T Nation

Shortness of Breath on Testosterone


I am on 200 mg of testosterone a week and 250 IU HCG 3x a week along with just .25mg of anastrozole (arimidex) one time on injection day.

This keeps my testosterone around 750 and estrogen around 22

My hemoglobin is still in range but closing in on the upper spectrum of healthy and normal.

My blood pressure is 140/80 (I eat extremely healthy and TRT has jacked up my blood pressure a bit)

I have been experiencing worsened cardio lately and it has been very hard to catch my breath during workouts. Is this from mildly high blood pressure or is it possible it is from hemoglobin and that I need to go give blood and back off my dose for a few weeks.

Any suggestions in lowering blood pressure on testosterone (besides eating healthy and exercising which I do)?

Thanks everyone


Go donate some blood and see if that doesn't help, that's easy to do. I wouldn't go messing around with my "dialed in" protocol just yet.


James the problem with all drug's is peoples anziety.People read-up on all the possible side afeect's and guess what? they have them all. my suggestion let the drug adjust to your body sfor at least a few month's.You stated the Estrogen number??? You know what Iv taken test for 30yr's and don't give a fuck about people who tell me to keep my E-2 below 30ty.These people are usually fat know it all's who never competed in bodybuilding,or any sport

Fuck back in the day do you think Arnold and the hundred's of big time bodybuilder's even knew about e-2 let alone had any adversr affect's.I don't think So.

Guy's that think on factor is the whole puzzle are usually guy's that don't train and read regurgitated steroid nonsense and tell each other. see ya john


My estrogen and protocall is perfect and dialed in. I feel amazing. It is not placebo about the shortness of breath, I definitely notice a difference especially the 3-4 days after the injection. Thanks for the input though I agree that everyone overhypes and overstresses little numbers


Don't ignore the BP and high hematocrit.
Testosterone supplementation is known to cause erythrocytosis.
High levels of red blood cells makes your blood thicker, which makes it harder for
blood to enter small capillaries. Let it go to long and you risk stroke.

The solution is to donate blood on a regular basis.
I do every four months, and since my iron is high, I am able to donate double red cells.
They take 2 pts of blood with a machine that separates it, takes all the red cells then,
than adds saline and puts my platelets and plasma back in. I feel less tired with
that method than just the single pint donation.

My libido and erection strength are always a little better afterwards too!


PKNY thanks for the response! Any blood donation center can do what you request?


Also, you never have to back off the protocall?? Donating blood is always sufficient?

Thanks again brother, it's good to hear an opinion with someone with experience


To be clear, I'm not knowledgeable and no pretending to be, but I do know of some one that was on 200mg test cyp/wk. His bloods came back with test levels at 52.05 nmol/L and that was a trough reading..

That is way too high for TRT... His endo dropped him back to 100mg cyp per week..
When I asked why he had to drop back to 100mg per week this is what he said and I quote him

"My red blood cell count & haemoglobin, which are markers for increased stroke & heart attack risk, were outside their ranges"

So Im wondering if that is your issue there.. On too higher dose for too long??


I see a lot of guys running 200mg/week on TRT, its usually too much and leads
to some bad side effects. But, if you have higher SHBG, you will need that much to
get your free T levels to a point that makes you feel good. Each person is different.

If you feel great at 200mg and the only side effect is BP and higher hematocrit, then
I'd stay at that dose, just donate blood regularly. I use a local blood bank, but
Red Cross also offers the double red procedure.

Good Luck !


Thanks again PKNY. I actually just went to a blood bank and they didn't have double procedure so I only did a pint. Hemocrit was 16.9 so not super high so I am interested to see if the shortness of breath issue is resolved. I may cut back to 150 for a few weeks then try and cruise at around 180mg a week.

At 180 mg a week plus 250 iu HCG 3 times a week my testosterone after 7 days (in the trough) was 634. I guess thats not too bad and I am curious to see what I am peaking at.


You probably hit 1200 total T at peak.
If your BP doesn't fall enough, you can always take 1 low dose asprin per day,
but the blood donation should drop you pretty good.


"Hemocrit was 16.9" - you are confused, HTC is typically in the 40's, at 16.9 you would dead or on your way.

