Raloxifene vs. Nolvadex + Raloxifene for gyno

[paxman1]

I'm 25, I've had naturally occurred pubertal gyno for more than 5 years (never took AAS though) and I recently decided to get rid of it (read below). I've read somewhere that a combination of Nolvadex and Raloxifene is especially strong and effective in gyno removal process. Should I combine them together or should I take Raloxifene alone? How long do you think I would need to take it to get gyno removed? Should I also combine raloxifene with arimidex /aromasin or not?

Here is the blood work by endo, made before I started to treat myself. He decided NOT to treat me whatsoever!
S-PTH 22 ng/L
s-testosterone 10,8 nmol/L (about 317 ng/dL) (personally I believe that's very low, but he doesn't think the same way)
s-lh 1,5 UI/L
s-fsh 2,2 IU/L
s-tsh 2,77 mU/L
s-ft3 5,2 pmol/L
s-ft4 13,6 pmol/L
prolactin (POOL and PEG) 8,5 ug/L
IGF-1 292 ug/l.
MRI of pituitary gland - everything within normal range

They didn't check other hormones. Also, reference ranges were not provided so they should be compared to these: en.wikipedia.org/wiki/Reference_ranges_for_blood_tests

I did however retest s-testosterone on my own while I was taking nolvadex and it really increased dramatically - 10.4 ng/ml (reference range 2.8 - 8.0), so about 3x higher in comparison to first result. But that was months ago, I have no idea what are the current levels.

Since endocrinologist won't treat me, I obviously have to do that on my own. Here is what I've tried so far:
- 6 weeks of tamoxifen 20 mg ED + 25 mg clomid EOD
- 2 weeks of tamoxifen 20 mg ED + letrozole 0.625 mg ED
- 3 weeks of letrozole 0.625 mg ED
- 2 weeks of letrozole 0.833 mg ED
- 4 weeks of letrozole 1.25 mg ED
- 2 weeks of letrozole 2.5 mg ED
- 2 weeks of letrozole - tappering down to 0.625 mg + tamoxifen 20 mg ED
- 1 weeks of tamoxifen 10 mg ED
- 1 or 2 months pause (can't remember exactly)
- 10 weeks of tamoxifen 20 mg ED + 25 mg clomid EOD (I'm currently at this point)


I'm planning to order raloxifene now. Here's my plan:
- drop tamoxifen and clomid for few days and get estrogen tested
- 2 weeks of raloxifene 120 mg ED + 10 mg tamoxifen ED
- xx weeks of raloxifene 60 mg + 25 mg clomid EOD (maybe I add tamoxifen too?)

What do you think of my plan? I know I've probably made some mistakes during that protocol, but it wasn't my idea. I've asked for advises on several forums (about 10 IIRC). I got little, but very mixed opinions, so I just tried to combine ideas. I don't know if my case is so complex or what's the reason to get such a bad response from forum members. Anyway, hopefully you will be able to help me out.

[lovbyts]

Ive read a LOT of post from people trying to get rid of puberty gyno. I have never read a success story other than diet or surgery. Aas gyno caught early enough is another story.

[paxman1]

Diet? But I'm already on about 12 % of body fat. I've been even lower, but that didn't help as well.

[lovbyts]

Diet? But I'm already on about 12 % of body fat. I've been even lower, but that didn't help as well.

Are you sure? 90% of people think they are 12% are a lot closer to 18% - 20%. Have it checked with calipers. Get down to 10% then see. A lit of guys myself included carry fat around the chest that is very hard to loose until you get down around 10%.

If it is gyno then start looking for a good doctor.

[paxman1]

Yes I'm sure, it was measured by a professional with caliper so I know I was below 10 % once. It's true though, I didn't loose much chest fat, but rather on other areas. I don't know why it's so stubborn in that area. I also tried with Yohimbine HCL, but it didn't make any difference.

[austinite]

Ive read a LOT of post from people trying to get rid of puberty gyno. I have never read a success story other than diet or surgery. Aas gyno caught early enough is another story.

It's been studied. I posted the studies several times but I am too lazy to look it up

[kelkel]

On a side note I'd look deeper into your Thyroid as a possible cause for your low T. Your TSH is on the high end even though it may be in your lab's range. A modern range is .3 - 3.0. Run a complete thyroid panel next time and see what's up.

