I had mine turned up when I bought my bike due to back problems (broken vertebrae). However as I healed I've since flipped it back to the stock position. I find the handling is much better, and I can really notice the aero benefits when riding in windy conditions. So far my back hasn't suffered much, but I do notice some stiffness in my neck. As far as the saddle, the guys at the LBS emphasized the need to keep the saddle level. They say it will put to much pressure on the hands and wrists.