About the aromatase inhibition study

[Guest guest]

This will be long. Sorry.

Phil, in another thread, you posted this link:

http://jcem.endojournals.org/cgi/content/full/89/3/1174

which I had looked at before, but this time I actually read it

carefully. And to me it presents a new way of thinking about

aromatase inhibitors, particularly for men who are NOT on TRT.

We talk all the time about taking an Arimidex dose that brings the E2

level down to the low 20s. But in this study there were two groups

receiving very different doses of Arimidex, and they ended up with

very similar E2 levels. What was substantially different was the

resulting T levels.

The authors point out that taking Arimidex is somewhat self-limiting

as to the resulting E2 level. I think the idea is that while more

Arimidex produces more aromatase inhibition, there is a lot more T on

which the remaining aromatase can operate, so some conversion still

takes place, and E2 doesn't fall very much.

So within limits, you would pick the Arimidex dose that produces the

target *T* level, not a target E2 level.

The problems with this are:

1. If substantially different Arimidex doses result in very similar

E2 levels, then what causes the very substantial changes in T?

2. You still have to be careful not to take so much Arimidex that E2

goes too low.

I'm not on TRT, but I started taking Arimidex after my baseline E2

test came back at 48. But I have had regular E2 tests done since

then (but not T tests) and I've found that cutting the dose in half

does indeed only raise E2 by a couple points - such as from 21 to

23. So within a certain range, which would be different for each

man, the authors of this study seem to be correct.

Well, I think this means if you get E2 to *about* the right level,

you still might be passing up some major benefits from further

tweaks. My plan, which was to just test and control E2, probably

isn't enough. Instead, I need to be tweaking T by means of the

Arimidex dose, with E2 tests only being used to make sure E2 doesn't

go too low.

Does any of this make sense?