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NeverskipLegDay01
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+ 13 Telmisartan - Why it’s a unique ancillary for BB

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Hello Eroids,
Since there are so many questions around blood pressure management and general health support on cycle I thought I write a article about my favorite ancillary drug for BB.
I researched many different drugs for a couple of years now. Will link all studies below.

Telmisartan:
What it is: Telmisartan is an angiotensin 2 receptor blocker that is used to treat high blood pressure, kidney failure and diabetic kidney disease.(1)

It has many more benefits for enhanced athletes as you will see here.

Angiotensin gets built in the renine angiotensine aldosterone system (RAAS). Steroids are known to impact this system. Since angiotensine has a vasoconstrictive function, an elevation in it will cause worse blood flow and thus increased blood pressure.
That’s the first key point of Telmisartan especially for assisted athletes, reducing blood pressure via blocking the RAAS and thus reducing ventricular hypertrophy (2) and visceral fat (3)

The next key point is potent activation of peroxisome profilerator-activated receptor delta (PPARd).
PPARd drives an increase in insulin sensitivity, reduced body weight, reduced adipose tissue, reduced oxidative stress, reduced hepatic fat, reduction in hyperglycemia, decreased triglycerides, increased fatty acid oxidization, increased HDL, enhanced glucose utilization. (4,5)
Telmisartan has shown to hold all these benefits in clinical trials (6,7,8)
Cardarine, a drug with similar effects, research was ceased due to models showing cancer cell growth. (9)
Telmisartan on the other hand has undergone and passed the same carcinogenicity testing as cardarine. (10)
A dosing of 40/mg day has been shown to be an effective dose for all these mentioned purposes.

So for those of you wanting to use a metabolic Modulator, you have the choice between 2 drugs, one that hasn’t pass testing and one that has.

Especially assisted athletes who obviously put more stress on the cardiovascular and RAAS system with steroids and those maybe predisposed with cardiac conditions could hugely benefit from adding an ARB like Telmisartan to their ancillary drug regiment.

(1): “Telmisartan Monograph for Professionals”. Drugs.com. American Society of Health-System Pharmacists. Retrieved 3 March 2019.

(2): Raman VK, Lee YA, Lindpaintner K. The cardiac renin-angiotensin-aldosterone system and hypertensive cardiac hypertrophy. Am J Cardiol. 1995;76(13):18D‐23D. doi:10.1016/s0002-9149(99)80487-1

(3): Chujo D, Yagi K, Asano A, et al. Telmisartan treatment decreases visceral fat accumulation and improves serum levels of adiponectin and vascular inflammation markers in Japanese hypertensive patients. Hypertens Res. 2007;30(12):1205‐1210. doi:10.1291/hypres.30.1205

(4) Risérus U, Sprecher D, Johnson T, et al. Activation of peroxisome proliferator-activated receptor (PPAR)delta promotes reversal of multiple metabolic abnormalities, reduces oxidative stress, and increases fatty acid oxidation in moderately obese men. Diabetes. 2008;57(2):332‐339. doi:10.2337/db07-1318

(5) Oliver WR Jr, Shenk JL, Snaith MR, et al. A selective peroxisome proliferator-activated receptor delta agonist promotes reverse cholesterol transport. Proc Natl Acad Sci U S A. 2001;98(9):5306‐5311. doi:10.1073/pnas.091021198

(6) Feng X, Luo Z, Ma L, Ma S, Yang D, Zhao Z, et al. (July 2011). “Angiotensin II receptor blocker telmisartan enhances running endurance of skeletal muscle through activation of the PPAR-δ/AMPK pathway”. Journal of Cellular and Molecular Medicine. 15 (7): 1572–81. doi:10.1111/j.1582-4934.2010.01085.x

(7) He H, Yang D, Ma L, Luo Z, Ma S, Feng X, et al. (April 2010). “Telmisartan prevents weight gain and obesity through activation of peroxisome proliferator-activated receptor-delta-dependent pathways”. Hypertension. 55 (4): 869–79. doi:10.1161/HYPERTENSIONAHA.109.143958

(8) Li L, Luo Z, Yu H, Feng X, Wang P, Chen J, et al. (March 2013). “Telmisartan improves insulin resistance of skeletal muscle through peroxisome proliferator-activated receptor-δ activation”

(9) Geiger, L.N. & Dunsford, W.S. & Lewis, D.J. & Brennan, C. & Liu, K.C. & Newsholme, S.J.. (2009). Rat carcinogenicity study with GW501516, a PPAR delta agonist. Toxicol Sci. 108.

(10) https://www.ema.europa.eu/en/documents/scientific-discussion/micardis-ep...

BFG's picture

@NeverskipLegDay01 This is your last chance, your final account here. If I sense even a hint of you promo whoring, you're done. Understood?

