Morgentaler and Touliatos: Keep Estrogen In a Certain Range

They do, in the US, I’ve found at least 2

Thanks guys. My question was poor and incomplete. I should have said off label the oxandrolone with the testosterone in place of the AI and tout the improved methodology.

But you guys are right I have seen clinics start with all three at once: test, oxandrolone and AI. Just thought it may be an interesting approach for the Gainz provider to tell the patient to not start the AI but instead start with oxandrolone for more GAINZ and E2 management. I am treading on a slippery slope here and I dont want to give anyone the idea that any of this would be good for long term health.

Also, interesting question if 50 mg per day of oxandrolone + 200 mg/week of testosterone will result in more gains that just 200 mg/week of testosterone? Taking the oxandrolone immediately drops you back to 100 mg/week of testosterone plus e2 benefits to anabolism.

For what it’s worth my place offered both without even explaining the impact lol. Those kinds of clinics probably don’t understand it themselves.

Ah yes, Costa Rica, home to TTRT (testosterone and trenbolone replacement therapy).

Can you explain (or link to one if you already have) why this would be? I assumed they were additive

Read here on down and links provided. Using 50% estimate but in reality your response will be dependent on your SHBG response to oxandrolone and baseline SHBG.

You said in another post that taking var or winnie drops your shbg but you wont come ahead in terms of free T, I would like to understand it better since I see you have good knowledge
Thanks

I started billing for my time doing ‘opinion only’ consults 3 weeks ago. I’m booked solid. I couldn’t keep up with the free messages anymore. This is the first time I’ve earned anything with my knowledge. To suggest clickbait or anything else is nonsense.

See the links above and here’s the original post:

Go through all those is a nice primer on apparent clearance rate, accuracy of online t calculators, shbg, free t.

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Thanks man

If my SHBG is already low and I’m on small daily shots of T anyway, adding Var would seem to have a smaller impact then?

Thanks, I’ve got a lot of reading to do lol

This video was literally just posted.

I don’t mean to sound like I’m attacking you personally, but as a physician who is a TRT pt (but not a TRT provider), I feel a need to respond to some of this.

So? I inject drugs originally developed to treat cancer into people’s eyes for non-cancerous conditions dozens of times a week. Drugs get repurposed all the time. What you’re doing here is not making a good faith, evidence-based argument against AI use, but rather attempting to frighten men into not using it by vilifying the compound itself. (It’s a CANCER drug! A LADY CANCER drug!) I hope that, upon reflection, you will agree this is not only specious; it is also unscientific and irresponsible.

Speaking of specious…Literally every substance in the universe–including both AIs and test cyp, but also seemingly mundane ones such as water, oxygen, etc–is potentially toxic. As Paracelus (sp?) noted a few years back, the dose makes the poison. So the fact that something is ‘toxic’ is not an argument either for or against its use.

Again, specious. This statement is true of literally every medical intervention on the planet, ie, it should only be used if/when its potential benefits are likely to outweigh its perceived risks. Further, you are again attempting to vilify AIs by implying they are a high-risk, last resort, Hail Mary/Broken Arrow type intervention. This is unwarranted–and as pointed out above, deeply inappropriate.

Having scanned a few of your posts, I have concluded the following:

  1. You have taken a deep dive into the TRT literature; and
  2. you surfaced from that dive having netted only studies that confirmed your pre-existing conclusions regarding AI use.

That is, while you may have read a great deal, it seems as though you have been moved only by studies that confirmed your opinions. In other words, you approach the medical literature in a manner opposite to what is appropriate–you let your conclusions shape your understanding of the literature rather than let your understanding of the literature shape your conclusions. Consider your claim that “there is literally not a single study out there that demonstrates the need to block or manage estradiol in a man.” This is so patently false as to be ludicrous. And if you truly believe it–that is, if it reflects your sincere understanding of the TRT literature–then my assertion about your approach to the literature is confirmed.

And to the subforum in general, let me be clear: I am not arguing that everyone should be on an AI. Nothing I said here should be construed as medical advice one way or the other in that regard. The only advice I would give is that everyone should seek care from a qualified medical professional. (And recall that I am not a TRT provider, so I have no skin in this game.) Additionally, I would urge everyone to bear in mind that, just because someone writes authoritatively and with an easy command of medical-ese, it does not follow that s/he knows what they’re talking about. This subforum has a checkered history in that regard; ie, posters who seemed to know their stuff, only to be revealed later as frauds, hucksters and posers. (To be clear, I am making general comments here, not referring specifically to @dbossa.)

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I need to run but I’ll leave a quick reply:

  1. I uses to take an AI. I was convinced estradiol was the cause of all my issues. I know better now.

  2. Every single physician I deal with used to prescribe AIs but don’t anymore because they know better now.

  3. The docs that still prescribe it clearly haven’t caught up and are doing things based in no evidence in the literature.

  4. Watch this and tell me where he has gone wrong, considering you are a physician:

Feel free to let me know your thoughts after watching it.

Come on @dbossa

We’ve gone through this.

Thanks for your time and thoughtful commentary @EyeDentist.

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Baseline SHBG and SHBG after oxandrolone would be the drivers. Dosing frequency will change your peak and trough (pharmacokinetics) of testosterone levels which would be secondary to the SHBG which sets free T to TT ratio in simple terms.

My pleasure, let me know your thoughts.

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My pleasure. Happy reading.

Mine did. But that was 3.5yrs ago and perhaps it’s gotten a little harder for them to justify it? I know the t-mill my BIL is going to can prescribe just about everything but oxandrolone is not on the list.

Thanks for weighing in. I modified my question slightly since it’s initial phrasing was a little lacking:

Perhaps I’m an exception but I saw modest reduction in SHBG and HDL on anastrozole. Not as drastic as oxandrolone. Regardless, to your point, many guys wouldn’t need an AI if they were actually doing TRT. Running supraphysiologic testosterone levels probably a good indication you will also have supra E2 levels with typical aromatization activity. But for truly high high SHBG guys who are baseline at 1200 ng/dL TT, I can see where 300-1200 ng/dL reference range is not applicable in order to get their free T to mid range. I hope everyone is having a nice weekend.

You’re too scientific here and too caught up with the numbers and the ranges. One of these days you and I should have a proper chat by phone :wink:

If I targeted my free T to be in the mid range of this ridiculous range we have, I’d be one miserable S.O.B.