Thinking of stopping my AI. Thoughts.

[Cips1975]

Thanks for the replies guys. I’ll continue to observe this thread and go from there. I see both sides. What I am on right now is working and no issues so why change at this point a year in. Good point. Then I see the other points as well that some folks will just need an AI. I am still kinda leaning on stopping the AI until my next labs in like a month or so. Only way to tell other than symptoms. Again, thanks for the replies.

Quick update. It’s only been 2 weeks off AI. So far so good. It’s funny how you kinda get paranoid checking for symptoms, I am
Always feeling my nipples or get alarmed if I feel some tingling, could all be on my head. A couple times already I almost said , F it, I am going back on. It’s as much mental as it is physical. Labs won’t be for a couple weeks.

 

[wsj357]

Quick update. It’s only been 2 weeks off AI. So far so good. It’s funny how you kinda get paranoid checking for symptoms, I am
Always feeling my nipples or get alarmed if I feel some tingling, could all be on my head. A couple times already I almost said , F it, I am going back on. It’s as much mental as it is physical. Labs won’t be for a couple weeks.

The nipple sensitivty goes away after a few months. atleast it did for me.

 

[wsj357]

I’d just take the smallest dose of ai possible as rarely as possible. That should alleviate symptoms. Eventually toy won’t even need it ime.

A little bit of nipple sensitivity is nothing.

 

[Cips1975]

Alright guys. Labs are in. As promised I said I would report on my next set of labs since stopping my Arimidex. As you can imagine I was very curious to see where I would end up especially with all the discussion back-and-forth. Here are some numbers:
estradiol = 72. I was normal range last time at 19 and now much higher.
Testosterone= 1022 high normal and quite a bit higher than last at 831
Free Test= 209.5 High much higher than last time at 144.
Red Blood Cell = 5.9. High
Rest of labs like my lipid’s etc. are all fine

So I will be consulting with the doctor this week if finding out what his recommendations are. Now he doesn’t know I stopped my Arimidex but I will tell him obviously. So my initial observations , I guess I was kind a hoping that my estrogen levels wouldn’t go up that much, but, labs are the labs and That’s why we get them right. This was also the first time that my red blood cell count has been high. Not sure if there is a connection. At this point I think I will likely start back on the prescribed arimidex until the next set of labs. Again these are just initial thoughts right now as I literally got the lab results. So during this experiment, I would say the only thing that was may be a noticeable side was slightly puffier nipples, no sensitivity. But I don’t know how much of this was just my mind playing tricks on me. I say that because I’ve always had somewhat puffy nipples. Stay tuned.

 

[tmaxey1]

Alright guys. Labs are in. As promised I said I would report on my next set of labs since stopping my Arimidex. As you can imagine I was very curious to see where I would end up especially with all the discussion back-and-forth. Here are some numbers:
estradiol = 72. I was normal range last time at 19 and now much higher.
Testosterone= 1022 high normal and quite a bit higher than last at 831
Free Test= 209.5 High much higher than last time at 144.
Red Blood Cell = 5.9. High
Rest of labs like my lipid’s etc. are all fine

So I will be consulting with the doctor this week if finding out what his recommendations are. Now he doesn’t know I stopped my Arimidex but I will tell him obviously. So my initial observations , I guess I was kind a hoping that my estrogen levels wouldn’t go up that much, but, labs are the labs and That’s why we get them right. This was also the first time that my red blood cell count has been high. Not sure if there is a connection. At this point I think I will likely start back on the prescribed arimidex until the next set of labs. Again these are just initial thoughts right now as I literally got the lab results. So during this experiment, I would say the only thing that was may be a noticeable side was slightly puffier nipples, no sensitivity. But I don’t know how much of this was just my mind playing tricks on me. I say that because I’ve always had somewhat puffy nipples. Stay tuned.

How do you feel? Any common E2 sides? Water retention? Nipples? Blood pressure? Any changes to your weight?

How close were your labs to your injection?

 

[Cips1975]

Hi. Just nips a little more puffier. Everything else pretty much the same overall. Feel fine otherwise. Felt fine when on arimidex too. Ohh. My last IM injection was on a Thursday and my labs were on the following Monday.

 

[tmaxey1]

Hi. Just nips a little more puffier. Everything else pretty much the same overall. Feel fine otherwise. Felt fine when on arimidex too. Ohh. My last IM injection was on a Thursday and my labs were on the following Monday.

I wouldn’t mess around with puffy nips. As a person who suffered from pubertal gyno trust me. Your nips don’t have to have rock hard lumps under them to have tissue growth.

It’s a life time embarrassing ailment. My advice...you either need to drop your T dose, get back on the AI, and or split your T dose to 3 times and week or a combo.... don’t play with bitch tits.

