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Why is it important to use an AI when on cycle?
It has been the opinion of members of the anabolic steroid community that an Aromatase Inhibitor (AI) does not need to be used when on cycle using one or more androgens that push estrogen levels above baseline.
For a number of reasons (explained below) I will try to make you (the steroid user) see that using an AI is an important part of cycling anabolic steroids. Those that suggest not to, do not understand the risks associated with increased levels of estrogen in males and demonstrate poor logic and understanding.
Estrogen – The Carcinogen
Estrogen is a carcinogenic compound. That means is a “cancer causing agent in living tissue” for anyone that does not know what a carcinogen is. Its a Group 1 IARC classified carcinogen which means it a pretty potent one really. The risks of estrogen and carcinogenic activity are then again confirmed in 'estrogen only' conraceptive treatment(s). Although the data is somewhat confusing (as some data is on estrogen+progestagen treatment), the links to various forms of cancer rates increasing is pretty clear in humans.
In a study [1] that looked at ‘estrogen only’ treatment and also combination therapry of ‘estrogen + progesterone’ below is what was found.
"Four studies (one cohort study and three large case-control studies) reported increased risk of endometrial cancer with estrogen repla***ent therapy (Cushing et al. 1998, Shapiro et al. 1998, Persson et al. 1999, Weiderpass et al. 1999), and three of these studies reported strong positive associations between risk of endometrial cancer and duration of estrogen use."
"Two of four case-control studies found that estrogen-only repla***ent therapy was associated with an increased risk of breast cancer (Heinrich et al. 1998, Magnusson et al. 1999)."
"One study found that estrogen therapy was associated with ovarian cancer (Purdie et al. 1999)."
"In 2009, IARC concluded there was sufficient evidence of the carcinogenicity of estrogen-only therapy in humans based on increased risks of endometrial cancer and ovarian cancer and limited evidence based on increased risk of breast cancer (Grosse et al. 2009). The findings for ovarian cancer were based on two meta-analyses (Greiser 2007, Zhou 2008). Since then, another meta-analysis has estimated a significant overall increase in ovarian cancer risk related to duration of use of estrogen-only therapy (Pearce et al. 2009)."
"In rodents, steroidal estrogens caused benign and malignant tumors, as well as pre-cancerous lesions, in a variety of organs, including the mammary gland and female reproductive tract (IARC 1999). Estrogenic compounds generally caused endometrial, cervical, and mammary-gland tumors in mice, mammary- and pituitary-gland tumors in rats, and kidney tumors in hamsters"
Although there is mixed data on estrogen treatment cuasing or accelerating cancers or being a carcinogen, the data cannot be ignored.
So the above data tells us that exposure to estrogen can cause health implications for females. But what else does it tell us? We know that womens bodies are a lot more tolerable of estrogen, primarily as that’s the hormone that makes them – female. Secondly, their bodies can experience extremely high levels of estorgen, such as, pregnancy, where levels of 500pg/ml are experienced. On the contrary, males suggested high end by doctors and health organisations is 50pg/ml, that’s 10 times lower.
Estrogen in Males
So we have established the estorgen is not necessarily a good hormone for males and certainly isn’t suggested to be at the high end or above 50ng/ml. So what is it good for and used for?
It’s important in males for a wide variety of reasons:
- GH and IGF synthesis
- Bone density
- Lipid profile function
- Glucose uptake and utilisation
- Androgen Receptor (AR) sensitivity and activation
- Immune function anti-inflammatory effects.
- Sex Drive (libido) and testosterone function/synthesis
There are studies for and against the importance of sex hormones on coronary heart disease (CHD) and mortality, but the hypothsis is plausible. Why?
- Estrogens decrease smooth muscle tone and inhibit smooth muscle proliferation
- Estrogenic effects on lipid profile and cholesterol
- Estrogen receptors are found in high-affinity in both vascular smooth muscle and endothelium
- Estrogens induce vasodilation and enhance the release of nitric oxide and prostacyclin from endothelial cells
- Estrogens exert indirect effects on the cardiovascular system through their influence on lipoprotein metabolism and the coagulation, fibrinolytic, and antioxidant systems
So you can not see the importance estrogen has on the cardiovascular system, CHD, therefore mortality rates [2]. Without estrogen, males simply would not function properly
Negative Estrogen Effects in Males
Estrogen is bad for males not just because of the negative cardiovascular issues stated above. Estrogen can also cause serious health problems in prostate tissue. Studies conducted on estrogens effects on the prostate show its dangers and the risks it can cause. Its not just DHT that can cause prostate issues, such as, enlargement. Estrogen has demonstrated changes in prostate cancer cell proliferation and differentiation in prostate tissue [3]. It should also be noted that prolactin (PRL) can worsen prostate tumour expression in males. A potent weapon against this nasty side effect is the use of Tamoxifen, which can limit cell proliferation and is now used medically for this action.
