Adjusting dose, dosage, frequency, even mode of administration from IM to sub-Q is one way to deal with edema or water retention while on TRT.
Are There Natural Ways to Control Water Retention While on TRT?
Water retention can be controlled by a diet rich in potassium, magnesium and cutting back on Sodium.
How Much Magnesium and Potassium is Required per Day?
Both Magnesium and Potassium should be supplied by diet and the body does not make any naturally. Both are needed to regulate blood pressure which plays a role in water retention apart from other vital functions that each of them perform.
NIH Recommends the Following Daily Intake:
Magnesium:
Adults assigned male at birth - 400 to 420 milligrams of magnesium per day,
Adults assigned female at birth need 310 to 320 milligrams per day
Potassium:
Adults assigned male at birth - 3,400 milligrams
Adults assigned female at birth - 2,600 milligrams
Substituting Regular Salt
A very simple habit of replacing regular bleached table salt with Himalayan salt, or pink salt is a good thing. Himalayan salt is also mostly Sodium Chloride like regular table salt but has additional trace minerals including Potassium and Magnesium.
Sea salt and Celtic salt also can be substituted to regular salt.
Diet
A daily diet of consuming fruits, vegetables and grains which are high in Potassium and Magnesium is very easy to cultivate and delicious as well.
Salads with Celery, Parsley Beets topped with toasted flax seeds not only help increase potassium and magnesium, but the lignans and omega 3 fatty acids from flax seeds are also heart healthy.
Special mention of banana – contains both potassium and magnesium. Starting the day with a banana is an easy way to include both. A handful of nuts with low fat milk, whole grain cereal will help you start a healthy day.
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List of foods that contain both Magnesium and Potassium:
| List | Magnesium | Potassium |
| Swiss chard | 150.5 mg, 36% DV | 960.8 mg, 20% DV |
| Edamame | 147.9 mg, 35% DV | 885.8 mg, 19% DV |
| Spinach | 156.6 mg, 37% DV | 838.8 mg, 18% DV |
| Cannellini Beans | 112.8 mg, 27% DV | 1004.2 mg, 21% DV |
| Acorn Squash | 88.1 mg, 21% DV | 895.9 mg, 19% DV |
| Salmon | 62.9 mg, 15% DV | 1067.6 mg, 23% DV |
| Avocados | 58.3 mg, 14% DV | 974.9 mg, 21% DV |
| Potatoes with skin | 48.4 mg, 12% DV | 925.6 mg, 20% DV |
| Medium Banana | 32 mg. 9% DV | 422 mg. 10% DV |
Why does TRT Cause Water Retention or Edema?
As this Indian journal of Urology study states(cited below) excess estrogens may cause increase in visceral obesity. With vigilant monitoring of serum estrogen levels, TRT promotes weight loss.
While it is well known to TRT prescribers that TRT causes risk of water retention or edema, the actual etiology as to why this happens is not yet very clear.
The degree of retention is generally mild, and usually after an initial period of starting TRT can also disappear on its own after the body adjusts to TRT.
Men with CHF(Congestive Heart Failure) need close monitoring.
Risks of testosterone replacement therapy in men E. Charles Osterberg, Aaron M. Bernie, and Ranjith Ramasamy PMCID: PMC3897047 PMID: 24497673
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