I just posted on this in the trt forum. I think the benefit to exemestane as far as lipid values and igf are direc tly related to estrogen (no shock there). While often it is stated that exemestane is "stronger" than anastrozole ..the fact is , as shown in this study ( http://jcem.endojournals.org/content/88/12/5951.full ) even at doses of 50mg/day , while e2 was drastically reduced..it was still at the low end of normal clinical range. My point being I think its easier to "crush" e2 levels with anastrozole than with exemestane. I am pretty thoroughly convinced all the igf / lipid effects of ai's are related to their effect as far as mediating e2. E2 play a critical role in lipid values and also a key role in igf production in the liver. What I find more interesting is that serm like tamoxifen actually decreases igf...but thats another thread/topic.




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