T Nation

High BP Issues?

Hey all, been a little while since I’ve posted, but was hoping to see if anyone else has experienced high blood pressure issues after starting TRT.

My BP has always been 118-122/65. Never higher, never lower. I am 33 years old, in good shape, exercise daily, and eat exceptionally well.

I started TRT back in May 2020, and unfortunately had not done any BP readings prior to May 2020 during the beginning of that year to see where it was at. However over the summer during a doctor visit my BP was 145/65, and now during testing at home, and during doctors appointments, my systolic is always in the 135-148 range, although my diastolic never goes over 70.

I have tried potassium, magnesium, l-Argenine, I eat very little sodium (all whole unprocessed foods and do not add salt to my foods), I am trying everything I can, but with no success.

I cannot help but wonder if this is associated with my starting TRT. I was originally on 200mg a week split into 2 weekly delt shots of 100mg each. That had my TT at 1436 (264-916), FT at 32 (8.7-25.1), and my estradiol at 87.6 (7.6-42.6).

I lowered down to 150mg per week about 12-16 weeks ago to see if that helped, and zero change in blood pressure. I am doing labs this Friday to see where my levels are now.

I understand that 150mg is still on the higher side, and am not opposed to going slightly lower, although I feel absolutely amazing and after not seeing any BP change after dropping it the first time, I am not optimistic that it will help.

I’m just curious if this has been an issue for anyone else. My doctor is kind of out of suggestions at this point aside from BP medication, which I will take if I have to. Just want to exhaust all options first.

Thank you

Might it be coincidence? Parents have HBP? Are they hypertensive? People develop HBP as they get older so TRT aside this seems fairly normal. Anecdotally I have seen a couple of posts on here with people complaining of HBP but usually with other issues as well.

Just out of curiosity do you have labs that you can put up? Have you had a a CBC done to make sure things look ok?

Thank you!

Yes, I forgot to add that portion, and I’m leaning towards thinking it is just my piss poor genetics.

I have FH (genetic high cholesterol). My dad has always had high BP, but my grandfather has FH but just shy of being “high BP”.

So it very well could be my genetics and a total coincidence.

CBC all came back “within range”.
WBC 7 (3.4-10.8)
RBC 5.60 (4.14-5.80)
Hemoglobin 16.8 (13-17.7)
Hematocrit 51 (37.5-51)
MCV 91
MCH 30
MCHC 32.9
RDW 12.4

Your hematocrit is high- this could very well be the cause. Your blood is thicker than it should be, which causes the heart to work harder to pump blood. Can you donate blood?

This was one of my first guesses when I first saw those labs, but my doctor sounded relatively confident that being at the upper end of “normal” was not high enough to cause these BP increases (15-25 points above my normal systolic).
My hematocrit before starting TRT was 43.9.

Would you say that this still could possibly be the case? I can look into giving blood, although having to do it frequently sure would suck!

It’s possible yes. My suggestion is to try it and see if it helps. If donating frequency is important, then you could do a double red donation, in which your red blood cells are filtered out and your plasma is returned to you. You’re allowed to do this every 4 months, and it might be enough to keep your hematocrit in check. You might not even need to do it that often.

There’s always a shortage of blood anyway, so if nothing else, you’d be a hero to someone who desperately needs it. (I donate as often as I can simply for that reason.)

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How are lipids looking on 150-200mg t/wk. How are the statins treating you?

I actually got my LDL down from well over 200 to 103 while on 200mg plus the 20mg rosuvastatin. My HDL took a dive from 38 to 29 though which was the only downside.

I feel like a new person though, as the statins tanked my FT from around 13/14 before staying to I believe 6.8. I can’t remember the reference range but it was below the low norm.

This is complicated stuff.

Go see a cardiologist.

https://www.atsjournals.org/doi/full/10.1165/rcmb.2007-0081OC#:~:text=Increased%20hematocrit%20(Hct)%20above%20baseline,baseline%20(1–3).

I have been seeing one who is helping treat my FH. He believes it is likely genetics catching up to me, and wants to put me on medication. This is just a last ditch effort to make sure there’s nothing being overlooked as I try to avoid medication if possible.

I’d discuss this with you’re doc. There are a myriad of pharmacological interventions one can introduce if required to combat uncontrolled hypertension. As to what medication is best for an individual is dependent on numerous factors taken into account via a patient by patient basis.

You’ve got beta blockers, ace inhibitors/ARB’s, numerous classes of diuretics, selective alpha a2a adrenergic receptor agonists, alpha blockers, calcium channel blockers etc.

Speak to a doc, online forums aren’t the best place to get medication advice, particularly regarding antihypertensives. You’re GP can easily treat this if required.

Oh, I totally agree, not trying to treat anything with this forum. More so trying to see if others have experienced a direct correlation between BP raising after starting TRT and if there was anything that maybe my doctors are overlooking. My cardiologist and lipid specialist both believe it to be genetic, however, they also don’t have much experience specifically with TRT patients. Just trying to look at all possibilities.