Blood Pressure

[newguy2]

I've been adding meds and still not happy with BP.

Currently protocol is
Telmisartan 80mg (PM dosing)
Ciln 10mg (PM dosing)
Cialis 5mg (AM dosing)

I've been on the telm for a month but went to 80mg a week ago and been on ciln for a week.

I have two monitors, these were today AM readings:
148/74
140/75

My 600mg test cycle ended 10-17 and I restarted trt @120mg on 10-31.

Restarted GH at 1iu just two days ago.

Reta @3mg a week.

I'm taking celebrex and read it can impact BP. I was accidentally doubling the dose at 400mg instead of 200mg. Cut that out 5 says ago completely AI said whatever impact that has should be cleared.

I'm kind of at a loss as to what could have my bp so high still.
Chatgpt said maybe hematocrit. But from labs peek blast on 10/10 I was

Hema: 50.9
Hemo: 16.5

So not terrible. Any thoughts folks?

 

[Ghoul]

I've been adding meds and still not happy with BP.

Currently protocol is
Telmisartan 80mg (PM dosing)
Ciln 10mg (PM dosing)
Cialis 5mg (AM dosing)

I've been on the telm for a month but went to 80mg a week ago and been on ciln for a week.

I have two monitors, these were today AM readings:
148/74
140/75

My 600mg test cycle ended 10-17 and I restarted trt @120mg on 10-31.

Restarted GH at 1iu just two days ago.

Reta @3mg a week.

I'm taking celebrex and read it can impact BP. I was accidentally doubling the dose at 400mg instead of 200mg. Cut that out 5 says ago completely AI said whatever impact that has should be cleared.

I'm kind of at a loss as to what could have my bp so high still.
Chatgpt said maybe hematocrit. But from labs peek blast on 10/10 I was

Hema: 50.9
Hemo: 16.5

So not terrible. Any thoughts folks?

You have ARB and CCB covered. The only other “normal” mechanism of action for BP control is a diuretic. Needing all three is not that uncommon, and combo pills with all three are available because of that.

If all three don’t bring BP under control (below 130) you have “resistant” hypertension, which needs a different approach.

 

[trtchin]

Anyone have any insight here.

AM reading I am generally always in the 120s, sometimes a bit lower. Before bed I am always 130+, never seen 140.

I generally stop all caffine by 1 pm or so.

Any lifestyle changes that could help?

 

[newguy2]

You have ARB and CCB covered. The only other “normal” mechanism of action for BP control is a diuretic. Needing all three is not that uncommon, and combo pills with all three are available because of that.

If all three don’t bring BP under control (below 130) you have “resistant” hypertension, which needs a different approach.

Any ideas on specifics of a different approach? I've never had high BP, usually in the 120's until about half way through my first cycle.

Frustrating honestly.

 

[Ghoul]

Anyone have any insight here.

AM reading I am generally always in the 120s, sometimes a bit lower. Before bed I am always 130+, never seen 140.

I generally stop all caffine by 1 pm or so.

Any lifestyle changes that could help?

Not an unusual amount of circadian variation. Treatment is based on averages, and yours seems relatively low.

The usual lifestyle changes would be lower sodium, lose weight, more cardio.

If that doesn’t help, a low dose med would be reasonable, like 20mg Telm, which would bring the high down, but not drop the morning numbers too much.

 

[trtchin]

Not an unusual amount of circadian variation. Treatment is based on averages, and yours seems relatively low.

The usual lifestyle changes would be lower sodium, lose weight, more cardio.

If that doesn’t help, a low dose med would be reasonable, like 20mg Telm, which would bring the high down, but not drop the morning numbers too much.

Thanks. I generally do 150 mins LISS per week. Sometimes do some intervals but its not super intense stuff.

Seeing my cardiologist in 2 weeks I am going to try to push for the 20 mg telm. Dont mind to pay for it but would rather get it for free if possible.

