Telmisartan and ARBs/ACE inhibitors are not a preventive cure-all for AAS users

[Type-IIx]

I am seeing a lot of gurus promoting these meds as a prophylactic ("preventive cure-all") for healthy AAS users without providing any cautionary disclaimers whatsoever. These drugs can harm the kidneys (and the liver). They should be used for treatment of hypertension (i.e., when your blood pressure is actually chronically elevated).

These drugs (here, looking at telmisartan specifically, but as a class, this [perhaps aside from drug-drug interactions]) can cause:

1a. potassium dysregulation, e.g. hyperkalemia (increased potassium retention despite its direct action), and 1b. electrolyte imbalance
2. ALT/AST elevation that can complicate oral androgen use
3. severe hypotension for those with salt/electrolyte depletion or prolonged diuretic use
4a. kidney/renal (GFR, eGFR) dysfunction (yes, even though it's used as a therapeutic for diabetic nephropathy - kidney function should be monitored with use of this drug), and with those that have decreased cardiac function (e.g., heart failure) can cause 4b. acute kidney failure

Some drug-drug interactions:
Unfavorable: decreased tamoxifen metabolism; diuretics (this should be obvious)
Unclear: decreased raloxifene excretion resulting in a higher serum level
Favorable (I'd add to the list of benefits): decreased excretion rate of testosterone resulting in a higher serum level
Non-exhaustive list

To summarize @PeterBond from his excellent Article: Measuring and Treating High Blood Pressure in Anabolic Steroid Users, Jul 2021, Source: Measuring and Treating High Blood Pressure in Anabolic Steroid Users - MESO-Rx, which I recommend everyone read:

- One may begin to consider use of ARBs/ACE inhibitors with a blood pressure of 140/90 mmHg if taken at the doctor's office, 135/85 if taken at home. It's also far more advisable to cycle off/reduce dose and make lifestyle changes before the addition of an ARB. Though if higher than 160/100, immediate drug treatment is indicated (as is an urgent call to the doc & cessation of drugs).

- Monitoring health parameters with the use of ARBs/ACE inhibitors:

Do a blood test before and one month after starting (or after an increase in dose), and if everything comes back normal, every half a year. Include creatinine, eGFR and electrolytes. (There are a lot of guidelines with regard to monitoring, but there isn’t too much consensus about it.) Please keep in mind that it takes about 4 to 6 weeks for the full effect of treatment. Ideally you reach a blood pressure below or equal to 130/80 mmHg (but above 120 mmHg).

Peter Bond, Article, Jul 2021, Measuring and Treating High Blood Pressure in Anabolic Steroid Users


Yes, there are recent instances of AAS users on these meds arriving at the hospital in acute renal failure as a result (usually with some other medications that act in concert to cause kidney failure... this danger is real... after cessation of the ARB and other medications, they have avoided dialysis).

 

[Iamnatty]

I have recently got a blood pressure monitor and my blood pressure is high for those of us that workout and everything do you think arb/ace are better than beta blockers. And it seemed that telmisartan didn't even lower my blood pressure very much anyway. I guess it's time to go see a doctor .

 

[Isrrike]

I am on ramipril I’ve noticed through blood work my egfr has lowered over the last 2 years of being on it. I have ordered telmisartan as I read it has kidney protective properties as well. Are you saying this is not the case?

 

[MFAAS]

I have recently got a blood pressure monitor and my blood pressure is high for those of us that workout and everything do you think arb/ace are better than beta blockers. And it seemed that telmisartan didn't even lower my blood pressure very much anyway. I guess it's time to go see a doctor .

Your BP and pulse both seem very high. I notice that your BP is taken at all various times of day? Are you in a rested state or are these measurements post exercise or possibly under stressful circumstances (whether mental or physical)?

Ate you currently running a cycle or anything other than TRT?

I would certainly advise a doctor visit.

