Got Testosterone?

[Vic303]

At what dosages do the neg sides show up, using Adex? DH takes half a tab weekly, so only 0.5mg.

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[WillBrink]

Will - Let's talk aromatase inhibitors, relating to TRT. Effectiveness, safety, side effects, etc. Most of the time I see people recommend Arimidex (Anastrozole) and I wanted to learn more. So, after a bit of research, I thought I'd shoot a doctor friend an email and get his thoughts on Letrozole VS Anastrozole. One of the primary concerns with using Letro as an AI is erectile dysfunction, which I mentioned in my correspondence to him, and his reply was...

"I see the concerns reading the ED from the letrozole, however, I am more concerned with the increase in side effects including ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole."

Anyhow, let's start there. Hopefully we can all learn something.

Not totally clear where he's coming from on that, but some macro Qs/comments arise from the use of either drug, both being in the AI class of drugs. It's essential to use an AI only if indicated to control excessive conversion of T -> E2, vs simply suppress E2 (estradiol). Men need E2, for HDL, mood, etc. Some people simply add in an AI without any legit reason or blood work to indicate a need for it under some impression it makes the TRT "work" better, and that's simply not the case and bad science. The loss of libido or ED will be a result of overly suppressing E2 or overly elevated levels, vs keeping in the range wanted, generally 20-29 pg/mL. Either AI can do that, but letrozole seems to be trickier to dose correctly, perhaps more associated with ED. I'm not aware of anything unique about letrozole per se to ED. Some feel once correctly dosed, letrozole has a lower side effect profile. Most men don't need either of those drugs, and with a loss of some bodyfat, adjustment in TRT dose, etc can be managed fine.

The above side effects listed via his response are again due to improper management of E2 levels vs the drug itself per se as far as I know. I'm not aware of any head to head studies that find increased rates of "... ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole" in men on TRT to control E2. Maybe inquire as to where/what his source is for that statement.

[WillBrink]

At what dosages do the neg sides show up, using Adex? DH takes half a tab weekly, so only 0.5mg.

See comments above. At what ever dose, which is highly variable person to person, where E2 is overly suppressed, do side effects tend to appear. AIs are used to control E2, not suppress it to below "normal" levels, which can happen easily with AIs.

[Irish]

My interest is in lowering E2 into the "accepted range", <30 pg/mL, when body fat isn't an issue. I'm pretty well versed on estradiol and the good and bad for both suppressed and elevated levels. I'm in the camp that if you had to choose your poison I'd definitely rather be higher than 30, rather than under 20, due to bone loss issues.

The above side effects listed via his response are again due to improper management of E2 levels vs the drug itself per se as far as I know. I'm not aware of any head to head studies that find increased rates of "... ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole" in men on TRT to control E2. Maybe inquire as to where/what his source is for that statement.

He stated the "official drug profiles" and is sending me a copy in the mail. I'll check them out and give you source when I receive them. Worse comes to worse I can scan them and email them to you too.

[WillBrink]

My interest is in lowering E2 into the "accepted range", <30 pg/mL, when body fat isn't an issue. I'm pretty well versed on estradiol and the good and bad for both suppressed and elevated levels. I'm in the camp that if you had to choose your poison I'd definitely rather be higher than 30, rather than under 20, due to bone loss issues.

He stated the "official drug profiles" and is sending me a copy in the mail. I'll check them out and give you source when I receive them. Worse comes to worse I can scan them and email them to you too.

Those will be online some place. Data will generally be on women with breast cancer and of minimal value to how it's used in TRT in men.

[WillBrink]

Please see latest TRT/HRT related news regarding yours truly here:

https://www.m4carbine.net/showthread...nkZone-team-up

[WillBrink]

Hot off the presses. Not only did this study not find and increase in cardiovascular events, it found a reduction is cardiovascular events with men on TRT. This was a big study and published in the most prestigious of med journals:

Association of Testosterone Replacement With Cardiovascular
Outcomes Among Men With Androgen Deficiency

JAMAInternal Medicine

Key Points

Question What are the cardiovascular risks of testosterone
replacement therapy (TRT) in men with androgen deficiency?

Findings When use in androgen-deficient men with documented
low morning testosterone levels, TRT was not associated with an
increased risk of cardiovascular outcomes. During long-term
follow-up the risk of cardiovascular outcomes was lower in
testosterone-treated men.

Meaning These findings support the use of TRT in
androgen-deficient men.

Full paper:

http://jamanetwork.com/journals/jama...rticle/2604140

[Vic303]

Will, that's good to see this study got published.

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[caprice]

This may have already been covered and I just missed it, what is the optimal level, and yeah I realize that is subjective per person, for T count?

Male 48 years of age..heavy lifting (weights) wanting to continue. Doc I see seems a little confused, says range should be 400-600, somehow I would think higher would be better as long as Estradiol is under control, right?


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[WillBrink]

This may have already been covered and I just missed it, what is the optimal level, and yeah I realize that is subjective per person, for T count?

Male 48 years of age..heavy lifting (weights) wanting to continue. Doc I see seems a little confused, says range should be 400-600, somehow I would think higher would be better as long as Estradiol is under control, right?

For some reason, many docs shoot for middle of the range, which is 400-600. There's no data to support that however. Two, optimal includes favorable free T levels and estradiol (E2), and perhaps DHT. One can have high total but low free and so forth, so only tracking total T gives a very incomplete picture. Finally, humans are more than a lab number, so factoring in how you feel is also taken into account by a competent practitioner in my view.

It's a long thread, but well worth taking the time to read through it, and perhaps give you info you can supply the doc with. Many studies published in the thread.