Telmisartan and bodybuilding

Although it has only come into the bodybuilding scene in recent years, if you are an assisted bodybuilder, you’ll have undoubtedly heard of and/or started using Telmisartan.

This compound is typically used to help lower blood pressure, and whilst its usage has become increasingly popular, many will take it without an understanding of what exactly it does. Therefore, the aim of this article is to explain how telmisartan works to lower blood pressure in the body.

What is it?

Telmisartan belongs to a class of drugs known as angiotensin 2 receptor blockers; but in order to understand what that means, lets get some things clear first.

There is a hormone system in our bodies called the Renin-Angiotensin-Aldosterone System (RAAS), which is in charge of regulating blood pressure and fluid balance. It regulates its response to things such as angiotensin, a naturally occurring chemical that narrows your blood vessels and can increase blood pressure. One specific type of angiotensin – specifically, angiotensin 2 – is of importance to us here, because the use of anabolic steroids raises levels of this specific type of hormone in our bodies.

So, in this context, why might it be important to take something such as Telmisartan?

Angiotensin 2 effects

Receptors for angiotensin 2 can be found in different parts of the body, which have specific consequences when the molecules bind to these.

Firstly, angiotensin can bind in the arterioles (in your heart), which causes vasoconstriction or narrowing of the blood vessels, contracting the heart’s muscular walls. As you can imagine, this will increase blood pressure as the heart is having to work harder to pump the same amount of blood around the body.

Secondly, angiotensin 2 can bind in the kidneys. On the one hand, this stimulates sodium reabsorption. As I say to clients, “where sodium goes, water flows”, meaning that an increase in sodium will lead to an increase in water retention, which further compounds blood pressure. On the other hand, binding also causes a decrease in glomerular filtration rate, which in short means that the filters that remove waste and excess fluid from the body are working sub-optimally.

Thirdly, angiotensin binding in the hypothalamus (brain) acts to stimulate the sensation of thirst, often resulting in increased fluid consumption and thus, higher blood pressure. Not only that, but this binding will also increase the secretion of antidiuretic hormone (ADH): a hormone involved in regulating the amount of water in your body, by controlling the amount of water kidneys reabsorb as they filter out waste from your blood. A decreased production of ADH leads to more concentrated urine to reduce the loss of fluid from the urination, thus making our body retain fluid.

Fourthly, in the sympathetic nervous system (the system in charge of our fight or flight responses), angiotensin binding will increase adrenaline production. Adrenaline is typically released in response to stressful situations and causes vasoconstriction of blood vessels, increased heart rate, and elevation of blood pressure. This increased adrenaline will have a direct impact on the release of renin.

Now, let’s think back to the start of the article, where I mentioned the Renin Angiotensin Aldosterone System; if you remember, this system regulates our blood pressure and fluid balance. So far, we’ve spoken about angiotensin, which as we can now see, also influences renin release indirectly. This is important, because renin is responsible for helping convert angiotensinogen (a precursor of angiotensin 2) to angiotensin 1. It is usually released in response to low sodium levels, blood volume, or blood pressure. As such, this subsequent increased release of renin due to anabolic usage will ultimately cause the body to re uptake sodium, fluid and thus increase blood pressure. Therefore, you can see how higher levels of angiotensin negatively impact on the body’s blood pressure both directly and indirectly.

Last but not least, angiotensin 2 binding also affects aldosterone (which you’d expect, given its role in the RAAS system). Aldosterone is a mineralocorticoid that ultimately influences electrolyte and fluid balance within the body. In the kidneys, it increases sodium channels, allowing more sodium to be reabsorbed by the body and an increased excretion of potassium within the body. The result: increase blood pressure and fluid retention.

Not to harp on about it, but I hope that reading through these effects that angiotensin has on the body – which are increased by the use of AAS – would compel you too to want to do something about it, such as using Telmisartan.

Why would bodybuilders use it?

Before you freak out, it’s worth noting that the body produces angiotensin 2 too and has evolved to use this hormone for its survival. However, the problem is that assisted bodybuilders have chronically elevated levels of this hormone as a result of their usage of PEDs. When you start to consider that people might be taking AAS for years or decades, it’s important to consider the long-term effects of elevated blood pressure.

As discussed, high blood pressure negatively affects both the musculature of the heart, as well as the kidneys: on the one hand, the heart is having to work harder and beat faster, and on the other hands, the kidney’s filtration rate will decrease, both in response to higher levels of angiotensin 2. You’re then left in a scenario in which your cardiac and kidney functioning is impaired.

With this in mind, it follows that assisted bodybuilders will use telmisartan as a harm reduction strategy. Specifically, using this compound will lower the levels of angiotensin 2’s ability to bind to its specific sites in the body, subsequently reducing its negative impact on blood pressure and kidney function. Critically, it’s a harm reduction not elimination strategy – that is, this situation is compared to a scenario in which an assisted bodybuilder doesn’t take anything at all to mitigate these negative effects.

From personal experience, I can attest to the positive effects that taking telmisartan has had on my blood pressure. In fact, I monitor my blood pressure multiple times across the week and after implementing it into my daily ancillaries, my systolic blood pressure dropped down from holding in the high 130’s to mid 120’s. Seeing that improvement helped me see that I clearly needed this compound for as long as I’d be using anabolics.

Why telmisartan versus other ARBs?

You might be wondering why bodybuilders opt for telmisartan out of all the other available angiotensin receptors blockers (ARBs). The answer is that telmisartan (1) has a higher affinity for the angiotensin 2 type 1 receptor, which is a long duration of receptor binding, and (2) the medication has a long half-life (24 hours to be precise). Ultimately, this means that it’ll stay in your system for longer, and it will be effective until the next time you come around to taking it again.

On top of lowering blood pressure, telmisartan has also been shown to be superior in reducing fasting plasma glucose levels by improving insulin sensitivity. It also increases adiponectin (a protein hormone), which is involved in regulating glucose levels as well as fatty acid breakdown. This equates to lower levels of overall cholesterol and reduced LDLs. Given that using anabolics steroids can raise LDLs, the fact that telmisartan influences this other side effect supports its use for both blood pressure reduction and “bad” cholesterol reduction too.

In summary telmisartan belongs to a class of drugs known as angiotensin 2 receptor blockers. When we use anabolic steroids, we raise our angiotensin 2 levels which can have a compounding negative effect on the increase of water retention, electrolyte imbalance, and increases in blood pressure (directly and indirectly). If levels of this hormone remain chronically high over a long period of time, this can impair cardiac and kidney function. Therefore, assisted bodybuilders may use telmisartan as a preventive measure to lower blood pressure, and support heart and kidney health. Telmisartan is also superior to other ARBs in many ways and this is why it is favoured over others by assisted bodybuilders.

Vaughan Wilson Bsc Hons

References:

https://teachmephysiology.com/urinary-system/regulation/the-renin-angiotensin-aldosterone-system/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947116/

https://www.youtube.com/watch?v=PWH54dqCF4M