Confusing New Bloodwork. Do I Increase AI Dosage? Lower T Dosage?

Pharma Testosterone Replacement
21

@equel my invite remains open. No BS.

22

Not very often, but I have and will, when a guy is convinced he needs it. I see a number of bodybuilder types, some older ones that still compete. Estrogen is their mortal enemy, want to be “shredded”. I discuss the health issues with them and they make a choice. I prefer no, but there are no absolutes.

Evidence based medicine:

  1. The expectations, wants, needs and desires of the patient.
  2. The best available evidence in the literature.
  3. The experience of the clinician.
23

By the same token, will you just prescribe anything that a patient is convinced they need?

Not to break balls or anything here. Genuine question.

They can be convinced. You will know better. You prescribe but now you’re responsible. Does that not get to you after awhile?

Would AI dose be limited to a given amount perhaps? Say the bodybuilder is convinced he needs 1mg a day of Arimidex?

24

Nope.

Sometimes, especially if I see negative lipid changes. Especially with joint issues. Then it’s easier to convince them to stop. I figure me working with them is better than seeing them go to another source and take everything they can sell them on.

I draw the line well before 1mg a day. Most take 0.25mg once weekly. Some will want to increase it for competitions. As we discussed, I honestly think it’s a placebo effect with some. I’ve even thought about not checking E2. Not there yet. A lot of new guys have already been all over the internet.

Funny story, earlier in the year I had a new guy start with testosterone. E2 was low, skinny, no fat. We discussed everything. He comes back in to “talk” to me. Seems he went to the gym and talked to the BBers who asked him if his doctor “managed” estrogen. Then they told him I was committing malpractice by not giving him a “blocker”. To his credit, he came back in to discuss his concerns. We discussed E2, again. I told him I’d give it to him, it’ll waste his money, and he doesn’t need it, in fact he needs E2. He stuck with my recommendation and is doing great.

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25

I was once that guy who bitched out the doctors in my area who promised me TRT but refused to give me an AI, even though I did everything in my power to convince them that the guys ‘in the know’ all know that the magical range for E2 is 20-30.

@equel would have gotten along great with me back then LMAO

26

Fortunately, most new patients are referrals from other patients and since the person referring them is not on an aromatase inhibitor, they are not expecting it either. It’s less and less of an issue.

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27

Starting to get sore a little more in my hand/feet/hip joints and lower back. 6 weeks in on 55mg every 3.5 days. Could this possibly mean low E2 or low T?

28

Low E2 is a rare thing if you’re not taking an AI. You’ve provided no labs so you’re speculating where you are in regards to T levels. You’re on a low dose. Maybe start your own thread for this one?

29

This happened to me while in flux. Around the 6 month mark, after starting therapy, I lowered my T dose and felt okay for a while but was dragging ass. So I bumped up to 210mg from 140mg. The difference was clear to me. Everything gets better with time as long as you have enough Androgens and you let your body adjust properly. Controlling E manually can give you the illusion that you have it figured out. Then when its not good you continue to make adjustments. So, stick the protocol as best as you can. Dont change a thing. Take Cialis and get through the rough days.