Prescribed Tamoxifen, Thoughts?

I am currently suffering a low total testosterone, a high-normal free testosterone, high estradiol, with symptomatic gynecomastia and various other symptoms, mostly related to energy levels and sense of well-being.

Before opting for surgery, my endocrinologist wanted to try Tamoxifen, as he cited a couple of studies that showed it caused regression of the glandular gyno tissue in a decent percentage of males. He said that in the end it should reduce chest adipose tissue if nothing else, and after four months if no regression of the glands are seen, we will set up the surgery.

I am hesitant to take any prescription, but from what I have seen there are some benefits for males with this condition. It acts, not like an aromatase inhibitor, but as a SERM and it also interferes with testicular feedback to the pituitary and because of this enzymatic effect, it can also increase testosterone. Both of these would appear to be beneficial to me. However, I have some concerns.

Tamoxifen has been associated with liver cancer due to irreversible formation of DNA adducts there. It has also been associated with fatty liver, because although it is an antagonist to estrogen in the chest and abdomen, it is an estrogen agonist in the bone, endometrium, and liver.

If anybody has any info, I would like to know:
1) Should I be concerned about these sides given I'm only going to be on it 4 months?
2) Are there any products that I should be on while doing Tamox, such as a liver support product or others to help detox estrogen like calcium d-glucarate and I3C?
3) I'm aware that phytoestrogens can actually interfere with Tamox, so would a liver support product
with milk thistle be a bad idea? For some reason, I thought psilymarin was a phytoestrogen...
4) Are the risks of this prescription to high to outweigh the potential benefit in your opinion?

http://www.aboutlawsuits.com/tamoxifen-side-effects-memory-cognitive-ability-8330/

Would avoid Tamoxifen. The best non-drug approach that beats it is Myomin by Chi Enterprises.

Gyno is a sign or symptom of low thyroid function. Either enhanced by prolactin or estrogen.

Anthony - I know you said in another thread that you were getting a sleep study for apnea. Please DO NOT take any medications before you get the results of that sleep study. The apnea could be the central source for all your issues. It causes insulin resistance and could be the reason why you can't lose weight/burn fat. The sleep study should be your first step because if you have apnea, treat them and monitor your labs. Your T could rise just by addressing apnea.

Thanks fellas.

I'm looking forward to the article, CS. I believe I'll get a second opinion on the thyroid issue, but I need to start tracking my temperature at least for piece of mind and a good indicator for the next physician. Its difficult getting an appointment as a new patient with a new endo, you typically have to wait 3-4 months before you can get in. I think everyone in America has diabetes, haha.

Hadrion, I think that is great advice. I actually spoke with one of the interns after the doctor left the room, and he said the same thing. He said given the normal free T and the low total T and mid-range LH, its probably a combination of the weight gain and apnea (if present) that is doing this, and obviously the sleep apnea could be primary to the stubborn weight gain as well. I'll be interested to see how this goes. But you think I should wait to try the Tamoxifen (if I do at all) until the sleep study is overwith? I could understand not wanting to risk the adverse effects of the prescription at all, but my impatience with this is starting to get the better of me.

I wouldn't start any medications until you ruled out apnea. Just get the sleep study done as soon as possible. Everything you're experiencing could be related to apnea. Your labs can change drastically if you have apnea and treat it. A doctor I recently consulted with told me that a huge portion of his insulin resistant and type II diabetic patients are that way from having untreated/undiagnosed sleep apnea. It's the first thing he tests for after seeing insulin resistant/metabolic syndrome blood test results. He told me how you can diet, work out and lose no weight or fat because of sleep apnea. It also can explain the low T.

Look, you may not have it at all, but if you do you can start your recovery by using a Cpap machine and not need meds at all. I would just get that sleep study done first.

I think I will do that. The sleep study is in two weeks or so. I'll just go ahead and wait to take the meds until I get those results first. Two weeks won't make or break anything. Good advice, thanks. Sometimes even though I should know better, the allure of taking a pill to fix everything still gets the better of me. I think its just that I've absolutely had it with these issues.

hadrion, do you have sleep apnea? I'm really interested in this because I have a tough time with insulin resistance and losing weight. Didn't used to, and can still lose a few pounds pretty quickly before stalling out, so have been chalking it up to mid-life and a couple decades of fairly crappy lifestyle. But I've also noticed some weirdness in my sleeping patterns over the last couple of years that could be symptoms of sleep apnea. This discussion is very thought provoking.

