TRT Myths Exposed: Testosterone, Adderall, and the Hidden Drivers of Hypertension

Is testosterone linked to high blood pressure—or is that a dangerous medical myth? In this episode of Your Infinite Health, we unpack the science behind testosterone replacement therapy (TRT), hormone optimization, and the real cardiovascular risks clinicians are seeing in practice today. Using a powerful real-world patient case involving hypoxic brain injury, exosome therapy, and ADHD stimulant medication, this episode exposes where most people—and even some doctors—are getting it wrong.

Our discussion centers on a young adult patient recovering from a severe methamphetamine overdose that caused anoxic brain injury. After a year of regenerative medicine, hormone optimization, and biologic therapies, his recovery has been remarkable. But when Adderall was reintroduced for ADHD management, his blood pressure spiked, raising urgent questions about whether testosterone therapy causes hypertension.

We dive into the most important clinical research, including a major New England Journal of Medicine trial of over 5,000 men, which found only a 0.3 mmHg increase in blood pressure in men using transdermal testosterone—an amount too small to be clinically significant. Even more importantly, the study showed no increased risk of heart attack or stroke, prompting the FDA to revise cardiovascular warnings on testosterone therapy.

In contrast, we explore the well-documented cardiovascular risks of sympathomimetic stimulant drugs like Adderall and Vyvanse, which are linked to hypertension, accelerated cardiovascular disease, and nervous system overstimulation—especially in patients with neurological trauma or substance abuse history.

You’ll also learn what true “optimization” medicine means: not simply replacing deficient hormones, but maintaining youthful physiologic levels to reduce inflammation, cellular aging, and the accumulation of so-called “zombie cells” that drive chronic disease.

Topics covered in this episode include:
 • Testosterone replacement vs optimization
 • Testosterone and blood pressure myths
 • Adderall, ADHD, and cardiovascular risk
 • Sympathetic nervous system overstimulation
 • Exosome therapy for brain injury recovery
 • Hypogonadism in young adults
 • FDA updates on TRT safety
 • Regenerative medicine and biologic therapies
 • Hormones, aging, inflammation, and longevity

If you’re concerned about TRT safety, high blood pressure, stimulant medications, or longevity-focused medicine, this episode delivers clarity grounded in both clinical data and real patient outcomes.

🎧 Subscribe for more deep dives into hormone health, regenerative medicine, brain recovery, and optimization science.

Transcript

Hey trip Hey, how's it going? Well, well, do you have a good week? Yeah It's awfully rainy today. Yeah, great day to sit inside and do a Great day to do nothing, but that's Yeah, a great day to sit in and do podcasting ⁓ So we've got we're doing something this afternoon and I hope this weather doesn't jack up the travel arrangements for

the addition to the Gulesby family. Right. So we're getting a Shelty puppy ⁓ and her name shall be Harlow Beesoo. Harlow Beesoo. Yeah. So kind of sprung it on the kids last night, but we've been waiting on this puppy for a while, right? yeah. She's coming all the way from Washington state from ⁓ Spokane area. Spokane, but like North, right? North of? Yeah.

We were going to go get her. We're like, we'll just drive there. And the breeders like, I don't know about, you sure? And then we started pricing it out and then we're like, not. Maybe just fly her here. Yeah. So she's coming from, ⁓ as guard, as guard, Shelties from Washington and we'll be picking her up this afternoon. So pretty exciting. Yeah.

looking forward to it. So we've accumulated, we also recently got a cat which we've never had a cat before. ⁓ is our youngest son's cat and he named him Cinder but I always, I don't know why but I always just want to call him Crisper. I have to catch myself. I wonder why. I don't know so now we're up to ⁓

We'll have two shelties, one silky terrorist, a cat named Cinder, and it's a house full. House full of animals. ⁓ So we're heading into the holidays, and of course I have to have a holiday joke.

Are you ready? I guess.

⁓

Where'd it go? How does a gingerbread man get around with a broken leg?

I don't know. With a candy cane. With a candy cane. Dun dun dun. I just dropped my phone. Sorry guys. Okay. Well enough shenanigans. Let's get into today's topic, which ⁓ I wanted to bring up. It's about testosterone and some sort of ⁓ information that's floating around about testosterone and high blood pressure. Yeah. I think we had a...

A case for a patient of ours who had hypoxic or anoxic brain injury and was getting ⁓ exosome therapy, his brain injury resulted from an overdose of methamphetamine and... Don't do meth. ...and a number of other ⁓ recreational pharmaceuticals. ⁓ he mixed. It was meth mixed? Yeah, it was ⁓ a complicated regimen, apparently. ⁓

So he he survived the initial insult but has multiple sequelae from the period of anoxia and his family is investing in ⁓ exosome therapy for that. But he's recovered significantly at this point and is- long have you been treating him?

been treating for about a year now. So how did he, how was he, how did he present when you first, when he first engaged? Well, he was non-communicative and, and all the communication was done through his, ⁓ through his mother. And he, ⁓ I mean, he was mobile and had, ⁓

some use of his extremities, but now he's ambulatory again and has improved his communicative and actually manifests a sense of humor. His improvement has been significant and not that he that ⁓ I think the exosomes have certainly helped in that recovery. We don't know. ⁓

obviously not having any formal studies or anything, but we know the regenerative capability of the exosomes for the brain are significant, ⁓ least in the animal models and in certain human trials. So ⁓ the family is invested in and he's reaping those benefits from his.

unfortunate accident. Well, you're not just treating, like it's not just exosome therapy. ⁓ You're doing other things. Right. We're doing the optimization and a number of other, ⁓ there are a number of other contributory therapeutics ongoing, biological therapeutics going on. But ⁓ at the same time, it's very gratifying to see the outcome that's occurring.

