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Raloxifene vs. Nolvadex + Raloxifene

P

paxman1

Member
Jul 8, 2013
21
0
#1
I'm 25, I've had naturally occurred pubertal gyno for more than 5 years and I recently decided to get rid of it. I've been on Nolvadex for 12 weeks (20 mg ED) + Clomid (25 mg EOD) but there were no noticeable effects. Now I've decided to give Raloxifene a try.
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?
 
P

paxman1

Member
Jul 8, 2013
21
0
#2
I have another question. Should I use arimidex (with raloxifene) even if my estrogen levels are normal? Should I even get estrogen tested since I'm on nolvadex + clomid right now? Won't results be unrealistic?
 
Bro Bundy

Bro Bundy

VIP Member
Nov 1, 2012
1,976
485
#3
ralox or nolva are great when using anadrol..nothing else seems to work for drol nips but them two
 
dr jim

dr jim

MuscleHead
Apr 7, 2014
785
168
#4
I'm 25, I've had naturally occurred pubertal gyno for more than 5 years and I recently decided to get rid of it. I've been on Nolvadex for 12 weeks (20 mg ED) + Clomid (25 mg EOD) but there were no noticeable effects. Now I've decided to give Raloxifene a try.
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?
People must understand ONE factor about gynecomastia, that is NOTHING REMOVES these E-2 dependent breast cells!

I know that's a tough pill to swallow but rather than looking for broscience for answers try to understand the disease process itself.

First: The number of E-2 dependent breast cells are probably established at puberty if not sooner.

Second: The number present are FIXED throughout life

Third: Changes which occur because of AAS, AI or SERM use ONLY effect the SIZE of these cells (hypertrophy) rather than their NUMBER (HYPERPLASIA)!

Fourth: Although the use of SERMs has been well established in the literature, almost ALL of these investigations involve specific cohorts namely; PMP Females, Pre-pubertal males or Males on an androgen suppressive regimen, usually as therapy for prostate CA This distinction may become important for several reasons including the contrasting TT, E-2 and or TT:E-2 ratio observed in these "study groups" when compared to those using AAS especially at the doses used by contemporary BB!

Fifth: Because SERMS block TISSUE SPECIFIC E-2 dependent receptors shrinkage occurs. (Like what is the best means of loosing weight? Block the entryway!

Sixth Although AI's cause shrinkage they are less effective because the entryway (E-2 receptors) remains open, and the amount of estrogen required for E-2 dependent breast tissue maintenance is minimal. Consequently, AI's should only be used as adjunctive therapy because the degree and duration of hypoestrogenemia needed to "reverse" gynecomastia quite often leads to side effects.

Seventh; YOU GOT IT YOU KEEP IT, unless surgical removal is performed! GOT IT!

Lastly; Although SERMS and to some extent AIs are effective in treating gynecomastia, if you understand number SEVEN you will also acknowledge, using AAS is inviting a recurrence and as such is best PREVENTED by beginning SERM therapy on a prophylactic basis (1-2 weeks BEFORE beginning a cycle)

Regarding your query on which SERM to use? Tamo is the DOC until more Ralo studies prove it's superior. This is important when cost comparisons are made, since Ralo is MUCH more expensive.

Perhaps Ralo should be added IF only low dose Tamo therapy can be tolerated. Otherwise stick with what is proven efficacious TAMO, at a dosage of 20mg QD.

The prolonged use of higher doses, exclusive of a few "loading" days, is NOT beneficial and probably harmful. Well at least that is what was noted in females with A LOT (I HOPE) more breast tissue than male BB.

Regs
JIM
 
dr jim

dr jim

MuscleHead
Apr 7, 2014
785
168
#5
I have another question. Should I use arimidex (with raloxifene) even if my estrogen levels are normal? Should I even get estrogen tested since I'm on nolvadex + clomid right now? Won't results be unrealistic?
1) NO
2) NO
3) NO

Based on your description the most reliable and recommended therapy for your condition is and has ________ already been answered.

jim
 
ketsugo

ketsugo

MuscleHead
Sep 10, 2011
2,643
491
#6
Personally I always keep novaldex on hand. I get called old school as it's very weak compared to many chems that have come out past decade . What is unique and I can vouch from personal experiences - tamoxifen can be " site specific" - vital importance for puffy nips issues. May be weak for other uses but caught early can avoid gyno
 
ketsugo

ketsugo

MuscleHead
Sep 10, 2011
2,643
491
#7
People must understand ONE factor about gynecomastia, that is NOTHING REMOVES these E-2 dependent breast cells!

I know that's a tough pill to swallow but rather than looking for broscience for answers try to understand the disease process itself.

First: The number of E-2 dependent breast cells are probably established at puberty if not sooner.

Second: The number present are FIXED throughout life

Third: Changes which occur because of AAS, AI or SERM use ONLY effect the SIZE of these cells (hypertrophy) rather than their NUMBER (HYPERPLASIA)!

