I suggest we remove the third point above about arimidex and change to something like after 6 weeks get labs to determine if an AI is necessary.
Change/amend AI recommendation in TRT protocol?
Looping in @Chris_Colucci to monitor this thread. And @KSman to review.
If not changed, amended. There needs to be more flexibility with this these statements.
My TRT started working when I stopped FUCKING with my e2.
I like this.
I suggested to a new member that he try using 50mg a week twice a week and no AI to see where his e2 is without it, to see if he even needs an AI. Someone else advised him that there was no value in finding this information out… I still cant believe I read that.
There is also no mention of needing more or less AI with a higher or lower SHBG. I think that’s also important.
Don’t worry about looping me in. I see all.
You want to make sure @KSMan is part of this conversation.
Thanks for taking the time to start this thread. This will help a lot of guys starting down this path.
What about someone who already has high E2 prior to starting?
Those bullets are general guidance. Of course things need to be addressed on a case by case basis. We can also say that some with high prolactin may also need to start with that medication that lowers prolactin.
That’s why we need to rethink sending newbies to this sticky. We can add things like SHBG is important in determining injection frequency.
with high e2 I mean if we say need to check labs in 6 weeks that means if you are starting high this typical protocol may not suit u or an AI need to start right away.
When my T was low my e2 was low with it. Not sure if this is typical.
My E2 was low before trt also. Maybe it’s common.
I think I’ve made my opinions known on this. 90% of my patients don’t use any AI and the ones that do typically have liver dysfunction issues. I think telling people on low dose t they need an AI with zero lab work and zero time to give their body an adjustment period (the newest research out of seminars is that over time your body naturally adjusts estrogen to the correctness levels) is not just bad advice but also extremely dangerous and negligent. I have encountered so many men who have wrecked themselves with information like the kind tossed around this forum about AI use and even thyroid misdiagnosis etc. it’s nonsense. So yes to answer you I think altering the info advising people to WAIT before adding in other drugs is advisable.
Bump. Please vote in 1st post above.
Protocols need to be created for a specific individual, if a guy has estrogen in the single digits pre-TRT I wouldn’t recommend an AI in the beginning, however if estrogen looks normal pre-TRT an AI will likely be needed.
The sticky is best for the majority of guys who are overweight and are expected to aromatase quite a bit more than a guy in good physical shape. Most guys coming here have a degree of hypothyroidism and low testosterone and is a recipe for aromatisation.
So then the protocol should state that it is for the unfit , not in shape or overweight guys?
Starting anyone with 1 mg a week of an AI is not wise even if e2 is slightly elevated at start.
I have a ton of readtime on here and yet to find 1mg per 100mg test gets you to the sweet spot. It’s actually to the contrary. Many go right through their sweet spot.
Completely true.
I disagree with this comment, and to my knowledge is contrary to everything commonly shared in this forum. For instance, go read anyone’s initial case. Regardless of height, weight, body fat, meds, symptoms, primary, secondary etc,. the beginning recommendation is the same across the board. It’s merely a generalized starting point, and should not be considered gospel. Also, if this were true the best thing we could do is push them to any other forum on this site and have them get in shape. TRT wont matter in the long run if your have 40% body fat and you’re a complete wreck. TRT could help with workouts, but nothing will matter if you keep shoveling 10,000 calories down the hatch with an alcohol chaser.
To ensure people are safe how about we also suggest they first discuss treatment with a medical professional. While we’re at it, how about we stop promoting hate against the medical profession. If we can’t have an open and candid conversation with our doctor, who I assume we’ve developed a relationship with rather than doctor shopping to obtain a controlled substance, that is on us not them. Not everyone with low T should be on TRT. Docs can help assess the big picture like family history, heart, prostate, cancer, HPTA, substance abuse, mental illness…way more variables to solve for than simply testosterone.
I rode the anastrazole roller coaster for way to long before I kicked it 6 months ago. I still don’t think I have 100% of libido/sexual function back after having way low E for way to long due to to much AI but am improving daily.
I’d rather start with single hormone manipulation and wait for a response before automatically adding an AI.
IMO It’s way more difficult to get a crashed E2 stabilized than to knock a high E2 down if needed.
Wisdom
Don’t expect a response man. People here don’t like advocating change lol.
Sometimes it takes a year to get healthy after fucking with estrogen and knocking it low. You’ll get better for sure. Your view on this subject is spot on