Effect of anastrozole on testosterone levels

[HealthMan]

I have been reading conflicting information about the effect of anastrozole on total/free testosterone levels while on TRT using testosterone cypionate.
Everything else unchanged what would happen to total/free testosterone levels if anastrozole dosage is increased? Shouldnt these levels increase given less testosterone is being aromatized to estradiol? If yes is this change relevant?

 

[Vince Carter]

I have been reading conflicting information about the effect of anastrozole on total/free testosterone levels while on TRT using testosterone cypionate.
Everything else unchanged what would happen to total/free testosterone levels if anastrozole dosage is increased? Shouldnt these levels increase given less testosterone is being aromatized to estradiol? If yes is this change relevant?

You could logically arrive at that conclusion only individual testing could indicate as much, for you. Could a T/FT increase be a few points? A hundred? who knows. I know at one-time I was pushing E as high as 88, now I'm down to 25-30 with Anastrozole and no change in my Cyp dosing so presumably...logically, I would have a better Total/FT

 

[johndoesmith]

I have been reading conflicting information about the effect of anastrozole on total/free testosterone levels while on TRT using testosterone cypionate.
Everything else unchanged what would happen to total/free testosterone levels if anastrozole dosage is increased? Shouldnt these levels increase given less testosterone is being aromatized to estradiol? If yes is this change relevant?

This is a question I've discussed with many, many people who are much more intelligent than myself, including pharmacists, a med student, and Dr Saya, in absolute excruciating detail.

The fact is, the amount of increase by cessation of aromatization is miniscule, especially considering the lack of potency of testosterone relative to estradiol(500 vs 600 test is unnoticeable but 40 vs 50 E2 is noticable).

I've found a study that accidentally compares this exact phenomenon.



Men were given testosterone gel. Blue without AI. Red with 1mg adex per day with intention of crashing E2 to nothing. They also used the LC/MS-MS test! Researchers are catching on!

I believe there was about a 100ng/dl difference in total which honestly isn't worth talking about.

 

[Dr Justin Saya MD]

Johndoesmith is, as usual, on point. The absolute concentration of estradiol in the system is so small in comparison to testosterone, that even if you completely suppress aromatization it would only "save" a small percentage of testosterone and, consequently, you would only see a negligible/small increase in testosterone (obviously at the trade-off of the side effects of low estradiol).

I have an older post here on the forum showing that even for FEMALES, the actual absolute concentration of estradiol is typically LESS than the concentration of testosterone. This is magnified several fold for males obviously.

 

[HealthMan]

This is a question I've discussed with many, many people who are much more intelligent than myself, including pharmacists, a med student, and Dr Saya, in absolute excruciating detail.

The fact is, the amount of increase by cessation of aromatization is miniscule, especially considering the lack of potency of testosterone relative to estradiol(500 vs 600 test is unnoticeable but 40 vs 50 E2 is noticable).

I've found a study that accidentally compares this exact phenomenon.

View attachment 3017

Men were given testosterone gel. Blue without AI. Red with 1mg adex per day with intention of crashing E2 to nothing. They also used the LC/MS-MS test! Researchers are catching on!

I believe there was about a 100ng/dl difference in total which honestly isn't worth talking about.

Great information! Much appreciated taking the time to answer my question!

 

[HealthMan]

Johndoesmith is, as usual, on point. The absolute concentration of estradiol in the system is so small in comparison to testosterone, that even if you completely suppress aromatization it would only "save" a small percentage of testosterone and, consequently, you would only see a negligible/small increase in testosterone (obviously at the trade-off of the side effects of low estradiol).

I have an older post here on the forum showing that even for FEMALES, the actual absolute concentration of estradiol is typically LESS than the concentration of testosterone. This is magnified several fold for males obviously.

That makes sense. Thanks Dr Saya! On a side note what about HCG effect on testosterone (comparing testosterone + HCG vs HCG monotherapy). Changes in HCG dosages have different impacts in changes in Total testosterone using these 2 different TRT approaches? i.e adding exogenous testosterone changes the way the body responds to HCG?

 

[johndoesmith]

Johndoesmith is, as usual, on point. The absolute concentration of estradiol in the system is so small in comparison to testosterone, that even if you completely suppress aromatization it would only "save" a small percentage of testosterone and, consequently, you would only see a negligible/small increase in testosterone (obviously at the trade-off of the side effects of low estradiol).

I have an older post here on the forum showing that even for FEMALES, the actual absolute concentration of estradiol is typically LESS than the concentration of testosterone. This is magnified several fold for males obviously.

Thank you for that Dr. Saya

The way I've explained it to people, is that estradiol is measured in PICOgrams/mL. A picogram is one trillionth of a gram.

A million seconds is 11 days, a billion seconds is 31 years, and a trillion seconds is 31,000 years. So the average E2 concentration in men is 30pg/mL or so, which is 30 seconds out of 31,000 years, even that is hard for humans to wrap their heads around.

You could almost call estradiol homeopathy Just kidding! Although the concentration of "ingredient" in homeopathy is highly diluted(to non existence) and doesn't work, estradiol DOES!

That makes sense. Thanks Dr Saya! On a side note what about HCG effect on testosterone (comparing testosterone + HCG vs HCG monotherapy). Changes in HCG dosages have different impacts in changes in Total testosterone using these 2 different TRT approaches? i.e adding exogenous testosterone changes the way the body responds to HCG?

Although I am not Dr. Saya, I may be able to answer what you've asked.

I think what you're asking is what effect will adding hCG to a guy on TRT in regards to testosterone levels? That will depend on how secondary vs. primary he is. A primary guy may notice very little increase but a secondary guy may notice a significant increase.

I don't think exogenous testosterone will alter the way the testes responds to hCG, as hCG is suppressive to the HPTA in and of itself.

 

[Dr Justin Saya MD]

That makes sense. Thanks Dr Saya! On a side note what about HCG effect on testosterone (comparing testosterone + HCG vs HCG monotherapy). Changes in HCG dosages have different impacts in changes in Total testosterone using these 2 different TRT approaches? i.e adding exogenous testosterone changes the way the body responds to HCG?

As johndoesmith mentioned, TRT will not alter the testicular response to HCG. Further, again as he stated, the testicular response to HCG largely hinges on the degree of PRIMARY Hypogonadism that is present. With that said, one can see a larger ABSOLUTE increase in testosterone production from HCG monotherapy as opposed to just the addition of HCG to TRT for a very simple reason...HCG dosing for MONOtherapy is typically much higher than HCG dosing simply for preservation of testicular function concurrent with TRT.

 

[HealthMan]

Thanks you both for the clarification! As always very helpful!

 

[Dr Justin Saya MD]

Thanks you both for the clarification! As always very helpful!

Anytime HealthMan.

 

[Sean Mosher]

This post is excellent!