 

[madman]

Alright guys. Labs are in. As promised I said I would report on my next set of labs since stopping my Arimidex. As you can imagine I was very curious to see where I would end up especially with all the discussion back-and-forth. Here are some numbers:
estradiol = 72. I was normal range last time at 19 and now much higher.
Testosterone= 1022 high normal and quite a bit higher than last at 831
Free Test= 209.5 High much higher than last time at 144.
Red Blood Cell = 5.9. High
Rest of labs like my lipid’s etc. are all fine

So I will be consulting with the doctor this week if finding out what his recommendations are. Now he doesn’t know I stopped my Arimidex but I will tell him obviously. So my initial observations , I guess I was kind a hoping that my estrogen levels wouldn’t go up that much, but, labs are the labs and That’s why we get them right. This was also the first time that my red blood cell count has been high. Not sure if there is a connection. At this point I think I will likely start back on the prescribed arimidex until the next set of labs. Again these are just initial thoughts right now as I literally got the lab results. So during this experiment, I would say the only thing that was may be a noticeable side was slightly puffier nipples, no sensitivity. But I don’t know how much of this was just my mind playing tricks on me. I say that because I’ve always had somewhat puffy nipples. Stay tuned.

Unfortunately regarding testing ones FT (free testosterone) most are using the direct analog-based free testosterone immunoassays which are inaccurate.

If anything you should be getting the equilibrium dialysis or better yet save yourself the money and use the Calculate free testosterone with TruT by FPT - Try the public free testosterone calculator at tru-t.org

Do you truly know your FT levels?






500726: Testosterone, Free, Mass Spectrometry... | LabCorp

Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

TEST: 500726
Test number copied

CPT: 84402; 84403






Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline (2018)


Testosterone Therapy in Men With Hypogonadism: An Endocrine Society * Clinical Practice Guideline



In men who have conditions that alter sex hormone–binding globulin (SHBG) (Table 2), or whose initial total testosterone concentrations are at or near the lower limit of the normal range (Fig. 1), clinicians should determine free testosterone concentrations either directly from equilibrium dialysis assays or by calculations that use total testosterone, SHBG, and albumin concentrations. Clinicians should not use direct analog-based free testosterone immunoassays, as they are inaccurate.





Are these most recent labs from your previous protocol 200mg/week (100 mg every 3.5 days).....and were they taken at (trough)?

Again what is your SHBG level as for all we know your FT is too high resulting in your high e2.....but again if you feel good overall and health markers from lab work are in range and you are experiencing no negative effects from elevated e2 than why worry!

Use of exogenous testosterone will increase ones hematocrit/hemoglobin and RBCs.

 

[Cips1975]

I wouldn’t mess around with puffy nips. As a person who suffered from pubertal gyno trust me. Your nips don’t have to have rock hard lumps under them to have tissue growth.

It’s a life time embarrassing ailment. My advice...you either need to drop your T dose, get back on the AI, and or split your T dose to 3 times and week or a combo.... don’t play with bitch tits.

I believe a lot of this is truly genetic. I remember as a kinda husky kid having puffy nips. I got rid of the chub by high school and been in decent shape ever since (43 now going on 44 in July) I am about 200 lbs at 5’8 body fat prob in that 15-20% range.. I have a “blurry” 6 pack that is visible lol. Hey I’ll take it and I am vascular and have visible striations. Love handles are my genetic downfall, there not bad but that is where my fat likes to hangout. I say all this because since I am in pretty good shape and somewhat lean overall, my nips have always been soft and puffy. Anyway, just popped 0.5mg arimidex this morning. Also emailed the clinic coordinator to tell my doc about me going off AI

 

[Cips1975]

Unfortunately regarding testing ones FT (free testosterone) most are using the direct analog-based free testosterone immunoassays which are inaccurate.

If anything you should be getting the equilibrium dialysis or better yet save yourself the money and use the Calculate free testosterone with TruT by FPT - Try the public free testosterone calculator at tru-t.org

Do you truly know your FT levels?






500726: Testosterone, Free, Mass Spectrometry... | LabCorp

Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

TEST: 500726
Test number copied

CPT: 84402; 84403






Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline (2018)


Testosterone Therapy in Men With Hypogonadism: An Endocrine Society * Clinical Practice Guideline



In men who have conditions that alter sex hormone–binding globulin (SHBG) (Table 2), or whose initial total testosterone concentrations are at or near the lower limit of the normal range (Fig. 1), clinicians should determine free testosterone concentrations either directly from equilibrium dialysis assays or by calculations that use total testosterone, SHBG, and albumin concentrations. Clinicians should not use direct analog-based free testosterone immunoassays, as they are inaccurate.





Are these most recent labs from your previous protocol 200mg/week (100 mg every 3.5 days).....and were they taken at (trough)?

Again what is your SHBG level as for all we know your FT is too high resulting in your high e2.....but again if you feel good overall and health markers from lab work are in range and you are experiencing no negative effects from elevated e2 than why worry!

