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Thanks for the continuous support of this thread. I am just going to jump right in and answer some of the questions. Hungry4life and Aussiebulldog both were interested in the topic of administering low doses of short acting test daily and i am all for it. Basically the closer we can mimic what happens in a human body the less chances that your body will react in a negative fashion. One of which is convert large amount of "un-needed" test to estrogen. Studies have shown that when there is a lot of testosterone floating around your body actually starts to ramp up and produce more aromatase enzyme to convert more test to estrogen. A normal healthy young male produces about 12-18mg of testosterone daily. So assuming you didnt have an issue with daily injections, you could essentially inject 15mg of testosterone propionate daily, seven days a week and end up with a very stable test, and very low E2 levels. This would make you retain a lot less water as well. At these dosages i see no reason for AI. Most of my patients inject testosterone cypionate twice weekly and i try to keep their total test levels between 800-1000 and when they do inject twice a week, their E2 level is 30-40 which is just fine without any ill effects. But to answer the question anyway, my personal favorite for an AI is exemestane. It is a suicide inhibitor unlike Arimidex (anastrozole) and just works a hell of a lot better and is lipid neutral. Mg per mg, letrozole does work better than exemestane but will dramatically affect your lipid levels in a negative way. So if the patient has already started to get some gyno, then i will recommend letrozole first since that is pretty much the only one that works if the gyno is present. But if gyno does not exist keeping E2 down using exemestane should be very successful. The dosage is dependent on how much testosterone a patient is taking weekly. For pure TRT purposes usually no AI is needed. For people that cruise at 250mg a week then your total test will be 1200-1500 with elevated E2 so 12.5mg daily or even every other day is enough. For 250-750mg of test weekly 25mg daily of exemestane is needed and for more than 750mg a week most will need 50mg of exemestane daily. These are all of course initial starting doses and a blood test should be done four weeks into your therapy to determine proper adjustment up or down.

Nothuman had a question about starting TRT early and if it would reduce lifespan. And yes it is a very general question and one that can't be answered with certainty. What we do know is that low T definitely can reduce lifespan by causing early death, higher chance of osteoperosis and higher rate of death due to cardiovascular accidents. The problem is that we live in a world of excess so if total testosterone of 800 is great then 1600 must even be better And things just dont work out that way. Assuming there was a need for TRT and levels were regularly checked to make sure that you are within physiologic range, lipids were in check, hematocrit and other normal labs were annually checked then i see no reason why it would reduce life span.

Sapps, yes you have a spruce green light from me for a test/tren or test/npp cruise at 100/100. You will be surprised by the results.

Torque asked a great question about SARMS which i think should be addressed. On initial glance everything looks good but if you dig deeper it is not as exciting anymore. There are two major problems i have with SARMs. One is that in the doses that helps gain lean mass, and prevent osteo across the board it will suppress natural testosterone production. And the second bigger issue i have is that across the board patients liver enzymes get elevated. From lurking on this board i have seen a couple of members that have posted their lab results and their liver enzymes were elevated along with low endogenous test. Also, there is no way to monitor any levels etc. So with that information it makes no sense to me to use SARM when simple weekly injections of test can be done and we can maintain patients on a very tight level and reduce any side effects.

BA69, there is really no such a thing as "low responder" to testosterone. You are injecting said amount of testosterone in the body. There is nothing to respond to. What may be happening is that you are converting test to other compounds such as estrone, estradiol, estriol or even DHT. Remember up to 10-30% of your test will get converted to DHT which is not picked up on total testosterone level tests. So if i had a patient like yours i would definitely check a E2 at the least to see if that is elevated. You may have a naturally high aromatase enzyme that converts more to estrogens. Also, i prefer cypionate much more than enanthate simply because you are getting more test mg per mg. It is not a lot but every bit counts. Also any test over 600-700 is fine. As long as you are feeling well and strong that is all that matters cause you may have a larger portion converting to DHT.

Last but not least aussiebulldog and sapps wanted to know about using long term low level test/tren as cruise. And the max i recommend is 100/100. As i had mentioned in other replies, tren is not the "big bad evil" AAS that everyone makes it to be. At very low doses it is very well tolerated and can keep a positive nitrogen balance better than any other compound out there. It is all individual and any AAS can throw your lipids off and just like anything else i recommend checking your lipids at 4, 8 and 16 weeks just to see where the trend is heading and adjust from there. We are all not the same. You maybe someone that just does not do well with a compound such as tren and have lipids going crazy and if that is the case you learn from that experience and move on. One thing about medicine is that there are is no absolute in anything.

Hope the above answers your questions for this week. I will be back next week with another round of answers.

Dr. G.