Always very helpful!
Letrozole definitely has been shown to have a superior suppression of E1S over Arimidex, in some clinical settings. From my readings, Aromasin had a lower percentage of suppression on E1 and E1S.
Although, this is subjective to the individuals expression and genetic action of 17β-HSD1 to estrone sulfate (E1S) <> E2.
Thoughts?
As always my time has been very compressed. A few things I'd like to add to your list gg.
Do not overdo it on phlebotomies, tanking your iron stores. It's been observed that iron deficiency (even without anemia) will increase platelets to become more "sticky", increasing the chance of clotting to occur.
Know your genetic background. If any first degree relative has a clotting disorder or any type of autoimmune diseases. Check for Factor V Leiden, Prothrombin mutation, MTHFR and Galectin-3, which has been implicated in the venous thrombogenesis process. Iron deficiency would exacerbate and an elevated level Galectin-3 potentiating the risk of a clot several fold.
One could also check their Fibrinogen levels, hs-CRP, Lp-PLA², Homocysteine and Myeloperoxidase levels.
One last thing, those that push the envelope on running high T3 doses. This can be pro-thrombotic in a hyperthyroid state.