nolva & clomid: are they safe?

[powerliftmike]

The use of Clomid and Nolvadex , as Selective Estrogen Receptor Modulators (SERMs), has gradually become well established in the steroid using community. The popular push of these drugs has almost made them mandatory. They have essentially become hormonal vitamins – vitamins that can do no wrong and provide seemingly endless benefits of testosterone support, bloat reduction, gynecomastia prevention and cholesterol health. It seems that we are all well educated about the benefits of Clomid and Nolvadex, so in this segment, I will present the risks and consequences from the short and long term use of Clomid and Nolvadex.

Upon examination of the research available for Clomid (clomiphene) and Nolvadex (tamoxifen ) we find that the research is quite extensive, and contradicting.21 We see many early studies with tamoxifen done on breast cancer patients, which show an acceptable "safety profile", with an apparent lack of adverse effects.22 On the other hand, many of the early in vivo animal studies showed severely toxic effects, with the development of cancer in the liver, uterus, or testes upon tamoxifen administration.30-34,41 However, this evidence was largely disregarded by ex vivo (test tube) research on human cell-lines which appeared to show a lack of toxic effects.21

For example, tamoxifen was generally accepted as being non-toxic to human liver upon the conclusion that tamoxifen did not cause noticeable DNA adducts (damage) during short-term ex vivo studies with human liver cells.35,36 This was in contrast to the in vivo animal studies showing dramatic carcinogenic effects on the liver.30-34,41 As scientists learned that the toxic effects from tamoxifen are from the metabolism and buildup of the a-hydroxytamoxifen, 4-hydroxytamoxifen and N-desmethyltamoxifen metabolites. It became apparent that ex vivo research was largely flawed due to low-rate metabolism.21 The carcinogenic effects of tamoxifen proved to be even more unusual and elusive, when it was hypothesized that tamoxifen had both genomic and non-genomic toxicity, which affecting different animals, in different organs.21 This created an obvious clinical challenge for measuring genotoxicity in a test tube. Eventually, it was established that tamoxifen was a bona-fide carcinogen in all species, at least in one way or another.21,37-39 Recent human studies have shown tamoxifen treated women to have 3x the risk of developing fatty liver disease, which appeared as soon as 3 months into therapy at only 20mg/day.24-26 In some cases, the disease lasted up to 3 years, despite cessation from tamoxifen therapy. Five and ten year follow-ups with patients on long term tamoxifen therapy showed cases of deadly hepatocellular carcinoma.27-29 In a 2000 case study involving tamoxifen induced liver disease, D.F Moffat et al made a profound statement –

"In addition, hepatocellular carcinoma in tamoxifen treated patients may be under-reported since there may be reluctance to biopsy liver tumours which are assumed to be secondary carcinoma of the breast."

In other words, it appears that the liver carcinoma from a large number of breast cancer patients on tamoxifen therapy has been misdiagnosed as a metastasis infection from the breast cancer itself.28 Upon closer examination it was found that the cancerous lesions in the livers of the long-term tamoxifen therapy case studies were identical to those seen in the early animal studies showing tamoxifen to be a potent hepatotoxin.28-34 Although the effects took much longer to manifest, it became obvious that tamoxifen was toxic to the human liver.

Another well known risk of tamoxifen therapy is the increased risk of developing endometrial cancer (uterine cancer).23,42 This is due to tamoxifen actually acting as an estrogen agonist in the uterus, presumable from the 4-hydroxytamoxifen metabolite.33,40 This estrogenic metabolite triggers abnormal growth of the uterus and the formation of cancer causing DNA adducts.33 As male bodybuilders we assume this presents no risk. On the contrary, the implications are quite scary when we realize the male equivalent to the uterus is the prostate -- differentiating from the same embryonic cell line and sharing the same oncogene, Bcl-2, and high concentration of the estrogen receptor. It is likely that tamoxifen has the same estrogenic action, and DNA damaging effects within the prostate.60-62 It is no wonder that tamoxifen failed as a treatment for prostate carcinoma.43

Aside from restoring testosterone levels post cycle, tamoxifen is often used to combat gyno during cycle when "flare ups" occur. While tamoxifen may provide immediate inhibition of growth, and serve as valuable tool, it also has the ability to up-regulate the progesterone receptor.54-56 This is a true contradiction, which dramatically increases your chances of bringing upon gyno in future cycles when utilizing Nandrolone (Deca ) or Trenbolone , both of which act upon the progesterone receptor. It is interesting to speculate: is tamoxifen use directly related to the increased gyno occurrences seen with modern day steroid users?