Fourth: Although the use of SERMs has been well established in the literature, almost ALL of these investigations involve specific cohorts namely; PMP Females, Pre-pubertal males or Males on an androgen suppressive regimen, usually as therapy for prostate CA This distinction may become important for several reasons including the contrasting TT, E-2 and or TT:E-2 ratio observed in these "study groups" when compared to those using AAS especially at the doses used by contemporary BB!

Fifth: Because SERMS block TISSUE SPECIFIC E-2 dependent receptors shrinkage occurs. (Like what is the best means of loosing weight? Block the entryway!

Sixth Although AI's cause shrinkage they are less effective because the entryway (E-2 receptors) remains open, and the amount of estrogen required for E-2 dependent breast tissue maintenance is minimal. Consequently, AI's should only be used as adjunctive therapy because the degree and duration of hypoestrogenemia needed to "reverse" gynecomastia quite often leads to side effects.

Seventh; YOU GOT IT YOU KEEP IT, unless surgical removal is performed! GOT IT!

Lastly; Although SERMS and to some extent AIs are effective in treating gynecomastia, if you understand number SEVEN you will also acknowledge, using AAS is inviting a recurrence and as such is best PREVENTED by beginning SERM therapy on a prophylactic basis (1-2 weeks BEFORE beginning a cycle)

Regarding your query on which SERM to use? Tamo is the DOC until more Ralo studies prove it's superior. This is important when cost comparisons are made, since Ralo is MUCH more expensive.

Perhaps Ralo should be added IF only low dose Tamo therapy can be tolerated. Otherwise stick with what is proven efficacious TAMO, at a dosage of 20mg QD.

The prolonged use of higher doses, exclusive of a few "loading" days, is NOT beneficial and probably harmful. Well at least that is what was noted in females with A LOT (I HOPE) more breast tissue than male BB.

Regs
JIM


Damn interesting thread !!
 
P

paxman1

Member
Jul 8, 2013
21
0
#8
1) NO
2) NO
3) NO

Based on your description the most reliable and recommended therapy for your condition is and has ________ already been answered.

jim
Thank you Dr. Jim for this comprehensive explanation, I truly appreciate it! Please understand that I'm a student and I really cannot afford surgery, while SERMS and AI still fit my budget somehow. I have an option to get Raloxifene relatively cheap, so I just though I'd give it a try since it looks a bit more promising than tamoxifen in case studies. Do you think it could at least shrink gyno or make nipples less puffy?

The reason I've asked for arimidex was that some people advised me to take it with SERMs. But if you say it's not necessary, I believe you. I did however consider to test estradiol levels, maybe they are elevated and arimidex could actually be beneficial? But that's just a hard guess and I don't even know if it's reasonable to test estradiol since I'm on nolvadex and clomid right now, which probably affects my estradiol levels, right?

I'd like to ask you to have a look at these result by endo from one year ago (before I started to treat myself with letrozole, nolvadex and clomid):
S-PTH 22 ng/L
s-testosterone 10,8 nmol/L (about 317 ng/dL)
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.
 
dr jim

dr jim

MuscleHead
Apr 7, 2014
785
168
#9
Thank you Dr. Jim for this comprehensive explanation, I truly appreciate it! Please understand that I'm a student and I really cannot afford surgery, while SERMS and AI still fit my budget somehow. I have an option to get Raloxifene relatively cheap, so I just though I'd give it a try since it looks a bit more promising than tamoxifen in case studies. Do you think it could at least shrink gyno or make nipples less puffy?

The reason I've asked for arimidex was that some people advised me to take it with SERMs. But if you say it's not necessary, I believe you. I did however consider to test estradiol levels, maybe they are elevated and arimidex could actually be beneficial? But that's just a hard guess and I don't even know if it's reasonable to test estradiol since I'm on nolvadex and clomid right now, which probably affects my estradiol levels, right?

I'd like to ask you to have a look at these result by endo from one year ago (before I started to treat myself with letrozole, nolvadex and clomid):
S-PTH 22 ng/L
s-testosterone 10,8 nmol/L (about 317 ng/dL)
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.
Fella FIRST get these units straightened out because although you say your TT improved post AI therapy it did NOT based on the units you provided. Your first TT was roughly 30ng/ml while the repeat was 11ng/DL!

What did I miss?

You have gynecomastia and no one bothered to check E-2, yet did image your pituitary, using an MRI,for a prolactinoma in spite of normal prolactin levels!

I guess thereafter they also considered the (nonexistent) possibility of your parathyroid gland being causative and assayed PTH levels!

Sorry the tests that SHOLUD have been done include a TT, E-2 and LH, no more or less BASED UPON the history you provide.

Best to ya
Jim
 
P

paxman1

Member
Jul 8, 2013
21
0
#10
I only wish to have a doctor like you, Jim, but unfortunately I don't.

Regarding to testosterone, when it was measured for the first time by endo, it was 10.8 nmol/L. That was before nolvadex/letrozole/clomid treatment. The second time I went measure it on my own, that was during nolvadex therapy, and it was 10.4 ng/ml. I've googled it and conversion factor seems to be 1 ng/ml = 3.47 nmol/l. We may also use this conversion calculator: nebido.com/tools/index.php/en/default/index/conversion-tool
As far as I see it, it was more than 3x times higher the second time or am I seeing it wrong?

