I'm on your side of this debate, but I think we need to individually evaluate studies associating harm with higher estradiol. For example, the study finding harm with estradiol over 34 pg/mL used an immunoassay test: "A quantitative competitive immunoassay (Immulite 2000) was used to measure serum 17 estradiol and testosterone." If this test was also measuring CRP then we cannot say that the negative association is necessarily with estradiol.
Good point. I agree with you. Any study regardless of results should be looked at. The reality is studies are not being done that show any harmful effects from an AI as long as the dose of AI still keeps E2 levels normal and not too low. Just as no one is studying men who take TRT and have elevated E2 levels due to the conversion.
Lets be honest about the realities of testosterone usage here. Most of us want our test levels to be above the normal range. Even though we know some men can have 1000 test levels naturally these guys are teens going through quick puberty and exceptionally rare athletes. Now I am all for men having elevasted test levels as long as its not causing harm to their bodies in other ways (blood pressure, prostate, blood count ect). But very few of us can achieve 1000+ testosterone levels without our E2 climbing to the level of a female or to the level of a man transitioning to a female without taking some dose of an AI.
Most will agree that AI's can be overused. Some people will be ok walking around with elevated E2... Is elevated E2 risky in isolation? Maybe, maybe not. We just dont know. But to take this anti AI stance and pretend we know we are putting some toxic chemical into our bodies is irresponsible and not based on evidence or science.
E2 levels can be managed without an AI.
We were discussing AI usage, not E2 levels. In the same article that was linked above, there are some valuable things that weren't quoted:
"There are scientific studies that demonstrate estrogen’s potential beneficial effects to a man’s vascular system. These protective mechanisms, however, have to be weighed against pathological damage the very same estrogen can induce.
As I mentioned earlier, despite the documented dangers of excess estrogen, levels that are too low also present risks, not only to bone,45,47-49 but to the vascular system as well.46,50,51 If a man were to intentionally lower his estradiol too much, he could very well suffer vascular disease because estrogen is vital to proper endothelial function.52,53
This is why it is so important for aging men to have annual blood tests. If estrogen is too low (below 18-20 pg/mL), or too high (above 30 pg/mL), corrective action should be taken."
....
"Some men are so deficient in aromatase that they do not make enough estrogen.
If a blood test reveals estradiol below 20 pg/mL, which may occur if Arimidex®, for example, is being taken at too high a dose, one should consider reducing the dose. Alternatively, applying a tiny dose of a compounded topical estradiol cream to the skin several times a week may also help increase estradiol levels. Follow-up blood tests 30-45 days later can assess if too much or too little topical estradiol cream is being used."
---
So the same article that talks about the dangers of high E2 also discouraged the use of the AI, because of potential negative effects of lowering E2 too much.
Not to mention that any substance, which affects liver enzymes simply cannot be safe for long term usage.
We were discussing AI usage, not E2 levels. In the same article that was linked above, there are some valuable things that weren't quoted:
"There are scientific studies that demonstrate estrogen’s potential beneficial effects to a man’s vascular system. These protective mechanisms, however, have to be weighed against pathological damage the very same estrogen can induce.
As I mentioned earlier, despite the documented dangers of excess estrogen, levels that are too low also present risks, not only to bone,45,47-49 but to the vascular system as well.46,50,51 If a man were to intentionally lower his estradiol too much, he could very well suffer vascular disease because estrogen is vital to proper endothelial function.52,53
This is why it is so important for aging men to have annual blood tests. If estrogen is too low (below 18-20 pg/mL), or too high (above 30 pg/mL), corrective action should be taken."
....
"Some men are so deficient in aromatase that they do not make enough estrogen.
If a blood test reveals estradiol below 20 pg/mL, which may occur if Arimidex®, for example, is being taken at too high a dose, one should consider reducing the dose. Alternatively, applying a tiny dose of a compounded topical estradiol cream to the skin several times a week may also help increase estradiol levels. Follow-up blood tests 30-45 days later can assess if too much or too little topical estradiol cream is being used."
---
So the same article that talks about the dangers of high E2 also discouraged the use of the AI, because of potential negative effects of lowering E2 too much.
Not to mention that any substance, which affects liver enzymes simply cannot be safe for long term usage.
