New thoughts on AI

[Blackhawk]

With a lot of things, society will sometimes go from one extreme to the far opposite extreme. Neither is right, as few things are absolutes. Eventually, we settle in the middle.

LOL. The earth is semi round-flat.

It is interesting to entertain social bias as a factor in science, but in the case of hormone levels and study social bias is not science. Certainly the discussion here over this issue has contained a huge amount of this kind of bias.

 

[Cataceous]

LOL. The earth is semi round-flat.

It is interesting to entertain social bias as a factor in science, but in the case of hormone levels and study social bias is not science. Certainly the discussion here over this issue has contained a huge amount of this kind of bias.

It's when the science is lacking that opinions fill the void. We don't have the long-term studies on the opposing conditions: supraphysiological estradiol or modest AI use to achieve physiological estradiol.

 

[DragonBits]

It's when the science is lacking that opinions fill the void. We don't have the long-term studies on the opposing conditions: supraphysiological estradiol or modest AI use to achieve physiological estradiol.

Even more pernicious, even when science is clear, long held opinions for many people don't change.

Many instances, flat earth, climate change, real cause of stomach ulcers, TRT causes heart attacks, cholesterol is a bad thing where lower is always better, etc, etc.

People form an opinion, maybe it's based on flawed science, they operate for a long time based on that opinion / flawed science, then science corrects the flaws but most don't revise their thinking for many years if ever.

 

[Vitamin_C]

There’s actually no evidence of high e2 being bad when test is also high.

The TOT guys preach zero ai fo TRT doses, and the levels for TRT are loose. Suggestion is lower the dose if needed and skip ai. I agree.

Elevated estrogen levels prevalence of T2DM, especially in aging patients despite testosterone levels.
Circulating Estrone Levels Are Associated Prospectively With Diabetes Risk in Men of the Framingham Heart Study

 

[MarcoFL]

Elevated estrogen levels prevalence of T2DM, especially in aging patients despite testosterone levels.
Circulating Estrone Levels Are Associated Prospectively With Diabetes Risk in Men of the Framingham Heart Study

I have had estrone levels of close to 100 and my TRT doctor does not like it that high and stays on me to keep taking the anastrozole to bring it down and also keep my E2 in the 20's but then I hear others say do not worry about it. HMMM.

 

[JimBob]

I have had estrone levels of close to 100 and my TRT doctor does not like it that high and stays on me to keep taking the anastrozole to bring it down and also keep my E2 in the 20's but then I hear others say do not worry about it. HMMM.

Does your doctor have a specific reason for not liking it that high?

 

[Tman]

Does your doctor have a specific reason for not liking it that high?

part of this boils down to the numbers game versus the how you feel game versus ratios between T & e. If you subscribe to the idea of a ratio then hi e is okay as long as you have the higher t. There are studies that demonstrate serious side effects with high and low e for men, but they're not aligned with men who supplement.
I can tell you based on a comprehensive review of my blood work over the last year I've absolutely felt horrible with t around 500 and e at 20. I've also felt horrible with t at 950 and e35, but I've also felt decent with t at 700 and e at 50. As a matter of fact, ignoring the numbers, that was the best I've felt in my search to feel decent on t. Frankly I was shocked that my e was so high because I had the least amount of side effects at this point

 

[Vitamin_C]

I have had estrone levels of close to 100 and my TRT doctor does not like it that high and stays on me to keep taking the anastrozole to bring it down and also keep my E2 in the 20's but then I hear others say do not worry about it. HMMM.

It depends on how you feel and what your other labs look like, such as lipids, hA1C, etc. If your estrogen is elevated, I would imagine we would be seeing it have an effect on some lab values.

 

[Appassionato]

Men with active HPTA and not on TRT with high estrogen are not healthy. Not the least bit surprising. The fact their testosterone levels varied is expected. Doesn’t tell us anything about a man with TT of 1000-2000 on TRT with e2 of 50-100. Zero.

