to sleep - so we changed that to a different drug today to see if it will work better. I also plan to reduce my dose of TEST next week to probably 100 or 110mg/week. I do appreciate all the great advice, I should come in here more often!

Does anyone know if there are any ‘find a good TRT doc’ online resources yet? Looking in the south Denver area. If not, maybe I should make one :wink:

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I don’t understand why you settle for idiot doctors when you could be working with a competent skilled TRT doctor. There are many hormones affected by testosterone, you can’t have estrogen or DHT without testosterone.

SHBG = Sex Hormone Binding Globulin, it binds testosterone (Total T) and creates a balance between Total T and Free T, Free T is the stuff circulating in your blood and interacts with all your tissues.

TRT protocols are judged by the free hormones, not the bound hormone that is not bioavailable. Most managed healthcare doctors do not care about becoming educated in TRT, they just do not care because TRT is low profit, low cost unpatentable product.

Defy Medical is a anti-aging clinic that does telemedicine and can even prescribe .125mg AI’s and won’t chastise you for needing it.

Dude. Getting OFF anastrazole should be your #1 priority.

@systemlord - would be nice to find a good doc. Just need to choose a Endo or Urologist. Some of those are better than others. I actually talked to a doctor at a men’s trt clinic and it is going to shoot up my bills and they are going to make me come into the clinic to get my shots - is this just in an effort to pump up bills? I hope the endo or urologist won’t require this.

I think I wasn’t clear on my question about SHBG. When talking about E2 I have to specify which test it is to my doc (one is more sensitive than the other) so they don’t put in the wrong E2 test (since they don’t order it that often). I was wondering if there was a test ‘code’ that would make sure they got the correct test.

I’ll check into Defy and see what they do.

@anon10035199 - can you please explain why I want to get off of anastrozole? I thought the idea was to get E2 down to 22 or so. I usually float around 65-70 without it, which I thought could set up for gyno and other undesirables - and the low dose could possibly be good for prostate cancer? It’s been a while since I researched all the hormones, so I have forgotten some of it…

These type of doctors do not specialize in TRT, you will most find them useless and have to fight with them and tell them which tests are the right ones, makes life harder than it needs to be. Defy Medical doesn’t force office visits, you inject at home and they know which testing to use and actually provide direction on your treatment.

Defy is cheaper than these TRT clinics and 10 times more competent.

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Lisinopril increases shbg? Is that like a significant increase or what? I take a tiny dose 5mg will that mess my shbg up?

You’d have to check yourself, It increased my SHBG by 20 points.

It could be causing your problems.

Wouldn’t be the first time someone stated that they had some weird symptoms and it resolved after they stopped the AI.

Get that 22 number out of your head. Its all about ratio. Higher test needs higher E2. As long as your not having symptoms, higher E2 is Ok.