T Nation

Losartan & High BP

Hello!

Looks like I’m in need of some advice… I am not currently on TRT (tried it previously) but I know from reading on here that a lot of you are very experienced in these kind of issues I’m having and hope some of you can help to explain why I’m having the results I am.

For reference, here is my current situation…

I just turned 44 and over these past several months of COVID lock-downs I have become increasingly sluggish, blood pressure is consistently high, put on weight, had some anxiety, body seems cold, cholesterol is back up, stopped working out, etc. All symptoms I’ve had previously that taking T3 to clear my RT3 seemed to solve - at least temporarily about 2-3 years ago.

So I decided to start digging back in with some self-ordered blood work to see what is going on and made an appointment with my GP doctor.

The doctor just put me on high blood pressure medication less than a couple weeks ago. I was running BP in the 135-150 / 87-100 range consistently.

Initially, I was prescribed Lisinopril at 20mg daily and I started off taking only 10mg (1/2 a pill). The Lisinopril did begin to drop my BP the first day which was a Friday (117/79 and then 108/74 by the third day) but as I did research I found on this very forum (and others) that Lisinopril raises SHBG and lowers Free Testosterone - which I’m not a fan of as my levels aren’t that high to begin with.

So on that following Monday I requested my doctor switch me to Losartan - which he did no problem; he prescribed 100mg Losartan pills but he said to start at 50mg daily and I started that this last Tuesday.

However I’ve been on Losartan 50mg for 6 days now and my BP has been back up around 125-140 / 85-90 consistently. I dunno if this is normal while my body transitions the medications, if there is some weird conflict since I switched from one to the other after only a few days or perhaps Losartan just takes longer to “kick in”?

Based off what I have read on here and every other site I can find, it appears as if Losartan should be an equally effective BP medication without the negative issues but I am just not seeing that. If you have any wisdom here I’d greatly appreciate it!

In terms of my blood work results, they should be attached to this post.

I had ordered a “Free T3” test and they gave me a “T3 Antibody” by mistake. They have an extra vial of blood (they drew too much I guess) so are supposed to run the test now but I have no way of tracking it since it doesn’t show up in my account as “ordered” so who knows if I’ll get it.

This my first time ordering blood work through this particular online company and they use Quest Diagnostics and I’m not sure if this issue is the website or Quest but they made this mistake and they were very slow in getting my results to me so it’ll be my last using them. I’ll be going back to LabCorp even though it’s a further drive to have the blood drawn.

Sorry for rambling but I’d really like to hear what your thoughts on the BP medication first and foremost but I am also considering taking T3 to get my RT3 levels down but is it OK to take T3 and BP meds? Both in the morning? Is it OK to take them together at all? My intention was to start with 12.5mg (half of my 25mg pill) per day and hopefully that will start to get my elevated RT3 going down.

I look forward to your feedback and really appreciate all you do to help others!

I would contact my doctor. My guess is he was planning on bumping you to 100mg anyway, but wanted to see if 50mg would be enough.

Getting back to exercise and losing the belly fat may help get your BP down and help the lipids. On the other hand, testosterone will also. I would think about both.

Thyroid in the morning, losartan at night.

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Thank you for the reply!

LISS cardio, 3-4x a week. Eat four full celery stalks daily. Losing weight and getting active should help quite a bit. If none of that works then sure, back to BP meds. But there are things you can do that may work without meds. I would start those concurrent with the meds for now and then revisit in maybe six weeks.

My Cardiologist said I was wrong for taking it at night. Dr. said "you are sleeping at night, your laying down what is the point? Take it 9-10 am when you need it most. I started 8 months ago on 25 mg. I’m required to bring him my blood pressures (3X a day) for 14 days) My pressure is a bit higher.(just over the border line) I have an appointment with my Cardio. on 12/17. I believe he will raise my dosage. My Dr. may put me on 2X a day. I take 25mg of Metoprolol twice a day. (every 12) This keeps my AFIB in check. My TRT is the culprit and definitely raised my BP. Why not try taking your Lorsartin every 12 hours. 25 mg twice a day. Start low and work up every 2 weeks. If you change quickly you may feel miserable like while I was acclimating to the dosage. I hope it all works out for you.

You should do what your doctor says.

There is no must do recommendation when it comes to time of day dosing.

It has a relatively short half life, but takes most of the day to fully metabolize. It can make some tired, which is behind the rationale for evening dosing. Also, the thinking behind before bedtime dosing is to have it in your system when you wake up. Heart attacks tend to occur early in the am.

Sorry, I put that up prior to seeing your edits.

As noted, everyone is different. Good luck with your afib management. Are you using an anticoagulant?

