Background on AI's and SERM's

drewbolic

New member
There have been alot of new guys asking for advice on AI's and SERM's so I thought this post I found is relevant and helpful.

OP xXDEVILDOGXx

A little background info on Estrogen Control:
When looking to control Estrogen, we have two choices. These are SERMS and AI's. SERM is an acronym for Selective Estrogen Receptor Modulator, and Aromatase inhibitor (AI) is an acornym for Aromatase Inhibitor.


SERM's:
Let's take a look at what SERM's do and our SERM options. SERM's, by definition, compete for the space that Estrogen binds to. This receptor is then full and cannot accept the estrogen and therefore cannot produce the effects of estrogen. Some of the more popular SERM's are: Clomiphene Citrate (Clomid), Tamoxifen (Nolvadex), Toremifene Citrate (Fareston), and Raloxifene hydrochloride (Evista).

AI's:
Now let's look at some of the AI's and how they work. AI's, by definition, prevent aromatizable steroids from converting to Estrogen via the aromatase enzyme. Some are more effective than others. Some of the more popular ones are: Anastrozole (Arimidex), Aromasin (Exemestane), and Letrozole (Femara).



So what are some facts and uses of the different SERM's and AI's?

Well, some AI's take time to build up blood levels and therefore need to be utilized for a certain time before they are effective, whereas SERM's go to work immediately.

SERM's:

Comid: Usually dosed from 25-300 mgs depending on the desired effect, is both effective during a cycle for estrogen sides and post cycle for support of natural Testosterone levels. While it has been claimed that Clomid "stimulates" production of LH and therefore of testosterone, in fact Clomid's activity is achieved not by stimulation of the hypothalamus and pituitary, but by blocking their inhibition by estrogen.

Clomid is a mixed estrogen aganoist/antagonist (activator/blocker) which, when bound to the estrogen receptor, puts it in a somewhat different conformation (shape) than does estradiol. The estrogen receptor requires binding of an estrogen or drug at its binding site and also the binding of any of several cofactors at different sites. Without the binding of the cofactor, the estrogen receptor is inactive.

Different tissues use different cofactors. Some of these cofactors are able to bind to the estrogen receptor/Clomid complex, but others are blocked due to the change in shape. The result is that in some tissues Clomid acts as an antagonist -- the cofactor used in that tissue cannot bind and so the receptor remains inactive -- and in others Clomid acts as an agonist (activator), because the cofactors used in that tissue are able to bind. Clomid is an effective antagonist in the hypothalamus and in breast tissue. It is an effective agonist in bone tissue, and for improving blood cholesterol.

Clomid also has the property of reducing the adverse effect of exercise-induced damage of muscle tissue. This is very significant for endurance athletes but is not very significant, if at all significant, with reasonable weight training. Clomid does not perceptibly affect gains of the weight trainer either favorably or adversely in my experience.

It should also be noted that Clomid seems to have estrogenic effects on mood, causing some slight depression or moddiness. It can also effect eyesight by causing it to seem blurry. No this isn't from crying while listening to James Blunt CD's. LOL

Nolva: Usually dosed from 10-100 mgs, Nolva is best dosed at 20-40 mgs. It has a certain affinity for binding to breast tissue receptors that Clomid doesn't. It can significantly raise Testosterone levels. However, it can reduce IGF-1 levels. It is commonly said that Nolva can accomplish at 20 mgs what Clomid can at 150mgs. Something to keep in mind. Nolva does not decrease the bodies LH response to LHRH like Clomid can. It can reduce the blood levels of Arimidex and Letro rendering them less effective. It does not affect Aromasin.

Evista: Evista is a second-generation SERM. It is approved by the FDA for this use in women. Although it bears structural and mechanistic similarities to other SERMs which have been approved either as fertility drugs (Clomid) or Breast Cancer medication (Nolvadex), it has not been approved for either of those uses. Ralixofene exerts its effects by antagonizing the estrogen receptor in some tissues, and agonizing it in others. In this way, certain estrogenic pathways are activated and others are blockaded. It seems to exert estrogenic effects on blood lipids, reducing LDL and total cholesterol, as well as estrogenic effects on bone, improving density.

