TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Discuss TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy at the Men's Health Forum; First it was Depo about two months ago. When my hemocrit levels raised when I went from 100mg to 125mg ...

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Old 09-09-2010, 11:00 AM
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Unhappy TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

First it was Depo about two months ago. When my hemocrit levels raised when I went from 100mg to 125mg I was yanked off rather quickly - I have 25 stents and take Plavix so high hematocrit is off the table. I was on Testim in the past and never had an issue before I almost successfully completed a protocol to restart my own HPTA axis and did not follow through with another year of TRT before trying the protocol again - I have idiopathic hypogonadism and the testes, pituitary, and hypothalamus all responded to the protocol so they are working fine. But that is not what I am talking about here.

I doubled my dose of Testim and my BP is about 145/95 and my cardiologist would like it no higher than about 125/85. I also noted my pulse rate is high - around 95, but both BP and pulse rate do drop during the day.

The Depo was awesome at first, but then libido and erectile dysfunction hit and hit hard. I switched to Testim, got some Arimidex (which I have yet to start at .25mg every third day), and do 250IU of HCG every three days. No real lab data on any of this yet.

I know everyone is going to scream at me here for not starting the T, waiting, getting a measurement along with E2, then stepping up at the right time to arimidex (if necessary) and then on to HCG when everything is stabilized. I am going to do this when I return from my anniversary cruise. Right now, my libido and ED are normalizing to a point where I may be able to use a PDE5 inhibitor (Levitra is my choice).

As my insurance does not cover Testim, when I return I am stopping everything and starting with 10g Androgel, which it does cover and then taking the slow approach described above. I did not respond at all to 5g in the past, but on 5g of Testim I had morning numbers around 560 with one and only one measurement of 795 total T (I think this was an outlier). No gyno, no tender nipples, some water retention but not a great deal. Taking an HCTZ blood pressure pill (which is a diuretic) did not make that much of a difference. I am already on 10mg of Norvasc/day.

I'm thinking cortisol caused by T being a little too high? Or maybe E2 being elevated but not enough to cause gyno, just enough to cause anxiety. My BP is tightly correlated to anxiety levels and I am on clonazepam to control this.

I just want to make it through my anniversary cruise and be able to function sexually. After that, I have no problem with the slow methodical approach. I am just asking for some theories as to what the high BP, anxiety, and higher pulse rate MAY be caused by.
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  #2  
Old 09-09-2010, 11:02 AM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Sorry, forgot to mention that due to the Plavix I cannot give blood. Where does one get a therapeutic phlebotomy? I live in Austin.
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  #3  
Old 09-09-2010, 05:52 PM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Quote:
Originally Posted by gmerits View Post
First it was Depo about two months ago. When my hemocrit levels raised when I went from 100mg to 125mg I was yanked off rather quickly - I have 25 stents and take Plavix so high hematocrit is off the table. I was on Testim in the past and never had an issue before I almost successfully completed a protocol to restart my own HPTA axis and did not follow through with another year of TRT before trying the protocol again - I have idiopathic hypogonadism and the testes, pituitary, and hypothalamus all responded to the protocol so they are working fine. But that is not what I am talking about here.

I doubled my dose of Testim and my BP is about 145/95 and my cardiologist would like it no higher than about 125/85. I also noted my pulse rate is high - around 95, but both BP and pulse rate do drop during the day.

The Depo was awesome at first, but then libido and erectile dysfunction hit and hit hard. I switched to Testim, got some Arimidex (which I have yet to start at .25mg every third day), and do 250IU of HCG every three days. No real lab data on any of this yet.

I know everyone is going to scream at me here for not starting the T, waiting, getting a measurement along with E2, then stepping up at the right time to arimidex (if necessary) and then on to HCG when everything is stabilized. I am going to do this when I return from my anniversary cruise. Right now, my libido and ED are normalizing to a point where I may be able to use a PDE5 inhibitor (Levitra is my choice).

As my insurance does not cover Testim, when I return I am stopping everything and starting with 10g Androgel, which it does cover and then taking the slow approach described above. I did not respond at all to 5g in the past, but on 5g of Testim I had morning numbers around 560 with one and only one measurement of 795 total T (I think this was an outlier). No gyno, no tender nipples, some water retention but not a great deal. Taking an HCTZ blood pressure pill (which is a diuretic) did not make that much of a difference. I am already on 10mg of Norvasc/day.

