T Nation

Hypertension, What’s the Cause?

I started TRT 6/3, 60 mg test cyp twice a week with .5mg anastrozole twice a week. Initial Testosterone 3 years ago was 330, in March before starting TRT total Testosterone was 464, estradiol was 37.

I gained 25 lbs in the first six weeks of TRT (not muscle) and became hypertensive (usually 160s /100s). Vial of test lasted me until August and I haven’t had any testosterone shots since August 23 (rite said I had to wait 36 more days for refill).

Six weeks after starting trt total testosterone was 611, estradiol 52, shbg 16, free testosterone was 17.2 (8-25 range)

It’s almost been a month with no testosterone and my blood pressure is still in the same range. I’ve lost 10 lbs of the weight I gained. Previously, regardless of weight change, my resting heart rate was always around 50 now my resting heart rate is 70s-80s.

Anyone have any idea what may be causing this?

Your protocol is to blame for the water retention probably caused by high estrogen, the water retention caused by high estrogen will increase blood pressure.

Your injection frequency is no longer appropriate, your SHBG is low and you should be injecting small doses daily or EOD. I bet your Free E2 was insane with the low SHBG with E2 at 52 pg/mL.

There could be mineral deficiencies, iron deficiency can increase heart rates and BP, something I know all too well. You are likely still shut down, I would have high BP with testosterone close to zero.

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My guess will be your blood is too thick. Know your HCT? Go donate a pint of whole blood and see if the BP drops. It should be immediately post donating.

You water weight gain was do to your E2 being thru the roof. Hard to believe you were taking 120mg/wk of T and 1mg/wk of anastrozole and your E2 was still thru the roof.

I only took it (anastrozole) the first week and began taking it again on the seventh week after the labs. Starting week 7 I also went to EOD shots @40 mg until i ran out. Haven’t taken anything since the 23rd of August. Hemoglobin was 15 and HCT was 46.5

I’m reluctant to restart TRT without first trying a restart (HCG,nolvadex) if it’ll cause hypertension .

Should I expect a similar reaction (high blood pressure) if I do a cycle in the future?

I would, not everyone was made for cycles. The cause of your hypertension is clear, low SHBG and E2 at 52 pg/mL.

There is no great mistery here, no puzzle to solve because I had the same experience. My SHBG is about the same as yours, when my E2 was 53 back when doing 20mg EOD, my water retention and BP was just as bad as you describe.

Too much estrogen can wreck havoc on men, estrogen is a powerful hormone that can make men overly moody and throw your BP control mechanism out of whack via water retention putting pressure on blood vessel walls.

I would say estrogen is more powerful than testosterone, some men are just sensitive to estrogen and can’t even handle estrogen at the top of the ranges.

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What’s your height and weight?

5’9” 215lbs

I’m 5’9 185lbs and fairly muscular and I still have a little weight to lose. At 215 unless you are jacked as F I bet losing weight would make TRT a lot more palpable. Who knows it could fix your issues completely. I know saying losing 30lbs sounds easy but it’s not a hard as you would think. I went from 200 lbs to 170 in less than 3 months doing half-ass keto.

I’ve done the same in the past. It’s been a fucked up year for me. Last August I was 180

I hear ya brotha

What are you trying to restart your natural T production? (a PCT)
I have never heard TRT causing high blood pressure when HCT is in check.
You must have something else going on.

Did you check your morning cortisol levels ?
Are you consuming too much protein ?
What is your bun test and creatinine
Co2 levels ?
Do you have sleep apnea ( ask you wife or if you are single put a recorder beside you to see if you snore ?

A lot of times water retention is not due to estrogen but diet ( sodium excess )and dehydration ( body tends to store more water as a natural defense system to protect tissues )

Are you allergic to any seeds ( cotton seed , sesame )

Whenever something unusual is happening , your body is giving you a sign .

Bacterial infections and inflammation also tend to raise blood pressure . Your wbc count
Neutrophils , lymphocytes?


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Your lipid panel really sucks. That is why you are having heart problems. If your lipids have been this bad for say the last 10 years you could have some serious plaque buildup.

I would stop all omega 6 usage and switch to omega 3
I would add 3000-4000 units of a high quality Fish oil use the liquid in the bottle not the pills. You can’t tell when the pills go bad. D3 would be another good supplement t add. Diet wise I’d eliminate all yellow cheese.
Your TT is just about right maybe a little low but your E2 is thru the roof. You need to take your AI. Your SHGB is low so you have gobs of free E2 with nothing to bind it so it is screwing everything up.

Your prolactin is also at the top of the scale. If it goes over and with your E2 at 50+ you can expect gyno in about a year. Gyno surgery is $8K

Lecithin (sunflower is better than soy) and CoQ-10 can help the cholesterol too, but clen diet is the main thing.

The lipids have been that bad for the past ten years!! I went to a few different doctors trying to get BP meds but they thought BP was normal (staff didn’t know how to take manual BP apparently).

I finally saw a cardiologist who took the BP himself and found it to be high, so did the tech who did the echo. I’m now on two meds for BP, 1 by cardiologist and from new Primary doc. Echo was fine, calcium score was zero, so no other cardiac issues to worry about. I did check total Testosterone a few weeks ago and it came back at 259 (range 250-827). Still feeling like crap but BP is normal.

