Advice for switching/tapering off from Tamoxifen to Letro while on hCG

HR_Watson

Member
Howdy folks, the thread title says it all.

I'm currently on 2000iu weekly of hCG that I split into three doses (750iu Mon, Thurs, 500iu Sat).
I'm finishing up 6 weeks of Tamoxifen to knock out a case of gynecomastia.
You can see my thread on my Tamoxifen/Nolva experience here.

Current levels:
T: 840 (200-1000)
Free t: 25 (8-25)
E2: 46 (<41)
Prolactin: 5.4 (3.8-19) (***this was 11 before then Tamoxifen, so dollars to doughnuts, this had a major part in the gyno)

I'm feeling awful on the Tamoxifen. It's taken care of the gynecomastia, but the side effects (zero energy, libido, muscle cramps, depression) are pretty awful.

Saw my Dr today. My E2 is high, but the Tamoxifen is blocking my body from utilizing it - so as a result, I'm getting the effects of low and high E2. (I'm seriously paraphrasing here.)

So the idea is that we're going to try and lower my E2 using Letro, since I've had bad side effects on Anastrozole.

He more or less said I should just stop taking the Nolva, start on the Letro. He's suggested. 2.5mg (one pill) once a week on Weds, the middle of my weekly cycle.

I kinda thought it might be smart to start tapering one down, start tapering the other in - maybe half a pill at first? or half a pill twice a week, eventually...

Thoughts?

Going on TRT isn't an option - I'm secondary, not primary, and fertility is a major concern.
 
Tamoxifen has a long half life and its metabolite has an even longer half life. To be on the safe side because of the gyno you could reduce the tamoxifen to 10mg on injection day until you have blood work to make sure estradiol is lowered and then you can stop tamoxifen. Letrozol should start working right away so in theory you can stop tamoxifen right away (specially given its long half life). But if gyno is a concern and you wanna be on the safe side keep the tamoxifen until you get bloodwork done. Tamoxifen can interfere with some AI so you might need to readjust letrozole dosage once tamoxifen is out of your system.
 
Tamoxifen has a long half life and its metabolite has an even longer half life. To be on the safe side because of the gyno you could reduce the tamoxifen to 10mg on injection day until you have blood work to make sure estradiol is lowered and then you can stop tamoxifen. Letrozol should start working right away so in theory you can stop tamoxifen right away (specially given its long half life). But if gyno is a concern and you wanna be on the safe side keep the tamoxifen until you get bloodwork done. Tamoxifen can interfere with some AI so you might need to readjust letrozole dosage once tamoxifen is out of your system.

I don't quite follow...wouldn't I want to taper down to 10mg a day, except maybe on shot day, where I'd do 20mg?

I was hoping to get Aromasin, but the Dr said he hadn't prescribed it in years - only Anastrozole, Letro, or Nolva...
 
I don't quite follow...wouldn't I want to taper down to 10mg a day, except maybe on shot day, where I'd do 20mg?

I was hoping to get Aromasin, but the Dr said he hadn't prescribed it in years - only Anastrozole, Letro, or Nolva...

I meant only take tamoxifen on injection day
 
I meant only take tamoxifen on injection day

This makes a lot of sense. Right now I'm doing 10mg tamoxifen daily, w/ .25mg of Anastrozole on shot day. Feeling better physically, energy-wise, emotionally - and no gyno.

I'm gonna keep tapering down on the tamoxifen, maybe switch over to Letro, we'll see. I'm tolerating the low dose of Anastrozole well, but who knows how effective it'll be without the support of the Tamox.

Does anastrozole have the same IGF-1 suppression as Nolva?
 
the gyno was caused by the testosterone injection ?
the tamoxifen has worked well for cured it ? how much were you taking ? no hair thinning as a side effect ?
 
it was a bad case of gyno ? there was a lump? or just puffy nipples ?
You didn't get hair thinning with the tamoxifen ?
thanks a lot !
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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