It would also appear to exert anti-estrogenic effects in breast tissue, displacing the traditional effects of estrogen, effectively helping prevent breast cancer in postmenopausal women. Evista only raises Testosterone by about 20%, much less than Nolva. Common Evista doses are 30-150 mgs. It is better utilized during a cycle versus being used in post cycle therapy (pct).

Toremifene: Usually dosed around 60 mgs, some dose it up to 240 mgs. Its androgenicity:estrogenicity ratio is 5x that of Nolvadex. It is prescribed to female patients for breast cancer and has shown a high affinity for bonding to the Estrogen receptors in the breast tissue. Male patients treated with toremifene citrate 80 mg compared to placebo demonstrated statistically significant increases in bone mineral density in the lumbar spine, hip, and femur skeletal sites. It decreased the risk by up to 50%. Toremifene citrate 80 mg treatment compared to placebo also resulted in a decrease in total cholesterol, LDL, and triglycerides, and an increase in HDL. There were also statistically significant improvements in gynecomastia. This data are from an ongoing study of men receiving treatment for ADT (androgen depravation therapy). These men are receiving ADT for advanced prostate cancer. ADT removes much of the testosterone and estrogen in the body which helps the prostatic cancer cells grow. So these men were suffering from side effects from reduced estrogen and testosterone in the body. Some studies have even suggested that Torm doesn't regulate progesterone receptors and we may see in the future the possibility of using it with 19-nors.

Some possible side effects include the risk of stroke, pulmonary embolism, and cataracts.

A typical post cycle therapy (pct) of Toremifene only would be similar to this:
Week 1: 120mg ED
Week 2: 90mg ED
Week 3: 60mg ED
Week 4: 30mg ED



AI's:

Arimidex: A-dex, seems to be the aromatase inhibitor of choice. Usually doesed from 0.25 - 3.0 mg it is effective even when not used every day. 0.5mgs per day can get rid of up to 50% estrogen.

Aromasin: Aromasin is usally doesed from 20-50 mgs per day. It can raise blood testosterone by 60%, and also help out your free to bound testosterone ratio by lowering levels of Sex Hormone Binding Globulin (SHBG), by about 20%! It can suppress estrogen by 65-80%. It's a third generation Aromatase Inhibitor just like A-dex and Letro, but unlike these A-dex and Letro, it is a Type I inhibitor. Whats the difference in a Type I and II inhibitor? Well, Type I inhibitors (like Aromasin) are actually steroidal compounds, while type II inhibitors (like Letro and A-dex) are non-steroidal drugs.

Hence, androgenic side effects are very possible with Type-I AIs, and they should probably be avoided by women. Of course, there are some similarities between the two types of AIs�?�both type I & type II AIs mimic normal substrates (essentially androgens), allowing them to compete with the substrate for access to the binding site on the aromatase enzyme. After this binding, the next step is where things differ greatly for the two different types of AI's.

In the case of a type-I Aromatase inhibitor (AI), the noncompetitive inhibitor will bind, and the enzyme initiates a sequence of hydroxylation; this hydroxylation produces an unbreakable covalent bond between the inhibitor and the enzyme protein. Now, enzyme activity is permanently blocked; even if all unattached inhibitor is removed. Aromatase enzyme activity can only be restored by new enzyme synthesis.

Now, on the other hand, competitive inhibitors, called type II AI's, reversibly bind to the active enzyme site, and one of two things can happen: 1.) either no enzyme activity is triggered or 2.) the enzyme is somehow triggered without effect. The type II inhibitor can now actually disassociate from the binding site, eventually allowing renewed competition between the inhibitor and the substrate for binding to the site. This means that the effectiveness of competitive aromatase inhibitors depends on the relative concentrations and affinities of both the inhibitor and the substrate, while this is not so for noncompetitive inhibitors.

Aromasin is a type-I inhibitor, meaning that once it has done its job, and deactivated the aromatase enzyme, we don�??t need it anymore. Letrozole and Arimidex actually need to remain present to continue their effects. This is possibly why Nolvadex does not alter the pharmacokinetics of Aromasin.

