Questins about Aromasin and Raloxifene

[YEM]

I developed gyno on one side from using finasteride. Had surgery in 2008, but it returned after using Ritalin until 2012 as my left side just seems to be very sensitive to estrogen from fin. It’s more like fibroids or diffused gyno as opposed to a solid limp behind the nipple. I can feel mushy gland under my left pec. When I tested 30-40mg hydrocortisone in the past to raise my cortisol the gland instantly atrophied as T3 was able to get into my cells.

My plan was the following:

Raloxifene: 60mg daily. If not gone in 6 weeks, increase by 20 mg every 3 weeks, up to 100mg daily.
Aromasin: 12.5mg/day splt between morning and night and ingested with dietary fats (pb, fish oil, etc.)

Should the ral doses be split between morning and night or taken all in the AM?

For a SERM, would Torem be a better choice?
For an AI, would Adex be a better choice?

Do I want to lower my E2 below what is considered a normal level or just enough to compensate for the increase in estradiol that will come from using a SERM?

If I just used Aromasin and no SERM is there any long term harm in using aromasin long term to keep estrogen at healthy levels since it is a steroid? Or should I use arimidex if planning on using long term?

Should I be checking Ultra sensitive estradiol every 6 weeks? Any other tests?

I don’t mind being on lowered doses of the SERM and AI, which would extend the time I would have to be on these substances if I can avoid messing up my thyroid and cortisol as I’m working to improve those levels

Labs from Nov 2014::

prolactin: 10.............<18 ug/L
glucose serum fasting: 4.5 nmol/L..............3.6-6.0 normal fasting glucose
hours fasting=11
cholesterol 4.34 .............desired: <5.20 mmol/L
triglycerides 0.51...........desired: <1.7 mmol/L
HDL: 1.66....................>= 1.00 nmo/L
LDL calc: 2.45 nmol/L
non-HDL calc: 2.68 nmol/L
TC/HDL ratio: 2.6
Vit B12 1260 .................>220pmol/L sufficiency (never supplemented with B12)
ferritin: 90................80-300 normal iron stores
sodium: 139...............135-145
potassium: 4.3..............3.3-5.1

LH: 4 ..............2-9 IU/L
cortisol fasting: 512.................17-540 nmol/L
DHEAS 5.2............... 2.41-11.6 umol/L
FSH 3................2-12 IU/L
SHBG 88 ...............16-56 nmol/L
PTH 4.8...............1.6-6.9pmol/L
testosterone: 44.1............7.6-31.4 nmol/L
progesterone 2.1...............0.7-4.3pmol/L
estradiol 61...............<157pmol/L (It was 147 until I started using transdermal Adex)
insulin 27...............fasting: 40-190 pmol/L

March 2, 2015

Iron: 23....range: 7 - 29 umol/L
TIBC: 52...range 45 - 77 umol/L
Saturation: 0.44...range 0.20 - 0.50
Ferritin: 110....range 24 - 453 ug/L

June 2015, 24 hour urine test:


Estrone (E1) μg/24hrs 3.3 .............3 - 12 μg/24hrs
Estradiol (E2) μg/24hrs 1.1 ............0 - 7 μg/24hrs
Estriol (E3) μg/24hrs 1.4 ...............1 - 16 μg/24hrs
Total Estrogens μg/24hrs 5.8 .........4 - 22 μg/24hrs
Testosterone μg/24hrs 54 ............45 - 85 μg/24hrs
Dihydrotestosterone (DHT) μg/24hrs 9.4 ........0 - 13 μg/24hrs
Androstanediol μg/24hrs 141 .......................48 - 578 μg/24hrs
Androstenedione μg/24hrs 1.2 Not Established
DHEA μg/24hrs 232 ...................................5 - 1476 μg/24hrs
Androstenetriol (5-AT) μg/24hrs 182 ............42 - 710 μg/24hrs
Androsterone (AN) μg/24hrs 4272 ................798 - 4705 μg/24hrs
11b-OH-Androsterone (OHAN) μg/24hrs 542 ...461 - 1692 μg/24hrs
Etiocholanolone (ET) μg/24hrs 1338 .............689 - 3252 μg/24hrs
11b-OH-Etiocholanolone (OHET) μg/24hrs 763 ....134 - 1186 μg/24hrs
Progesterone NONE DETECTED - NONE DETECTED
P is normally not detectable in urine (<<1 μg/24hrs). The level of its major metabolite,
ie., pregnanediol, reflects progesterone homeostasis.
Pregnanediol (PD) μg/24hrs 326 ......................32 - 501 μg/24hrs
5-Pregnenetriol (5-PT) μg/24hrs 231 ...............28 - 1062 μg/24hrs
Cortisone (E) μg/24hrs 143 ...........................92 - 366 μg/24hrs
THE (tetrahydrocortisol) μg/24hrs LOW 1213 .............................1365 - 5788 μg/24hrs
THB (tetrahydrocorticosterone) μg/24hrs 107 ......................................32 - 238 μg/24hrs
5a-THB (5a-tetrehydrocorticosterone) μg/24hrs 236 .................................135 - 588 μg/24hrs
THA (11-dehydrotetrahydrocorticosterone) μg/24hrs 94 ........................................52 - 277 μg/24hrs
Cortisol (F) μg/24hrs 69 ..............................35 - 168 μg/24hrs
THF (tetrahydrocortisone) μg/24hrs LOW 799 ...............................942 - 2800 μg/24hrs
5a-THF (Allo-tetrahydrocortisol) μg/24hrs LOW 580 ..........................796 - 2456 μg/24hrs

