Most guys don’t realize they don’t need an ai or the sides they are geting is because of the ai. They don’t pursue knowledge. They just take there doctors word on everything. How many of these guys could come off an ai and have one less medicine but be healthier because of it?
It looks like the protocol they gave him has a good chance of needing the ai. It will most likely put him over the ranges in total t and free t. Plus HCG converting to e2.
@systemlord I weight 235 lbs, 6’ tall, and carry a lot muscle. But I am I good 30-40 lbs overweight. So I am likely to aromatize at a higher rate due to the extra body fat.
I will admit my diet is not perfect and I have few bad snacks a day. But I lift weights 4x per week and hit cardio 4-5x per week.
My lipid profile is mainly poor due to my shitty metabolism and compromised liver. Which is a product of my low Testosterone. My Cholesterol in November of 2018 was 190 lbs when I tried my restart and my levels back up to 700.
But they could not stay there naturally. So here I am. Lol.
I hoping TRT will help with this problem along with cleaning up my diet.
I see what you all are saying about AIs. I think I will wait to use it until I see high estrogen symptoms.
If my Test levels are through the roof, I will just scale the dosage back in 2-3 months. I do think it is high as well but let’s see how my body responds.
Defy medical has done right by me so far. So I have no reason to distrust them. Those doctors have been the most knowledgeable medical professionals I have talked to thus far.
I also do not think they are too expensive. So let’s see how this plays out.
Thanks again for everyone’s responses.
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I’m 70 lbs overweight (6ft/238 lbs, normally skinny 160-170 lbs), put me in a wetsuit and I look like a seal!
Together with your overall poor metabolism/liver metabolism, the AI was the right call. It’s the job of the liver to rid the body of excess estrogen, the liver is also needed to metabolize testosterone.
There are some of us that will have to fight to get back our health and TRT will only show positive results to those who work the hardest. There are a lot of guys who go on TRT, continue to eat like crap and don’t workout and therefore don’t see much improvements.
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@systemlord are you on an ai right now? And if not why is that?
I don’t take AI’s when levels aren’t stable, only when my levels are stable will I take an AI. When levels are not stable and I take an AI, do to wildly fluctuating levels, if I take an AI when levels are swinging low and the AI kickin at that moment, E2 stays low longer than I would like.
If I take an AI when levels are stable, my levels recover so fast I don’t notice low levels because I recover so quickly. Anastrozole destroys me even at 0.050, 1/10th or 1/20th aromasin is better tolerated and slower acting.
I try not to take AI’s if I can manage without. I’m sure someone who doesn’t over-respond and doing well won’t have a problem with AI’s.
So why your post about needing the ai because your overweight. Op is less over weight than you. You are backing up defy on ai when YOU can’t even use it without messing everything up. Obviously your weight had nothing to do with it in your case.
We are all different. I hope op respond appropriately to protocol.
No basis for this just a wild guess
I think OP may need the ai cause they are starting him at 150 mg testosterone and HCG.
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Your dose is reasonably low for someone with testosterone levels as low as yours. Spiking your dose with respect to you your endogenous (what you make) level increases the probability of side effects.
I have no idea why the culture here is anti aromatase inhibitor. If you are not feeling well, my laymen’s advise is to do what is reasonable to correct the problem.
I’m not sure what the concern is however; any side effects from anastrazole are associated with the testosterone’s metabolites.
Sidebar
Test has a very short half life (about 45 min). When testosterone went from the lab to the gym, it was dosed in oral form. To slow the rapid metabolism one method was to add a methyl group to the testosterone molecule and Dianabol was created (of course slowing down metabolism also was toxic to the liver when doses were high or period was long. In this case the half life is measured in hours rather than mins.
Fast forward and today we frequently use test cypionate. An 8 carbon ester is added to the testosterone molecule, is not toxic to the liver and increases the half life from mins to days. The full prescribing information indicates a half life of 12 days. In actual practice, the half life is about 4-5 days.
If your doc chooses a weekly testosterone dose for you and then directs you to dose semi-weekly, you will have decreased the relative amplitude (peaks and troughs) of your serum concentration. My experience and hearing this from others is that if you are on low dose test (like you are) and dosing once per week, then you may detect the drop at about day 5. If this is the case, then you dose twice a week AND INCREASE dose. If you don’t increase the dose you will run the risk of dropping to the testosterone concentration to the level where you start experiences the effects of deficiency. Of course you can simply ensure your weekly dose is high enough such that your weekly trough dose is above the concentration where you experience symptoms.