 

[Crobg52]

Currently on 40mg pharma telmisartan with BP 120/90, as coming down to a cruise **with crushed e2 at 8pg/ml**. Not sure if thats the cause of the diastolic rise but have read it could be. Beta blockers have 0 effect on HR (resting between 85-95 with an increase during gym that stays elevated 30-45 mins post at around 105) oand diastolic currently. Lipid panel not great, slightly out of range by 4 pts on ldl(104) , hdl was 36 trigs 170 so started ezetimibe 10mg last week.

Would anyone recommend adding amlodipine as I have it on hand (pharma) for the diastolic, or am I at risk for further pushing down of systolic in a negative low range?

Also ordering the telma-cip combo as we speak for future runs from india.

14 days in on 40mg telmi, 5mg amlodipine, and bp at night seems to remain at 120/90 manual reading, it did drop slightly to 120/87 a few times.

My bp machine (2 different machines) gave me 132/74 and 132/72 this morning, so I assume they have to be fairly correct. I dropped down to trt (150mg/wk) about 2-3 weeks ago, with eq likely still pulling down e2(800mg/wkEQ before pulled and dropped to trt) E2 was about 8pg/ml on the 17th of october.

What direction should I go?

 

[Ghoul]

Any ideas on specifics of a different approach? I've never had high BP, usually in the 120's until about half way through my first cycle.

Frustrating honestly.

If your BP is normal off cycle, these wouldn't be appropriate for you, just mentioning it for future reference if it does become a problem off cycle. One involves a quick procedure using radio waves to ablate (cut off) a few small nerves that “squeeze” the kidneys raising BP, and the new meds reduce excess aldosterone, which was recently established as the major root cause of resistant hypertension (this is a major breakthrough).

IMO, even before adding a diuretic, try 20mg Ciln. AAS raises baseline adrenaline, basically increasing physical stress (and therefore BP), and Ciln is very effective at reducing that. But it’s been observed that below a certain cutoff it’s not effective in some people.

In other words, going from 10 to 20 can go from ineffective to effective.

If this starts working after giving it a week, you could lower Telm to 40 of you like. Not because there’s a risk of hypotension, but because if the Ciln 20 works, 80mg Telm is likely unnecessary since these meds are hitting completely different targets.

 

[Ghoul]

Thanks. I generally do 150 mins LISS per week. Sometimes do some intervals but its not super intense stuff.

Seeing my cardiologist in 2 weeks I am going to try to push for the 20 mg telm. Dont mind to pay for it but would rather get it for free if possible.

The easiest way would be to fib about your numbers at home, to be honest. “I’m seeing 135-140 / 80-85 morning and night, I’ve tried lifestyle changes but the numbers haven’t moved. I’m focused on long term health, so I’d like to try low dose Telmisartan, 20mg, which seems to have a low risk of side effects. “

I doubt they’d object. It’s a cheap, safe generic.

 

[newguy2]

If your BP is normal off cycle, these wouldn't be appropriate for you, just mentioning it for future reference if it does become a problem off cycle. One involves a quick procedure using radio waves to ablate (cut off) a few small nerves that “squeeze” the kidneys raising BP, and the new meds reduce excess aldosterone, which was recently established as the major root cause of resistant hypertension (this is a major breakthrough).

IMO, even before adding a diuretic, try 20mg Ciln. AAS raises baseline adrenaline, basically increasing physical stress (and therefore BP), and Ciln is very effective at reducing that. But it’s been observed that below a certain cutoff it’s not effective in some people.

In other words, going from 10 to 20 can go from ineffective to effective.

If this starts working after giving it a week, you could lower Telm to 40 of you like. Not because there’s a risk of hypotension, but because if the Ciln 20 works, 80mg Telm is likely unnecessary since these meds are hitting completely different targets.

Ok that's helpful thank you. I keep expecting the BP to come down since I've stopped the cycle. I know after 3.5 weeks my hormones are potentially still elevated. Just thought I would see a more significant drop by now. I'll bump the ciln to 20 and see how that goes.