That’s why this debate doesn’t end. Evidence doesn’t exist except personal experience. I haven’t taken an ai since sometime in January. Best change I’ve made. I’ve been dialed in since late January. E2 is 90+. Libido through the rough and erections harder than ever.

I’m kinda backing away from this forum bc of this nonsense. I really only come here for the studies but somehow end up in threads like this with no substance.

What are your free T, free E2 and SHBG levels?

Also, I thought the whole purpose of TRT is to get close as possible to a healthy young man hormonal profile. I've been around natural testosterone optimization forums in the past and there were men that managed to get their total T exceeding 1100 ng/dL with an E2 that was never exceeding 35 pg/mL. So why someone on TRT and a total T of about 1000 should have an E2 of 90+ pg/mL?
Furthermore, aren't these doctors basing their claims about high E2 being beneficial on the very same papers done on people not on HRT or even on women?
The "not being symptomatic thing" is surely somethign to take in account, but I think many people are scared of long term effect on health, as no one is wishing to die from one day to another for a stroke.
There are body builders on steroids with a total T of 3000 ng/dL and an E2 of 100+ claiming to feel great, or even an endocrinologist (or at least this is what he claims to be) on T nation forum with a total T of 6000+ ng/dL and an E2 of 40 pg/mL, saying he doesn't have any symptoms.
Alright, but what do we know on the long term effect of such high hormones levels? What are the effects on aging organs?

Just to be clear, my tone is not polemic, I'm just trying to understand, because we are all on the same boat after all and the common goal should be restoring people healths as much as possible.

 

[JimBob]

At ~7:25 Dr. Kominiarek, again, addresses AIs, and the negative health consequences. The entire interview is pretty good, too.

 

[Appassionato]

At ~7:25 Dr. Kominiarek, again, addresses AIs, and the negative health consequences. The entire interview is pretty good, too.

Once again, he quoted 40k papers showing AIs have negative effects on health' like low mineral density etc etc. But where are the numbers? Did they drop their E2 to single digit?
No one is saying here to drop E2 where is not supposed to be.
Funny thing is that he says the "microdose" of AI he is prescribng is 0.25mg of Anastrazole, a dose that would have sent an over-responder like me to bed for one day.

I think the attached image is self-explanatory.

 

[equel]

At ~7:25 Dr. Kominiarek, again, addresses AIs, and the negative health consequences. The entire interview is pretty good, too.

I dont understand it. They keep saying that shit but WHERE ARE THE NUMBERS? No one dismiss that too low e2 is a problem, but WHERE are the studies that lowering ur e2 to the normal good range is harmful?!

 

[equel]

Men with active HPTA and not on TRT with high estrogen are not healthy. Not the least bit surprising. The fact their testosterone levels varied is expected. Doesn’t tell us anything about a man with TT of 1000-2000 on TRT with e2 of 50-100. Zero.

That’s why this debate doesn’t end. Evidence doesn’t exist except personal experience. I haven’t taken an ai since sometime in January. Best change I’ve made. I’ve been dialed in since late January. E2 is 90+. Libido through the rough and erections harder than ever.

I’m kinda backing away from this forum bc of this nonsense. I really only come here for the studies but somehow end up in threads like this with no substance.

What is ur shbg? I have low shbg and found that i just cannot tolerate much e2 at all.

 

[James]

I have low shbg and found that i just cannot tolerate much e2 at all.

The experience I've had with minor adjustments to my protocol are all the studies I need. Low dose AI and keeping E2 at or lower than my SHBG can be a winning formula. But likely won't work for the guy with mid/high SHBG. Understanding the role SHBG plays can lead to success.

 

[tmaxey1]

At ~7:25 Dr. Kominiarek, again, addresses AIs, and the negative health consequences. The entire interview is pretty good, too.

