How are your serum potassium levels on that amount?
Funny you should ask. Potassium came back a little high at 5.4 recently. But in August it was 4.3, and I’m pretty sure I was already at telmisartan 120 at that time. I will recheck in March.
Hmm. I would re-test it to confirm. 5.4 is a bit higher than I would be comfortable with I think.
@DrFraser would you say a Potassium level of 5.4 is high enough to reduce the dose?
I’d tend to get it redrawn as handling of the specimen is critical with potassium levels. If indeed it remains at 5.4, that is not ideal. Having higher range potassium seems healthier until your get over the upper reference level (some labs 5.0, others up to 5.4). Interestingly we see an increased rate of cardiac events in individuals with potassium levels that are elevated - especially if on diuretics. However, it probably matters on what the cause is (e.g. bad kidneys = bad blood vessels = high potassium).
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Thanks all. I will get it redrawn. I suspect/hope its just handling. Typically it’s more in the 4-4.5 range. My kidneys have never been deficient.
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It looks like if you have atrial fibrillation vulnerability, 40mg telmisartan lowers BP, but doesn’t affect AF. In contrast 80mg telmisartan lowers both BP and AF:
Conclusion: The results indicated that telmisartan in low doses was as effective in controlling the blood pressure as in high doses, but high doses of telmisartan had beneficial effects on preventing the recurrence of AF in hypertensive patients.
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It’s an Egyptian paper. However the results appear interesting.
The dose of Telmisartan is 80 mg. HBA1C is reduced by 1.5 (along with variability) which is quite significant!
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I decided to start telmisartan and I had 40mg on Dec 8, then I missed the dose on Dec 9, and then I took 40mg each of the past 4 evenings (including tonight).
Early in the evening yesterday I noticed I felt pretty good. Then I felt really great all day today, and I noticed that I was talking to way more people (at the gym, in a store I went to, and even to a parking lot attendant). Whether I’m consistently initiating conversations with random strangers is probably my best marker for if I’m truly in a good mood.
Anyways, maybe it’s the telmisartan? I remember a couple people in this thread mentioned it positively affected their mood and reduced apathy.
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I never started the Amlodipine because my BP has continued downward average and now averaging:
117/77
I know some see slightly lower as ideal but for me this is PHENOMENAL!
After nearly 2 decades 140/95 averages at the doctor with excuses like “it must just be white coat syndrome” sort of denial, along with “just drop some weight and salt and let’s check in in a few months”.
I dropped the weight (averaged 270 pounds for many years, highest was 329, sometimes crash dieted to 240s) with Tirzepatide and the final few pounds switching to Retatrutide (maintaining health BMI and BRI at 180 pounds, 9mg Reta/week). But even weight loss only dropped BP averages to mid-130s/upper-80s.
40mg daily Telmisartan (thanks @adssx !) and Reta 9mg/week (which has its own BP lowering impact) seems to have gotten me to distance!
Shocked and thankful. Not sure what I’ll do with the year supply of Amlodipine from India now but for less than $70 I’m happy for it to sit unused.
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The telmisartan mood phenomenon is a bit difficult to describe, isn’t it, but your experiences are very much the same as mine. I like your observational metric. It formal tests, it might demonstrate good predictive and discriminant validity.
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This is a brief report for those interested. A month ago, I increased my dose of telmisartan from 40 mg at bedtime to 80 mg at bedtime. I can detect no symptoms and my BP readings are the same as they were on 40 mg. For me, the initial dose led to a drop from high normal/borderline high to the current state of mid- to low normal, maybe an average drop of 15-18 points SBP and little drop in DBP because it was already mostly in the low normal range.
The most significant benefit I’m seeing in telmisartan is a significant reduction the standard deviation of the distribution of my readings. As one example, I no longer see those high morning spikes typical of pre-telmisartan. The worst case now is a reading of 122/70. I believe this reduction in variance could be more significant to reducing ASCVD events than merely lowering mean BP by 10-15 points.
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Great thread so much in the trenches info, much appreciated!
BP had creeped up to 152/103 and scared the bezeebus out of me, so I went to the GP to specifically request Telmisartan. Never taken BP meds before.
At the appointment my BP was 142/93, and the PA said I didn’t have high blood pressure and didn’t need any medication. I told her she was wrong and I wanted to start on 40mg of Telmi, she said she needed an OK from the Dr. first as this was not what they normally do as they start with diuretics first… I said I’m not taking those or statins and request that you prescribe the Telmi… she came back 5’ later with the OK.
