Prophylactic Use of AI

Thread starter #1
I saw an interview with Dr. Rand McClain and he mentioned a "prophylactic" use of anastrozole... I also think I've heard Dr. Chrisler mention this in an interview...

If a guy is starting TRT and has a high body fat percentage (say over 20%), they may start him on an AI right from the beginning. What do you guys think of this? Low consistent prophylactic dose vs a scrip to be used on an as-needed basis vs no AI until/unless follow-up labs show high E2?
 
#2
there is not such thing as prophylactic use of an AI
low estrogen levels are far worse for man's health than high estrogen levels.. if man has high estradiol levels proved by proper bloodtest than his doctor might prescribe him an AI if he doesn't want to lower it naturally. the risk of such reckless AI use "prophylactic" can cause more problems than low testosterone.
 
#3
I've definitely heard Dr. Rand say that but never have heard Crisler.
Have always wanted to know why he believes in suppressing estradiol to such low levels.
 
#4
Not exactly sure what he means by prophylactic use, but if a fat, middle aged guy has elevated E2 on pre TRT labs and they begin a course of testosterone and hcg, it doesn't take a rocket scientist to think this guy is probably going to need an ai. So I have no problem starting off on a very low dose rather than waiting six weeks to get results. Just my 2 cents.
 
#5
You can do Labs after six weeks of starting trt. My opinion is wait to have your Labs then consider if you need an AI. If you do have very high estradiol levels before starting trt, probably the best way would be to use a low-dose AI right from beginning. So like we say every patient is totally different.
 
#6
Not exactly sure what he means by prophylactic use, but if a fat, middle aged guy has elevated E2 on pre TRT labs and they begin a course of testosterone and hcg, it doesn't take a rocket scientist to think this guy is probably going to need an ai. So I have no problem starting off on a very low dose rather than waiting six weeks to get results. Just my 2 cents.
how do you know if he will need an AI? recently some guy started thread how hes e2 got crashed on trt (testosterone + dhea no ai).. sometimes e2 doesn't raise on trt but goes down instead
 
#7
I saw an interview with Dr. Rand McClain and he mentioned a "prophylactic" use of anastrozole... I also think I've heard Dr. Chrisler mention this in an interview...

If a guy is starting TRT and has a high body fat percentage (say over 20%), they may start him on an AI right from the beginning. What do you guys think of this? Low consistent prophylactic dose vs a scrip to be used on an as-needed basis vs no AI until/unless follow-up labs show high E2?
We typically decry any use of an AI as a basic inclusion in ANY protocol, for any reason at all. It's simply innappropriate to prescribe it based on "maybe" and should only be used when negative symptoms are present and verified by the proper testing.
 
#8
We typically decry any use of an AI as a basic inclusion in ANY protocol, for any reason at all. It's simply innappropriate to prescribe it based on "maybe" and should only be used when negative symptoms are present and verified by the proper testing.
Excellent post. And even with proper testing, the "sweet spot" is still variable. I chased a number for awhile and felt awful when I should have felt great. I feel much better with what some will consider elevated e2.
 
#9
I believe Ive heard one of the Drs state that they prescribe it because they get questioned about it from the get-go, it's expected by the patient, so they prescribe a very low dose something like .125mg with a use a needed but then new guys really can't judge things like that very well.
 
#10
^there is no sweet spot.. people sometimes feel great at 20-30 e2 because something happens and you feel almost "high" that only happens if one is shutdown and on trt you won't get same effect with 20-30 e2 not on trt. eventually you no longer get that effect from being in 20-30 e2 zone. chasing that high makes people crash their e2 eventually. I can't prove this by any study only by my personal experience with usage of arimidex.. these same people who say they feel best at 20-30 e2 feel like shit if they stop AI and can't tolerate any e2
 
#12
The year spent low testosterone, low estrogen cause floaters in both eyes, I would prefer to be towards mid-high normal for estrogen to be safe. Estrogen is far too important to short changing yourself and cause other health problems down the road.
 
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