T Nation

Added Anastrazole, Feeling Better

71 years old. After several years on T shots, with nothing to show except weight gain, my urologist and I discussed trying anastrazole. He has over 30 years experience with hormone replacement. Went back to basics; 100 mg Test E, IM, weekly(3 months),with 1mg anastrazole the past month. I’ve lost 5 pounds. Libido is more consistent. Penis is fuller and longer. Nocturnal erections now and then, compared with zero, even with higher T dosing (at one time,30 mg, daily and E2 60). Current: Blood glucose 90-99. BP 116/70.

I’m not yet claiming an ai is the missing piece but neither is the sky falling on me. And if it does prove to be that missing piece, then I’m an outlier. For now, my doctor is monitoring me. Have labs coming up.

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Going back to basics would have been to start on T only, especially since you lowered the dose. Adding an AI at 200mg/wk will lower your E levels from 60 to half or more. Instead, you lowered your T dose which will aromatase less to begin with, and now you’ve added an AI which could dip your E levels into the death zone. Be careful with your E levels dipping too low, at your age it can cause rapid bone density loss which you wont be able to recover from so easily. Some people need Estrogen control, but since you didnt get any labs prior to resetting your protocol, well Im going to have a hard time believing your Doc was thorough. Anyway, get labs in a few months and monitor your E levels. At 100mg I would never touch an AI. I take 220mg and Ive never experienced any negatives from higher E levels. We’re all different. Just be careful

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On excelmale.com there are several men using 1 to 3.5 mg of anastrazole a week, all reporting improved sexual function as well cognitive improvement and weight loss. My doctor read those posts, too, and he was intrigued. Those men, under a doctor’s care, are outliers. I’m the one who brought up the subject and we thoroughly discussed it. Basically, I seem to overaromatize. Again, it’s an experiment. My previous labs in August, before going back on testosterone, had a TT of 398, FT of 45 and E2 of 34.

The 3mg AI per week has consistently shown to cause osteoporosis in a little as several months to a few years.

Dexa scans were used to confirm the osteoporosis diagnosis.

A weekly protocol isn’t going to be optimal for everyone, more shot frequency might be the answer to consistent sexual function.

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@highpull takes and prescribes weekly injections. One guy on here, I recall reading, was taking 100 mg weekly and saw his erections come back and a 15 pound weight loss. As for dosage and frequency, you know there isn’t ‘one size fits all’. For me 100 mg is the starting point and I want to stay at that dose for several more months. My failing is that I’ve never been consistent. I should have been listening to my urologist, not reading about everyone else’s protocols on various men’s health sites, believing that I’d quickly see my erections return, along with improved overall health.

I recall reading in the European Journal of Urology of a patient on test undecanoate, over the course of three years, reversed dyslipidemia, type 2 diabetes, lost weight, lowered blood pressure and regained his erectile function. Test U is 1000 mg every 3 months. Yes, maybe I’ll need more than 100 mg, weekly, but it’s not a given.

Regarding the ai, as I stated; it’s an experiment. We both post on excelmale and you’ve read the thread of a few men saying they feel/function better with low estradiol. Again, they’re outliers, but if they experience significant improvement WITHOUT significant side effects are we to argue that they shouldn’t take an ai, even if it means their sexual function and overall well being declines?

Talked to two guys this morning regarding their follow-up labs. One with an E2 of 133, the other 38. The guy (200mg once a week) at 133 feels great. The guy at 38 (70mg twice a week) reports being emotional, tender nipples, they hurt when putting on a shirt, and bloating.

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Thank you for replying to my thread. I always find your posts interesting, since you’re a physician. The way I read your reply, am I to draw the inference that higher E2(100 or higher) isn’t problematic as opposed to E2 in the so called normal range?

As I posted, at 60 pg E2, I was bloated and gained 15 pounds, when I was already at 155, far over my ideal weight @ 5’ 4".