I think inclined bed therapy is supposed to help with apnea. Have you researched/considered/tried that?

I've been considering getting a frame or insert to lift my bed, and I think this thread just pushed me into doing that.

Anthony, is this something you'd be interested in trying maybe before going the tamoxifen route?

Oh absolutely. Its odd that you bring that up because for the past several years I have insisted on having multiple pillows to elevate myself while asleep. I almost wonder if it was an intuitive thing, like I didn't consciously understand why I was insisting on them. It would be interesting to try this, but I'm just not sure it would be enough for my case.

I actually just found out that as a child I was born with underdeveloped lungs so I had what I guess you could call a severe case of apnea even during waking hours. I would literally just quit breathing all of the time. I had to be on a machine that would startle me into breathing. Yeah I thought the same thing, what the hell was wrong with me? I must be genetically fucked if I don't even breathe properly out of the womb haha.

Anyhow, that got cleared up. But I think the two must be releated, and perhaps when I started smoking heavily about 5 years ago I did damage to the lungs and perhaps aggravated that old problem. The thing is I just don't feel that its obstructive. It feels more like central apnea, or a combination of the two.

Most Eastern disciplines hold that most people (Westerners in particular, because of our hustle and bustle culture) don't breathe properly. Sometimes I catch myself holding my breath during the day, and at night I have occasionally awakened after hearing a strange, loud, vibrating noise in my bedroom (that I later realized was actually coming from inside my chest/throat...snoring, haha). I've also awakened myself after becoming aware that I was holding my breath while I slept. Dunno if it happens often enough to call it apnea, but it has happened often enough in the last few years to provoke thought.

Another thing is that extra weight can cause sleep apnea. So if you get fat, you could conceivably cause yourself to develop apnea. It also appears sleep apnea can cause extra weight by not allowing your body to heal and properly regulate its own biochemistry. So if you get fat and cause yourself to develop apnea, you could stay fat because you can't sleep properly. Vicious cycle, that.

Anyways, I just bought this inclined bedframe insert

http://www.sleighters.com/mattresses/bedsup.shtml

Pretty cheap, relatively speaking, especially considering some other stuff this forum has provoked me into buying. LOL

We'll see how it goes.

whodathunkit,

I do have sleep apnea. It was causing low normal T, bad lipid profiles, high blood pressure and difficult weight loss. I use a mouthpiece that was designed by my dentist when I sleep that pushes my jaw forward slightly so the air comes in and I only sleep on my sides. When I'm sleeping on my back I stop breathing and wake up gasping. My wife noticed this when we first got married and I gained a ton of weight. As I've lost the weight, she's told me I don't really do it anymore. The other thing that has helped me with my sleep is Ecklonia Cava Extract. Before I used to be a guy who didn't get into bed until 3am most nights. Now whenever I hit the pillow I'm out in minutes.

I did a consultation with a doctor who specializes in insulin resistant patients. I'm definitely insulin resistant. He told me before he'll write a prescription for metaformin or any drugs, he makes insulin resistant patients get a sleep study done. He'd rather them treat the apnea, if they have it, then put them on harmful drugs. He told me 9 out of 10 times his insulin resistant patients have apnea and treating it, with them following a Paleo style diet, changes their health, bodies and lives.

If you're insulin resistant, get a sleep study done and change your diet. Don't mess around with Ray Peat (sorry Peat fans) and follow a solid Paleo style diet. Jack Kruse's Leptin reset works. If you can't do the cold therapy he recommends, it still works. Since I started my day w/in 30 minutes of waking with 50-75 grams of protein and no carbs, I've changed dramatically. I eat 2 meals a day now with a snack in between. Both meals are Paleo inspired although I'll eat beans or a sweet potato as my carb. I'm not as hungry as I used to be. I don't even want lunch when I look at the clock and see it's lunch time. I'm never starving. I don't crave sweets anymore. Even if I have them as a cheat, they don't affect me like they used to. For the first time in my life if you give me a pint of ice cream, I can stop eating it before finishing the pint. It's amazing.

