Hi Ellis:

It is not mandatory that every man who uses testosterone in
injectible or topical form use Arimidex to block estradiol
conversion. In our clinic, only 15 - 20% of our male clientele
develop elevated levels of Estradiol ( >60) and need to have
it treated. These men tend to be older and/or fatter as the
aromatase enzyme is located in fat cells and in the skin fat
cells.

There also seems to be more testosterone-to-estrogen conversion
with the use of topical testosterone products like Androgel or
Testim when compared to injecting longer acting forms like
Testosterone Cypionate or Sustanon.

We generally try to give as little Arimidex as possible to achieve
a blood estradiol level of 55 or less, however not so much that
this level falls below 20. For most men that is 0.5 to 1 mg/week.

If you gave Arimidex to every testosterone using man you would
have many with blood estradiols of 10 or less.

Estradiol plays a key role in bone and brain health in men as it
does in women, hence it would probably not be a good idea to have
too little estradiol.

Randy Ice P.T., C.C.S.
Vintage Medical Group
Temecula, California
(951) 676-3748

Ellis: Hello Randy,

I do not say you are mistaken, because I know you have much
more experience than I do... however I always give everybody who
takes testosterone their pill of Arimidex and then a blood test a
few weeks later, and adjust as seen from the blood test.
For me, they go together, you take one, you take the other. And
I have never had a client with a problem with LOW ESTRADIOL because
he took Arimidex and Testosterone.... .

It is interesting that we have different interpretation of
what is "too high"... I think anything above 30 is too high,
and you say anything above 55 is too high.

I don't know if you are right and I am wrong, because I don't
know what happens if estradiol is left at 50, for example. But
I know that if I try to get estradiol between 10 and 30, everybody
is happy, and I can get it to between 10 and 30 with a pill
of Arimidex for each shot of testosterone.

I learned from the Life Extension article about the year 2002,
"Male Hormone Modulation Therapy"... they considered 10 to 30 to
be the ideal range, ... I paste from their page:

http://www.lef.org/protocols/male_reproductive/male_hormone_restoration_02.htm

"Estrogen. Estrogen (measured as estradiol) should be kept at
30 picograms per milliliter (pg/mL) or lower. If a man’s estrogen
level is more than 30 pg/mL, it should be reduced by using
aromatase-inhibiting drugs or nutrients." - Life Extension
Foundation "Male Hormone Restoration" July, 2007.

I agree that estradiol should not be too low, and maybe 10 is
too low... In any case, I have always recommended to take one
pill of Arimidex for each shot of testosterone, and then a
blood test at some point after to monitor estradiol, and then
to adjust the Arimidex accordingly... Nobody has ever reported
to me that they got a 10 or lower on their blood test, but from
now on I will recommend that it should be between 20 to 30...
and I won't be upset if it is a bit higher than 30, since you
say that you aim for less than 55, so you are not upset if it
is 40 or 45 or 50...

Thanks very much for your extremely valuable comments. Randy
is THE PERSON who I would consult with FIRST if I would ever be
in any kind of health problem, such as if I ever would have
cancer, or end stage kidney disease, or HIV+, or liver problems
etc.

Three stars for this post. Even if we have different opinions,
Randy's opinion is based on what hundreds of patients are
actually advised to do at his clinic, and mine is only based
on what I learn from him and Life Extension Foundation and other
good doctors and patients. Thank you, Randy! - Ellis