Blood Pressure & Hematocrit Hacks: What actually moved the needle for you?
Hey everyone,
Wanted to drop a thread on something I think a lot of guys gloss over until their bloodwork comes back looking like tomato paste: managing blood pressure and hematocrit on heavier blasts.
We all know the standard cookie-cutter responses: "Take 40mg Telmisartan, donate blood, do LISS cardio."
While those work, they don't always tell the whole story—especially when hematocrit sits at 52%+ or diastolic BP creeps into the upper 80s/90s during a wet or heavy cycle.
I wanted to open up a discussion on what specific ancillary protocols, lifestyle tweaks, or dietary additions have given you guys measurable, trackable results on your labs/cuff.
A few points I’ve been analyzing and experimenting with:
1. Hydration & Electrolyte Ratios: Most guys track water, but balancing high sodium with high potassium (3,000–4,000mg+) made a noticeable shift in my resting diastolic within 7 days.
2. Telmisartan vs. Nebivolol: Telmi is the gold standard for ARBs, but Nebivolol (5mg) seems to be superior for lowering resting heart rate without messing with lipid profiles or exercise capacity. Anyone combining low-dose of both?
3. Phlebotomy / Blood Donation vs. Grapefruit Seed Extract / Nattokinase: Donating blood drops HCT fast, but it can crush ferritin if done too often. Has anyone successfully managed red blood cell density strictly through daily cardio + high-dose Nattokinase/Grapefruit extract without tanking iron?
4. Cardio Protocols: LISS vs. Zone 2—does 30 mins 5x/week actually bring your numbers back to baseline on 500mg+ test, or do you have to scale up to keep the heart happy?
Curious to hear from the experienced guys who actually log their daily cuff readings and run regular panels. What’s your go-to stack or protocol when your BP starts creeping into Stage 1 territory mid-blast?
Drop your protocol and bloodwork experiences below.
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Olemesartan 10mg
Clinidipine 20mg
Cialis 10mg
Can’t do nebivolol, gives me strange anxiety. The cleanest bp med for me is clinidipine/amlodipine but I can only take so much before I get real bad edema. 5mg amlodipine or 20mg clinidipine which is why I chose clinidipine, I can run it higher. 20mg is equivalent to 10mg amlodipine.
Could run olemesartan higher but don’t need to. I prefer to run lowest effective dose.
Cialis helps a bit too. Great gym pumps and all kinds of pumps really.
Donating double red twice a year
Obviously ancillaries play a huge role in controlling both hct and bp as many have stated.
Some things that people may forget about controlling the two…
Being low body fat percentage
Low moderate iron intake
Cardio
Removing nicotine or other vasoconstrictors
My daily ancillaries as prescribed by my Indian doctor:
Telmisartan 80mg
Nebivolol 5mg
Eplerenone 50mg
Ezetimibe 10mg
Cabergoline 0.5mg (per week)
Rosuvastatin 10mg
T4 100mcg
T3 100mcg
Clen 120mcg
Also take Injectable glutathione 1200mg / wk, and all the main supps / vitamins you'd expect. Have been running high dose taurine and potassium for debloat and clen cramps. Effective.
This is what everyone should be on to stay as healthy as possible, people take AAS but not preventative care, thyroid hormones is a little more difficult to dial in and clen isn’t necessary but solid
I probably shouldn't have included the clen since running at this dose is specifically for my fat burning protocol, same with the higher dose of T3.
Although I am seeing reports suggesting clen and t3 at low doses is beneficial to run long term. Have not validated this though.
Think i saw the same study but the doses ranged from 20-40mcg, clen fucked me good at 40mcg so im trying out mirabegron instead of beta 2 agonist its a beta 3 agonist, doesnt burn as much fat but seems like a good add on
Get labs for sensitive E2. If it is high get it to a normal range. Everyone is different. My sweet spot on E2 is 15-25. Anything higher and I have water retention, high bp, hematocrit goes up 3-5 points. No processed food. And the most important part is taking the lowest effective dose. If I go over 100mg of test these days my hematocrit goes up with the dose.
Also, masteron helps with water retention and for sure lowered my Bp caused by the excess water. But everyone is different
Always keep my cardio in my training programs even if it’s a brisk walk for 15 min . I also do therapeutic phlebotomy ordered by my doctor to maintain a certain hemoglobin level. If I’m in range I donate dump blood that month. Lastly I am on Telmasartan/hcl combo which has my bp the best it’s been in years . Gotta maintain overall health for longevity . Full blood panel every 6 months plus pre and post cycle labs .
To Teabody's point, this is what happened when my doctor thought draining 400ml a month for 4 months was a good idea. Feeling tired all the time is no way to live. The worst part about depleted iron is it takes MONTHS to recover, and thats with supplemental iron tablets. Do not donate more than once or twice a year, and only as a last resort. Honestly if your HCT is high enough to warrant phlebotomy, reconsider your doses and the other things mentioned in this thread.
Thats where im at homie. I was giving whole blood every month until 2 months ago. Did that shit for 8 months. Im just now losing some of the fatigue.
Never again man, its been pretty rough. Some of these doctors are living in the stone age. We got enough info at our fingertips to handle most things on our own outside of dire emergencies.
Yea man, I didn't realize supping my iron wouldn't allow me to recover. I started thinking I was getting cancer or some shit. I'd sleep through the night, then if I was at my desk for more than 5 minutes I would just pass the fuck out.
Ferritin was down to 20, iron was 33. Felt like a fuckin zombie.
Man, seeing those labs posted makes it crystal clear—a ferritin of 25 and TSAT at 11% is brutal. That fatigue is no joke. Really appreciate you sharing the actual panels here. It’s a huge warning for guys who just blindly hit the blood bank every 6–8 weeks without checking ferritin.