[jimmyinkedup]

I would run the ralox at 69mg/day and do not evaluate anything for 8 weeks. No need to eval at 6 weeks and then up dose. It takes time. Most gyno reversal studies run at least 6 motnhs. I would only run an ai if it was necessary to manage my e2 levels. Best of luck.

[numbere]

The half life of ralox is about 28 hours, a once per day dose should be fine. I would dose ralox at 120 mg/week for the first week and 60 mg/week there after until the desired results are reached. Ralox can take a long time to treat gyno. Anywhere from 3 to 9 months plus. I don't think you will have much progress in the 6 weeks you mentioned unless you are experiencing pain. Discomfort should subside within the first 4-6 weeks. Keep in mind that gyno begins in a florid stage and becomes more fibrous with time. SERM therapy has the best results before a lump has become fiberous. I don't think using an AI is a good idea because your e2 is fine and if you aren't introducing exogenous test then you run the risk of crashing your e2.

[YEM]

Last time I tried nolva I had a surge of estrogen. So should I use Adex or aromasin along with Ralox in this case? I have some shitty E2 metabolism genes according to 23andMe. Not all but some

For Ralox, would the dose be 120mg/day for week 1 and then 60mg/day thereafter?

Will any of this affect my T3 or cortisol?

Thanks

[numbere]

At the end of the day you know your body better than anyone else. I feel that you should have an AI on hand but begin using only ralox. Then have BW in a few weeks to see how your body is responding. If your estradiol is elevated then begin using an AI to keep it within range. A sensitive estradiol assay will give you the most accurate reading, as the standard estradiol test is geared towards women. Men will usually get a 10-20 point higher reading then their actual amount on the standard estradiol test.

Yes, that ralox dosage is what I would recommend.

No I don't think ralox will negatively effect your T3 or cortisol, but BW will let you know for sure. I say this because in all the studies I have read ralox side effects were minimal and usually mood/libido related. Please keep us updated. I'm interested in hearing about your recovery process. By the way welcome to the forum!

[YEM]

What dosage of Adex would be recommended to start with if I need it?

[numbere]

That would depend on your e2 level. If it is elevated but not too high you might be able to get it in range with 50-75 mg zinc per day. When on a 500-600 mg/week cycle it's advised to take 0.25 mg/EOD of dex or 12.5 mg twice per day of aromasin. If your e2 level was elevated you would probably be better of with aromasin because it is more gentile and therefore less likely to lower your e2 too much.

[kelkel]

The half life of ralox is about 28 hours, a once per day dose should be fine. I would dose ralox at 120 mg/week for the first week and 60 mg/week there after until the desired results are reached. Ralox can take a long time to treat gyno. Anywhere from 3 to 9 months plus. I don't think you will have much progress in the 6 weeks you mentioned unless you are experiencing pain. Discomfort should subside within the first 4-6 weeks. Keep in mind that gyno begins in a florid stage and becomes more fibrous with time. SERM therapy has the best results before a lump has become fiberous. I don't think using an AI is a good idea because your e2 is fine and if you aren't introducing exogenous test then you run the risk of crashing your e2.

To compliment what numbere said regarding what florid stage is:


http://cursoenarm.net/UPTODATE/conte....htm?6/38/6763


Consider Andractim Gel (DHT gel) along with your serm....

[YEM]

Using Aromasin will increase T which will offset the lowered T that comes from using Andractim. I suppose I should apply it only once I've settled on a dose of Ralox and aromasin. I'll be doing ultra sensitive estradiol and Total Testosterone labs every 3-4 weeks.

Will Aromasin shut down my natural production of T since it is a steroid?

Appreciate all the feedback and help I've been getting.

[kelkel]

Aromasin will not dramatically increase your T considering all things are normal.
Andractim will not lower your T.


You're over-thinking this.

[YEM]

How does toremifene compare to ralox regarding gyno? toremifene increases cortisol whereas ralox decreases it and my cortisol is already low.

