T Nation

Anastrozole v. Aromasin v. Letro

I have had a terrible time finding the correct AI for me. I started with anastrozole, but by process of elimination, determined that it was the cause of some bad back acne, which is apparently extremely rare because I couldn’t find any other instance where it actually caused it. I can assure you this was the cause. It was constantly present for 5 months, and began to subside as soon as I stopped taking it.

My hormone specialist compounded progesterone in my testosterone cream to see if that was an adequate AI; it most definitely was not.
E2 ran rampant and I would rather deal with the back acne than deal with the emotional state of elevated E2.

I self-switched to exemestane (aromasin) RC, and everything was going great, except I am having a lot of trouble going to sleep and staying asleep. I am also having some pretty disturbing dreams. These two side effects have been nonexistent since beginning TRT in November 2011. Alcohol is the only OTC that helps, which is NOT the right answer. After some googling, insomnia isn’t that rare of a side-effect. If I don’t sleep, I am a miserable person to be around. I’ve read on some breast cancer forums of women taking some prescribed sleep aids. I’d rather not go down that route.

This leaves me with only one other option that I know of; Letrozole. I don’t think I’ve read one single case on here of someone using it as their AI, but I am out of options here. If anyone has some input I would like to hear it.

Here is my context with all other information. I haven’t updated it in a while since I’ve been trying to figure this AI thing out:

Letro will work, but stories indicate that it can be hard to dose. Some reports indicate that some have very low E2 with letro. But most of stories come from body builders and that is never a good data source. Suggest that you work up from very small doses.

Still taking progesterone with your T? Some freely progesterone–>cortisol. If applied in PM, might make you wakeful. This is a well known effect in women. Hardly any data for men.

Never heard of progesterone as TRT AI. But one source for an idea like that would be from women to take a lot of progesterone which can have a negative feedback effect on their HPOA reducing LH/FSH thus reducing native progesterone, E2 and T. But transferring that effect to your context would be extremely stupid. Increased progesterone will not have any effect on T–[aromatase]–>E2! Ask for some T cream without progesterone and eval for sleep.

Can you place E2 lab results associate with Anastrozole-sleep issues?

I’ve run two seperate tests to see if the aromasin was the cause of the insomnia. The first one wasn’t on purpose. I had just begun taking it, but was drinking 6 beers a night after work. I was sleeping fine. I didn’t drink the next two nights, and I barely slept. It would take me 2 hours to get to the inbetween sleeping and awake phase, and I would stay there for another hour or two. Then, I would fall asleep around 5am and wake up a couple of times briefly after that. Up for work at 7.

I knew alcohol helps me sleep, so back to the 6 beers a night thing. I’ve spent the past 3 days in transit, and haven’t drank a drop. Same as before. Can’t fall asleep. Can’t stay asleep. Wake up exhausted.

As far as the progesterone goes, I already have a compounded cream ordered without it. It was a shot in the dark for an AI. I only apply it in the morning.

I am currently on 45mg of hydrocortizone tablets a day for adrenal fatigue, so if some freely convert progesterone->cortisol, my cortisol might be running rampant right now. I’ll have to get bloods to confirm.

I haven’t had an E2 test in a while, so I can’t associate it with sleep. I’m constantly on the road and dealing with all this has been a chore. I do have data that sleep was not an issue when E2 was at 110 or sub-20’s.

Im interested as well in letro, mainly because its more cost effective. I have read of guys using 200mcg a day but i got no idea on how they cut those 2.5mg tabs down that small, unless they use a liquid letro??

It has a long half life so im guessing it might be able to be dosed twice a week similar to arimidex, maybe 1/4 tab approx 600mcg on a mon thurs schedule.

Any thoughts on the above dosing for letro??

Also maybe the HC is too high and also causing insomnia, maybe either try eliminating your last dose of the day or dose it abit earlier, another option is phosphatidyleserine(ps) at 400mg at night to lower night time cortisol before sleep. I have found the ps helpful for sleep.

cheers!!!

After reading up on it today, almost entirely in AAS forums, I ordered some letro RC. Just like you said, the dosage is ridiculously small for our application, so cutting up tablets would be almost impossible.

You’re probably right about the HC dose being too high. I wasn’t given extensive instructions when it was prescribed to me. I was prescribed 30mg/day, and was told to “take a little more if I was stressed”. At the time, I was working a lot and constantly under stress, so I worked my way up to 45mg. I’m slowly tapering down. Already down to 40mg.

I plan on updating my log and throwing all this information in there once I reach my “happy place”.

Its a tough issue to sort out adrenal fatigue as well as sorting out the low testosterone.

Have u thought of cutting back on hc and adding pregnenolone cream as it can help with cortisol production and help back fill other hormones once your shut down fromt TRT, just a thought?? I use just 5mg of hc in the morning and then use the preg cream and oral dhea for adrenal fatigue, seems to help some and with the ps at night my sleep cycles have improved.

Have u found trt improving energy from adrenal fatigue? I understand you are probably a work in progress like many of us but interested to see what has worked for you.

good luck,
cheers!!

Though I have only started Letrozole recently (Liquid) I have researched a lot about it and have noticed the reputation of the drug’s effects are overblown. Most ‘body builders’ say it will wipe out your estrogen and destroy your libido and gains when actual studies have dosed obese men with high estradiol on 2.5mg a day and their estradiol only decreased 50-60%…hardly to zero. And with 2.5mg a day! Letrozole also has a much higher ability to penetrate fat and thus decreasing the aromatase enzyme more efficiently.