Yup. And dietary iron doesnt really move the needle, so im taking 60mg supplemental alongside 250mg vitamin C every other day. And it is estimated to be 6-8 months before I am fully saturated again.
Telmisartan 40mg daily for BP, I like it split.
Diet, low sodium intake, low water retention, and dipping on water nonstop all day for Hemo. I used to donate blood in the regular but that fucks up your ferritin levels.
Beyond the basics; hydration, cardio, meds, everyone should be tested for sleep apnea. When you stop breathing your body makes red blood cells to make up for lack of oxygen. ANd high hemtocrit pushes bp higher.
For hematocrit, something alot of guys dont address is sleep apnea. They either dont think they have it or think its not a big deal. Alot of us spend so much time and money on this lifestyle, but many wont even get a sleep study done. Ive used a CPAP for many years, and only recently found the perfect machine setup. I was dealing with mid-50s hct, now its under 50 again in a matter of a few months.
Telmisartan kinda pulls both these levers, lowering BP as well as lowering hct. Only gonna see a 1 or 2 point drop in hematcorit, but for guys that are borderline high, thats a big deal. Something we all should consider.
Everyone should be doing cardio daily. I like 30 minutes of zone 2 every day. I honestly fucking hate it LOL, its boring, but it helps both bp and hct.
Dont get too fat in the offseason. High bodyfat will negatively impact both.
And ill say it again, GET A SLEEP STUDY. Especially yall over 200lbs or with a big ass neck.
I’ve suspected I’ve had sleep apnea. My wife says sometimes I jerk in my sleep so hard I like punch the headboard. I have no memory of that. And right when I wake up my heart rate spikes to like 100. I have it checked every 5 min in my sleep and it’s always 70s but right when I wake up it jumps. Does that sound like it ?
Its possible. If you snore at all its a good indicator as well. I went in for a sleep study because my wife said I would stop breathing for like 30-40 seconds at a time, then gasp, then go back to snoring. SO I was asleep, but not getting good sleep. Best
to ask your doc for a sleep study to be sure
Nope no snoring at all. Just ask your pcp that’s all? Any online tele health sleep apnea people ?
Go to a sleep specialist and do an at home sleep test. Depending on your insurance you may need to get a referral from you pcp. It has been a life changer for me. I was having 30-40 apnea episodes an hour. Now I have maybe 1 an hour or less.
There may be online options, but I honestly dont know. I got my initial check through the VA, but your pc should be able to show you the right direction
I’ve had hypertension most of my life, I’m on low dose of amlodipine, but it didn’t change much. Good hydration and diet is where results are. Low sugar low salt, lots of water.
I just ordered a heart stack, telm and ezitimibe or however it’s spelled. Even though losing 25 pounds and changing eating habits, my bp still hovers around 130s/90s. I can sometimes feel a rush of adrenaline with a spiked heart rate, clammy skin, I’m assuming it’s that. Hoping to get it down to your numbers.
We’re all different, you’ll get there. I’ve ran different cycles, nothing affected me like equipoise. It took a little while to work, but great pumps and vascularity, unfortunately my BP hit 160/100 and stayed there for a little over a month no matter what I did. EQ is not for me. But test, mast, even dbol at a reasonable dosage was never a problem as long as I ate correctly. I’d have 2 cheat meals a week, the rest of the time I was eating like a monk. Moderate cardio work, nothing crazy, usually 15min on the treadmill just to get the blood moving. From now on (hopefully starting next week) it’ll be the stationary bike because of my neck, no more running.
Solid numbers right there—110/67 on or off blast is as good as it gets. Did you stay on the low-dose Amlodipine alongside the diet changes, or were you able to drop it completely once your nutrition dialed in?
Thanks bro. I’m on the amlodipine and 5mg off rosuvastatin. My numbers weren’t terrible, but my doc aims to get the numbers as close to perfect as possible with minimal meds. If I quit smoking I could probably drop the amlodipine. If I quit the occasional cheesesteaks I could drop the statin, but we have to live a little right? lol. All jokes aside, I’ve found that most issues (my cholesterol and triglycerides are inherited) can be fixed by diet and hydration. Many will say they eat clean, but I’d bet most people with high blood pressure drank a gallon of water a day and
Rye or wheat toast with sugar free spread or peanut butter for breakfast
An apple or banana mid morning maybe with unsalted nuts
6oz of chicken or fish with rice and a vegetable (preferably raw) with low fat dressing for lunch
Repeat snack #2 with a different fruit or a vegetable
8oz of chicken, lean meat, or fish with vegetables (again raw) and a small portion of simple carbohydrates for dinner
Throw in a protein shake if cravings hit
Do that for two weeks and stick to it, I pretty much guarantee BP will drop to the 115/70 levels, but most people will cheat, they’ll follow a similar diet and do well, then eat a bag full of McDonald’s and say “See, diets don’t work.” Soda is a huge culprit too.
Listen, if occasional cheesesteaks and a cigarette are the price we pay to keep 110/67 stats, I’d say the pharma gods and your doctor are doing something right! --
You hit the nail on the head though—guys will run 700mg of gear, smash a double Big Mac meal with a 32oz soda, and then act shocked when their cuff reads like a pressure washer. Respect for keeping it real on the diet and layout!
Get yourself a decent pulse oximeter if your budget allows as well. Between a decent BP machine, a pulse oximeter, and glucose meter, you can give yourself basically a mini physical. If things get out of whack, see your physician or get some bloods done. Remember, with your physician, you took B12 not steroids, you don’t want to risk being dropped by your insurance. There’s expensive ways around that, but just use common sense.