Use of exogenous testosterone will increase ones hematocrit/hemoglobin and RBCs.

Thanks Madman for the detailed post. To answer your ?s. These labs were based off my current usuage of about 150mg total per week divided into Monday and Thursday IM shots. Mostly IM into glutes but recently will rotate and use my Delt using a smaller insulin pin. I like the twice/week schedule. In regards to the type of test assay that Quest Diagnostics is using for Free Test you mention above, I am not positive , but I am Ok with the clinic using what they feel is best practice. There is always something that may be little better or more accurate for any type of testing, I am sure what they use now is perfectly fine to help guide support and treatment for my basic TRT program. SHBG are not part of the lab results I get.

 

[Tman]

First, let's consider the half-life of Anastrazole. It's about 4-5 days. Which means that after 5 days only 50% of the substance is cleared from your body. He's taking 0.5mg on Friday. By Sunday he's stacking another 0.5mg on top of whatever amount hasn't been eliminated yet. So roughly speaking by Monday there's 0.75mg of Anastrazole in his system (this is not an accurate number, but I hope you get the idea). If you don't allow the medication to clear your system completely, the potential of building up unhealthy levels is quite obvious.

Alcohol was an analogy. Not 1:1 comparison. The logic that he's "taking it now, and feels good" doesn't make any sense to me.
You can drink excessively for years before suffering serious health consequences.
Prolonged use of AI is also dangerous. Although most studies were done on cancer patients, it should be clear that such a strong substance can indeed be toxic.

"Toxicity was reported by 42% of patients, and AI therapy was stopped due to toxicity in 19%. The toxicities reported were similar to those reported elsewhere, except that fewer hot flashes were reported. Osteoporosis was found in a higher proportion of patients on an aromatase inhibitor than has been reported in the literature, but 17% of patients had documented bone loss prior to therapy."

Emerging Data on Side Effects of Aromatase Inhibitors : Oncology Times

If you need more "proof" google Anastrazole toxicity.

Then there's also common sense. You cannot take a powerful pharmaceutical and think that it's only lowering E2, nothing works in isolation. It's like dropping a bomb and expecting it to only kill the bad guys. That's just not how it works.
Why do you think hundreds if not thousands of patients report problems from low dose AI usage? Typically it doesn't happen right away, but please don't be naive to think that an adverse effect cannot happen because it hasn't happened yet.

interesting article, I appreciate the read. I'm just curious what the dosage wasn't it wasn't listed in the study I imagine it's much greater than trt dosage, but the toxicity toxicity issue remains

 

[Tman]

i always battled e2 sides unless going 100 or less. currently experimenting on 300 per week no ai. crisler talked about this if you take the dose high enough you can negate e2 sides. so far so good.

Keep us updated. I've been thinking about the same thing. I can't help but wonder if I'm taking just enough to screw my body up and piss it off with the estradiol symptoms and if I could push higher would I negate the estradiol. right now I'm moving the other way I'm continuing to lower my dose hoping I can reduce the need for estradiol intervention.

 

[Deleted member 16042]

interesting article, I appreciate the read. I'm just curious what the dosage wasn't it wasn't listed in the study I imagine it's much greater than trt dosage, but the toxicity toxicity issue remains

Uh... I'd like to point out that the use of the word "toxicity" in that article is entirely bogus.


"Toxicity" in every case in that article is used as a blatantly wrong substitute word for correct terminology like "side effect", "sign", "symptom" and "adverse effect". It is not even synonymous.

A few examples, the article calls osteoporosis, myalgias and arthralgias "toxicities".

Osteoporosis is not a toxicity, it is a diagnosable condition and also could be referred to as a sign relative to it's associated cause e.g. osteoporosis is a potential sign of having low estrogen. Another unrelated example: A heart attack is a potential sign of coronary artery disease... Osteoporosis is no more a "toxicity" than a heart attack is a "toxicity"

Likewise, myalgias and arthralgias are aches and pains, they are symptoms. They are not "toxicities".

And in the next paragraph, It even puts "fracture" in the category of "toxicity... Sorry, WHAT? A fracture is not a toxicity either. It is a friggin broken bone.

I am not saying there is no possibility that arimidex has toxicity, I am saying is that the article shows no documentation or evidence whatsoever of toxicity as a cause, and the author's use of the term is blatantly wrong. So people are now citing this as evidence of toxicity of anastrozole? Incredible. It is evidence of potential side effects of anastrozole, yes, however:

Every instance of the term "toxicity" refers to a sign, symptom or condition of LOW ESTROGEN!