You should always collect lab work on your trough day. We are mitigating a deficiency. It makes no sense to concern ourselves with the peak if there are no symptoms of excess. Keep in mind that I am referring to clinical excess (both physical sings and complaints - Not the lab work). Physicians that base their judgement primarily on lab data are practicing at a medical student or intern level. All doc’s are taught in their first year to treat the patient not the lab form. Lab data is used to confirm a diagnosis and detect gross deficiencies and excess.
I don’t know a single person that is experiencing side effects from anastrazole. Of course the population I am referring to has not been biased to believe that this medicine is wrought with side effects. I think there is a chap below that said he dosed 0.1 mg of anastrazole and and blew out his hormonal axis. No way. That was a somaticism.
I’m sure you know that testosterone metabolises in both directions to DHT and E2. If you add aromatase inhibitor it “inhibits” the aromatic pathway and pushes the reaction toward DHT. Add a 5 alpha reductase inhibitor and it pushes the reaction toward E2 (generally we avoid this).
One more point that may help some of you. Our medical model is setup to treat acute disorders not chronic problems. If you go to an endocrinologist, the reason they are not going to treat many of you is not because they don’t read FLEX magazine and understand the the problem, they see no disease process. It’s laughable when you peruse the forum and see the “experts” making comments such as the doc doesn’t understand free thyroid or they don’t want to treat because the insurance company this or gov’t that. Again - no way. They would treat you if there was a disease process in place. Now there are those physicians that believe (rightly so in my layman’s view) declining hormone levels in the aged results in degenerative disease. In other words they are practicing preventative medicine. Great. It is very, expensive. Imagine if every post here was a trip to the doc asking them if it’s a problem because my aromatase dose is 0.4 mg/wk instead of 0.5 mg or is it a problem that my peak dose of testosterone 1001 and the lab form says it’s high if over 1000. I think you get my drift. I have a few more comments however, let’s see if you find this helpful.
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Well thats the point here. He hasn’t even started his protocol yet and already he has been prescribed an AI.
Most of the anti AI feelings around here are due to our resident Endo Physiologik who has numerous posts in regard to steering clear of AIs. Also look into Dr. Neal Rouzier and watch some of his lectures which are usually an audience of doctors. He has been preaching against AIs for quite a few years now.
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OK, you asked so here you go.
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Testosterone - I am fine with the 150mg/week dose. I think twice a week injections would be fine to start. I think you will end up with at least that anyway so would not waste time with 100mg. Just me going off what guys I know do and respond to. However, I’d also be fine with starting at 100mg, this depending on your level of patience. I am not very patient. I would also be OK with three times a week dosing, I just think it likely unnecessary, but it will not hurt you.
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HCG - Why? Two reasons, actively trying to conceive or concerned with testicular atrophy. Unless you have voiced these issues with your doctor, you do not need to be using hCG, especially out of the gate.
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Anastrozole - No. You should not start with this, if ever, although the dose is relatively low. Do a little reading on aromatase inhibitors, these should be avoided at all costs. I’ll post a video from one of the foremost hormone doctors in the country on this topic. Your E2 is very low to start. Unless you report a previous history of high E2 symptoms, gynecomastia, etc., you should not start with an AI.
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DHEA - What? Your DHEA level is good. Hard to support this recommendation.
You understandably lack confidence, or trust, in your doctor. That does not mean that your questions and concerns are not valid. They are. However, these should have been addressed with you so you have a thorough understanding of what they want you to do and why. For me, these conversations are best held face to face, eyeball to eyeball. Your doctor is a stranger with whom you have spoken with over the phone. I understand why some go that route, some, I suppose, have little, if any, choice.
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@episodic Thanks for the response man! Much appreciated. Very informative response. I do not know anyone suffering from adverse effects to AIs either. I do know those people are out there though. Interesting point about DHT conversation as well. The truth of the matter is I am going to have play around with the dosages until I find a protocol for me that keeps both my DHT and E2 in normal rages without inhibitors. That might 8-12 months. I’m okay with that honestly. As long has I do not fry my hair (or what’s left of it) or grow bitch tits.
