HCTZ and Insulin Resistance

[bg65]

I work in medicine so I can recommend a medication that I personally give and see it’s affect on 100s of people with blood work involved. I know what I’m talking about, that’s why “research” is useless in this situation. When they post a study about bodybuilders taking AAS then we can debate a topic, but I don’t see it, do you?

Were the subjects obese? Did they have other meds on board while taking HCTZ?

The lack of studies on bodybuilders using AAS is definitely a potential issue but that logic could be applied to nearly every medication in existence. If we start refuting studies because they weren't done on bodybuilders we're gonna run out of studies real quick.
A personal example... I've found that tren can give me hyperkalemia. (Maybe inhibits aldosterone?) And although studies on ACE-Is weren't done on AAS using bodybuilders, its still useful for me to know that lisinopril can cause hyperkalemia so i avoid that if running tren. In contrast i have used HCTZ (i know, should follow my own advice and use chlorthalidone haha) with tren as it is a very potent kaliuretic, moreso even than lasix. Info also from studies not done on bodybuilders.
Your personal experience definitely does give weight to your opinion, and i respect that, but you didn't mention that in your post.
This day and age i think we can assume most participants in any study are obese.
With regard to study subjects possibly being on other meds, most bodybuilders i know are fantastic examples of polypharmacy

The bigger issue that prompted my response is that, after coming on this board for like 12 years or so, i don't really understand the vibe or culture that the board is trying to cultivate. Someone can post a thought or opinion w/o citing a study and they can get shit on for that. Someone can post a study to try to support their viewpoint and they can get shit on for that. And then board members lament the lack of useful/meaningful discussion. I mean, i totally get flaming the trolls and douchebags (thank you southernmuscle!) but maybe if people who are genuinely trying got redirected or something instead of mocked it might foster better discussion.

You could have said, i have a lot of experience in this area, have seen those studies, but in my experience... but you just made fun of him for trying to post studies he may have found on Google.
And actually, as far as search engines go, Google is one of the better ones for academics. Yahoo, for example, ranks search findings based on page popularity or traffic while Google's algorithm ranks search findings based on how many other sites cite or link the web pages in the search result. So, unless someone has full access to pub med or a library at an academic hospital Google is pretty decent.

Much respect for someone who works in healthcare, genuinely.

 

[CorgisOnTren]

The lack of studies on bodybuilders using AAS is definitely a potential issue but that logic could be applied to nearly every medication in existence. If we start refuting studies because they weren't done on bodybuilders we're gonna run out of studies real quick.
A personal example... I've found that tren can give me hyperkalemia. (Maybe inhibits aldosterone?) And although studies on ACE-Is weren't done on AAS using bodybuilders, its still useful for me to know that lisinopril can cause hyperkalemia so i avoid that if running tren. In contrast i have used HCTZ (i know, should follow my own advice and use chlorthalidone haha) with tren as it is a very potent kaliuretic, moreso even than lasix. Info also from studies not done on bodybuilders.
Your personal experience definitely does give weight to your opinion, and i respect that, but you didn't mention that in your post.
This day and age i think we can assume most participants in any study are obese.
With regard to study subjects possibly being on other meds, most bodybuilders i know are fantastic examples of polypharmacy

The bigger issue that prompted my response is that, after coming on this board for like 12 years or so, i don't really understand the vibe or culture that the board is trying to cultivate. Someone can post a thought or opinion w/o citing a study and they can get shit on for that. Someone can post a study to try to support their viewpoint and they can get shit on for that. And then board members lament the lack of useful/meaningful discussion. I mean, i totally get flaming the trolls and douchebags (thank you southernmuscle!) but maybe if people who are genuinely trying got redirected or something instead of mocked it might foster better discussion.

You could have said, i have a lot of experience in this area, have seen those studies, but in my experience... but you just made fun of him for trying to post studies he may have found on Google.
And actually, as far as search engines go, Google is one of the better ones for academics. Yahoo, for example, ranks search findings based on page popularity or traffic while Google's algorithm ranks search findings based on how many other sites cite or link the web pages in the search result. So, unless someone has full access to pub med or a library at an academic hospital Google is pretty decent.

Much respect for someone who works in healthcare, genuinely.

Interested to hear more about your story of hyperkalemia on tren. That’s really odd, never heard of that. Did you only notice it on bloodwork, or did you become symptomatic and have to go to the hospital?

 

[bg65]

Interested to hear more about your story of hyperkalemia on tren. That’s really odd, never heard of that. Did you only notice it on bloodwork, or did you become symptomatic and have to go to the hospital?

Thank God i found it on blood work and yeah, i had never heard of it either. I'd have to look up the value but it was well over 5. On all my lab work my whole life I've only had my lipids deranged by AAS, electrolytes, creatinine, blood counts, etc always normal. For a while running test and mast year round with doses varied depending if cruising or blasting. If i add another compound i generally still keep the test and mast. Bloods always good on that combo. This was years ago but i added tren in and that's when i caught the hyperkalemia. I had been taking lisinopril for years already and no hyperkalemia so the tren was the only change in what i was taking.
ARBs can also cause hyperkalemia but are less likely to do so than ACE-Is so i switched to a combo cozaar-hctz and repeated my bloodwork ASAP. All was good. I since switched back to lisinopril but when i run tren again I'll plan to take hctz or chlorthalidone.

