question from a user
I just started TRT and was put on 180 mg test cypionate and anastrozole. Reddit hates AI but my physician put me on it. The huge amount of people saying no no no to the AI is freaking me out but I want to side w my physician because it’s random Reddit peeps. What are your thoughts about someone going on AI right away? My Estrogen is 30
AlphaMD's Answer
Never let the people on the internet get between you and a physician you trust. That being said, here are some general thoughts…
The primary idea in any field of medicine is that “less is more”. By that, I mean that you should never need a second medication to treat the side effect of another medication.
Another rule of thumb is that you should never start two medications at the same time. If you develop side effects, you won’t know which one caused them.
180mg/wk is a high enough dose that about 90% of men will be supra-physiologic (TT >1250). Men who have such high TT will inevitably produce a higher amount of estrogen.
While you should follow the plan you and your doctor made, our thought is that it is better to start a bit lower and raise the dose than to start high and need an AI.
“AI equals too high” is a saying in men’s health, so no doctor should aim for a TRT dose that would necessitate an AI.
Some men need an AI due to high aromatization. But for now there is no reason to think you may need one.
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