The best method of dialling in Aromasin dosage

[sweetfastline]

Dialling in your AI dosage can feel a bit like walking a tight rope, especially with Aromasin as crashing your E2 with it is more unforgiving than with Arimidex due to Aromasin's suicidal nature.

A study Pharmacokinetics and Dose Finding of a Potent Aromatase Inhibitor, Aromasin (Exemestane), in Young Males says:

'The terminal half-life was 8.9 h. Maximal estradiol suppression of 62 ± 14% was observed at 12 h after a single 25-mg dose of exemestane. Estradiol remained suppressed by 58 ± 21% at 24 h and returned to baseline 3–6 d after treatment'

My takeaway from this is that how to dial in your Aromasin dosage is highly dependant on your individual rate of producing new aromatase enzymes.

If you take 6 days to return to your baseline levels, but dose Aromasin E3D, then you will keep pushing your E2 levels further down and down.

If you take 3 days to return to baseline levels, then dosing E3D could be just right for you.

I haven't found my ideal AI dosage yet and my plan is the following. I'm taking 12.5mg Aromasin on pin days currently and I'm taking an E2 blood test every pin day in the morning to see where my E2 is at. For me my E2 is only slightly elevated, but it's enough to give me puffy nipples with slight sensitivity. As soon as it's lowered, the puffiness goes away. But I have to be careful, because the day after taking 12.5mg Aromasin I can sometimes feel low E2 sides, such as achy joints and dry skin.

I might switch to injecting M,W,F and taking 6.25 Aromasin on injection days, to keep blood levels more stable.

I will report back with updates.

If anyone has anything of value to add then I look forward to the discussion.

 

[JanEv]

Anything to report?

 

[Dr.V.P.C.]

Exemestane works great in daily low dosages (compounded), much easier do adjust than anastrozol ,and have some androgenic proprieties .

 

[brookseth]

Would it not be better to keep the aromasin in a steady state with more regular dosing with lower doses? That way you'd keep your enzymes and E2 levels more consistent?

 

[JanEv]

I think the challenge stems from the dosage (tablet) of 25mg. To get to 6.25mg dose you’re already in quartering a tablet.
I was interested to hear of an update from the OP as I’m in very similar territory myself, and would like to hear how 6.25 EOD was going for him in contrast to his past experiences.

 

[JanEv]

To come back to you guys on this. I tried for a fairly short period 6.25mg EOD during my TRT which is 96mg/week Test Cyp. In short it crashed my oestrogen to 25pmol/L so I stopped immediately.
My pre TRT level was circa 90-100, and had risen to 190 after 3m of treatment. I was seeking to consolidate around the 100 mark, but clearly this regimen was way too effective for my treatment level!
I rebounded relatively quickly and currently assessing next steps..

 

[Vince]

To come back to you guys on this. I tried for a fairly short period 6.25mg EOD during my TRT which is 96mg/week Test Cyp. In short it crashed my oestrogen to 25pmol/L so I stopped immediately.
My pre TRT level was circa 90-100, and had risen to 190 after 3m of treatment. I was seeking to consolidate around the 100 mark, but clearly this regimen was way too effective for my treatment level!
I rebounded relatively quickly and currently assessing next steps..

Any chance you can use a low dose Exemestane. Like the above post mentions.

 

[dirkwright]

I have high E2. I just got my results back: 54 (max limit is 29)
My TT is 993, also above range (827 max). So, I'm reducing my dose of T a little.
Hemoglobin and hematocrit are within range.
I only now take 70 mg of T per week. I also take 5mg daily tadalafil, which apparently can increase T but I don't know if it works on TRT men.
I have exemestane, 25 mg tabs. I can't find a lower dose from usual non-prescription sources. I tried daily dosing exemestane and then tested E2 as basically crashed. Should I try EoD, E3D, or what for taking exemestane. Splitting the tiny pills is really hard and not likely to produce uniform dosing. If exemestane reduces E2 by 60%, then that dose should be good for me, right? It should take me down to about 24 pg/ml.

 

[Vince]

I have high E2. I just got my results back: 54 (max limit is 29)
My TT is 993, also above range (827 max). So, I'm reducing my dose of T a little.
Hemoglobin and hematocrit are within range.
I only now take 70 mg of T per week. I also take 5mg daily tadalafil, which apparently can increase T but I don't know if it works on TRT men.
I have exemestane, 25 mg tabs. I can't find a lower dose from usual non-prescription sources. I tried daily dosing exemestane and then tested E2 as basically crashed. Should I try EoD, E3D, or what for taking exemestane. Splitting the tiny pills is really hard and not likely to produce uniform dosing. If exemestane reduces E2 by 60%, then that dose should be good for me, right? It should take me down to about 24 pg/ml.

How are you feeling with the higher E2 levels?

 

[JanEv]

Splitting them isn’t too difficult to get it close.
I was every other day with a quarter tablet and even that was way too much. Although half life is short the effect is longer so it effectively compounds as the days go by. Even every other day dosing means your E2 is becoming sequentially lower each dosage, and the impact of that is high. Even a quarter every third day could still have that effect.
In the event I’ve learned that my e2 is basically fairly high naturally and higher still on TRT. However if you’re not experiencing problems with that level I shouldn’t worry.
For a long term prospect if your effects of e2 are a problem you need to lower your trt dose further I would say. I don’t think supplementing a trt regimen long term with an AI is tenable.

 

[dirkwright]

How are you feeling with the higher E2 levels?

No libido and ED. So, not good. Thanks for asking.

 

[dirkwright]

Splitting them isn’t too difficult to get it close.
I was every other day with a quarter tablet and even that was way too much. Although half life is short the effect is longer so it effectively compounds as the days go by. Even every other day dosing means your E2 is becoming sequentially lower each dosage, and the impact of that is high. Even a quarter every third day could still have that effect.
In the event I’ve learned that my e2 is basically fairly high naturally and higher still on TRT. However if you’re not experiencing problems with that level I shouldn’t worry.
For a long term prospect if your effects of e2 are a problem you need to lower your trt dose further I would say. I don’t think supplementing a trt regimen long term with an AI is tenable.

OK, but the information up top says that E2 returns to baseline after 3-6 days. So, I would guess E3D would be a good option? I guess I'll just have to experiment to find out.