@highpull Thanks for giving your analysis dude. I want HCG because I do not want testicular atrophy. It was my idea. Not Doctor’s. He asked if I wanted and it was not necessary. That was my decision.
I think I will hold of on AI until 6-8 weeks when I do my own labs and see where everything it at. I am mostly concerned about my heart through this whole process so I would like to have less AIs in my life. Lol. But this is a learning process and my protocol will change along the way. My goal is get a point where E2 and DHT are stable with AIs or DHT inhibitors.
The jury is still out on DHEA for me. I am going to start with 25 mg/day and see what happens.
You are 100% correct in me lacking options in terms of medical treatment due to my age and dumb ass doctors.
My experience with Defy so far as been pleasant and affordable. Two things I can not find in my local market here. It is not like I do not trust the doctor. He was great actually and clearly explained his reasoning for all the dosages. But I question, research, and look for more opinions on everything. That how I got to where I am in this process.
Otherwise, I would have trusted my other dumb ducking doctors that wanted to load me up on statins and said my 200s Testosterone levels were normal.
Thank god for this forum. You guys are awesome and give me more stuff to research and ask questions about.
Anyway, sorry for rant guys.
Thanks again for everyone’s input. It is much appreciated.
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I’m surprised that people would want to take a medicine given to cancer patients for life.
Doctors have given ai to every single man that’s on TRT without thinking twice. They were told dose T and control Estrogen. This was just something docs did without any real understanding of why. They recently felt started looking into this and realized that this drop of estrogen in men is very unhealthy. The protective effects of estrogen are being weakened. Then the medicine itself is toxic and causes other side effects on its own. Isn’t the goal to be healthy? We’re taking a hormone that is our foundation for life, but on the other end we’re sticking cancer medication into our body… there’s a reason our body converts T to e… why are we messing with this. It’s not logical.
Now the more intelligent docs are starting to realize that if the clients dose is right, then they shouldn’t have issues with estrogen. Most issues men have when starting hormones are normal and dissipate as they stabilize: others can be modified by tweaks in dosage. Now they say you can micro dose. These are options presented to us and worth a try. Or be lazy and give everyone an ai for the rest of there life.
The problem I see here (above) is a man who has a naturally low e2. The doc is not saying “here take this if you have the following symtoms”. He jsut throws him in this protocol expecting the e2 to be a problem. Wtf?
He might come back in 3 weeks asking for help because his symtoms are deathly. I’ve seen this happen several times in the short three months I’ve been here. It could of been avoided if the doc actually gave a f about his clients and opened his eyes.
For this OP : If e2 is low pre trt, then his body definitely doesn’t have estrogen dominance and his body might manage it well. Similar to myself. I barely aromotized and maybe gained 4 points on e2 after 5 weeks. If I had taken the ai, then I would of crashed my e2 and spent weeks or months recovering. Who knows what long term damage it does to your heart or bones or other organs and systems.
Ai should only be taken if you start trt and e2 makes life hell. Not because a lab range says your high. Or if your seriously over weight… but then again maybe an overweight man might process the estrogen more efficiently due to his genetics. Is it true that all obese men are going to have issues when starting trt? How about a guy with 5-10lbs extra fat… I’m that guy and don’t need it.
I hope that makes sense. Ai should be at the bottom of the list and be used temporarily until the man has fixed his diet, health and has a balanced body and system.
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Are you kidding. Did you ever read what ai can do to your lipids?
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Not a problem, all is good.
What?
When is dosage ever determined by how low you were Natty?
What’s your protocol?
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Thank you. It’s mind boggling. People don’t realize what it’s doinf to them until it’s too late. God knows how many folks on trt have these issues and the doc doesn’t realize the ai is causing it…
If enough defy patients are active in this forum. Defy will plant a worker in here…
If they are not here already. They overpower the forum. I hope it don’t happen here. And try to establish group think.
It’s good to have everyone’s opinion just not a coordinated intentional effort to back up someone’s business with the purpose of stopping us from giving our opinions which in a lot of cases are intelligent opinions based on evidence.
That’s why I don’t enjoy Excel male.
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Damn, so I’m not the only one that wondered about that? Brilliant, although devious, marketing approach.
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