For men, on TRT? I’d be interested in seeing these studies if you have them handy

We’re all after symptom resolution. If you need the AI to get that, then I say take it. Are their risk involved with that, short and long term? Maybe. There’s risks with TRT as well. Do what you need to do

I think he’s demonstrating how two guys with two different high e2 levels respond differently

@highpull was, but my question, though poorly worded, asks is there a point as E2 rises where symptoms resolve and there’s overall improvement. Bloating, weight gain, poor erectile function…until E2 goes to 75 or 80 or 90 or 100 or higher? This is seen with some psychiatric drugs such as Lamictal or Serequel where the patient’s symptoms don’t resolve at a low dose, but do improve when the dose is higher.

Well duh, no shit.

But seriously, im not surprised. SO MANY MEN would feel SO MUCH BETTER on trt if they actually got out of this stupid “never touch an AI!!” - bs that got spread by a certain (uneducated in the subject) individual.

AIs can be a “life saver” for so many guys on TRT. So many dudes dropping out and going back to natty-low-T cause they dont get any benefits on test, why? Because they do not control their estrogen, “just let it run free man!!”.

Jesus … how many examples like this do we need, understand that AI is very very good, for many.

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Maybe there is, it’d probably be unique for everyone (or for most, maybe). my e2 has been 75-103pg/mL and I didn’t feel awesome, but wasn’t horrible either. Get down to 45-50pg and I feel great

I don’t know. However, it is not as though one will have symptoms from higher E2, so we take it even higher. There are times when someone will start to experience symptoms from elevating estradiol and decide ride it out and those symptoms end up resolving without dose adjustments or the addition on an AI.

Thanks. Men who say they feel & function, better, with low E2, 5 or <5 are, IMO, biochemical outliers. And I don’t know if they can remain healthy, over time, with E2 that low, without developing cardiovascular or orthopedic problems.

As I wrote, I’m 71. I don’t want to put myself at risk for some major health issue. I’m on testosterone for life and when I do get a spontaneous erection(daytime or nocturnal) it’s rock hard, though short lived. Still sorting through, ‘An AI or not to use an AI’.

You make a valid argument for AI usage. It’s obvious that if taking an AI makes things better, then utilize it. Right now, no issues from anastrozole. But, don’t want to set myself up for a coronary or something else, serious. And with treatment resistant bipolar, I’m high risk, period. My doctors and I have to take everything into account.

You will see that there are two groups, those who dont take AIs and those that do. There used to be arguments regarding this. Take what you feel you need to, some people are simply not built for high T and or High E. We’re all different. I get what you’re saying. Heck I have great hard ons and Im both high T and High E. If anything Ive become a better athlete and lover because of genetics. My libido is nondependent on hormone levels. I remember being super low T and High E with the need to bang daily. High T and high E, 2 years later and Im just as horny. Its how were wired in our brains too.

You definitely, IMO, have genetics on your side.

For me, with bipolar illness, there’s general agreement in the psychiatric community, that the hypothalamus and pituitary are malfunctioning. I’m fortunate to have a urologist who sees endocrinology as his avocation. He’s quite knowledgeable. Up until I relapsed in 2004, I didn’t have any trouble sexually functioning or sleeping. With return of bipolar, I began going downhill. Medications don’t work. Genetics, indeed, are probably in play. My doctor and I keep trying to hack the hypothalamus or compensate for its malfunction. Now and then, I’ll experience a raging erection, then, whatever triggered it, vanishes. It’s like I have an intermittent connection that will occasionally work, and most times, won’t. Whether E2 is a factor, I don’t know. Right now, it’s just another avenue to explore.

Have you also been measuring prolactin levels? I think at least some of the issues surrounding high e2 side effects are caused by the concurrent increase in PRL.

Last labs it was 7. I believe 5 or 4.5 is ideal. A few years ago, when it was 15, my doctor prescribed cabergoline. Made me hypomanic and messed up my already poor sleep.