So from the article and the study itself:

"The study was based on a retrospective chart review of 640 postmenopausal women with early-stage hormone-sensitive breast cancer"

"The women received an AI either as upfront therapy for five years (43%), as part of a switching strategy after two to three years of tamoxifen (36%), or as extended therapy after five years of tamoxifen (21%)"

OK then:

Arimidex standard label use is for hormone receptor positive and advanced and metastatic breast cancers in post menopausal women intended to suppress estrogen to below 7. The dose is 1mg/day.

Indeed, if you suppress your E2 below 7 for 5 years you will very likely develop Osteoporosis, myalgias and arthralgias (and among other things increase your risk of cardiovascular disease and likelihood of all cause mortality) due to estrogen suppression.

Did any of the patients in the studies the article refers to have healthful E2 levels? I suspect not if the treatment target is that low and the dose is that high for that long.

The article notes some side effects of estrogen suppressed to unhealthful levels... No doubt, Yes.

Also, ALL of these women had BREAST CANCER and were most likely taking additional meds. Anastrozole's use for breast cancer is typically as an "adjuvant" or additional treatment to enhance other primary treatments. ... would breast cancer itself and other cancer drugs used in conjunction with Arimidex not also cause some of these signs and symptoms as well?

Bottom line, the article is seriously flawed at many levels and in no way whatsoever determines toxicity as causation.

So once again, where is any evidence Arimidex is toxic in a harmful way if you use it responsibly and do not suppress E2 to unhealthful levels? If the stuff is indeed toxic, I want to know, and I want to see that documentation please.

 

[Cips1975]

Hey gang. Had my consult and recommdations. As expected an no surprise they want me back on the arimidex 0.5mg 3 days per week. No changes to my test dose so still going with 200/mg/week total. Though Like I said in previous post, I am doing 150mg/week total. Regarding RBC , no changes at this time as they feel this should resolve when back on the AI and normal E levels. Blood work will confirm this on next set of labs. That’s all for now guys. Thanks for the feedback and discussion. What I’ve gleamed as expected is there are different schools of thought and I respect that. Thanks again

 

[Cips1975]

Uh... I'd like to point out that the use of the word "toxicity" in that article is entirely bogus.


"Toxicity" in every case in that article is used as a blatantly wrong substitute word for correct terminology like "side effect", "sign", "symptom" and "adverse effect". It is not even synonymous.

A few examples, the article calls osteoporosis, myalgias and arthralgias "toxicities".

Osteoporosis is not a toxicity, it is a diagnosable condition and also could be referred to as a sign relative to it's associated cause e.g. osteoporosis is a potential sign of having low estrogen. Another unrelated example: A heart attack is a potential sign of coronary artery disease... Osteoporosis is no more a "toxicity" than a heart attack is a "toxicity"

Likewise, myalgias and arthralgias are aches and pains, they are symptoms. They are not "toxicities".

And in the next paragraph, It even puts "fracture" in the category of "toxicity... Sorry, WHAT? A fracture is not a toxicity either. It is a friggin broken bone.

I am not saying there is no possibility that arimidex has toxicity, I am saying is that the article shows no documentation or evidence whatsoever of toxicity as a cause, and the author's use of the term is blatantly wrong. So people are now citing this as evidence of toxicity of anastrozole? Incredible. It is evidence of potential side effects of anastrozole, yes, however:

Every instance of the term "toxicity" refers to a sign, symptom or condition of LOW ESTROGEN!

So from the article and the study itself:

"The study was based on a retrospective chart review of 640 postmenopausal women with early-stage hormone-sensitive breast cancer"

"The women received an AI either as upfront therapy for five years (43%), as part of a switching strategy after two to three years of tamoxifen (36%), or as extended therapy after five years of tamoxifen (21%)"

OK then:

Arimidex standard label use is for hormone receptor positive and advanced and metastatic breast cancers in post menopausal women intended to suppress estrogen to below 7. The dose is 1mg/day.

Indeed, if you suppress your E2 below 7 for 5 years you will very likely develop Osteoporosis, myalgias and arthralgias (and among other things increase your risk of cardiovascular disease and likelihood of all cause mortality) due to estrogen suppression.

Did any of the patients in the studies the article refers to have healthful E2 levels? I suspect not if the treatment target is that low and the dose is that high for that long.

The article notes some side effects of estrogen suppressed to unhealthful levels... No doubt, Yes.

Also, ALL of these women had BREAST CANCER and were most likely taking additional meds. Anastrozole's use for breast cancer is typically as an "adjuvant" or additional treatment to enhance other primary treatments. ... would breast cancer itself and other cancer drugs used in conjunction with Arimidex not also cause some of these signs and symptoms as well?

Bottom line, the article is seriously flawed at many levels and in no way whatsoever determines toxicity as causation.

So once again, where is any evidence Arimidex is toxic in a harmful way if you use it responsibly and do not suppress E2 to unhealthful levels? If the stuff is indeed toxic, I want to know, and I want to see that documentation please.

Great post by the way Blackhawk.