question from a user
Why do some people here say to only use AI like Anastrozole if symptoms appear but some TRT clinics just put men on it proactively regardless of having symptoms or not? I also read that the testosterone to estradiol ratio should be about 10:1. What is considered high estradiol and what symptoms do you look for to decide if anastrozole should be taken?
AlphaMD's Answer
To be blunt a lot of online clinics will just put you on a far higher Testosterone level than you need, then assume you'll have side effects like high Estrogen, and put you on an AI knowing that so they don't have to talk to you & can charge you more.
For therapeutic dosing, only ~25% of men need an AI. The ratio matters less than how you feel, so we do not have an ideal here. Some men feel best at 40, others below that, while having the same T doses/levels. Typically anything approaching 50 we want to keep an eye on. Additional emotional responses like crying at moves you normally wouldn't or nipple pain/sensitivity are we we mostly keep an eye out for.
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