Low Dosing Aromasin (Exemestane); read HRT

[MD2B]

Question:
I am curious to whom may have experience supplementing Aromasin (Exemestane) in daily low doses? I am going to rattle some thoughts off here so anyone more educated on the matter please step in to right my wrongs if so need be.

Background:
First and foremost, if I can get away without ever requiring an aromatase inhibitor (or any drug for that matter) then that is the route I will most definitely take and be ecstatic to do so. The only way I personally will ever begin such a regimen would be if my blood work and body both direct me to this route. It seems like that should go without saying but I am saying anyway. My personal situation is I have been supplementing with testosterone cypionate under physician supervision for five weeks total, have recently performed a complete male hormone panel (privatemdlabs), am awaiting results, and am looking to next add HCG to my protocol for it's numerous positives (most notably maintain fertility). I'm following along Dr. John Crisler's protocol as closely as possible (although from the article I read he mentions only Arimidex (Anastrozole) as an aromatase inhibitor). I do not yet know if estrogen will be problematic for me on my current protocol or with the addition of HCG to my protocol. I am merely preparing myself for what may be necessary plus using this as a learning opportunity for myself and possibly others as this generally interests me.

Discussion:
I am considering a low dose to be close to 3-6.25mg ED as I believe any more may typically result in overkill for someone on HRT doses of testosterone. Due to the short half life of Aromasin (Exemestane) I would feel most confident dosing on a daily basis as to keep my profile as stable as possible (plus it's just easy to remember to take a pill on a daily basis). I chose Aromasin (Exemestane) over Arimidex (Anastrozole) or any other type II aromatase inhibitor due to it's nature of being an irreversible steroidal inhibitor (binds permanently to aromatase enzymes thus permanently taking it from an active to inactive state). This is important as other types of aromatase inhibitors can have a negative long-term influence on lipid profiles and lead to possible rebound after discontinuation if not tapered properly.

Note:
Since we are speaking HRT here we are by association speaking a long term, life long commitment so this is why I place importance on long-term lipid profile changes. Of course this is all assuming one is able to obtain Aromasin (Exemestane) in the first place...Arimidex (Anastrozole) appears to be more common and perhaps more easily prescribed.

Thanks for your time; any comments, suggestions, and experiences welcome.

[HRTstudent]

First of all, nobody knows the long term (decades) implications of men taking AI's.

It's my personal opinion that I will somehow get off of anastrozole/arimidex -- Most likely through small weekly amounts (of T).

Next, the use of aromasin is a relatively new thing in HRT. We are certainly seeing a lot of talk about it this year, but from what I have read, not many doctors are using it. It's more along the lines of some patients are asking for it.

Then again, AI in men for HRT is off-label as it is, so anecdotes and somewhat-related publications are really what we have to go on.

My opinion is, for now, take what AI makes you feel best (whether aromasin or anastrozole) but if you can get away with NOT using an AI then that's the best. Next best is to try herbals such as DIM, calcium d-glucarate, Chrysin with bioperine, and even grapeseed extract. These do work to control excess estradiol, but they are much more mild than the powerful pharmaceuticals.

[MD2B]

Outstanding, thank you for your feedback HRTstudent. That answers every question I had actually.

I personally believe, like you, that I will make it my mission to never require use of an AI. It's exciting to see the new results being found with subcutaneous injections of testosterone and the possibility of using this technique to help manage estradiol.