Why Some People HAVE to Use an Aromatase Inhibitor

Agreed.

I understand the general point they're trying to make. There was a time in the Crisler era when 90%+ of the men on TRT were using an aromatase inhibitor for no reason - the vast majority of them were on an awful protocol (200mg injected once per week, 300mg every two week etc), saw that E2 was above range, and proceeded to put two and two together to get five. Then they spend the next year altering their dose of AI to fix a problem that wasn't inherently caused by elevated estrogen. This is where their advice of drop the AI, increase administration frequency to EOD / ED and wait eight weeks is somewhat applicable.

However, they fail to understand that there's a small but significant proportion of men (that I am not part of - this isn't me justifying my own AI use) who have done that and still fail to feel better. When those same men are say that they don't feel good, like you said, they're told "AIs are toxic, go watch the videos" and the case is closed / no longer up for debate.

Besides the fact that there exists no data demonstrating the use of a low dose AI to restore elevated e2 back within range causes harm - even if there was, that kind of treatment does literally nothing to aid the patient in question.

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