I'm thinking cortisol caused by T being a little too high? Or maybe E2 being elevated but not enough to cause gyno, just enough to cause anxiety. My BP is tightly correlated to anxiety levels and I am on clonazepam to control this.

I just want to make it through my anniversary cruise and be able to function sexually. After that, I have no problem with the slow methodical approach. I am just asking for some theories as to what the high BP, anxiety, and higher pulse rate MAY be caused by.
Testosterone therapy cause a slight increase in blood pressure, it is very common, but can be managed with proper dosing.
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Old 09-10-2010, 09:23 AM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Thanks Chris.
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  #5  
Old 09-10-2010, 09:25 AM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Quote:
Originally Posted by gmerits View Post
Sorry, forgot to mention that due to the Plavix I cannot give blood. Where does one get a therapeutic phlebotomy? I live in Austin.

At almost any blood bank/donation center. The difference is a doctor's order.
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Old 09-10-2010, 05:08 PM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

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Originally Posted by Michael Scally MD View Post
At almost any blood bank/donation center. The difference is a doctor's order.
Thanks Mr. Scally. It turns out I can give blood on Plavix, just not platelets, so I can just walk in now and without a precription.
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  #7  
Old 09-10-2010, 07:41 PM
zkt zkt is offline
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Quote:
Originally Posted by gmerits View Post
First it was Depo about two months ago. When my hemocrit levels raised when I went from 100mg to 125mg I was yanked off rather quickly - I have 25 stents and take Plavix so high hematocrit is off the table. I was on Testim in the past and never had an issue before I almost successfully completed a protocol to restart my own HPTA axis and did not follow through with another year of TRT before trying the protocol again - I have idiopathic hypogonadism and the testes, pituitary, and hypothalamus all responded to the protocol so they are working fine. But that is not what I am talking about here.

I doubled my dose of Testim and my BP is about 145/95 and my cardiologist would like it no higher than about 125/85. I also noted my pulse rate is high - around 95, but both BP and pulse rate do drop during the day.

The Depo was awesome at first, but then libido and erectile dysfunction hit and hit hard. I switched to Testim, got some Arimidex (which I have yet to start at .25mg every third day), and do 250IU of HCG every three days. No real lab data on any of this yet.

I know everyone is going to scream at me here for not starting the T, waiting, getting a measurement along with E2, then stepping up at the right time to arimidex (if necessary) and then on to HCG when everything is stabilized. I am going to do this when I return from my anniversary cruise. Right now, my libido and ED are normalizing to a point where I may be able to use a PDE5 inhibitor (Levitra is my choice).

As my insurance does not cover Testim, when I return I am stopping everything and starting with 10g Androgel, which it does cover and then taking the slow approach described above. I did not respond at all to 5g in the past, but on 5g of Testim I had morning numbers around 560 with one and only one measurement of 795 total T (I think this was an outlier). No gyno, no tender nipples, some water retention but not a great deal. Taking an HCTZ blood pressure pill (which is a diuretic) did not make that much of a difference. I am already on 10mg of Norvasc/day.

I'm thinking cortisol caused by T being a little too high? Or maybe E2 being elevated but not enough to cause gyno, just enough to cause anxiety. My BP is tightly correlated to anxiety levels and I am on clonazepam to control this.

I just want to make it through my anniversary cruise and be able to function sexually. After that, I have no problem with the slow methodical approach. I am just asking for some theories as to what the high BP, anxiety, and higher pulse rate MAY be caused by.
You need to get your priorities straight.
25 stents? You exaggerating a little?
But none the less: you need to get your BP in a safer range.
How many infarcts have you had? BP is the number one predictor of future events.
You are also heading for a case of cardiomyopathy with the tachycardia.
Tell your doctor you want to try metoprolol. HCTZ is often effective in lowering BP if hypervolumia is the root cause. Metoprolol will address the cardiomyopathy by lowering the rate and intensity of contractions.
In addition, you appear to be a good canditate for an A2 receptor blocker, terazosin, for instance.
T will definately raise BP and HCT. The last things you need. So will GCs.
Get the aromitization under control and you wont need so much T.
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  #8  
Old 09-19-2010, 09:09 PM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Quote:
Originally Posted by zkt View Post
You need to get your priorities straight.
25 stents? You exaggerating a little?
But none the less: you need to get your BP in a safer range.
How many infarcts have you had? BP is the number one predictor of future events.
You are also heading for a case of cardiomyopathy with the tachycardia.
Tell your doctor you want to try metoprolol. HCTZ is often effective in lowering BP if hypervolumia is the root cause. Metoprolol will address the cardiomyopathy by lowering the rate and intensity of contractions.
In addition, you appear to be a good canditate for an A2 receptor blocker, terazosin, for instance.
T will definately raise BP and HCT. The last things you need. So will GCs.
Get the aromitization under control and you wont need so much T.
No dude, I really have 25 stents in three arteries - LAD, CX, and RCA. Check out my site Lump on a Blog where I have all the procedures printed out in the my story section. I am 43 and had 43 heart attacks between the ages of 38-41. Turns out I was resistant to 75mg Plavix before switching to 150mg. No stents since then.
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  #9  
Old 09-20-2010, 09:04 PM
zkt zkt is offline
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