 

[Gonz0]

@Ghoul just wanted to say thank you for recommending clinidipine. Nothing has ever improved my blood pressure like this , I originally was going to take 40/5/2.5 telmisartan/ nebivolol / clinidipine but that was actually lowering my diastolic too much so instead I switched to 80/5 telmisartan/clinidipine and that’s working great even on a relatively heavy cycle. It’s crazy they don’t offer it in the states but they have no issue prescribing amlodipine lol

 

[Ghoul]

@Ghoul just wanted to say thank you for recommending clinidipine. Nothing has ever improved my blood pressure like this , I originally was going to take 40/5/2.5 telmisartan/ nebivolol / clinidipine but that was actually lowering my diastolic too much so instead I switched to 80/5 telmisartan/clinidipine and that’s working great even on a relatively heavy cycle. It’s crazy they don’t offer it in the states but they have no issue prescribing amlodipine lol

Great to hear your success story.

Ciln excels are reducing BP caused by elevated stress hormones, unlike other BP meds, with the L calcium blocking acting like Amlodipine, and N calcium only really kicking into high gear when brain initiated stress ramps up (a common gear, or aggravation lol, induced condition).


Because it’s going to be approved under a special program as an “orphan drug” for a rare disease (systemic Scoliosis), despite the fact it’s a dirt cheap generic for blood pressure in Asia, it’ll be treated as a newly invented drug in the US, and pharma business analysts estimate it to go on the market for, get this, $218,000 / year. Or $597.00 per 10mg once a day tablet!!

 

[Gonz0]

Great to hear your success story.

Ciln excels are reducing BP caused by elevated stress hormones, unlike other BP meds, with the L calcium blocking acting like Amlodipine, and N calcium only really kicking into high gear when brain initiated stress ramps up (a common gear, or aggravation lol, induced condition).


Because it’s going to be approved under a special program as an “orphan drug” for a rare disease (systemic Scoliosis), despite the fact it’s a dirt cheap generic for blood pressure in Asia, it’ll be treated as a newly invented drug in the US, and pharma business analysts estimate it to go on the market for, get this, $218,000 / year. Or $597.00 per 10mg once a day tablet!!

That’s insane , I love how the fda always has our best interest ! I feel bad for the people that depend on medications like this and are not familiar with Indian pharma.

 

[Champion7164]

I mostly lurk, but wanted to thank the people in this thread who provided great suggestions. I had my doctor change my meds and received great results. Not on any gear, just always had elevated blood pressure.

Pre-switch from Losartan: 137/87
Post-switch to Telmisartan: 116/79

Stack:
Amlodipine 10 mg
HCTZ 25 mg
Telmisartan 40 mg

 

[malfeasance]

Wow, 25mg of HCTZ would have me completely cramped up and unable to function, much less workout intensely in the gym.

And the amlodipine would give me cankles.

 

[Arathorny]

Thanks for all the info in here! What at home blood pressure monitors are you guys using? Got one off of Amazon but it’s been giving me readings all over the place.

 

[Champion7164]

Thanks for all the info in here! What at home blood pressure monitors are you guys using? Got one off of Amazon but it’s been giving me readings all over the place.

Amazon: iHealth Track Smart Upper Arm Blood Pressure Monitor with Wide Range Cuff That fits Standard to Large Adult Arms, Bluetooth Compatible for iOS & Android Devices.

I like that it syncs over Bluetooth and lets me export the results. The readings have always been consistent, nothing ever seems way off from one day to the next.

 

[Lifting88]

If you dont see a drop from telmasartan is there a good drug to switch it for?

I almost see no reducing from 40 or 80
Im on 40 telma 20 clini 5 tadadefil but i notice after 6 weeks blast bloodpressure slowly raise to 125/130

 

[Almoister]

I would kinda want to know alternative too i have borderline high potasium no matter what i eat so dont think telmisartan is safe for me

 

[TRENdy07]

I switched from nebivolol to amlodipine/telma. I had horrible side effects from amlodipine. Basically all the side effects. Increase heart rate. Edema ect. I’ve had decent success with nebivolol so I guess I’m going to switch back to that for the time being. Might give Cilnidipine/telma a try first? I’ve been out of the loop for a minute. Are the India sites still g2g? Any recent recommendations would be appreciated.