Here’s the story of what I think is the best aromatase inhibitor and my experience with it.
Awhile back, I read a post at Danger and Play on testosterone replacement therapy (TRT). While I wasn’t terribly interested in injecting myself with testosterone once a week or even more often, the take-home message I got from that post is this: why would you let anyone else’s opinion on TRT influence your course of action? Sure, if there are health risks to TRT and someone knows better than me, I’m always ready to listen, but most of the objections to TRT that I’ve seen are moralistic, to the effect that you shouldn’t take T because it isn’t “natural” or something like that. Apparently you should just be satisfied with getting older, losing your muscle or your sex drive, becoming weak, in general just fading away, all because someone somewhere doesn’t like the idea of boosting testosterone. But I decided that that was all hogwash.
The reasons that I wasn’t terribly interested in TRT as far as injections went were two. One, while I’m nearly 60 years old, my T levels were not so bad, having been measured at 575 a couple years back. I can probably credit that to a decent diet (low-carb paleo) and my weightlifting habit. The second reason is the expense: unless one is willing to go the illegal or semi-legal routes, you’ve got to pay for a doctor (unless insurance covers that, more on this below), as well as the T itself. The doctor is by far the biggest expense; if you’re paying cash out of pocket, and going to a doc you’ve never seen before, then you’re talking hundreds of dollars just to get going, besides all the hassle of appointments and so on.
Nevertheless, I thought boosting my T levels might be a good thing to do.
I already had a doctor of longstanding who helped me with chronic fatigue syndrome. He’s a cash only doctor, doesn’t take insurance, but I saw and paid him willingly for years because the other doctors I’d seen for my fatigue were not much use. Even though I’ve recovered from my chronic fatigue, I still occasionally see him, and so I emailed him and asked whether, at a T level of 575, he considered me a candidate for TRT.
Most doctors would not, I think, even consider TRT for a man with a T level that high. Testosterone is listed as a Schedule 3 drug, which means it’s considered to have a potential for abuse, and is therefore tightly controlled. Doctors can come in for extra scrutiny when they prescribe too many controlled drugs, and I think this accounts for the reluctance of many doctors to do so.
My own doctor shot back with a suggestion: an aromatase inhibitor. Aromatase inhibitors work to boost T by decreasing the production of estrogens, especially estradiol, the most potent estrogen. Since estradiol feeds back on natural T production, inhibiting it, lowering estradiol levels results in an increase in T. My estradiol level at the last reading had been 70, higher than the upper limit of normal for men. Why that was I don’t know, but estradiol levels increase with age in men, so maybe that was all there was to it.
So my doctor prescribed me anastrozole, the most commonly used aromatase inhibitor. Anastrozole, also known by the trade name of Arimidex, is generic and cheap: I pay about twelve dollars for a three month supply. The dosage is one-half milligram twice a week, which is quite low. Estradiol is necessary even in men, with things like bone composition depending on it, so you don’t want to drive it too low or abolish it altogether.
I noticed a difference shortly after starting to take it. For one thing, my exercise recovery appears a lot better. I used to need a solid three days off between weight sessions in order to recover fully; now I need only two. I haven’t gained any weight, but I’d say my body composition is better: a bit leaner, a bit more muscle. (I can’t seem to gain weight to save my life at this point.) And, yes, my sex drive increased noticeably.
Last time my T level was measured, it had increased to 700, a modest increase of about 20%. In some studies, using higher doses of anastrozole and in low T men, T levels have increased as much as 50%, and free T levels even more. Probably my modest but noticeable results came about because I use a low dose and wasn’t low T to begin with.
However, my estradiol level decreased to 40, well within the normal range of a young man. This may also account for what I consider a successful result of the treatment.
Reinforcing what I wrote above about doctors, I recently went to see a new doc, insurance-paid, for the first time, and told him I was taking an aromatase inhibitor, which I coyly said was to lower my estradiol levels. He said that he’d never heard of it being used for that, and told me that I needed to see an endocrinologist, as he wasn’t going to prescribe it for me.
Hell with that, I thought. I went back to my old, cash-only doc, who had no problem renewing my prescription for anastrozole. I intend to keep taking it for some time to come.
There’s been a generational, secular decline in testosterone levels, which may be caused by environmental pollutants, endocrine disruptors, or obesity, or all of them together. Many men, even young men, have low T levels, and if this is caused by estrogens in the environment, an aromatase inhibitor might be just the thing. If you can’t seem to get rid of that belly fat, or your exercise recovery doesn’t seem right, this might be something to consider.
As for older men, an aromatase inhibitor could help them too. The possible downsides seem low, anastrozole is cheap, and it may not be difficult to find a doc willing to prescribe it.