Letro: Letrozole is currently the most powerful aromatase inhibitor available. It has been shown to reduce estrogen levels by 98% or more.Administration of Letrozole lowered Estrogen by 46% in the young men tested, and 62% in the elderly subjects. Because estrogen is part of the negative feedback loop of the HPTA, Letrozole (and other anti-estrogens) are able to raise testosterone in male subjects. Letrozole was studied in men, and found to significantly increase LH levels to a 339 and 323% in the young and the elderly, respectively and Testosterone by 146 and 99%, respectively.

Letrozole was also able to produce a peak LH response to Gonadatropin Releasing Hormone equal to a 152 and 52% increase from baseline in either young or older men, respectively. In a similar study 0.02 mg of Letrozole increased testosterone by 45% after 2 days. That same twenty micrograms of Letrozole was also enough, in one study done on men, to reduce estrogen levels by roughly a third. Letrozole has a 2-4 day half-life, and it needs to be taken for up to 60 days to get a steady blood plasma level. Letro is best dosed from 0.125-2.5 mgs depending on the desired effect.
 
This is good. I'm surprised the article doesn't say anything about effects on the lipid profile. I've always heard that letro wrecks it. Unfortunately its the only Aromatase inhibitor (AI) that keeps my from having gyno symptoms on cycle, even Aromasin won't do it for me anymore.
 
top thread man :)
However .... need some skill advice on what Aromatase inhibitor (AI) to run during my deca/test E cycle. I have Human Chorionic Gonadotropin (HCG) and Nolva lined up for post cycle therapy (pct). So what Aromatase inhibitor (AI) to run during the cycle and dosage ?
 
Aromasin is a type-I inhibitor, meaning that once it has done its job, and deactivated the aromatase enzyme, we don�??t need it anymore

I really, really, would like clarifcation on this. Could someone perhaps explain this in terms of dosages, durations and percentages or whatever would make it apply in practical terms?
 
here is an analogy from hummdidly. Be sure to give him some green. BTW great post Drew.

Perhaps an analogy can help. Pretend you (exemestane) are a hitman in a drug house. However you only have the keys to certain doors in the house. Periodically new people (aromatase) spawn in the rooms. The first run you go through and kill everything and there is lots of killing. The second run through there are less people in the rooms you have access to so the people killed is less. However the people in the locked rooms (dense lipid cells) go on making drugs (estrogen). The house's overall drug production is increased but since you don't have the keys you can not completely halt the drug production.

Now lets apply that analogy to dosing. When you increase the dosing it is like increasing the number of hitmen and as a result more rooms in the house can be entered. Eventuallly with enough hitmen you could kill the entire population of the house and cease drug production.
 
DET, yeah ive read that analogy from the other thread. Shouldn't that last line from the first para read "the overall drug production is decreased"? I assume so. lol

I'm still confused though, i dont think these broad analogy's answer specific questions like mine.

Im asking in light of the quote

"meaning that once it has done its job, and deactivated the aromatase enzyme, we don't need it anymore"

....does this mean after a month you've successfully reduced your estrogen by a certain amount so you can stop?

So what if you kept taking that same dosage, for say, another month? No more reduction?

How do you determine when you've "deactivated the aromatase enzyme" then?

The details on dosages, duration and actual effect seem to be very limited on aromasin.
 
....does this mean after a month you've successfully reduced your estrogen by a certain amount so you can stop?.

No because new enzymes are produced all the time. All suicidal means is it attaches itself to that individual enzyme until that enzyme is discarded. with the other 2 AI's it only attaches itself to a certain enzyme for a period of time. Once it lets it go that enzyme can go back and initiate aromatase.

this is why the 2 non setroidal AI's can cause a rebound, because once it stops attaching to the enzyme, that enzyme plus the new ones can create more estrogen.

there is no rebound with aromasin, and its not bad for your lipids like the other 2.

Obviously though once you stop deactivating enzymes then more enzymes will be created, and none of them will be prohibited, so your estrogen can go back up.

since your stopping the finasteride though the hope is that once you correct levels they will stay that way since they will not be influenced by the finasteride anymore.

Im with RJ your over thinking this thing way too much.
 
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