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How to Successfully Use SERM and AI Medication with TOT


Selective Estrogen Receptor Modulators (SERM) and Aromatase Inhibitors (AI) are ancillary medications that can correct potential side effects of TOT treatment. More and more physicians are using a SERM (such as Clomid, Nolvadex or Toremifene) or even an AI (such as Arimidex) as the part of a “TOT” protocol. However, before you start treatment, it is essential to understand how to use SERM and AI medication to achieve maximum efficiency. Here’s everything you need to know:

The Effects of SERM and AI

Talk to any man who has dealt with having his estrogen levels pushed too low. It feels terrible! There is no sex drive or function, and you often experience lethargy and overall lifelessness. Short-term aromatase-enzyme blockades unmask impaired feedback adaptations in luteinizing hormone (LH) and increase testosterone levels in older men. These medications elevated LH and overall testosterone levels, so it’s easy to see why such an approach would be taken. Using medication in combination with a successful TOT protocol, SERM and AI can improve your sex drive, increase your libido and improve the overall effectiveness of the treatment. If your doctor has you on a SERM or AI as a ‘sole form of TOT,’ you should show them The TOT Bible. It will help them understand why using testosterone is a much more effective treatment.

How Much SERM or AI Do You Need

A severe limitation of using aromatase inhibitors in isolation when treating aging men is that the stimulating effect on testosterone levels may be too weak. It is especially true for men who have low baseline testosterone levels and would potentially benefit from more stimulation. The notable exception is for TOT patients who want to remain fertile (generally between 30-50 years old). These patients should consider using low doses of Clomid, or hCG monotherapy, to restore and improve low rates of natural testosterone production.

When to Apply Medication

Typically, there is only a narrow therapeutic window for regulating estrogen (estradiol/E2) levels before you start to impact your libido and health negatively. Lower estrogen levels are rarely better, and you will need to monitor them regularly with an experienced TOT physician. Remember, it is all about achieving a balance in your body.

How to Combine TOT with SERM or AI

Combining TOT with SERM or AI  is often necessary for short-term success. It allows you to achieve the optimal balance between testosterone and estrogen. However, you should only apply this kind of treatment when there is an observed clinical need, due to the symptoms being reflective of higher E2 levels.

Possible Side Effects of Medication

A significant risk of using AI alone is the possibility of driving estrogen levels too low. It could have terrible consequences for good cholesterol profile, bone mineral density, libido, and overall feeling of well-being. We recommend that AIs are ONLY for short periods of time. It should only be applied to get estrogen levels within an acceptable therapeutic range to achieve a healthy hormonal balance and alleviate any side effects. A much safer and more effective strategy is to either reduce the testosterone dosage or alter the dosing schedule to deal with the symptoms of excess estrogen.

Take Action

If you want to learn more about SERM and AI medication, and the benefits of increased testosterone levels with this revolutionary treatment, buy The TOT Bible today – the number one solution for becoming a healthier man.


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