Aromasin (Exemestane) and IGF
The common reason for not using an AI is, that it may limit gains made... But do they?
AI's have little impact on IGF-1 levels and Exemestane does not have any effects at all, If IGF-1 was somewhat lowered, we also need to understand that exogenous testosterone and other anabolic steroids are going to increase IGF-1 and further negate these effects. To realise how little effect AI's have on IGF-1, read this study.
To summarise; Nine young healthy men who received femara at 2.5 mg daily for 28 days had a 15% reduction in IGF-1, a 24% reduction in leptin, and a 14% increase in LDL (bad cholesterol).
As for Exemestane on lipid levels, it has far less impact than other AI's although it does not have the benificial effects of SERMs. Some data, such as this one, states,
"no clinically significant effect on the serum lipids".
Another study stated, "Overall, exemestane has no detrimental effect on cholesterol levels and the atherogenic indices, which are well-known risk factors for coronary artery disease. In addition, it has a beneficial effect on TRG levels"
Here is one thats slightly more applicable on young males user's, this study states, "Plasma lipids and IGF-I concentrations were unaffected by treatment."
Becasuse of the way prolactin is regulated in males using an AI will also help control this hormone from also becoming out of range when andorgens are used that interact with the estrogen receptor (ER) or prolactin receptor (PRL).
Final Thoughts
10mg every day of Aromasin (Exemestane) or 5mg twice per day is suggested to keep estrogen in normal ranges and in most cases is sufficient. Twice per day dosing can be used AM and PM due to its short active life when suppressing circulating estorgen.
Arimidex (Anastrozole) can also be used effectively at 0.25-0.5mg every other day due to its longer active life. This AI, though, is not as friendly on the lipid profile of male users, nor does it not impact IGF.
[1] http://ntp.niehs.nih.gov/ntp/roc/twe...sSteroidal.pdf
[2]http://www.science20.com/news_releases/estrogen_makes_men_more_likely_to_die_of_heart_dis ease
[3] http://www.ncbi.nlm.nih.gov/pubmed/17786930
For a number of reasons (explained below) I will try to make you (the steroid user) see that using an AI is an important part of cycling anabolic steroids. Those that suggest not to, do not understand the risks associated with increased levels of estrogen in males and demonstrate poor logic and understanding.
Estrogen – The Carcinogen
Estrogen is a carcinogenic compound. That means is a “cancer causing agent in living tissue” for anyone that does not know what a carcinogen is. Its a Group 1 IARC classified carcinogen which means it a pretty potent one really. The risks of estrogen and carcinogenic activity are then again confirmed in 'estrogen only' conraceptive treatment(s). Although the data is somewhat confusing (as some data is on estrogen+progestagen treatment), the links to various forms of cancer rates increasing is pretty clear in humans.
In a study [1] that looked at ‘estrogen only’ treatment and also combination therapry of ‘estrogen + progesterone’ below is what was found.
"Four studies (one cohort study and three large case-control studies) reported increased risk of endometrial cancer with estrogen repla***ent therapy (Cushing et al. 1998, Shapiro et al. 1998, Persson et al. 1999, Weiderpass et al. 1999), and three of these studies reported strong positive associations between risk of endometrial cancer and duration of estrogen use."
"Two of four case-control studies found that estrogen-only repla***ent therapy was associated with an increased risk of breast cancer (Heinrich et al. 1998, Magnusson et al. 1999)."
"One study found that estrogen therapy was associated with ovarian cancer (Purdie et al. 1999)."
"In 2009, IARC concluded there was sufficient evidence of the carcinogenicity of estrogen-only therapy in humans based on increased risks of endometrial cancer and ovarian cancer and limited evidence based on increased risk of breast cancer (Grosse et al. 2009). The findings for ovarian cancer were based on two meta-analyses (Greiser 2007, Zhou 2008). Since then, another meta-analysis has estimated a significant overall increase in ovarian cancer risk related to duration of use of estrogen-only therapy (Pearce et al. 2009)."
