Anastrozole - Use ONLY as Needed?

I hear more and more of clinic docs prescribing weekly Anastrozole as part of a TRT protocol, to decrease E2 and “get mire out of your T”. Based on all the experienced inputs I have gathered, Anastrozole should ONLY be used on a “break glass in case of emergency” basis. Agreed?

In the emergency case, if one is on a cycle (or TRT for that matter), what would be the protocol? Start using it when symptoms appear (nipples tingling, visual gyno, etc)? How much? Use until physical symptoms resolve?

I suspect there may be a justified use at the end of a cycle along with weaning down (this is the most likely time when the E2/T ration gets out of whack and causes gyno?) What is the protocol then?

I don’t know if I would say it’s an emergency use situation but here is my take. The most methodical approach from my engineer brain says start one drug at a time. Deficient in T? Treat with testosterone. After peak saturation and some time to adjust, pull labs and see if an AI is needed or reduce dose. It’s just makes the most sense from a diagnostic standpoint. If you throw everything at a person at once you won’t know what’s causing issues plus you may be over medicating.

Last, many docs overprescribe testosterone and then use the AI. So the AI is a medication used to control another medication. Where else in medicine is this a common place? Not very many circumstances justify this in the medical community but it runs rampant in T Clinics.



No DOE (Design of Experiments)?

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That would be useful for a response surface that is not well understood. Dose response of Test and AI are pretty well characterized in the human body (within reasonable uncertainty inherent in biological systems).

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I wasn’t serious about the DOE haha. I wouldn’t try it myself, I have a bad track record with DOEs. I am good at figuring out what variables don’t matter and shouldn’t have been included lol.

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We should report results of all experiments…“good” or “bad”. Too bad science today is often publish only “positive” stuff that largely won’t be repeatable haha.

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