Hi, Yes I take 10mg of Xarelto everyday. One year ago I had both legs loaded with blood clots (DVT) I was on 30 mg a day to bust it up. It took a full 12 months to rid myself of this nightmare. 10mg will protect me against the TRT as well as the AFIB. If one isn’t on a blood thinner I would take one 325mg aspirin a day as a precaution, TRT can cause clotting.

How if my hct, hgb are fine?

The only thing I get which is strange is when my elbows are bent I get numbness and some days it’s worse than others. But I have had this for years even before TRT.

Honestly, I have no clue. I would start with my General Practitioner. You may be referred to a specialist. It may be nothing, and it can be something.

Never been on TRT or AAS, but had to go on BP meds at 23 due to genetics and some not-so-great health habits. Average was 150/90 or so, despite lifting 4 days a week and about 1 day of cardio a week.

I will say, Lisinopril was fucking miserable for me, even at the lowest dose. The cough was awful and I felt castrated while on it. No aggression/libido and saw a big swing of muscle to fat (10 lbs) on my InBody assessments. The drop in free test and increase in SHBG would make sense in that case. Lisinopril took me down to an average of 115/70.

6 months of suffering later, I asked for something else and was given Losartan (25mg) which controlled my BP just fine. The cough went away and I felt better. BP was averaging 125/75. I did struggle big time with dehydration because of how badly it made me shed electrolytes. I started adding cardio (3 days/week) and felt shitty, then went to my doc and my BP had dropped into the 110/65 range, so she let me try to come off.

Since coming off, I’ve felt like a juggernaut. Lisinopril kicked my ass and I thought Losartan got me back to normal, but it really only got me to 80% or so. If at all possible, you should try and work with your doc to come off and manage your BP via diet and LISS cardio. You’ll feel better and your kidneys won’t be under as much stress (especially with Losartan). Obviously, work through your doc and don’t try that on your own. My experience is only n=1, but it’s fostered the mindset of trying like hell to control your health on your own first and leave meds as a last resort. Best of luck to you!

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Thank you very much for the thoughtful reply! I know you are right and know my current lifestyle (eating habits, not working out, etc.) is definitely not helping my genetic predisposition for high BP and heart problems.

I do intend on getting things lined back out but I also know that it may take me a while to get to that point so I’d rather avoid the “wear and tear” on my body in the meantime and I can always come off of the meds later - if possible.

For anyone curious, here is a link to one study on Lisinopril: https://pubmed.ncbi.nlm.nih.gov/9877521/

The one thing about Losartan that really has me puzzled is I read most people are on 25-50mg but I’ve been on 50mg for 7 days now and I’m not seeing really any decrease in my BP and no where close to what Lisinopril did at only 10mg/day. I guess I will try to up my dose to the full 100mg but that just worries me that as I get older I have no where to go in terms of “upping my dose” if my BP get more difficult to control due to age.

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Exactly the same here. I thought I was doing enough to prevent it but it really didn’t do much.

This is the right move. Let the meds do their work while you do everything you can to get yourself back in check, then re-evaluate when you’ve made some noted improvements.

If you max out your dose and it doesn’t help you then your doc will put you on multiple. People in my family are on (a) Lisinopril and Metoprolol; (b) HCTZ and Metoprolol; © Losartan, HCTZ, and Metoprolol. I was lucky and got away with just the low dose of Losartan. Given that you weren’t egregiously high before I would be surprised if you can’t get it under control yourself, or at least enough so that current meds/doses work for you.

This may be useful regarding losarton it’s from PDR.NET. By the way I wouldn’t ask for duertic unless you really need it.

For the treatment of hypertension, either alone or in combination with other antihypertensive agents.

Oral dosage

Adults and Adolescents

Initially, 50 mg PO once daily, unless the patient is volume depleted. The maintenance dosage range is 25 to 100 mg/day PO, given in 1 to 2 divided doses. Maximal effects generally occur within 3 to 6 weeks. The addition of a diuretic has a greater effect on lowering blood pressure than increasing the losartan dosage beyond 50 mg/day. The addition of hydrochlorothiazide 12.5 mg to losartan 50 mg daily results in an additional 50% reduction in DBP and SBP. A modest reduction in blood pressure (up to 3 mm Hg) is achieved by increasing the daily dose of losartan from 50 to 100 mg. When volume depletion is suspected (e.g., patients taking diuretics), initiate therapy with 25 mg PO once daily.

I noticed this says it can take “3-6 weeks to reach maximal effect”…what did everyone who has taken it notice? How long did it take for it to begin working for you?

Lisinopril took effect for me within a week at most. I’m not sure on Losartan because I transitioned directly from Lisinopril. When my dad tried that transition his BP spiked and he had to abandon ship and go back.