 

[CorgisOnTren]

Thank God i found it on blood work and yeah, i had never heard of it either. I'd have to look up the value but it was well over 5. On all my lab work my whole life I've only had my lipids deranged by AAS, electrolytes, creatinine, blood counts, etc always normal. For a while running test and mast year round with doses varied depending if cruising or blasting. If i add another compound i generally still keep the test and mast. Bloods always good on that combo. This was years ago but i added tren in and that's when i caught the hyperkalemia. I had been taking lisinopril for years already and no hyperkalemia so the tren was the only change in what i was taking.
ARBs can also cause hyperkalemia but are less likely to do so than ACE-Is so i switched to a combo cozaar-hctz and repeated my bloodwork ASAP. All was good. I since switched back to lisinopril but when i run tren again I'll plan to take hctz or chlorthalidone.

Very interesting. Glad you caught it on bloodwork before symptoms arised.

 

[bg65]

Very interesting. Glad you caught it on bloodwork before symptoms arised.

Yeah, maybe it never would have gone high enough to cause an arrhythmia but who knows. It shocked me as i opened up my lab results while i was drinking a glass of orange juice, eating a salad w tomatoes and avocado w a side of potatoes and fried banana.
(The meal part may be made up, the shock part was definitely real)

 

[beastmode121]

The lack of studies on bodybuilders using AAS is definitely a potential issue but that logic could be applied to nearly every medication in existence. If we start refuting studies because they weren't done on bodybuilders we're gonna run out of studies real quick.
A personal example... I've found that tren can give me hyperkalemia. (Maybe inhibits aldosterone?) And although studies on ACE-Is weren't done on AAS using bodybuilders, its still useful for me to know that lisinopril can cause hyperkalemia so i avoid that if running tren. In contrast i have used HCTZ (i know, should follow my own advice and use chlorthalidone haha) with tren as it is a very potent kaliuretic, moreso even than lasix. Info also from studies not done on bodybuilders.
Your personal experience definitely does give weight to your opinion, and i respect that, but you didn't mention that in your post.
This day and age i think we can assume most participants in any study are obese.
With regard to study subjects possibly being on other meds, most bodybuilders i know are fantastic examples of polypharmacy

The bigger issue that prompted my response is that, after coming on this board for like 12 years or so, i don't really understand the vibe or culture that the board is trying to cultivate. Someone can post a thought or opinion w/o citing a study and they can get shit on for that. Someone can post a study to try to support their viewpoint and they can get shit on for that. And then board members lament the lack of useful/meaningful discussion. I mean, i totally get flaming the trolls and douchebags (thank you southernmuscle!) but maybe if people who are genuinely trying got redirected or something instead of mocked it might foster better discussion.

You could have said, i have a lot of experience in this area, have seen those studies, but in my experience... but you just made fun of him for trying to post studies he may have found on Google.
And actually, as far as search engines go, Google is one of the better ones for academics. Yahoo, for example, ranks search findings based on page popularity or traffic while Google's algorithm ranks search findings based on how many other sites cite or link the web pages in the search result. So, unless someone has full access to pub med or a library at an academic hospital Google is pretty decent.

Much respect for someone who works in healthcare, genuinely.

I understand your frustration.

“Can cause hyperkalemia” and “will cause hyperkalemia” are totally different.

Any drug has side effects, and ARBs are more notorious to cause hyperkalemia than ACE inhibitors.

Now, I and many others been using telimsartan for years and never once I had hyperkalemia.

Last point I want to make here, situations differ, for an example:
When you say this “medication” will lower blood pressure, and post a study, it doesn’t have to be done on bodybuilders.

But when it has to do with bodybuilding like insulin resistance; we’re going to need this study to be done on people who are active not couch potatoes.

Good day

 

[bg65]

i really dont want to get into an unfriendly exchange, i absolutely respect your input, experience and time but after i had posted, regarding hyperkalemia, that ACEis >ARBs and you said ARBs > ACEis i just figured that was not a good service to our community to have two opposing statements standing. i obviously dont know what you do in healthcare, although it sounds frontline, but i may have an unfair advantage working with a lot of nephrologists. i had never bothered to look up a study regarding this topic before. where i got my information was when my labs showed hyperkalemia and i talked with a nephrologist friend about it at work (i didnt tell her about the tren obviously haha although i do get frequent quips/jokes at work about AAS). she was the one who told me to ditch lisinopril and take cozaar-hctz. she explained it had something to do with ACEis inhibiting the whole renin-angiotensin-aldosterone pathway whereas ARBs only block the receptor for angiotensin II type 1. she referred to it as "aldosterone escape" although, admittedly, i have never really delved into studying that. also, this AM, i texted a different nephrologist friend and she said that as far as she knows that both ACEis and ARBs are essentially equal risk, so there's that. regardless, as you have pointed out (or at least implied, dont have time to re-read everything) most of these studies are done on people with other medical conditions. with that said, however, a common thread in the studies is patients with CKD and i do think there's a good number of bodybuilders walking around with CKD, whether they know it or not. the biggest take home i would like our community to implement is that if/when someone starts an ACEi/ARB it is wise to check your chemistry panel a week or two later just to make sure the kidneys are doing well with the new med, especially guys who are also taking beta blockers as these in combination with ACEi/ARBs increase the risk of hyperkalemia. i am always a big advocate for use of either ACEi/ARBs for bodybulders, a main reason being the protection imparted against cardiac remodeling.