 

[supremedonkey]

I've used up to 160mg telmisartan and lowered it to 80mg. Been on for years. My kidney bloods are always excellent. On tren my creatinine is in ref range. Grf 85. It doesn't lower BP very much when compared ramipril for example

I've heard telmisartan makes it harder to get lean and I would like to hear your take on it. I used to stay very lean with very low effort and that doesn't seem to be the case anymore.

I have done stupid things like blasted tren for many years straight and then had a heart ultrasound done. I've pretty much blasted gear non stop for the last decade. There was nothing abnormal found with my heart. Not even enlargement. I've been on cardarine and nebivolol for years too though. I was sure they would find something but who knows. Maybe the drugs prevented it.

 

[Iamnatty]

Your BP and pulse both seem very high. I notice that your BP is taken at all various times of day? Are you in a rested state or are these measurements post exercise or possibly under stressful circumstances (whether mental or physical)?

Ate you currently running a cycle or anything other than TRT?

I would certainly advise a doctor visit.

I been checking it when I wake up and when I goto bed. Been on like 500mg test

 

[Type-IIx]

I've used up to 160mg telmisartan and lowered it to 80mg. Been on for years. My kidney bloods are always excellent. On tren my creatinine is in ref range. Grf 85. It doesn't lower BP very much when compared ramipril for example

I've heard telmisartan makes it harder to get lean and I would like to hear your take on it. I used to stay very lean with very low effort and that doesn't seem to be the case anymore.

I have done stupid things like blasted tren for many years straight and then had a heart ultrasound done. I've pretty much blasted gear non stop for the last decade. There was nothing abnormal found with my heart. Not even enlargement. I've been on cardarine and nebivolol for years too though. I was sure they would find something but who knows. Maybe the drugs prevented it.

Bro, that is great. I will say that you should consider yourself lucky with all those facts. You may be resilient to harms thus far, but getting older can change the playing field.

Don't make the mistake of attributing your being blessed with health despite blasting tren for years straight to telmisartan, cardarine, or nebivolol. Definitely don't stop taking them, but I think it's fair to say that thus far you are one of the individuals that is fairly resistant (an outlier) genetically perhaps... but an important fact for many readers:

Just because you have been healthy despite some decisions, does not mean you have been healthy BECAUSE of them.

And supremedonkey, what has worked to keep you healthy despite much drug abuse would not be likely to work for another, or even most.

 

[barbell001]

If someone is wanting to run AAS and in turn it is giving them High BP then they are going to need some kind of medication to get control of it and bring it down to a safe level. The safest two types of BP medication are ARB's and ACE's and indeed some of them such as Lisinopril are actually designed to protect the kidneys from high BP. My Doctor specifically recommended ACE inhibitors just today to me to protect against Kidney damage caused by high blood pressure and in turn said it will not damage eGFR. I think this article may actually scare people off taking medication for fear of damaging themselves, I know it would put me off if I didn't already know what I do on the subject.

If you are saying these methods are possibly unsafe - then what are you recommending people do instead?

 

[Type-IIx]

If someone is wanting to run AAS and in turn it is giving them High BP then they are going to need some kind of medication to get control of it and bring it down to a safe level. The safest two types of BP medication are ARB's and ACE's and indeed some of them such as Lisinopril are actually designed to protect the kidneys from high BP. My Doctor specifically recommended ACE inhibitors just today to me to protect against Kidney damage caused by high blood pressure and in turn said it will not damage eGFR. I think this article may actually scare people off taking medication for fear of damaging themselves, I know it would put me off if I didn't already know what I do on the subject.

If you are saying these methods are possibly unsafe - then what are you recommending people do instead?

Not sure if you're serious here. Did you read the title post? It's rather brief and states clearly that the intent of this thread is to dissuade prophylactic use of these drugs: quite unlike your being prescribed it for chronic hypertension. These drugs are excellent when their use is indicated, but being an AAS user is not an indication for their use per se.