What they continually address is the exaggerated person taking high dose AIs that results in E2 levels in the single digits. There is not a single study or any evidence at all that shows that maintaining an normal man E2 level is harmful in any way at all.

No one is arguing that have E2 levels of 5 isn’t healthy. If someone can show me that it’s unhealthy for me to have a E2 level of 30 then it’s a different conversation.

 

[Gman86]

What they continually address is the exaggerated person taking high dose AIs that results in E2 levels in the single digits. There is not a single study or any evidence at all that shows that maintaining an normal man E2 level is harmful in any way at all.

No one is arguing that have E2 levels of 5 isn’t healthy. If someone can show me that it’s unhealthy for me to have a E2 level of 30 then it’s a different conversation.

Exactly! Well said. This drives me bonkers! Lol. I know the docs are smart guys with a ton of experience, but to me, they just sound like a bunch of morons when they quote studies done on people with <5 E2. Dr. Rob said him and his staff spent 2 weeks going over hundreds of studies about the effects of lowering E2. This is the most idiotic thing I’ve ever heard. Why waste your time going over hundreds of studies about men and women with no E2, on super high doses of ai? You know you’re just going to find the same conclusions in every single study. Yes, we know that having no E2 is fckn horrible. After 25 years of experience, you really need to continue to go over studies to figure this out, or solidify your position on the subject? Most of us here are not doctors, and haven’t gone over hundreds of studies, and we figured this out a long time ago. Yet, we’re the dumb ones, according to jay and dr Nichols.

Until someone does a study on using very low ai dosages, to get men’s E2 in a healthy range, while on TRT, they just need to stop with this whole “extrapolating data from thousands of studies on the subject” stuff. Imo, they just continue to discredit themselves by not realizing how idiotic it is to extrapolate data off of these EXTREMELY flawed studies. Doesn’t matter if there’s 10 of them, or a million of them. The number of flawed studies is irrelevant.

 

[Appassionato]

My shbg is 22-25 usually. Not even sure where TT and e2 are yet. Was about 1600/90 before I added hcg. I’ve been all over the map for 4 years with different protocols.

We don’t have long term proof of anything regarding TRT that is definitive really. Just studies with some indications, and honestly the doc with TT of 6k may be extreme, but if his lips and metabolic panel are coming back perfect (kinda skeptical) he may be doing a service to his health. The conclusive answer isn’t out there so he’s taking an educated risk.

Everybody asking for the numbers? Who cares? There’s no proof of any particular number making you healthier or feel better. There’s tons of indications that not restricting e2 is beneficial. Ditch the ai and pick a dose. Ride out the side effects taking lower and lower doses of ai. Eventually you realize you’ve been dialed in for months. Then do blood work to look at health markers. Make a change if needed. I’m right at that point. 300/wk is obviously high, but being dialed in, I’ll only lower it if bloodwork says to. Advice from my doctor.

You're kind of a borderline patient, being close to juicing doses (400 mg per week could be considered a conservative steroid cycle), so obviously with such high total T numbers I think you can afford to go higher with your E2, but it's just peculating here. Just keep in mind that HCG skyrocketed both my T and E2 level, so I would consider get some further blood test if I were you.

As said before, we have been told TRT is to try to replicate a healthy young male hormonal parameters, and, as we saw from all the studies, no one was ever exceeding an E2 of 35 pg/ml, with the average being something around 28 pg/mL.
Just to tell you my case, as explained here:
Calling for the experts - Daily injections routine failure
with only 7.5 mg per day, I got a free T on 28 ng/dL (top of the range, but still within the range) and an E2 of 61 pg/mL that gives horrible symptoms. I tapered it down to 5 mg per day and I'm waiting for to see how it goes, but if that fail and all the other strategies have failed, why shouldn't I try with a micro-dose of an AI? Just because Jay says it's "toxic for the biological system"?