[numbere]

Ralox is your best chance at remission before considering another surgery.

[jimmyinkedup]

How does toremifene compare to ralox regarding gyno? toremifene increases cortisol whereas ralox decreases it and my cortisol is already low.

You keep trying to make this more complicated than it needs to be. take the ralox with the andractim, if that doesnt work surgery will be your only option. Ralox is the best serm for this without question.

[jgd]

Are you saying Rittalin/adderal can cause gyno?

[YEM]

Looks like in Men ralox actually increases cortisol: https://books.google.ca/books?id=NJM...sol%22&f=false

[YEM]

Ritalin normally wouldn't cause Gyno in most people. My cortisol and T3 were really low at the time and my estrogen was on the high side. I guess ritalin exacerbated my already low cortisol which drove up my T metabolism. My E2 and SHBG rose to compensate for the high T.

[jimmyinkedup]

and the key to getting rid of your gyno ( or your best chance) is still.........raloxifene.....

[YEM]

Updated my original post with my latest lab results and they don't look good

[numbere]

Updated my original post with my latest lab results and they don't look good

I must be missing something because all your values look fine.

[YEM]

I stopped raolx as it made me tired a few hours after taking one pill a few weeks ago and my temp dropped .4 or .5 degrees lower than what it normally is at that time of day. Since I have low cortisol my plan is to raise my cortisol before attempting ralox again. I've been using the CT3 Method since mid May and recently started cold exposure therapy - two 30 min baths, first thing in the morning and right before bed, plus a 10 min cold shower in the afternoon. The good news is my temps are rising. However, I'm also experiencing estrogen being dumped into the tissues and my nipples have been really sensitive over the last couple days.

Should I stop the cold exposure for now till estrogen is controlled?
Should I use a higher dose of adex or also include a short run of ralox even though it's only been a few days that I noticed the nipple pain? If I should add ralox since estrogen is being dumped into the tissues, how long should I use it for in this current scenario? Is 60mg/day enough or is 120mg a better choice?

[numbere]

You are making this process much more difficult than is necessary. If rolax made you drowsy you should try taking it before bedtime. The dosage hasn't changed, 120 mg/week for the first week and 60 mg/week thereafter until remission.

I thought that you were taking aromasin? I don't think it is necessary to take an AI while on ralox. However, if your e2 goes out of range then an AI should be considered.

[YEM]

Since late afternoon of July 2, I've been using 120mg ral/day + (as of today) switched my AI to aromasin (12.5mg twice a day) as TD adex cream didn't seem strong enough. I didn't have access to high dose Adex so I switched to aromasin just for this current issue. Once resolved I will switch to low dose adex.

The recent onset of nipple pain has went down a lot but still present. How long will it take until the pain goes away?

Once gone when can I safely lower my dose of aromasin or switch to low dose adex (.1 mg EOD or every third or fourth day)

[YEM]

I just realised that since I have enlargement of the nipple area and not a lump behind it that I have Progesterone gyno. Is there a different protocol for this?

[YEM]

Would it be better to drive down estrogen with letro for a short while?

[numbere]

I doubt that you have PRO induced gyno because your last test showed relatively low levels of PRO and e2.

Using letro is not a good idea.

Like I've said above in post #3, I don't think you need an AI while taking ralox unless BW shows elevated e2. Irritation should diminish within the first 4-6 weeks of ralox therapy. Also, when gyno is in it's fibrous stage treatment with ralox can take many months. Patience is a virtue.

Honestly man you seem to be only following the advise that you want to hear. I think you should stop treating this yourself and make an appointment to see a gyno specialist or plastic surgeon.

Do I Have Gynecomastia? If you're asking this question, read this thread.

Estrogen, Prolactin, Progesterone Management + Gynecomastia Prevention & Reversal

Stop Using Aromatase Inhibitors to Reverse gynecomastia! SERM's Only!

**I have Gyno? What should I do? Look here.**

Progesterone and prolactin induced gynecomastia

[YEM]

My understanding is that enlargement of the nipple is progesterone related. But controlling E2 will limit any effect of progesterone. My E2 was high as well. My E2 in my previous test (not posted here) was over 40 and that was when I wasn;t using an AI. In the above tests I was using an AI

Unfortunately my body is dumping what it considers excess T into (almost entirely) E2, instead of mostly DHT. It was the opposite way around before using finasteride. My body is reacting to my normal T as if I was on high doses of steroids.

Took 2mg (mini troche) + raloxifene and as of 11am my temp is 98.5. No side effects to report. I'm going to stick with an AI + ralox and see how I do. I appreciate your patients with me as this is not a simple case as I have a low metabolic rate that I have to take into account. Please continue to follow my progress.