You should all of your posts in one thread so we could see lab work if you have ever posted, or at least link to that.

Have you read the advice for new guys sticky? TRT can make things worse if there is an underlying thyroid or cortisol problem.

Take mini aspirin every day. Take 5 of those on day one. That will help with your circulation.

You should have homocysteine in your lab work to see if there is a problem with arterial inflammation.

Your cholesterol lab work is also needed.

EFA's: fish oil caps, flax see meal or oil, nuts
DHEA if labs show lowish DHEA-S
Vitamin C and natural source vit E
5-6,000 iu vit-D3 in small oil caps
high potency vit-B complex multi-vit with trace elements and iodine.
Heathy fats


Full blood results from last test (7 days after injection)

IGF-1: 379
Glucose: 93 (70-105)
BUN: 29 (7-25)
Creatinine: 1.35 (.70-1.30)
Cholesterol: 164
Triglycerides 57
HDL: 45
Chol/HDL Ratio: 3.64
LDL 107
LDL/HDL ratio 2.39
WBC: 5.5
RBC 5.42
Hemoglobin: 16.3
Hematocrit: 47.6
MCV 87.9
MC 30.1
TSH 2.078
Free T4: 1.07
Free T3: 3.23
Iron: 83
Estrodial 34.3
DHT: 33
DHEA 172
Testosterone 809
Free Testosterone 22.30 (8.8-27)
PSA: .35
SHBG: 23
Homocysteine: 8.6

Keep in mind this is at the end of the week so estrodial is higher than it is the rest of the week because I only take .25mg of arimidex on injection day now (occasionally I will throw in another .25 mid week. I feel better that way. I don't feel great the day after arimidex but feel amazing the rest of the week. I am an overresponder. I also gave blood after this test so hematocrit and hemoglo

Just a recap I am doing 200mg of testosterone cyp 1 time a week, 250IU HCG 3x a week and between .25-.50 mg of arimidex a week.

Blood pressure was 139/76 today. I am lowering testosterone dose to 160mg a week to see if it has an effect on bph.


Thank you for the great insight. I just posted blood panel.


I had the exact same issues on HCG. I was at 0.2ml Test every other day, 500IU of HCG every 4 days and 0.125mg Anastrozole every 4 days. The doc took me off the HCG until we talk. Our consult is today and I will try to let you know what he says.

About 3 hours after I inject the HCG (sub-q in belly) I get really bad palpitations, chest tightness and reflux. This slowly dissipates over the next 36 hours. During this time, my testicles get much larger. The entire time I am very susceptible to shortness of breath. After the 36 hours I’m doing really well and I feel great, still get shortness of breath though. On the 4th day, before the HCG shot I usually experience a headache in my temples.

The first 3 weeks I was on HCG didn’t cause this. I suspect this was because my testicles were so atrophied from years of testosterone without HCG as a backup. Once my testicle size came back; however, the issues with the HCG started.

My testosterone was a little elevated on tests. E2 was right in the middle of the normal range. My RBC count is elevated but it’s always elevated because I live at atltitude in Colorado.

Even with donating blood, eating 1/2 grapefruit daily and taking a baby aspirin daily, all of which should have helped with the high RBC count, I still got the shortness of breath.

Anyway, appointment with Doc today. Will try to let you know what he says.


I spoke with the doc. Instead of 500IU every 4 days he recommended 200IU every other day at the same time as my testosterone injection (0.2ml every other day). Doc said that 800IU are needed per week to stop testicle atrophy caused by testosterone injection. If still have problems with shortness of breath and other symptoms, reduce too 100IU every other day and call him because we may need to do 100IU daily to reach the minimum per week. If the 200IU is ok he wants me to slowly increase to 300IU every other day if possible.

Anastrozole is to be taken WITH the testosterone injection to mitigate aromatization but every 4 days, not every 2 days. Doc wants estradiol in the 25 to 35pg/mL range and right now I’m running at 18 which is a little low. I was running at 37pg/mL without the Anastrozole so I may get along well without it at all.

Yes, I know I’m bumping an old thread but I found this in search engines and I thought my current information would be helpful.