Head pressure problem that never goes away

[pengu]

Symptom: A 24/7 constant pressure in the head feeling (akin to if you were hanging upside down), not as bad as a headache, but still bad. When I lay down in sleeping position, the pressure feeling is halved.

Cause: I'm 30. I was on TRT for almost year and half, starting Aug 2018. A few months in is when this head pressure symptom surfaced. My BP also increased to 135/80 and continues to remain at that level, where before TRT it was 105/65. It took me a year to finally figure out my problem was due to increased hematocrit (I researched online and saw many others who had high hematocrit have this same head pressure symptom). Tested November 2019, my hemoglobin was at 17, hct 50%. I quit TRT in January this year, hoping it would sort itself out. I waited a good 6 months, the symptom still remained. Hemoglobin was still at 17, didn't drop one bit like one would expect.

A month ago I did a few phlebotomies. I tested hemoglobin and it dropped down to 13.5. It's been exactly 3 weeks since I tested the hgb at 13.5, and my head pressure symptom still remains, did not feel any better. BP is still the same and hasn't dropped. I've tried otc BP lowering supplements hoping for a band aid fix, even pharma drugs like lisinopril- didn't budge the BP.

I'm quite lost now. I'm sure my problem was due to elevated red blood cell count, which I've already lowered to normal range. I stay hydrated throughout the day. Is it perhaps since I've had this problem for over a year and a half, that my body recognizes it as the new norm and would take much longer than a few weeks to return to normal?

Appreciate anyone who wants to take a crack at this. @Michael Scally MD can I get your opinion on this please?

 

[Avies48]

Have u actually talked to a local doctor? Have actually got scripted bp meds or bought them 2nd or 3rd hand off web sites???

Id be going to a doctor

 

[kropotkin]

So you haven't been on any aas for more than 6 months? Did you do a PCT, have you checked your hormone levels. Are you on any ancillaries, low sodium diet, taking supplements or anything else that has side effects related to blood pressure? Do you have good days where you don't feel any head pressure or is this a 24/7 thing?

A 50% hct really isn't that high. People freak out about this, but think about those that live at high elevations, they have a normal life span and don't experience the typical symptoms of high hct and yet they can have a 60% hct. And a blood pressure of 135/80 is nothing, that's a goal bp for me.

Normally when the hct is high and I'm talking >60%, you can expect heavy heart beats, pounding head, headaches, ears ringing, you can actually hear your pulse in your ears, itchy lower legs especially after a hot shower, shortness of breath due to reduced circulation.

The danger zone for hct is 70% or higher, that's when you feel all the above symptoms and it's time to get a liter or more drained off depending on body weight and lean muscle mass.

I haven't had a hct as low as 50% in more than a decade, I run myself up to 65% every 6 weeks and drain off a liter of whole blood and feel much better.

I take no supplements other than a multivitamin with low dose iron, b12/folate, to keep my rbc production going without running into problems of exhausting the building blocks for rbcs with increased production and constant blood lose due to phlebotomy.

I also recommend going to a doctor if you haven't already.

 

[RunTrenFckTens]

So you haven't been on any aas for more than 6 months? Did you do a PCT, have you checked your hormone levels. Are you on any ancillaries, low sodium diet, taking supplements or anything else that has side effects related to blood pressure? Do you have good days where you don't feel any head pressure or is this a 24/7 thing?

A 50% hct really isn't that high. People freak out about this, but think about those that live at high elevations, they have a normal life span and don't experience the typical symptoms of high hct and yet they can have a 60% hct. And a blood pressure of 135/80 is nothing, that's a goal bp for me.

Normally when the hct is high and I'm talking >60%, you can expect heavy heart beats, pounding head, headaches, ears ringing, you can actually hear your pulse in your ears, itchy lower legs especially after a hot shower, shortness of breath due to reduced circulation.

The danger zone for hct is 70% or higher, that's when you feel all the above symptoms and it's time to get a liter or more drained off depending on body weight and lean muscle mass.

I haven't had a hct as low as 50% in more than a decade, I run myself up to 65% every 6 weeks and drain off a liter of whole blood and feel much better.

I take no supplements other than a multivitamin with low dose iron, b12/folate, to keep my rbc production going without running into problems of exhausting the building blocks for rbcs with increased production and constant blood lose due to phlebotomy.

I also recommend going to a doctor if you haven't already.

1L every 6 weeks. That's twice the amount they take when you give blood and you are supposed to only do that every 3 months.

 

[kropotkin]

1L every 6 weeks. That's twice the amount they take when you give blood and you are supposed to only do that every 3 months.

No worries man, I worked as a medical laboratory technologist for 25 years. I spent years working in blood bank performing crossmatches and antibody IDs, hematology, clinical chemistry, so I have a background for this.



The main problem with secondary erythrocytes is the question of iron stores.

When removing too much blood in one setting you have a problem of fluid volume loss which can cause your heart to become tachycardic(speed up) to compensate for sudden volume loss.

I don't suffer from tachycardia at all when I draw off a liter at one time and that has to do with my size. At 6'2" 245lbs I have at least 6.5 liters, plasma volume is replace at about 125ml per day, typically we produce 25ml of packed red cells per day(more in my case because of suppression of hepcidin allowing more iron absorption.