[Docd187123]

It's been studied. I posted the studies several times but I am too lazy to look it up

Agree. Multiple studies showing tamox treatment reversing pubertal gyno.

Tamoxifen treatment for pubertal gynecomastia .

AuthorsDerman O, et al. Show all Journal
Int J Adolesc Med Health. 2003 Oct-Dec;15(4):359-63.
Affiliation
Abstract
We evaluated the efficacy of the tamoxifen treatment in 37 patients with pubertal gynecomastia. All had distinct, easily palpable breast swellings with a diameter of over three cm. Pain, tenderness, and swelling associated with gynecomastia were reported by six patients. Eight of the patients were obese. One patient also suffered from varicocele. Pain and size reduction was seen in all patients with tamoxifen treatment. No long-term side effects of tamoxifen were observed. The dose of tamoxifen was increased in three patients due to poor response. Two of the treatment group had recurrence problem at follow-up. We did not need to refer any patient to surgery. Tamoxifen treatment is relatively non-toxic, may be beneficial and we think it should be considered for pubertal gynecomastia.

Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia.

AuthorsLawrence SE, et al. Show all Journal
J Pediatr. 2004 Jul;145(1):71-6.
Affiliation
Comment in
J Pediatr. 2005 Apr;146(4):576; author reply 576-7.
J Pediatr. 2005 Apr;146(4):576; author reply 576-7.
Abstract
OBJECTIVES: To assess the efficacy of the anti-estrogens tamoxifen and raloxifen in the medical management of persistent pubertal gynecomastia.

STUDY DESIGN: Retrospective chart review of 38 consecutive patients with persistent pubertal gynecomastia who presented to a pediatric endocrinology clinic. Patients received reassurance alone or a 3- to 9-month course of an estrogen receptor modifier (tamoxifen or raloxifene).

RESULTS: Mean (SD) age of treated subjects was 14.6 (1.5) years with gynecomastia duration of 28.3 (16.4) months. Mean reduction in breast nodule diameter was 2.1 cm (95% CI 1.7, 2.7, P <.0001) after treatment with tamoxifen and 2.5 cm (95% CI 1.7, 3.3, P <.0001) with raloxifene. Some improvement was seen in 86% of patients receiving tamoxifen and in 91% receiving raloxifene, but a greater proportion had a significant decrease (>50%) with raloxifene (86%) than tamoxifen (41%). No side effects were seen in any patients.

CONCLUSION: Inhibition of estrogen receptor action in the breast appears to be safe and effective in reducing persistent pubertal gynecomastia, with a better response to raloxifene than to tamoxifen. Further study is required to determine that this is truly a treatment effect.

[lovbyts]

Agree. Multiple studies showing tamox treatment reversing pubertal gyno.

Ive seen/read the studies I've just never heard of anyone over the years being here that had success with it first hand but many have tried.

[Docd187123]

Ive seen/read the studies I've just never heard of anyone over the years being here that had success with it first hand but many have tried.

I'm pretty new to the forums but I've noticed most ppl who post about gyno never come back and report their results. This is just what I've seen with my own eyes on several different forums. I have heard first hand accounts though from medical professionals of it working on pubertal gyno so that and the studies is what I based my statements on. If that doesnt work I'd agree surgery the only other alternative but I've seen and heard reports of a high percentage of surgical patients not being satisfied with the results either. Not that it didn't get rid of the gyno but that the results were far from aesthetically pleasing. IMO, it's safer, easier, and cheaper to at least try out the SERMs first as you could always decide to do the surgery down the road but you can't exactly undo the surgery lol. My $.02

[lovbyts]

Your right its worth a try and your also right, most people dont bother to report back.

[paxman1]

Well I'll report back for sure. As you may see, I have quite a history already . So, what do you think about my questions in OP?

[austinite]

I'm pretty new to the forums but I've noticed most ppl who post about gyno never come back and report their results. This is just what I've seen with my own eyes on several different forums. I have heard first hand accounts though from medical professionals of it working on pubertal gyno so that and the studies is what I based my statements on. If that doesnt work I'd agree surgery the only other alternative but I've seen and heard reports of a high percentage of surgical patients not being satisfied with the results either. Not that it didn't get rid of the gyno but that the results were far from aesthetically pleasing. IMO, it's safer, easier, and cheaper to at least try out the SERMs first as you could always decide to do the surgery down the road but you can't exactly undo the surgery lol. My $.02

What are you doing for lunch? I'm thinking BBQ - Let's do this.