Treating undiagnosed apnea and following that style diet will help you lose weight, change your labs without medications and do a dramatic turnaround health wise.

I'm going back for another sleep study to see how I'm doing. I didn't use the Cpap machine, even though it was suggested to me, and I often wonder if I did use it would it help me out even more. The fact that I still can't sleep on my back bothers me so I may give the machine a try and see if that helps me in that regard. It's such a simple thing and it should be investigated before anyone profiling insulin resistant starts taking diabetes drugs or statins or HBP meds. It can fix all of that if you fix the apnea.

Hadrion,

That was an awesome post. Thanks for that. The piece about your doctor's recommendations was especially interesting, particularly because he supposes apnea as soon as he sees insulin resistance. I am looking forward to this sleep study. I think it will be big take care of this problem.

Anthony - I'm going in for another one too. The mouthpiece from the dentist helps, but I feel like it's pulling my jaw out of alignment with nightly use. Plus some nights I pull it out and wake up with it in my hands or on the floor. If they tell me to get the Cpap machine I'm going to do it this time. My insurance wouldn't cover it last time so I went to a dentist who made me the mouth piece. Sleeping sound and healthy is so important. I'm less focused on hair now and more focused on overall health. It was great to meet a doc who doesn't send patients out with fistfulls of prescriptions but is looking for lifestyle changes to help patients. He told me I'm doing everything right and encouraged me to do another sleep study and see what it yields. My wife doesn't think I have the problem anymore, but I know I am unable to sleep on my back without holding my breath/stopping breathing and that's just not normal. Let me know how it turns out after you do the test.

To anyone else reading, don't self diagnose yourself with this. Don't buy a cheap mouthpiece on the net or use breathe right strips on your nose. You have to get the test. If you have it, you need to correct it or you'll be courting a huge host of health problems.

Yes, hadrion, thanks. Great post.

Another question...how difficult was it to get your insurance to pay for the sleep study?

whodathunkit wrote:Yes, hadrion, thanks. Great post.

Another question...how difficult was it to get your insurance to pay for the sleep study?

They paid for the sleep study, well I had a co-pay, but they would not pay for the Cpap machine. Someone at the sleep clinic referred me to a dentist with sleep apnea experience who fitted me for my mouth piece. The mouth piece is great, but it won't let me sleep on my back. The Mouth Piece is not as effective as a Cpap machine, but it helped me sleep better when I slept on my sides and I started to lose weight finally.

I'll post as soon as I get the test. Should just be a couple of weeks. I'm really hoping insurance is willing to cover the c-pap should I need it but I guess I'll find out. Thanks again Hadrion.

Tamoxifen worked for me in recovery Fin Out

Steven Tyler,

Do you mean you used it post cycle? What type of recovery do you mean? I've heard a lot of guys
use it for PCT and it helps testosterone rebound quite well. But the sides are worrisome. There tend
to be more immediate sides for women, but the threat of liver cancer isn't welcoming either. In the
short term, however, I"m not sure how realistic that is.

Just take your medicine bro

anthonyspencer54 wrote:Steven Tyler,

Do you mean you used it post cycle? What type of recovery do you mean? I've heard a lot of guys
use it for PCT and it helps testosterone rebound quite well. But the sides are worrisome. There tend
to be more immediate sides for women, but the threat of liver cancer isn't welcoming either. In the
short term, however, I"m not sure how realistic that is.

Post Cycle Fin ou Roidz ?

Fin destroyed me completely, Brain Fog, Zero libido, Depression, to recover it all tried numerous drugs but what worked was Testosterone Cypionate (400mg Week), Nolvadex (Tamoxifen) 20mg /day I also fasted for 14 days only with water and then started a Vegan diet

Nolvadex do not give me any side, my Test Total, Free and DHT are normal now, Clomid is an alternative (or even better) but I had MANY side with him even at low doses

http://www.ncbi.nlm.nih.gov/pubmed/12904801

I was talkin' about steroids. Everytime I hear recovery, for some reason I think of someone doing
a cycle. But I've heard of people taking Nolva for PCT and said it helps reboot T production. I
saw a study at one point showing a 150% increase in serum T over 4 weeks I believe.