"In rodents, steroidal estrogens caused benign and malignant tumors, as well as pre-cancerous lesions, in a variety of organs, including the mammary gland and female reproductive tract (IARC 1999). Estrogenic compounds generally caused endometrial, cervical, and mammary-gland tumors in mice, mammary- and pituitary-gland tumors in rats, and kidney tumors in hamsters"
Although there is mixed data on estrogen treatment cuasing or accelerating cancers or being a carcinogen, the data cannot be ignored.
So the above data tells us that exposure to estrogen can cause health implications for females. But what else does it tell us? We know that womens bodies are a lot more tolerable of estrogen, primarily as that’s the hormone that makes them – female. Secondly, their bodies can experience extremely high levels of estorgen, such as, pregnancy, where levels of 500pg/ml are experienced. On the contrary, males suggested high end by doctors and health organisations is 50pg/ml, that’s 10 times lower.
Estrogen in Males
So we have established the estorgen is not necessarily a good hormone for males and certainly isn’t suggested to be at the high end or above 50ng/ml. So what is it good for and used for?
It’s important in males for a wide variety of reasons:
- GH and IGF synthesis
- Bone density
- Lipid profile function
- Glucose uptake and utilisation
- Androgen Receptor (AR) sensitivity and activation
- Immune function anti-inflammatory effects.
- Sex Drive (libido) and testosterone function/synthesis
There are studies for and against the importance of sex hormones on coronary heart disease (CHD) and mortality, but the hypothsis is plausible. Why?
- Estrogens decrease smooth muscle tone and inhibit smooth muscle proliferation
- Estrogenic effects on lipid profile and cholesterol
- Estrogen receptors are found in high-affinity in both vascular smooth muscle and endothelium
- Estrogens induce vasodilation and enhance the release of nitric oxide and prostacyclin from endothelial cells
- Estrogens exert indirect effects on the cardiovascular system through their influence on lipoprotein metabolism and the coagulation, fibrinolytic, and antioxidant systems
So you can not see the importance estrogen has on the cardiovascular system, CHD, therefore mortality rates [2]. Without estrogen, males simply would not function properly
Negative Estrogen Effects in Males
Estrogen is bad for males not just because of the negative cardiovascular issues stated above. Estrogen can also cause serious health problems in prostate tissue. Studies conducted on estrogens effects on the prostate show its dangers and the risks it can cause. Its not just DHT that can cause prostate issues, such as, enlargement. Estrogen has demonstrated changes in prostate cancer cell proliferation and differentiation in prostate tissue [3]. It should also be noted that prolactin (PRL) can worsen prostate tumour expression in males. A potent weapon against this nasty side effect is the use of Tamoxifen, which can limit cell proliferation and is now used medically for this action.
Aromasin (Exemestane) and IGF
The common reason for not using an AI is, that it may limit gains made... But do they?
AI's have little impact on IGF-1 levels and Exemestane does not have any effects at all, If IGF-1 was somewhat lowered, we also need to understand that exogenous testosterone and other anabolic steroids are going to increase IGF-1 and further negate these effects. To realise how little effect AI's have on IGF-1, read this study.
To summarise; Nine young healthy men who received femara at 2.5 mg daily for 28 days had a 15% reduction in IGF-1, a 24% reduction in leptin, and a 14% increase in LDL (bad cholesterol).
As for Exemestane on lipid levels, it has far less impact than other AI's although it does not have the benificial effects of SERMs. Some data, such as this one, states,
"no clinically significant effect on the serum lipids".
Another study stated, "Overall, exemestane has no detrimental effect on cholesterol levels and the atherogenic indices, which are well-known risk factors for coronary artery disease. In addition, it has a beneficial effect on TRG levels"
Here is one thats slightly more applicable on young males user's, this study states, "Plasma lipids and IGF-I concentrations were unaffected by treatment."
Becasuse of the way prolactin is regulated in males using an AI will also help control this hormone from also becoming out of range when andorgens are used that interact with the estrogen receptor (ER) or prolactin receptor (PRL).
Final Thoughts
10mg every day of Aromasin (Exemestane) or 5mg twice per day is suggested to keep estrogen in normal ranges and in most cases is sufficient. Twice per day dosing can be used AM and PM due to its short active life when suppressing circulating estorgen.
Arimidex (Anastrozole) can also be used effectively at 0.25-0.5mg every other day due to its longer active life. This AI, though, is not as friendly on the lipid profile of male users, nor does it not impact IGF.
[1] http://ntp.niehs.nih.gov/ntp/roc/twe...sSteroidal.pdf
[2]http://www.science20.com/news_releases/estrogen_makes_men_more_likely_to_die_of_heart_dis ease
[3] http://www.ncbi.nlm.nih.gov/pubmed/17786930