Yeah, but one of his issues apparently was he had Attention Deficit Disorder and was on Adderall or Vibas for a while and then Adderall as a child and then into young adulthood. He's in his early 20s at this point in time.

And was the family is putting back on his and his other ⁓ treating psychiatrist has put him back on Adderall. ⁓ Like now? Yeah. When he's been non communicative? Well, yeah, and his. ⁓ And immobile? Well, no, he's more mobile. no, like he can't talk and he can't move and they put him back on. No, no. OK. He's he's improved to the point where.

those were felt to be by his treating psychiatrist were felt to be beneficial. In any event, so we've run into an issue here recently because part of his optimization process, he was hypogonadic, testosterone level was below the normal range even for...

even for an elderly adult. so part of his treatment has been optimization of his testosterone levels and his other hormone levels. And more recently, as they have increased the dose of Adderall, his blood pressure has now become a problem again. And it seemed fairly evident to me that his...

It might be the sympathetic nervous system stimulation that was doing that as Adderall is known to do that. the ⁓ mother was concerned that it was the testosterone ⁓ causing the high blood pressure. Why did she make that assumption? Well, I think the old FDA warnings... ⁓

⁓ on testosterone included a possibility of aggravation of blood pressure. So that's piqued my interest because testosterone is a cardioprotective agent and ⁓ more often and is a vasodilator. So. ⁓

was curious to see if there was any data to tell us that there was a risk of ⁓ hypertension ⁓ or blood pressure issues in these individuals taking testosterone, ⁓ particularly in hypogonetic men or in ⁓ optimization. Now, for the optimization, there's ⁓ optimization of testosterone. ⁓

has, there's no good data that I could find, but more recently about a year and a half ago, there was a large trial published in New England General Medicine for replacement therapy for ⁓ men who were.

with the transdermal approach with testosterone, which has garnered a lot of information for that modality. And it's interesting to note that in that trial, they followed the blood pressure to assess whether or not it was going to be hypertensive because the trial was geared to follow up and see if there were any complications related to

related to cardiovascular demise or strokes or ⁓ cardiovascular disease overall. And so they were following the blood pressure quite closely. And in that trial, which I think was about 5,000 men, that trial garnered information that in the treated, in those men that were treated, the...

there was a 0.3 millimeter mercury increase in ⁓ blood pressure ⁓ in those men receiving the testosterone. So 0.3 millimeters is not even a point on the...

blood pressure scale. So realistically on that trial, they did not document any complications related to increasing blood pressure. Likewise, that trial demonstrated that there was no increase ⁓ in heart attacks or strokes. ⁓ So that being said, the cardiovascular safety ⁓ recommendations were revised by the FDA and

resulted in a change in the recommendations and precautions from the FDA over the last year or so. So really interesting information. So obviously my initial ⁓ thought that the Adderall was the culprit in this.

and this increasing blood pressure ⁓ issue ⁓ with our patient is probably correct. But I did take a look and see if there was any information on the ⁓ combined use of testosterone ⁓ and ⁓ sympathetic ophthalmotics in individuals with ⁓ neuropsychiatric disorders. And ⁓ there had been no.

specific trials to address it, but the ⁓ conclusion that I could draw from the information that I researched showed that realistically, it's unlikely that ⁓ doing optimization therapy or ⁓ replacement therapy with testosterone are...

cause to worry about, worry about blood pressure issues. So maybe following the blood pressure and making sure that everything stays in a normal range. Was there a thought to maybe remove the Adderall? Well, that was my suggestion. actually, in part because of ⁓ his recreational drug abuse in the past, I was contrary to initiating the Adderall and have

⁓ cautioned, cautioned about its use again, particularly in his case. However, psychiatrist is driving, kind of driving that car at the moment, but given this new information and having researched the...

the challenge more carefully, I think I'll be a little bit more insistent on trying to drop that dosing as quickly as possible. Yeah. Just in case the listener doesn't know, because you keep using the word optimization, what does that mean to you? Well, so as we age,

as we age, optimization, we kind of reach our peak in our mid-20s. And after that, the body starts to deteriorate. And until we can, in an absolute fashion, that deterioration, we can...

maintaining that youthful environment helps prevent the development of the adversarial environment that causes damage to our cells and ⁓ ultimately the increase in what I call the welfare cells or the zombie cells in that population that creates inflammation in the body and further deterioration and the aging process. ⁓

That being said, is basically the maintenance at youthful levels, at that optimum level where we're youthful, maintaining that environment, that physiologic environment in our bodies so that we potentially have less damage occurring and less need to consume our reserve of healthy cells and stem cells and that type of thing.

Cool. So essentially there is no data to support that testosterone is linked to high blood pressure. No, and studies actually again that just doesn't add on it. Studies on the studies on Adderall show that one in four of patients on long-term sympathetic or memetic ⁓

Sympathetic on a medic ⁓ medications for ADD or ADHD are have shown to develop have been shown to develop accelerated cardiovascular disease and hypertension and those types of things. So I think the culprit in my case here is, ⁓ is, is clear and needs to be addressed.

Cool. Well, guys, I hope that was helpful. I guess that's all we've got. ⁓ I really just wanted to touch on that this time. So that being said, I hope you found it informational, educational, somewhat entertaining. And until next time.