Aromatase inhibitors suppress estrogen from the adrenals.

It helps to try different AI's, different manufacturers. I ended up taking brand name letrozole (Femara) though in the last month I found a generic I could tolerate.

I found that walking at least 40 minutes also helped, as well as tai chi. I was fortunate in not having severe issues (except for bone loss which has been mitigated with Tymlos).

I did the Breast Cancer Index test to see if I would benefit from extended treatment and the answer was no. I felt safe while on Femara to be honest, but I followed the advice of the BCI and stopped.