NeverskipLegDay01's picture

Understood and thank you a lot ! Appreciate the last chance!

Mac12769's picture

Thank you for that read. That's a good medication option depending on one's individual needs. Haven't had BP issues as of yet, but considering a little Dbol kickoff next cycle, and this was a concern. I'll definitely bring this one up to my PCP on my pre-cycle lab check next month. Should be an easy sell for a script to keep on hand for sure.

Caner's picture

super information. Thanks dude . I always have telmisartan . +1

NeverskipLegDay01's picture

Thanks !

Makwa's picture

High BP even just a bit above normal is a slow killer. Something that really needs to be kept in check for long term health. All of the sartans (telmasartan/losartan) etc work on the same pathways. I use losartan which has really helped to keep my BP at acceptable levels. My doc also added HCT which is a mild diuretic and that dropped it 10 more points in combo with the losartan. Now I just need to work on my cholestorol Lol

NeverskipLegDay01's picture

Hey man !
Did you ever try something like enalapril ? Also, did the diuretic make you feel any different, any sides etc ?

Makwa's picture

Never tried enalapril. The diuretic is such low dose that you don't even notice anything.

JEX30Sex's picture

Love this write up. Thank you for this info.

smoke1more's picture

Nice read thanks

Drexyl's picture

Awesome write up! I may take some heat for this, but I would urge anyone and everyone considering any medications for hypertension to see a physician first. All the drugs work by different mechanisms of action. What may work perfectly for some could send you straight to the ER. Manipulating your hormones are one thing, you do not want to play games with your circulatory system.

NeverskipLegDay01's picture

Yes GP should always be first step but unfortunately many of them don’t have a clue or don’t know that there are “safer” options and medications with fewer side effects like Telmisartan is way more tolerable than beta blockers for example. Never had any athlete complain about any sides on Telmisartan, side effects especially sexual on beta blockers are very common though !

press1's picture

Great write up - explains it all well. If there is one thing I wish I paid more attention to in the early days its all the advice I was given to keep an eye on BP and take meds for it if regularly over 130 Systolic. I took the stupid attitude of I don't need BP meds as they are for old people with heart problems and that's not me, I'd rather spend money on gear than BP meds. I had a bit of a mental stigma attached to them. At the same time I'd always be wondering why training was just so damned hard all the time, and why I was so breathless after hard sets etc. Years later now I do take them, I realise its because my BP was way too high which puts a huge strain on the heart trying to pump blood round the body when you are out of breath. Makes a huge difference now things are within range. Then there is the fact the huge BP is blowing out the filters in your kidneys which WILL eventually happen over the years if you continue to run high BP. Ramipril is the med that I use as I can get it on script, where as Telmisartan is less favoured here. Luckily I do not get the ACE inhibitor cough as that was a dread of mine. In fact for all the guys new to steroids reading this, Blood Pressure IMO is the number one thing to watch and to use your money for if you do need to buy tablets for it.

NeverskipLegDay01's picture

That’s 100% right. Blood pressure should be the no.1 priority to get right on top of blood work of course. If one can’t control blood pressure he should either don’t go on a cycle if it’s high to begin with before he has it under control, or stop the cycle because every lb of added body weight and more steroids will only make it worse.
You may don’t feel it know but high blood pressure can and most likely kill you long term.!
I’ve seen dudes running around 170+ systolic consistently which is crazy!

For some people high(ish) blood pressure is also cause by a too high hematocrit.
Since I am not a fan of donating before 54-55 there are so many supplements to reduce it and even the Telmisartan and ACE inhibitors in fact reduce hematocrit ! So one more plus point. Last resort should always be donation because when you donate your body seems to produce more red blood cells faster again and you’ll end up with a higher hematocrit than before donating after a while.

press1's picture

I never realised that buddy, that ACE's reduce Hematocrit! Funny thing is before ever doing gear my BP was perfect, I was also naturally light and extremely fit from lots of mountain biking and tennis and then gradually over the years with the bigger cycles and addition of around 60lb's BW thats a whole different story now. Although once down to low test again I no longer need the meds. I seem to remember one of the reasons Seth Feroce stopped cycling was because whether he donated or kept his gear moderate his hematocrit still got sky high and there wasn't much he could do to stop it.

NeverskipLegDay01's picture

Yes body weight has most likely the biggest impact on blood pressure, so not getting to chubby during off season is a big factor too.

NeverskipLegDay01's picture

Definitely worth trying to start with 40mg/d Smile

NeverskipLegDay01's picture

Keep it in year around especially when gaining.

press1's picture

I actually have some 80mg monsters that I bought a while back lol Ramipril I only take 2.5mg tabs.

NeverskipLegDay01's picture

Welcome