Wow. I read that Bill Roberts (a big name in AAS) uses 2.5mg/week off cycle. I’m sure he’s one of those guys who uses never comes off and “cruises” when off cycle.

Keep us informed with E2 stats before and after if you don’t mind. This is honestly my last hope. If this doesn’t work, I have the following options to choose from.

A) Horribly painful and unsightly back acne from anastrozole

B) Not sleeping and being an all around grumpy @$$hole from aromasin

C) Having high E2 and being an all around crazy @$$hole from no AI at all

D) Quitting TRT all together and feeling like total garbage

Maybe I’ll just cycle through all the options to keep things fresh.

[quote]Kaynon311 wrote:
Wow. I read that Bill Roberts (a big name in AAS) uses 2.5mg/week off cycle. I’m sure he’s one of those guys who uses never comes off and “cruises” when off cycle.

Keep us informed with E2 stats before and after if you don’t mind. This is honestly my last hope. If this doesn’t work, I have the following options to choose from.

A) Horribly painful and unsightly back acne from anastrozole

B) Not sleeping and being an all around grumpy @$$hole from aromasin

C) Having high E2 and being an all around crazy @$$hole from no AI at all

D) Quitting TRT all together and feeling like total garbage

Maybe I’ll just cycle through all the options to keep things fresh.[/quote]

I am of the opinion, purely from countless hours of research alone and not because I am qualified, that TRT is for the most part unnecessary unless you have damage to your testosterone making abilities (such as cancer, injury, castration, old age, etc.)…most hypogonadism is caused, again in my opinion, by the current environment we live in. Bad diet, very little exercise, stress, bombardment of synthetic estrogen compounds found in numerous things (from cosmetics to plastics), fluoride, deficiencies in different nutrients such as IODINE and Monounsaturated and Omega 3 fats…

[quote]Kaynon311 wrote:
I’ve run two seperate tests to see if the aromasin was the cause of the insomnia. The first one wasn’t on purpose. I had just begun taking it, but was drinking 6 beers a night after work. I was sleeping fine. I didn’t drink the next two nights, and I barely slept. It would take me 2 hours to get to the inbetween sleeping and awake phase, and I would stay there for another hour or two. Then, I would fall asleep around 5am and wake up a couple of times briefly after that. Up for work at 7.

I knew alcohol helps me sleep, so back to the 6 beers a night thing. I’ve spent the past 3 days in transit, and haven’t drank a drop. Same as before. Can’t fall asleep. Can’t stay asleep. Wake up exhausted.

As far as the progesterone goes, I already have a compounded cream ordered without it. It was a shot in the dark for an AI. I only apply it in the morning.

I am currently on 45mg of hydrocortizone tablets a day for adrenal fatigue, so if some freely convert progesterone->cortisol, my cortisol might be running rampant right now. I’ll have to get bloods to confirm.

I haven’t had an E2 test in a while, so I can’t associate it with sleep. I’m constantly on the road and dealing with all this has been a chore. I do have data that sleep was not an issue when E2 was at 110 or sub-20’s.

[/quote]

How long have you been on hormone therapy? You may need to give it time.

I’d get more lab work: http://www.lef.org/Vitamins-Supplements/ItemLC100012/Male-Basic-Hormone-Panel-Blood-Test.html

I would workout no matter where you are on the road. If you are taxing your body’s muscles they will tire and will give natural sleepiness. TV and computer screens are notorious robbers of good sleep. Read a book or magazine and don’t eat carbs before bedtime. There’s no easy method to rid yourself of insomnia, however melatonin rather than beer will give you better results. But start at a low dose at first. Prayer, especially that you be given peace works.

I’d get off gels or compound creams and go the injection route. You will feel much better and stronger. Letrozole is going to knock your E2 levels more harshly than the aromasin and anastrozole. It has a bad reputation with regards to libido. By all means keep us posted if you go that route.

[quote]Receptor wrote:
Though I have only started Letrozole recently (Liquid) I have researched a lot about it and have noticed the reputation of the drug’s effects are overblown. Most ‘body builders’ say it will wipe out your estrogen and destroy your libido and gains when actual studies have dosed obese men with high estradiol on 2.5mg a day and their estradiol only decreased 50-60%…hardly to zero. And with 2.5mg a day! Letrozole also has a much higher ability to penetrate fat and thus decreasing the aromatase enzyme more efficiently.[/quote]

Let us know in three-four months if this is working for you. Keep a log and help out the community.

i would be cautious of exercise if one has adrenal fatigue especially pushing through it. if u have adrenal fatigue and u dont get that exercise high but feel knackered and no oomph then call it quits until u get your oomph back. look into ultra abbreviated routine of even 1 exercise can be helpful, something like a few sets of squats or overhead squats or power cleans no more then twice a week and not pushing yourself until you are functioning well. Then cycle your training intensity once your feeling better as its too easy to come crashing down once u have been broken before.

Your probably know this Kanyon, as many of us have gone through the push crash cycles a few times before we learn what is going on. Even when we feel better its hard to work out where our boundaries are and going outside our boundaries can flatten us for months, not like in the good old days pre adrenal fatigue when all u needed to do after a really hard workout was to take a day or 2 off and hind site probably needed to take more time off recovering and cycling training intensity better.

Activity and pacing are very important part of treating adrenal fatigue.