Even if I get another doctor, I will have to wait months for an appointment. Should I get tested estradiol on my own in meantime? I planned to order raloxifene in a few ways as a last resort for gyno. Would estradiol levels even matter in the end?

And lastly, I know it's kind of unpleasant advise to give, but you know the proper way for sure. The last time I was at endo, he said that I can visit him again to retest testosterone if I'll have problems (libido, sex drive etc.). If I get the same endo again, what should I tell him? The whole truth about my self-therapy? I have a wide chance to exaggerate here. For example: I can tell, that I didn't take anything, I can like about (non)effectiveness of drugs I've taken, etc. Basically anything.
But still, I have no idea what way to choose in order to enforce some treatment? Psychical problems perhaps?:confused: But then again, everything will be archived in health card index, so in long-term, I'm not sure if that's a good idea.
 
dr jim

dr jim

MuscleHead
Apr 7, 2014
785
168
#11
To convert nMol/L to ng/ml MULTIPLY by 3THREE, and to convert ng/ml to nMol/L divide by THREE!.

It matters not which units are selected but, it's always best to use the SAME units when making comparisons.
That being said AIs generally do increase TT albeit at the reduction of E-2, to some extent.

What AIs do achieve is an an absolute reduction of E-2 and an INCREASED TT:E-2 ratio. The latter is very important for physiologic purposes and often determines benefits or adverse effects of these hormones.

Now if I understood your post correctly you have already tried Tamo, Clomid AND an AI simultaneously to treat your gynecomastia?

If that is indeed the case, Ralo will be of NO USE, IMO.

REASONS FOR SERM/AI "failure" INCLUDE;

1) Insufficient dosing and duration of SERM or AI therapy
2) Total body fat exceeding 20-30% of TBW
3). The continued use of aromatizable AAS
4) A TT:E-2 ratio less than roughly 10
5) An "excessive" E-2 load

Does E-2 matter? HELL YES IT MATTERS!

Why because just like skeletal muscle "needs" TT for maintenance or growth, the same is true for E-2 dependent breast tissue. Which is why I believe it unfathomable an Endo didn't order this test, goodness!

Tell him you read on the "net" an elevated E-2 is associated with gynecomastia and you want it ordered,!

Regs
Jim




I only wish to have a doctor like you, Jim, but unfortunately I don't.

Regarding to testosterone, when it was measured for the first time by endo, it was 10.8 nmol/L. That was before nolvadex/letrozole/clomid treatment. The second time I went measure it on my own, that was during nolvadex therapy, and it was 10.4 ng/ml. I've googled it and conversion factor seems to be 1 ng/ml = 3.47 nmol/l. We may also use this conversion calculator: nebido.com/tools/index.php/en/default/index/conversion-tool
As far as I see it, it was more than 3x times higher the second time or am I seeing it wrong?

Even if I get another doctor, I will have to wait months for an appointment. Should I get tested estradiol on my own in meantime? I planned to order raloxifene in a few ways as a last resort for gyno. Would estradiol levels even matter in the end?

And lastly, I know it's kind of unpleasant advise to give, but you know the proper way for sure. The last time I was at endo, he said that I can visit him again to retest testosterone if I'll have problems (libido, sex drive etc.). If I get the same endo again, what should I tell him? The whole truth about my self-therapy? I have a wide chance to exaggerate here. For example: I can tell, that I didn't take anything, I can like about (non)effectiveness of drugs I've taken, etc. Basically anything.
But still, I have no idea what way to choose in order to enforce some treatment? Psychical problems perhaps?:confused: But then again, everything will be archived in health card index, so in long-term, I'm not sure if that's a good idea.
 
Last edited:
P

paxman1

Member
Jul 8, 2013
21
0
#12
Now if I understood your post correctly you have already tried Tamo, Clomid AND an AI simultaneously to treat your gynecomastia?

I was taking tamoxifen, clomid and letrozole only for few weeks simultaneously, because I've read that this combination might decrease effectiveness (probably broscience). So here's my protocol in short:
- 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 1
0 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've ordered 112x60 mg of 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.


1) Insufficient dosing and duration of SERM or AI therapy
I've stated dosing in protocol above.

2) Total body fat exceeding 20-30% of TBW
It was below 20 % all the time, the lowest I've been was about 9 % body fat, currently it's around 12 %.

3). The continued use of aromatizable AAS
I've never used steroids or exogenous hormones whatsoever. If I would, I would have study a lot about PCT and thus prevent steroidal induced gyno.

4) A TT:E-2 ratio less than roughly 10
No idea about that one because I never got estrogen tested. But I'll do it now on my own, it's not that expensive. Let's presume it's elevated, what do you suggest? Exemestane or arimidex and how much?

5) An "excessive" E-2 load
From where?
 
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