I’m back on testosterone therapy again with my primary doc. 0.3mL twice a week (120mg) of test cypionate. My bloodwork recently was phenomenal except for the low free and total test (271). Last time I got in TRT, my blood pressure went up and my resting HR. I’m 5’10” and 205lbs. I’m really concerned about my blood pressure and all again. I wanted enclo, but my doc of 30+ years did the 💉 again. Any suggestions? Thank you.

To clarify, was your recent bloodwork with the before or after you restarted TRT? That would be odd for you to have low T levels with the dose you listed (120mg/wk).

Enclomiphene, as well as its cousin clomiphene, are still not approved by the FDA for use in men, and their use is entirely off-label use for men for hypogonadism. In addition, there still are very few long-term studies on its effectiveness or safety, so more conservative doctors will likely be uncomfortable with use of enclomiphene and go with a more tried and true method of TRT.

In regards to blood pressure, there are some studies that TRT lowers blood pressure, and some that show it raises it. In those that show an elevation, there are two prior culprits, the first being an increase in hematocrit, and the second being an increase in estrogen.High hematocrit causes thicker blood, which results in increased arterial resistance. Also, because testosterone metabolism produces estradiol and estrogen retains sodium (ie. women complaining of bloating right before menses), men who are on TRT who do not control their estradiol levels are more likely to have a high sodium content, which causes fluid retention, resulting in increased blood volume and high blood pressure.