Aromatase Inhibitor: To AI or To Not AI?

by | Nov 11, 2020 | Aromatase Inhibitor, General

November 11, 2020

Even if you’re new to hormone optimization/hormone replacement therapy, you are likely aware that there are multiple schools of thought on the use of an Aromatase Inhibitor (aka, Arimidex/Anastrozole).  Opinions range from “take Anastrozole 2-3 times a week at all times when on HRT and almost consider it malpractice to do otherwise,” to “as long as you have no side effects, there is no need to be on an Aromatase Inhibitor regardless of Estradiol levels.”

A Quick Background on HRT and the Impact of Estradiol

Testosterone at higher levels will start to be converted into Estradiol once in the body, therefore potentially elevating blood levels. Some men are genetically predisposed to this and may experience unwanted physical side effects.

It is not uncommon for men to have the belief that any level of Estradiol is bad.  Nothing could be further from the truth, and there are severe consequences with driving this number too low. Estradiol plays an important role in determining bone mineral density in men and could be a major cause of bone loss in elderly men. Low estradiol levels are also associated with increased fat and decreased sexual desire and erectile function compared to higher levels.  Both of these are counter-intuitive to why we do hormone optimization.

High estradiol levels, on the other hand, can cause gynecomastia (male breast development and enlargement) and edema (fluid retention in the extremities).  This occurs because Breast tissue contains receptors for estrogen. As such, high levels of estrogens promote breast tissue growth and lead to gynecomastia.  This is one of those areas where having an AI on hand from your provider is key so that at the first sign of sensitivity, you can respond and eliminate any issues.  This is why EWAA includes Anastrozole as part of all its male stacks.

What If You Are Not Prone to Any Physical Signs of Elevated Estradiol?

I have attempted to run my advanced HRT regimen with and without an AI on several occasions. Each time I had the same experience. No gynecomastia, no water retention, no erectile dysfunction, nothing physically at all.  This also goes for taking higher doses and getting my Estradiol next to zero.  With both very low and very high Estradiol, the overwhelming emotional sensitivity hits hard and is a real issue.  This can be frustrating to you and more so your family and friends.

Therefore, while the two schools of thought are not wrong on many levels, my recommendation is to run a moderate dose of AI weekly to prevent Estradiol from getting too high or too low.  Again, these may not be physical side effects, but my bet is it will impact you mentally and emotionally. And this could impact your ability to remain on therapy.  If you want to feel your best, don’t take the chance and run your HRT without at least a low dose of AI weekly.  Keeping those Estradiol levels in check may take some adjustment with your AI does. However, once you determine how your body responds, stay with what works.

We Can Help!

Each person is different. That is why EWAA makes sure all patients have an Aromatase Inhibitor on hand when on an Elite Stake of any kind.  EWAA is here to make sure you have what you need to not only look your best but be your best.

If you can identify with any of the above or feel it’s time to get a professional opinion, we are here for you. Schedule your confidential consultation today!

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Hi, I'm Clay

I’m one of the founders of Elite Health. We launched EHO to help people experience the best version of themselves. 

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