Snoring was made worse by Testosterone or the high BP, . Turns out that’s a good thing, I was diagnosed with sleep apnea (I’m pretty sure I’ve had it for a long time).

Hows your cardio? How often do you work out? Diet? I think these are also important things to address aside from trt.

Trt won’t fix your heart or lipids, I don’t wanna say it will make it worse, but neglegence of proper diet and excersize will be detrimental to trt. So dw about your e2 or even trt. Get those lipids in check.
Hopefully you’re not relying on trt to be a cure all. If you stick to trt, I’d say lower your dosage to 100mg a week with daily injections, according to your triglycerides you’re very overweight so a lot of it will convert to e2 unless you inject daily smaller doses.

With this low SHBG you have no choice but to use daily injections. Otherwise you will have always E2 and other hormone issues. And yes your lipids suck. You need to clean your diet and start consuming a lot of high quality fish oil.

So here’s an update guys, but first I want to thank you all for your time and advice. Believe it or not Most of you seem to know more and are more thorough when it comes to this stuff than most (probably all) the doctors I’ve been seeing in the past year or two.

Recap…I’ve been mostly in shape my whole life, never obese but sometimes a bit overweight (now, :joy:). I’ve always had high lipids, in shape or out. I have gout. 39 years old, 5’9” 210 lbs

Back in February-August 2018 I got in decent shape and felt great. I was in the gym for hours everyday (I know better now) I was down to 180, again pretty decent shape, and things were pretty good. A friend in his 50s, jacked and ripped year round and competing/winning multiple competitions that year, insisted I try some of his “Amino Acids” that he got from over seas…I took a few scoops on two separate occasions, around July-August (he insisted and I really though nothing of it. I was also started on a new medicine for uric acid around that time, the previous one used to make me drowsy whenever I ate. I’m not sure if the medicine I started, the Amino Acids my friend gave me, or something else was the cause of what was about to happen.

In the next few 2-6 weeks I slowly went from being very motivated, high energy, working out everyday and being very confident and optimistic, to being a total loser. As if someone flipped a switch and shut me off. My mood Started dropping, I had zero motivation to do anything, stayed in bed all day, libido went etc…over the next few months things got worse and the two things that were most awkward were loss of libido and mood…I had never had problems wanting sex, but I didn’t care at that point , and my mood had always been positive but now was continually dropping. I didn’t know what caused this but thought it was low test when I started doing some research. I remember testing at TT of ~360 back in 2016 but the doctor wanted to give me statins due to lipids being out of wack, I was in very good shape back then too weight around 175(used to do BJJ classes many times a week sometimes twice a day) . Symptoms back then were mainly increasing lack of concentration and short term memory problems. I wasn’t taking statins as the doctor was suggesting so even then I let things be.

This time I went to an HRT clinic, 6/2019, looking for help. My mood had hit rock bottom and I went from feeling great a year before to feeling like a loser pussy regularly (all new to me for that year). After TRT for about 3 months I felt better, not great, but the TRT helped me out of what I consider part of the roughest patch I was going through. Estradiol went up along with prolactin, probably because I only took anastrozole in the beginning. I had developed pretty high blood pressure and gained a bunch of weight, after starting TRT. Rite aid was making getting my refill complicated, coupled with high Blood pressure I decided to stop cold turkey on 8/23/2019.

I felt bad the first few months but not nearly as bad as I had felt before TRT. Checked my TT on 10/29/19 and it was 259.
I had bloodwork on 1/3
TT 357 range 250-1100
Free T 64 range 46-224
Bio available 137 range 110-575
Shbg 21 range 10-50
FSH 3.0 range 1.6-8.0
LH 1.5 range 1.5-9.3
Prolactin 6.9 range 2.0-18

I’m feeling way better, motivation is shit, the little I have is very hit or miss but I’m glad my mood is better ( the previous 1.5 years were scary to say the least).

My lipid panel is still shit, but even the cardiologist said that probably wasn’t a problem and might be genetic, he didn’t recommend statins even before we found out my calcium score was zero.

I plan on avoiding all kinds of plastics and limiting any other exposure to endocrine disruptors. Soon I’ll try to force myself to start some kind of exercise program and maybe clean up my diet a little (I really don’t eat unhealthy).
My question is where do I go from here? These numbers don’t look great, I know, but any advice/insight is appreciated. Looking forward to putting some fire back in me!

Sorry for the long read, thanks for your time and help :pray:t2:

Edited…original post I wrote AAs to mean Amino Acids, not Androgenic Anabolic steroids…although I suspect it could’ve been the latter and my friend chose not to tell me. He did admit to me that he’s on gear last August, but denied giving me anything, then offered to provide if I ever wanted any :joy:

Your Testosterone levels are crap. TRT is a process of finding the right dose that makes you feel like a normal to optimal man. The wrong dose will have you feeling less than. If I were you and the other ailments aren’t of concern I’d give TRT another go. There are telemedicine clinics for around $150/month (includes the Test shipped to your door) that are extremely easy to deal with. My estrogen & prolactin are elevated on TRT and I feel great. Being overweight can make you respond less than positively to TRT so definitely work on losing the weight.

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