The red cross typically removes around 450mls per donation and sets it at every 56 days. The problem is I produce a shit load of rbcs, I mean I never get down to 50% hct ever, if I don't remove blood for two months I'll easily hit close to 70% hct and feel like shit

So the easy solution is supplementation with low dose iron at 11mg/day and B12/Folate every day.

It's tricky because naturally your ferritin levels(iron stores) will drop, no man was ever expected to lose blood in this manner and that is why a typical man only needs 1mg of iron per day in order to keep normal rbc production going(thanks to the constant recycling of old rbcs that are destroyed to release iron), pre-menopausal women need 2mg/day because they menstruate.

AAS screws up this delicate balance and that is why many men are taken off trt, because most doctors don't want the headache of constant phlebotomy for the rest of ones life.

 

[Oldj]

I had a similar issue. In my case it was sinus pressure and permanent inflammation. I saw a lot of docs and specialists that got Me no where. The second ENT was like holy chit no one realized this are they blind? You need surgery. I lived on prednisone, antibiotics and kenalog shots for 2.5 years. It absolutely sucked azz.... It was from an epidural. I have never been so sick in all my life. I have had a few friends over the years end up talking about the pressure in their head. All ended up being sinus related for one reason or another.

 

[Avies48]

I had a similar issue. In my case it was sinus pressure and permanent inflammation. I saw a lot of docs and specialists that got Me no where. The second ENT was like holy chit no one realized this are they blind? You need surgery. I lived on prednisone, antibiotics and kenalog shots for 2.5 years. It absolutely sucked azz.... It was from an epidural. I have never been so sick in all my life. I have had a few friends over the years end up talking about the pressure in their head. All ended up being sinus related for one reason or another.

Kenalog oh soo goood! Only thing besides aleve cold n sinus that opens my nasal passages up

So u had to have surgery? How bad was that shit?

 

[Multislacking]

I haven't had a hct as low as 50% in more than a decade, I run myself up to 65% every 6 weeks and drain off a liter of whole blood and feel much better.

I take no supplements other than a multivitamin with low dose iron, b12/folate, to keep my rbc production going without running into problems of exhausting the building blocks for rbcs with increased production and constant blood lose due to phlebotomy.

I also recommend going to a doctor if you haven't already.

Just curious if you've ever tried ip6 and curcumin to lower?

 

[Avies48]

No worries man, I worked as a medical laboratory technologist for 25 years. I spent years working in blood bank performing crossmatches and antibody IDs, hematology, clinical chemistry, so I have a background for this.



The main problem with secondary erythrocytes is the question of iron stores.

When removing too much blood in one setting you have a problem of fluid volume loss which can cause your heart to become tachycardic(speed up) to compensate for sudden volume loss.

I don't suffer from tachycardia at all when I draw off a liter at one time and that has to do with my size. At 6'2" 245lbs I have at least 6.5 liters, plasma volume is replace at about 125ml per day, typically we produce 25ml of packed red cells per day(more in my case because of suppression of hepcidin allowing more iron absorption.

The red cross typically removes around 450mls per donation and sets it at every 56 days. The problem is I produce a shit load of rbcs, I mean I never get down to 50% hct ever, if I don't remove blood for two months I'll easily hit close to 70% hct and feel like shit

So the easy solution is supplementation with low dose iron at 11mg/day and B12/Folate every day.

It's tricky because naturally your ferritin levels(iron stores) will drop, no man was ever expected to lose blood in this manner and that is why a typical man only needs 1mg of iron per day in order to keep normal rbc production going(thanks to the constant recycling of old rbcs that are destroyed to release iron), pre-menopausal women need 2mg/day because they menstruate.

AAS screws up this delicate balance and that is why many men are taken off trt, because most doctors don't want the headache of constant phlebotomy for the rest of ones life.

So are u saying if we supplement with iron daily, and b12/folate, it can help us NOT have to do phlems??

Is there a way to unsupress hepcidin whilst on trt or aas???

 

[Avies48]

Just curious if you've ever tried ip6 and curcumin to lower?

I wish ip6 worked for me, just made me feel like crap

 

[KingCahoot3627]

I had a similar issue. In my case it was sinus pressure and permanent inflammation. I saw a lot of docs and specialists that got Me no where. The second ENT was like holy chit no one realized this are they blind? You need surgery. I lived on prednisone, antibiotics and kenalog shots for 2.5 years. It absolutely sucked azz.... It was from an epidural. I have never been so sick in all my life. I have had a few friends over the years end up talking about the pressure in their head. All ended up being sinus related for one reason or another.

I missed what the problem turned out to be. Deviated septum?

What did the procedure do?

Do u still have symptoms?

 

[KYMuscle]

Do you have bad anxiety? I had constant tension headaches (rubber band around head feeling) for months, I have stage 2 Hypertension, but that was ruled out as the cause. I was put on 3mg Clonazepam Daily & they’re gone completely, never felt anxious, but was diagnosed as such.

Ruled out a ton of Nasal/Neurological related causes luckily

My cause does not seem to be as complex as yours although, so might not be of any help

My resting heart rate is low 50’s, so I’m not prescribed any BP meds currently, super low dose Amlodipine almost killed me