When we bring our attention to Clomid, we find less research is available on long term human toxicity, probably because of the relatively short term (3-4 week) clinical application for ovarian stimulation,59 although long term follow ups with patients who received Clomid for ovulation induction have shown an increased risk of developing uterine cancer.74 This is to be expected, since many of the same carcinogenic tendencies found with tamoxifen are the same effects seen with clomiphene.44,45,57,58 Upon analysis of anecdotal reports from Clomid and nolva users, we see the typical short term side effects of low libido, erectile dysfunction, and emotional instability – despite many men showing normalized testosterone and estrogen levels during the use of these SERM’s. Research on male breast cancer patients also shows frequent reports of low libido, thrombosis (arterial blockage), and hot flashes with tamoxifen use.47 Another common side effect associated with both SERMs, but more common with Clomid, is the loss of visual accuracy and development of visual "tracers", due to the ocular toxicity.46

As the medical community became more aware of the side-effects associated with clomiphene and tamoxifen treatment, newer and safer SERMs, such as toremifene and raloxifene hit the developmental fast track. Toremifene appears to be less liver toxic, but it is an analog of tamoxifen, so it also carries many of the related genotoxic effects.48,49 Raloxifene appears to be even safer by being the least liver toxic, and not having any potential issue with the uterus or prostate.50-52 Unfortunately, raloxifene has been associated with a higher incidence of thromboembolism52 (arterial blockage), and also has very low oral absorption, making it an expensive alternative at a typical 120mg/day dose.53 Still, raloxifene could presumably be equally effective as Clomid or Nolvadex at restoring HPTA function, while imparting less side effects.53 Newer SERMs are already being evaluated such as bazedoxifene, arzoxifene, and lasofoxifene, in hopes of reducing risk even further.

Another SERM that may be useful for post cycle therapy is resveratrol.87,88 Resveratrol is a natural polyphenol extracted from grape skin, that has recently been under heavy research for its cancer fighting effects in the breast, prostate and liver.63-69 Contrary to Nolva or Clomid, resveratrol appears to actually have beneficial effects on the liver,70 as well as having multiple benefits on cardiovascular health by limiting LDL oxidation and improving endothelial function.71-73 Improved blood vessel function may be a mechanism by which resveratrol improves erectile function in many men. Research also suggests that resveratrol may actually extend life, by reducing oxidative stress on organs such as the heart,77 and preventing the metabolic syndrome by fighting insulin resistence.79,80 It’s becoming well known that insulin resistance is a leading cause of low testosterone .82 More specifically, improving insulin sensitivity will increase your leydig cell sensitivity, and therefore increase the testes response to LH.81

It should be pointed out that resveratrol may not be the best choice to combating emergency gyno, due to its lower binding affinity to the human ER of about 90x less than tamoxifen, and about 30x less than clomiphene.75,76 However, considering that resveratrol is a pure estrogen antagonist at the pituitary,89 while Clomid has mixed agonist/antagonistic effects,90-94 resveratrol could be a suitable substitute for PCT. Aside from acting as a SERM, resveratrol can also help control estrogen by actually limiting aromatase enzyme production.82 Based on the research, it appears that at least 100mg/day would needed to increase LH, FSH and testosterone production.84 This is comparable dose of resveratrol found in an advanced topical based product, Dermacrine Sustain (found here - http://www.primordialperformance.com).

Admittedly, no steroid users are dropping dead from a 4 week protocol of Nolva or Clomid, and many will say "the consequences far outweigh the benefits" -- but why deal with the potential consequences when alternatives are available?

--****morphosis

[MorganKane]

i really dont see how this is relevant.
I dont have a uterus and I will not use it for 5 to 10 years.

The BB community are using those products for a few weeks not months or years.

The rest is pretty much speculations.

[pedro01]

source ???

[powerliftmike]

source ???

Pretty old article. Got it somewhere http://www. m e s o m o r p h o s i s.com/articles/index.htm

It may have been removed now, but either way they got alot of good info on nolva and clomid over there.