Dr. Kominiarek on AIs...

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JimBob

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So, Dr. K states that long term use of AIs does damage, at least with regards to bone density, in all men except for the odd outlier, regardless of dosage. This is, of course, diametrically opposed to Dr. Crisler's position, who has frequently stated that there are no studies showing harm when the dosage is an "appropriate" amount. Is Crisler saying there are no studies showing harm when the dosage is an "appropriate" amount, or that there are no studies at all to begin with? Big difference. Anyway, a good presentation by Dr. K.

 
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At 11:55 (start at 11:45 he says to increase the frequency of the dose by spreading it out farther to decrease symptoms of high estradiol. I thought it was the opposite?

Also, Jay mentioned that AIs contain toxic chemicals. I wasn't aware of that.
 
At 11:55 (start at 11:45 he says to increase the frequency of the dose by spreading it out farther to decrease symptoms of high estradiol. I thought it was the opposite?

Also, Jay mentioned that AIs contain toxic chemicals. I wasn't aware of that.

Yeah, that was confusing. If you go from injecting every 3rd day to every 4th day at a reduced dose, you would be decreasing the frequency, not increasing the frequency, right? And yeah, for eliminating E2 symptoms, this is ass backwards from what we normally hear.
 
Ya obviously he meant going from 4 days to 3 days, but said it the other way around. But it was confusing, because it wasn’t just a quick slip up, he explained it for a minute or two and never realized that he was saying it backwards.

So ai’s contain toxic chemicals? I also wonder if that’s true. I’ll have to google it and see what I come up with.
 
Jay first said increase the frequency then Rob said it also.

They always talk about “these studies”... but never any specifics pointing to a quality study.

We get it. 3x1mg per week anastrozole is bad.

What if I’m on anastrozole and my e2 is still double my pre trt levels?
 
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The impression I get (which I have to agree, fewer drugs is always the goal), is that they are arguing that for 95% of guys your doc should be able to dial you in without the use of an AI.
Obviously there are outliers, but I think this is what they're driving at.
This also somewhat leaves the assumption that you're doc isn't doing his/her job if their first response is to just throw in an AI without trying multiple other tweaks and changes.
This is just how I'm hearing what they're saying so it's my opinion.
I do agree that this quick 20 minute clip was the way it should have been approached from the beginning, no heightened emotions, no shoving this down people's throats, just a rationale discussion with a top notch doctor on his philosophy of treatment.
 
I think the E2 madness came from some doctors trying to get patients. Patients seeing Endos couldn't even get them to check their levels and wouldn't even consider an AI. Next will be back to dosing T for mid range and drop HCG. We will be back to the protocol of the Endo that didn't know what they was doing.
 
Jay first said increase the frequency then Rob said it also.

They always talk about “these studies”... but never any specifics pointing to a quality study.

We get it. 3x1mg per week anastrozole is bad.

What if I’m on anastrozole and my e2 is still double my pre trt levels?


EXACTLY!!!!! I don’t understand how such smart men can extrapolate information from such flawed studies. I understand that there are no long term studies done in healthy males on TRT and a small dose of ai that keeps their free E2 mid range, top of the range, or slightly above the top of the range, but until then, quoting these extremely flawed studies done on men with either zero E2, or men with very high E2 but don’t specify how high their E2 was, or how they felt subjectively, is just making them look bad and discrediting all their valid points, imo.

It’s like if someone were to tell you 10 things, and then the 11th thing u found out was a lie. It would then discredit the other 10 things they just told you, because now you would have to wonder if they were all lies as well. I’m just saying that if these doctors aren’t smart enough to see how flawed these studies are, how are we supposed to trust that they are intelligent enough to extrapolate data from all the other “studies” that they supposedly have gotten their information on in regards to very elevated E2 having only benefits and no risks?
 
The impression I get (which I have to agree, fewer drugs is always the goal), is that they are arguing that for 95% of guys your doc should be able to dial you in without the use of an AI.
Obviously there are outliers, but I think this is what they're driving at.
This also somewhat leaves the assumption that you're doc isn't doing his/her job if their first response is to just throw in an AI without trying multiple other tweaks and changes.
This is just how I'm hearing what they're saying so it's my opinion.
I do agree that this quick 20 minute clip was the way it should have been approached from the beginning, no heightened emotions, no shoving this down people's throats, just a rationale discussion with a top notch doctor on his philosophy of treatment.

Great post. I think you’re spot on, and this is the overall message that they’re trying to get across, which is completely valid, imo, and will defintirly help a lot of men on TRT get dialed in.
 
EXACTLY!!!!! I don’t understand how such smart men can extrapolate information from such flawed studies. I understand that there are no long term studies done in healthy males on TRT and a small dose of ai that keeps their free E2 mid range, top of the range, or slightly above the top of the range, but until then, quoting these extremely flawed studies done on men with either zero E2, or men with very high E2 but don’t specify how high their E2 was, or how they felt subjectively, is just making them look bad and discrediting all their valid points, imo.

It’s like if someone were to tell you 10 things, and then the 11th thing u found out was a lie. It would then discredit the other 10 things they just told you, because now you would have to wonder if they were all lies as well. I’m just saying that if these doctors aren’t smart enough to see how flawed these studies are, how are we supposed to trust that they are intelligent enough to extrapolate data from all the other “studies” that they supposedly have gotten their information on in regards to very elevated E2 having only benefits and no risks?

A question for "Nelson", please
 
The impression I get (which I have to agree, fewer drugs is always the goal), is that they are arguing that for 95% of guys your doc should be able to dial you in without the use of an AI.
Obviously there are outliers, but I think this is what they're driving at.
This also somewhat leaves the assumption that you're doc isn't doing his/her job if their first response is to just throw in an AI without trying multiple other tweaks and changes.
This is just how I'm hearing what they're saying so it's my opinion.
I do agree that this quick 20 minute clip was the way it should have been approached from the beginning, no heightened emotions, no shoving this down people's throats, just a rationale discussion with a top notch doctor on his philosophy of treatment.

But, I don't think Dr. K was giving the "outliers" a pass by any means, not after his remarks concerning bone loss...At best, I think he was suggesting AI use on only a temporary and limited basis for anyone and everyone.
 
I think what they're trying to get across is that nobody should ever take an AI unless it's absolutely necessary, but only for a few weeks if coming down from a high dose with extreme symptoms. They're toxic chemicals and cause osteoporosis and other problems, so never take them. The outliers are only those who need them for a short period of time. That's what I heard.

I understand that they're reacting to men routinely being prescribed adex .5 or 1mg 3x a week. I'm also not sure how it could be discerned that's in fact why a guy has osteoporosis, although I'd trust his judgement on that because of his experience and how many times he's seen it--everyday according to the woman at the desk. He must be seeing a lot of guys who have been to anti-aging clinics, as opposed to just those who had a GP or endo lacking experience. I think they could approach that whole thing differently.

Edit: I like the professional approach of Crisler and Rand (? the guy with gray hair who wears scrubs and answers questions on YT).
 
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I would like to hear why the guy had been taking an AI so long he now has osteoporosis. What was the AI doing for him to want to take it for so long. Was it worth what it has done to him?
 
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