i also better understand now that last point you made...
"Last point I want to make here, situations differ, for an example:
When you say this “medication” will lower blood pressure, and post a study, it doesn’t have to be done on bodybuilders.

But when it has to do with bodybuilding like insulin resistance; we’re going to need this study to be done on people who are active not couch potatoes."

• Published: 14 October 2021

A comparative study assessing the incidence and degree of hyperkalemia in patients on angiotensin-converting enzyme inhibitors versus angiotensin-receptor blockers​

• Jonathan R. Salik,
• Sara B. Golas &
• Thomas H. McCoy

Journal of Human Hypertension volume 36, pages485–487 (2022)Cite this article

• 198 Accesses
• 1 Citations
• 4 Altmetric
• Metricsdetails

Overview​

Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers (ARB) are the most commonly prescribed anti-hypertensive medications in the United States, yet whether ACEI or ARB use is associated with a greater risk of hyperkalemia remains uncertain. Using real-world evidence from electronic health records, our study demonstrates that treatment with ACEI is associated with both a higher incidence and greater degree of hyperkalemia than treatment with ARB in adjusted models, especially in patients with chronic kidney disease. Providers should therefore consider this possible difference in hyperkalemia risk when choosing between ACEI and ARB therapy.


this thread started with talking about HCTZ and insulin resistance?! hahaha

 

[aHarness]

i really dont want to get into an unfriendly exchange, i absolutely respect your input, experience and time but after i had posted, regarding hyperkalemia, that ACEis >ARBs and you said ARBs > ACEis i just figured that was not a good service to our community to have two opposing statements standing. i obviously dont know what you do in healthcare, although it sounds frontline, but i may have an unfair advantage working with a lot of nephrologists. i had never bothered to look up a study regarding this topic before. where i got my information was when my labs showed hyperkalemia and i talked with a nephrologist friend about it at work (i didnt tell her about the tren obviously haha although i do get frequent quips/jokes at work about AAS). she was the one who told me to ditch lisinopril and take cozaar-hctz. she explained it had something to do with ACEis inhibiting the whole renin-angiotensin-aldosterone pathway whereas ARBs only block the receptor for angiotensin II type 1. she referred to it as "aldosterone escape" although, admittedly, i have never really delved into studying that. also, this AM, i texted a different nephrologist friend and she said that as far as she knows that both ACEis and ARBs are essentially equal risk, so there's that. regardless, as you have pointed out (or at least implied, dont have time to re-read everything) most of these studies are done on people with other medical conditions. with that said, however, a common thread in the studies is patients with CKD and i do think there's a good number of bodybuilders walking around with CKD, whether they know it or not. the biggest take home i would like our community to implement is that if/when someone starts an ACEi/ARB it is wise to check your chemistry panel a week or two later just to make sure the kidneys are doing well with the new med, especially guys who are also taking beta blockers as these in combination with ACEi/ARBs increase the risk of hyperkalemia. i am always a big advocate for use of either ACEi/ARBs for bodybulders, a main reason being the protection imparted against cardiac remodeling.

i also better understand now that last point you made...
"Last point I want to make here, situations differ, for an example:
When you say this “medication” will lower blood pressure, and post a study, it doesn’t have to be done on bodybuilders.

But when it has to do with bodybuilding like insulin resistance; we’re going to need this study to be done on people who are active not couch potatoes."

• Published: 14 October 2021

A comparative study assessing the incidence and degree of hyperkalemia in patients on angiotensin-converting enzyme inhibitors versus angiotensin-receptor blockers​

• Jonathan R. Salik,
• Sara B. Golas &
• Thomas H. McCoy

Journal of Human Hypertension volume 36, pages485–487 (2022)Cite this article

• 198 Accesses
• 1 Citations
• 4 Altmetric
• Metricsdetails

Overview​

Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers (ARB) are the most commonly prescribed anti-hypertensive medications in the United States, yet whether ACEI or ARB use is associated with a greater risk of hyperkalemia remains uncertain. Using real-world evidence from electronic health records, our study demonstrates that treatment with ACEI is associated with both a higher incidence and greater degree of hyperkalemia than treatment with ARB in adjusted models, especially in patients with chronic kidney disease. Providers should therefore consider this possible difference in hyperkalemia risk when choosing between ACEI and ARB therapy.


this thread started with talking about HCTZ and insulin resistance?! hahaha

They always get derailed from what I can see, so no worries