I took my first dose at 1pm, by 7pm my BP dropped 10 points, very pleased, had my lowest BP reading in many months.
Only 1 day, but there does seem to be a mood lift, I feel great today! Also, this stuff makes me lose a lot of water, peeing like a rhino today.
Hope I get more BP drop in the coming weeks. Thanks to all for posting your experiences.
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I agree @RufusDawes. The sharing, collegiality, and depth of knowledge here are unparalleled. It pleased me when I read of your experience just now, and how people here may have provided needed information at the right time for you.
I’m sure you know that it takes quite a few BP readings, taken under different conditions common to you, and with some control over the external environment, to arrive at a good profile of your BP. Nonetheless, it is incomprehensible that your medical office was ready to blow off your significantly elevated reading without at least further investigation. It would seem they have not kept up with national guidelines for many years. Your elevated readings might have been so-called white coat hypertension (as has been my lifelong situation) or may reflect your typical blood in normal, relaxed environments. Either way, it is in your interest based on the best available evidence to move it down to at least the middle range of normal BP.
I found that the “relaxation” effect of telmisartan kicked in almost immediately but was so subtle that it took a few days to pinpoint it. As I recall, my BP also dropped close to 10 points early on but I found that it required 20-30 days for the lowering effect to fully stabilize with no further decreases. As is common, my readings are higher in the morning (typically ~122/72) and lowest in the evenings when a reading of 110/65 is not uncommon). I also think my “white coat” spikes, which in the past could be 150/90 or more are much more constrained now. My BP at my last flight physical, standing and talking with no rest, was 128/78.
The current reductions and changes in variance as as far as i’m interested in going. That’s as far as I’m interested in going. I now measure my BP for a day or two every few months and don;t think about it otherwise.
Good luck and keep everyone posted.
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Update: the 40mg daily Telmisartan lowered my bp 20pts to 122/81, just what I was looking for. However, it gave me a weekly sinus infection or a chest cold, both mild, but one of the lesser side effects.
I went off it and now trying Amlodipine 5mg daily, so far so good. Like what was mentioned, takes 3-4 weeks to see the medication fully kick in, hoping for no unusual side effects (so far just mild headache in the morning that goes away, and a mild flushing in the face that also goes away).
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I was looking to lower BP and started using 40mg then 80mg (for the PPAR activation). But I reduced to 40mg because I had transient low BP causing some light headedness.
My BP no longer measures above 133/85 (highest measure in last couple months) and usually is around 116/76. Likely had some additional improvement from 9mg Retatrutide weekly too. Stopped most supplements (beet root extract, magnesium, etc) related to BP.
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Yes. I had a similar problem. It is too effective. I’ve reduced my dose from Telmisartan 40 mg to 20 mg and my arms no longer fall asleep at night while I sleep.
A new medication recently approved which is a PPAR delta agonist is called Seladelpar. Studies are limited for now to primary biliary cholangitis but I’d be interested to see if it had similar performance enhancement effects to cardarine.
Cardarine cancer effects were always so unfortunate to me, it seems like such a promising molecule otherwise.
I did find this with more information on PPAR delta agonists including but not limited to Seladelpar:
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As I continue to explore drug combinations for my own possible future use, I post studies which I think might have general interest. And so I posted several interesting studies on the combination of telmisartan and pioglitazone in the pioglitazone thread, and I’m linking them here. There I also posted an extremely interesting study looking at the differential effects of telmisartan and pioglitazone on mTORC2 driven cell proliferation and migration.
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As pioglitazone has been associated with increased risk of bladder cancer, taking it concurrently with telmisartan might be of interest.
Telmisartan inhibits human urological cancer cell growth through early apoptosis
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Pioglitazone has been associated with increased risk of bone fractures. Telmisartan, being a partial PPAR-gamma agonist, might also be suspected to increase bone fracture risk. However as the mode of telmisartan activity differs significantly from pioglitazone, so there has been some interest in determining whether sartans such as telmisartan or losartan has any impact on the biology of bone health.
Effects of telmisartan and losartan treatments on bone turnover markers in patients with newly diagnosed stage I hypertension
“Neither telmisartan, despite its partial peroxisome proliferator-activated receptor-γ agonistic effect, nor losartan treatment had significant effects on bone turnover markers in newly diagnosed stage I hypertensive patients.”