I didnt mean to seem disrespectful; I`m the most serious guy you will ever meet when it comes to this sort of thing. Been to the cath lab 6 times myself, renal not cardiac.
I dont think there is room for 25 stents in the cardiac arteries. 25 and 25 angioplasticies I can see. Post a link to the site you mentioned. I really want to check this out.
But back to the subject:
First of all, why the fuck didnt your cardiologist perform grafts after say the first half dozen or so?
Thats crazy.
Secondly, controlling BP is a hell of a lot more important to you than libido. One major clot 10 minutes away from help and libido wont matter any more. What BP meds are you on?
Surely your cardiologist knows that Plavix is more effective in conjunction with asprin.
What lipid (LDL, HDL, VlDL, TG) control drugs are you taking? My HDL tested at 94 last time, might have some useful recomendations.
I would really like to follow up on this with you.
Please tell me all you can relating to your condition.


Quote:
Originally Posted by gmerits View Post
No dude, I really have 25 stents in three arteries - LAD, CX, and RCA. Check out my site Lump on a Blog where I have all the procedures printed out in the my story section. I am 43 and had 43 heart attacks between the ages of 38-41. Turns out I was resistant to 75mg Plavix before switching to 150mg. No stents since then.
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  #10  
Old 09-20-2010, 11:01 PM
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Default Re: TRT Blood Pressure and Pulse Rate & Therapeutic Phlebotomy

Quote:
Originally Posted by zkt View Post
I didnt mean to seem disrespectful; I`m the most serious guy you will ever meet when it comes to this sort of thing. Been to the cath lab 6 times myself, renal not cardiac.
I dont think there is room for 25 stents in the cardiac arteries. 25 and 25 angioplasticies I can see. Post a link to the site you mentioned. I really want to check this out.
But back to the subject:
First of all, why the fuck didnt your cardiologist perform grafts after say the first half dozen or so?
Thats crazy.
Secondly, controlling BP is a hell of a lot more important to you than libido. One major clot 10 minutes away from help and libido wont matter any more. What BP meds are you on?
Surely your cardiologist knows that Plavix is more effective in conjunction with asprin.
What lipid (LDL, HDL, VlDL, TG) control drugs are you taking? My HDL tested at 94 last time, might have some useful recomendations.
I would really like to follow up on this with you.
Please tell me all you can relating to your condition.
I did not take it that way and would not mind it even if someone were combative (I have very thick skin), so don't hesitate to call BS if you see it. It is the only way to learn as far as I am concerned.

Here is the link: Heart Disease Blog. There is actually plenty of room for 25 stents and there is not theoretical limit to the number of stents one can have. My doctor's personal record is a patient with 72. You can have stents within stents within stents as they are very think mesh tubes. My LAD is a full-metal jacket (stem-to-stern) with no room left for bypass.

My original issue seems to have cleared itself up when I switched to the Testim gel and got off the shot. I also added HCG and have done two .25mg Armidex every third day (250IU on the HCG). As my insurance does not cover Testim, I am now going to stop everything, switch to 10mg pump Androgel and do this methodically - Androgel, then Arimdex (if needed) and then HCG. On the Testim/HCG my libido increased and my ED resolved within about seven days and the anxiety resolved as well. The Arimidex made a small difference in my libido but it was nothing to write home about and I was already doing quite well. I metabolize drugs very quickly and often must dose them at much higher levels. The cardiology picture is stable - blood pressure is excellent and I burn about 1000 calories in 1 hour (I can literally blast away at full throttle when on T therapy). Interestingly,when I am on T I have 0 excercise induced angina - even on the shots. A little research turned up some anecdotal evidence that T acts like a calcium channel blocker and dialates arteries.
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