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Testosterone and High Blood Pressure

There has been quite a bit of buzz about the possible threats to heart health with testosterone replacement therapy (more on that later), but the media and lawyers’ ads are missing the more common issue: What is the link between therapy to replace testosterone and high blood pressure?

At the “heart” of cardiovascular disease lies the propensity of the body to form clots and blood pressure. Blood pressure changes often arise when blood becomes thicker. The true issue at hand is how testosterone affects the thickness of blood.

So, let’s take a look at how testosterone can make your blood thicker, and how that can relate to blood pressure changes in patients using this medication.

testosterone-high-blood-pressureIs There a Link Between Testosterone and High Blood Pressure?

Testosterone has a suppressive effect on a peptide hormone called pepcidin. It was only recently discovered, but it is known to be a regulator of iron absorption. It is primarily made in the liver, and when suppressed, it can lead to increased iron stores in the blood.

It is the job of your bone marrow to make red blood cells (RBC’s), and a primary component is iron. When the bone marrow sees more iron, it makes more RBC’s. This is a good thing, to a point. Red blood cells hold hemoglobin, and hemoglobin carries oxygen. More oxygen is good, but more red blood cells may not be.

Obtaining more red blood cells and oxygen carrying capacity is the reason people who compete in endurance sports train in the mountains. If you are a marathon
runner or cyclist training at altitude, your body responds by making more RBC’s and helping you to breath more efficiently even in “thin air” environments. Blood doping is the easier, but illegal way around this.

With secondary erythrocytosis or secondary polycythemia (increases in RBC’s due to outside factors) there is a point where this can pose a health risk.

What Does Having Too Many Red Blood Cells Do?

Red blood cells are the solid portion of blood. So, if you increase the solid portion, but don’t increase the liquid portion (plasma), the solution becomes thicker. This higher viscosity blood exerts more pressure on the cardiovascular system.

Learn more about the side effects of testosterone replacement therapy or contact us with your questions.



(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.


  1. Kenny Rice on 03/22/2017 at 6:58 am

    I’m currently taking enthante and I’m bloated. Getting my Blood Pressure checked today.
    Having hip replacement surgery on 4/18. Trying to build up strength. Had the other one done last month it was easy.
    What steroid do I take to relieve the bloating?

    • Augie Galindo on 03/30/2017 at 5:49 pm

      Mr. Rice,

      Bloating is not an issue due to testosterone itself, but rather estrogen. Whoever is prescribing your TRT should be checking and mitigating your estradiol levels regularly.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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