 

[Vitamin_C]

Men with active HPTA and not on TRT with high estrogen are not healthy. Not the least bit surprising. The fact their testosterone levels varied is expected. Doesn’t tell us anything about a man with TT of 1000-2000 on TRT with e2 of 50-100. Zero.

That’s why this debate doesn’t end. Evidence doesn’t exist except personal experience. I haven’t taken an ai since sometime in January. Best change I’ve made. I’ve been dialed in since late January. E2 is 90+. Libido through the rough and erections harder than ever.

I’m kinda backing away from this forum bc of this nonsense. I really only come here for the studies but somehow end up in threads like this with no substance.

Yeah , there isn't a whole lot of data out there with guys on TRT with high total/free testosterone and elevated estrogen. I have taken up to 600mg of Sustanon and I didn't use an AI, I felt fine. We just don't know much due to lack of studies. As long as you feel fine and your lab values aren't hurting.

 

[DragonBits]

My shbg is 22-25 usually. Not even sure where TT and e2 are yet. Was about 1600/90 before I added hcg. I’ve been all over the map for 4 years with different protocols.

We don’t have long term proof of anything regarding TRT that is definitive really. Just studies with some indications, and honestly the doc with TT of 6k may be extreme, but if his lips and metabolic panel are coming back perfect (kinda skeptical) he may be doing a service to his health. The conclusive answer isn’t out there so he’s taking an educated risk.

Everybody asking for the numbers? Who cares? There’s no proof of any particular number making you healthier or feel better. There’s tons of indications that not restricting e2 is beneficial. Ditch the ai and pick a dose. Ride out the side effects taking lower and lower doses of ai. Eventually you realize you’ve been dialed in for months. Then do blood work to look at health markers. Make a change if needed. I’m right at that point. 300/wk is obviously high, but being dialed in, I’ll only lower it if bloodwork says to. Advice from my doctor.

It doesn't really matter to me what anyone else does, but a blood test isn't an all inclusive indicator of health. If it was, then why even have a doctor or a physical, just get an annual or semiannual blood test and look for anything that triggers a flag. (Though you do trigger a flag for high T and high E on any blood test).

One of the long term consequences of supra-physiological doses of testosterone is eccentric cardiac hypertrophy and sudden cardiac death.

You aren't going to get any studies on it, because doctors would consider it unethical to do a long term study of supra-physiological doses of testosterone. And what would be the purpose of such a study, see if you either lived longer or died an early death?

No idea how you "test" for cardiac hypertrophy. But if it does happen, it probably won't kill you till you are 50 or 60.

 

[JimBob]

Exactly! Well said. This drives me bonkers! Lol. I know the docs are smart guys with a ton of experience, but to me, they just sound like a bunch of morons when they quote studies done on people with <5 E2. Dr. Rob said him and his staff spent 2 weeks going over hundreds of studies about the effects of lowering E2. This is the most idiotic thing I’ve ever heard. Why waste your time going over hundreds of studies about men and women with no E2, on super high doses of ai? You know you’re just going to find the same conclusions in every single study. Yes, we know that having no E2 is fckn horrible. After 25 years of experience, you really need to continue to go over studies to figure this out, or solidify your position on the subject? Most of us here are not doctors, and haven’t gone over hundreds of studies, and we figured this out a long time ago. Yet, we’re the dumb ones, according to jay and dr Nichols.

Until someone does a study on using very low ai dosages, to get men’s E2 in a healthy range, while on TRT, they just need to stop with this whole “extrapolating data from thousands of studies on the subject” stuff. Imo, they just continue to discredit themselves by not realizing how idiotic it is to extrapolate data off of these EXTREMELY flawed studies. Doesn’t matter if there’s 10 of them, or a million of them. The number of flawed studies is irrelevant.

Have you, by chance, seen these studies Dr. Kominiarek referred to? I'm finding it hard to imagine that Dr. Kominiarek is so stupid as to refer to studies such as what you are describing. Can anyone provide a link to these studies?