[Docd187123]

What are you doing for lunch? I'm thinking BBQ - Let's do this.

You bring the bbq I and I'll bring the hummus, tabbouleh, and kibbe

[jimmyinkedup]

On a side note I'd look deeper into your Thyroid as a possible cause for your low T. Your TSH is on the high end even though it may be in your lab's range. A modern range is .3 - 3.0. Run a complete thyroid panel next time and see what's up.

Good catch and I think its a great idea to look into this.
For your gyno I personally would rely solely on raloxifene. Id dose at 60mg/day. It is totally worth a shot before the surgical option. Plan on running it for the long haul. Most gyno reversal studies I have seen run for 6 months and bout 8 weeks is the time you may start seeing results, if you are lucky you may get away with 8-12 weeks but i would think you will have to run for at least 16 weeks. Ralox will also increase your t levels, not as much as clomid or tamox, but it will.

[paxman1]

Thanks, so no there's no need for AI like exemestane or anastrazole?

[jimmyinkedup]

Thanks, so no there's no need for AI like exemestane or anastrazole?

The thing is there might be, there might not be but I didnt see your e2 level in any of the things you posted. I am all for using an ai to mange e2 while taking a serm to treat gyno if it is necessary but there is no way of knowing that you need one for sure or not without blood work.

[paxman1]

Ok, so I should get E2 tested. But will results be accurate since I'm on nolvadex and clomid right now? Won't estrogen be elevated in that case?

[jimmyinkedup]

Ok, so I should get E2 tested. But will results be accurate since I'm on nolvadex and clomid right now? Won't estrogen be elevated in that case?

Yes it will.
Maybe its tie to take a step back, abandon the shotgun approach. Let your body return to what is its normal state, get blood work, and do this right. Working with a dr is the correct approach but since that doesn't seem like a possibility for you given your drs response, thats what I would do.
I know you want this taken care of but there is no instant solution and mixing things together because you heard one person say this and one person say that is prob not best. I would do a straightforward gyno reversal.
Step 1 -Raloxifene is clearly the best serm for the job. Thats what I would use. I would perspna;y dose at 60mg/day. SOme do 60mg/day week 1 then drop to 30, I wouldnt. Studies I have read seem to imdicate 60 is the preffered and most often used dose, I am sure there is a reason for that.
Step 2- Look at bloodwork e2 levels. If you need to pick an AI to manage estrogen. I like exemestane as it has a very good safety profile but adex can be used very successfully as well. Either one is fine IMO. If e2 is high start using an ai to manage it based on your "clean" blood work.

Thats what I would do.

[paxman1]

Thanks, unless some gives counter-argument, I'll take your advise.
testosterone and estrogen in comparison to tamoxifen and clomid, so blood work shouldn't be that abnormal if I get it done while I will be on raloxifene, right? Or should I rather make few weeks of complete pause before migrating from tamoxifen+clomid to raloxifene and do the blood work just right before taking first raloxifene tablet?

[jimmyinkedup]

Thanks, unless some gives counter-argument, I'll take your advise.

I would get everything out f your system. Let your body normalize, then get blood work. Like I said I understand the urgency but you have had this for years I assume so just take your time and at least do this right . If it works great, if it doesnt you can rest assured you tried the best way possible and it just didnt work so you are left with one option.
Get your blood work. If you like post the numbers here and if you should need an ai for some reason you can get a good starting dosage idea. If e2 isnt bad and its an androgen/estrogen ratio issue causing your gyno a serm will take care of that in all likelihood. Even ralox has a bigger impact on T than it does on E2, altering that ratio. IF the androgen/estrogen ratio is a cause the post your treatment for gyno you may be a good candidate for say clomid therapy but one step at a time.

[clarky.]

Great advice as usual jimmy.

[wamy]

I've been using Raloxifene at 80mg/day for about 2 weeks now...half in the morning half at night.

My uni-lateral gyno was shrinking and almost was gone last weekend...now it's coming back with a vengeance. Sensitive and enlarged nips, the whole works. I just took 12.5 mg of Liquid Stane as a safety precaution in case my Raloxifene is bunked.

*Side note: My liquid Raloxifene is sitting in a drawer in my bedroom and during the beginning of the week, it was very hot outside (90 degrees). Could this have bunked my Raloxifene? Any advice or tips are appreciated (cough...Austinite...cough).