This is an excellent point. I've been as guilty as anyone of the "more is better" thinking, but lately with daily propionate I've been testing the lower limits. On a mere 6 mg per day subjective results for libido, sexual function and mood have been as good as or better than when using higher T doses over the years. What I haven't done is lower the AI dose—from 34 mcg/d anastrozole. This means that trough estradiol has probably gone from low 30s pg/mL to upper 20s. Less estradiol and better sexual function? It seems to be an individual thing, so we just have to experiment.
To be fair the article is not discouraging the use of AI. It is discouraging people from using a dose that drops your estrogen below a health level. The article actually discourages estrogen levels above 30 which most men taking testosterone will likely have when trying to achieve high/normal testosterone levels.
So according to the article men would need to keep testosterone levels in a low enough range to avoid E2 levels over 30. For most people this is only achievable with the use of a low dose AI.
The effect anastrozole has on liver enzymes are actually very low and not considered dangerous long term.
Anastrozole
Absolutely. I will come back and report. Right now my plan is to come off and monitor any symptoms until next bloods. I am sure I will be kinda anxious and overly observant now for stopping thinking some type of symptoms will occur or make up in my head. Lol. I’ll post labs. Also, if I fall off and start again, I’ll own up to it and let you guys no.
Blackhawk
Member
While there may still be outliers who learn bad information around body building or bro science communities who want to knock E2 below healthful levels, the overall approach of discussion on this forum has long been advocating healthful E2 levels as it is well known that low E2 leads to many problems including bone loss and overall mortality.
No one here that I know of advocates dropping E2 below healthful levels with AI. I don't understand why these discussions keep coming back to this talking point.
No one here that I know of advocates dropping E2 below healthful levels with AI. I don't understand why these discussions keep coming back to this talking point.
CoastWatcher
Moderator
It reminds me of a political or religious argument where the same points are made and made and made...
Wow I didnt think it was possible for someone to be as wrong as many times in 1 post as you were just now.
I'm pretty sure most people on here have watched this TRT roundtable. The difference is we didnt let Jay Cambells propaganda mouth take away our critical thinking ability as easily as you have. Jay Campbell has a business relationship with a few of those doctors and he tries to push potential patients/customers to these doctors. Of course the need to try to stand out from the rest of the doctors offering telemedicine and this is one of the only angles they have come up with. If you want to listen to a guy who says E2 isnt a problem and claims he doesnt even test it and then a week later slips up and says his E2 test results were delayed then go ahead. Meanwhile he pretends rubbing his sack with DHT is the #1 protocol on another video, ignoring the rapidly thinning hair on his head and also ignoring the prostate issues that could come from high DHT. Just because you can't see through him doesnt mean we can't.
We asked the obvious normal and rational questions and we can't get a real answer.
We see the potential health risk associated with too high an estrogen level. You choose to ignore them. We have been shown zero evidence that taking an AI to keep estrogen levels normal is harmful to anyone.
The biggest failing in your flawed reasoning is pretending that what works for you is what has to work for everyone. This is foolish and as a grown up person you should be beyond this type of thinking.
Just because you dont have estrogen side effects without an AI doesnt mean everyone else doesnt. Some people can start growing breast tissue and swell up at E2 levels of 40. Just because you don't does that mean someone else can't? Let me guess? The person should just reduce their test dose then as you said. Wrong. The test levels at which you feel beneficial from TRT therapy is not what works for everyone.
The reason this debate keeps surfacing is because people like you and Jay Campbell that can't accept that each person is unique and react differently to different protocols.
You show your lack of original thought and critical thinking ability in you "magical number" nonsense. You sound like Jay Campbell once again. People are not searching for magical numbers. They are searching for symptom resolution.
Try doing a little research about the levels at which estrogen is beneficial. You will find that level is pretty low and a level that we all maintain. While you are at it try learning about the levels at which estrogen can be harmful to men. More is not always better. This applies to both Testosterone and Estrogen.
For many there's a catch-22 involved in trying to recreate "natural" conditions with TRT. Even at low doses most guys experience HPTA shutdown. There's at least reasonable suspicion that this causes problems in addition to atrophied testicles—in part related to all those unstimulated LH receptors that used to do something. So we add hCG to deal with that, but this introduces other potential problems because of its long half-life and direct stimulation of aromatization. Now you may have disproportionately high estradiol even at low TRT doses.
