May be of interest. Copied from a post I made elsewhere.
We often see guys who get hit by high E2 before their followup lab work; if their doc will even look at E2. When the few who are anastrozole over-responders feel messed up from low E2, they usually know something is wrong and have read in the stickies, or have been directly advised, that they can stop taking anastrozole for 5-6 days then resume at 1/4th the expected dose and see how that feels.
Please note that if their doctor puts them on Rx anastrozole, the same events will unfold except their doc probably has no knowledge of the over-responder issue and has not provided any advice about what to look for and what to do. When a guy has very low E2, lab results may be below the reporting threshold and you do not get any lab data. In that case, one cannot then do the linear dose correction calculation to get the right dose. Note that this calculation also decreases anastrozole dosing appropriately. And this leads into dose refinement that one cannot do with 1/4mg increments by cutting the 1mg pills. The only way to appropriately small dose increments is with a liquid products that are not generally available by Rx.
However, a compounding pharmacy could make this up. For over responders, taking 1/4mg per week in EOD doses is not an easy task. We do have some who dissolve their 1mg tablets in vodka and dispense by the drop. Note the anastrozole is hydrophobic and will not dissolve in water; does dissolve well in alcohol and 80 proof vodka works well.
To do a dose calculation, one first needs get to into a reportable lab range. The over-responder needs to feel his way there. If one is not taking anastrozole and does E2 lab work, there is no dose calculation possible and the first dosing of anastrozole after E2 lab work still carries the chance that one may have low E2 as an over-responder and one then is needing to feel their way into lab range, then get E2 tested again and then the dose calculation can land a guy near target levels. In that case, two lab followup cycles with their doc can take a long time. That can be a really burden, especially those who might be depressed to begin with.
Then we get docs who Rx 1mg anastrozole per day because that is what the prescribing info states [for breast cancer].
Yes, people are different. It is amazing that that for some on TRT without an AI will report that they feel a lot worse than before. Any those events cannot all be explained away by thyroid or cortisol complicators. And the misery that guys can feel from elevated E2 can easily be shared with ones wife and kids. Coping skills can be very challenged. When I report that when I got on anastrozole years ag0, E2=37-->22, it really was like a rebirth.
The changes to brain structure created by T when one grows up makes coping with estrogen dominance very difficult, more for some than others. For those who like such reading, "The Male Brain" by Louann Brizendine is a very good read and you might also like the companion book "The Female Brain". These books explore the roles of hormones on brain and personality development, and the effects of losses of hormones. Good info on the role of neural transmitters.
These books also explore the effects on social interaction, sexual development, sexual pursuit, competition, nurturer, mental health etc. The reading of one book, makes the next book of great value as one starts to understand the differences, one vs that other. The result is greater than the sum of the parts. But such interests are really not what many will care for.