When adding Arimidex (anastrozole) to testosterone replacement therapy (TRT), the goal is to help keep estrogen levels within an optimal range. Estrogen is produced via the aromatization of testosterone and serves important functions, but too much estrogen can lead to side effects in men on TRT.
Some key points on using Arimidex with TRT:
- The typical starting dose of Arimidex with TRT is 0.5mg twice per week. This can be adjusted based on lab work and symptoms.
- Arimidex lowers estrogen levels by blocking the aromatase enzyme which converts testosterone to estrogen. Lowering estrogen can help mitigate side effects of TRT like gynecomastia, water retention, and mood issues.
- It's important to monitor estrogen levels along with testosterone when using Arimidex. The goal is not to crash estrogen levels but rather optimize the testosterone to estrogen ratio.
- Symptoms like joint pain, fatigue, low libido, erectile dysfunction, and changes in mood can indicate that estrogen is too low. The Arimidex dosage may need to be reduced if symptoms develop.
- Using the lowest effective dose of Arimidex is recommended to avoid side effects associated with estrogen deficiency. Sometimes only 0.25mg twice weekly is needed.
Finding the appropriate Arimidex dosage requires some trial and error guided by lab testing and evaluating symptoms. Here some some general dosage considerations:
- For mild elevation in estrogen - start with 0.25mg Arimidex twice per week
- For moderate elevation in estrogen - start with 0.5mg Arimidex twice per week
- If estrogen is still high with 0.5mg twice weekly, increase to 0.5mg every day
- Maximum daily dose is around 1mg per day. Exceeding this is unlikely to further lower estrogen. Titrate downward if symptoms of low estrogen develop.
Lab Testing Guidance When Using Arimidex
These lab tests are useful for guiding Arimidex therapy:
- Sensitive estradiol - assess baseline levels before starting TRT Arimidex, then follow up around 6 weeks after making a dosage change
- Testosterone - measure both total and free T, ensure levels are within an optimal range
- CBC - reveals changes in hemoglobin and hematocrit that can indicate high estrogen
- Lipid profile - monitor for negative changes which may reflect low estrogen
In summary, when adding Arimidex to TRT the approach is to start low, titrate slowly, and adjust the dosage based on clinical response and lab testing. Using the minimal dose needed prevents adverse effects and optimizes the testosterone to estrogen balance. Monitoring bloodwork and listening to symptoms helps guide appropriate Arimidex dosing on an ongoing basis. Speak to an experienced
hormone therapy physician for customized recommendations.