What are one or two of those studies that you think best demonstrate that surpraphysiological estradiol levels are beneficial in males? Also what is their source for normal estradiol levels? My references say that in healthy men average estradiol peaks at around 28 pg/mL and drops to the low 20s over a lifetime.
Vince Carter
Banned
You guys can keep on circling the exact same thing getting nowhere like you do every other time you try to play this circle jerk game with each other.
there's so much confusing and incorrect information here it's kinda absurd.
Why are people trying so desperately to make someone take AI's when there is really no need for it? Maybe I am missing something here, but none of this makes any sense.
Yes high E2 levels aren't great (maybe even dangerous), but that does not mean a patient has to take an AI to lower them. There are other ways to deal with elevated E2. But that doesn't have anything to do with the topic of the OP.
OP's levels are actually on the lower end of the spectrum (which is also not desirable). Given this specific situation, not some random studies on elderly men or women with cancer, there is no reason to keep taking a heavy pharmaceutical. This is circle jerk is indeed maddening, because everyone just keeps saying the same stuff over and over, without an ounce of consideration for the actual situation that OP brought up.
Again, OP's E2 levels are fine. Then take a freaking break from the medication. How difficult is that to comprehend? Nobody is going to die of a stroke even if E2 levels go above the norm. We'd have thousands of people dropping dead, but that doesn't seem to be the case at all.
By the logic of some people here, we should take antibiotics regularly to avoid infection. Take ibuprofen to prevent some pain that may happen during training. Take antidepressants to avoid depression, even if you are feeling completely fine.
To me this shows complete lack of understanding about how medications work, and how to take them.
Why are people trying so desperately to make someone take AI's when there is really no need for it? Maybe I am missing something here, but none of this makes any sense.
Yes high E2 levels aren't great (maybe even dangerous), but that does not mean a patient has to take an AI to lower them. There are other ways to deal with elevated E2. But that doesn't have anything to do with the topic of the OP.
OP's levels are actually on the lower end of the spectrum (which is also not desirable). Given this specific situation, not some random studies on elderly men or women with cancer, there is no reason to keep taking a heavy pharmaceutical. This is circle jerk is indeed maddening, because everyone just keeps saying the same stuff over and over, without an ounce of consideration for the actual situation that OP brought up.
Again, OP's E2 levels are fine. Then take a freaking break from the medication. How difficult is that to comprehend? Nobody is going to die of a stroke even if E2 levels go above the norm. We'd have thousands of people dropping dead, but that doesn't seem to be the case at all.
By the logic of some people here, we should take antibiotics regularly to avoid infection. Take ibuprofen to prevent some pain that may happen during training. Take antidepressants to avoid depression, even if you are feeling completely fine.
To me this shows complete lack of understanding about how medications work, and how to take them.
Feel free to correct the 'absurd incorrect' information here.
I havent seen the post where anyone is trying so desperately to make someone take an AI. Maybe I missed that one. Help me out.
The incorrect information that keeps getting spread is concerning how dangerous these 'heavy pharmaceuticals' are. There simply isnt any evidence backing up this claim.
The answer to the OP's question is relatively simple. If he wants his E2 to increase then he can stop taking the AI or lower his dose. Of course neither option will kill him.
This topic will always bring the Jay Campbell anti AI mob squad around.
If this is what high estrogen turns people in to then I better call defy and ask for the anastrozole asap.
CoastWatcher
Moderator
Thank you - your closing sentence is a rational response.
I know of other members here who have found they feel better off with an AI, and that’s all they need to know.
Exactly. Some will benefit, some will not.
The key to anything in life is balance. It will always be balance. For whatever reason, the universe works off of a system of balance. If you’re ever wondering which side is correct, always remember that 99.9% of the time it is going to be a balance of both ideas that is ultimately correct.
The key to anything in life is balance. It will always be balance. For whatever reason, the universe works off of a system of balance. If you’re ever wondering which side is correct, always remember that 99.9% of the time it is going to be a balance of both ideas that is ultimately correct.
Interesting. Would like to hear how it goes.
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