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BigdaddyEdDiesel
05-17-2010, 07:49 PM
by Anthony Roberts -- Aromasin (Exemestane) is one of those weird compounds that nobody really knows what to do with. What we generally hear about it makes it very uninteresting…It’s a third generation Aromatase Inhibitor (AI) just like Arimidex (Anastrozole) and Femera (Letrozole). Both of those two drugs are very efficient at stopping the conversion of androgens into estrogen, and since we have them, why bother with Aromasin? It’s a little harder to get than the other two commonly used aromatase inhibitors, because it’s not in high demand, and there’s never been a readily apparent advantage to using it. And I mean…lets face it: It’s awkward-sounding. Aromasin doesn’t have much of a ring to it, and exemestane is even worse. Arimidex has a bunch of cool abbreviations ("A-dex" or just ‘dex) and even Letrozole is just "Letro" to most people. Where’s the cool nickname for Aromasin/exemestane? A-Sin? E-Stane? It just doesn’t work. It’s the black sheep of AIs. And why do we even need it when we have Letrozole, which is by far the most efficient AI for stopping aromatization (the process by which your body converts testosterone into estrogen)? Letro can reduce estrogen levels by 98% or greater; clinically a dose as low as 100mcgs has been shown to provide maximum aromatase inhibition (2)! So why would we need any other AIs? Well, first of all, estrogen is necessary for healthy joints (3) as well as a healthy immune system (4). So getting rid of 98% of the estrogen in your body for an extended period of time may not be the best of ideas. This may be useful on an extreme cutting cycle, leading up to a bodybuilding contest, or if you are particularly prone to gyno, but certainly can’t be used safely for extended periods of time without compromising your joints and immune system.

So that leaves us with Arimidex, which isn’t as potent as Letrozole, but at .5mgs/day will still get rid of around half (50%) of the estrogen in your body. Problem solved, right? Use Arimidex on your typical cycles, and if you are very prone to gyno or are getting ready for a contest, use Letro.

But what about Post Cycle Therapy (PCT)?

I think at this point most people are sold on the use of Nolvadex (Tamoxifen Citrate) instead of Clomid for PCT, since both compete estrogen at the receptor site, both increase serum test levels, and both drugs may also alter blood lipid profiles favorably (6). But since 20mgs of Tamoxifen is equal to 150mgs of clomid for purposes of testosterone elevation, FSH and LH, but Tamoxifen doesn’t decrease the LH response to LHRH (6) I think most people agree to Nolvadex’s superiority for PCT.

I’ve always been in favor of using Nolvadex during PCT, along with an AI, because reducing estrogen levels has been positively correlated with an increase in testosterone (7) so in my mind, it’s be beneficial to increase testosterone by as many mechanisms as possible while trying to recover your endogenous testosterone levels after a cycle. SO which AI do we use? Letro or A-dex? Well, why don’t we just keep using whichever one we used during the cycle, and add in some Nolvadex? Unfortunately, Nolvadex will significantly reduce the blood plasma levels of both Letrozole as well as Arimidex (8). So if we choose to use one of them with our Nolvadex on PCT, we’re throwing away a bit of money as the Nolvadex will be reducing their effectiveness.

This, of course, is where Aromasin comes in, at 20-25mgs/day.

Aromasin, at that dose, will raise your testosterone levels by about 60%, and also help out your free to bound testosterone ratio by lowering levels of Sex Hormone Binding Globulin (SHBG), by about 20% (12)…SHBG is that nasty enzyme that binds to testosterone and renders it useless for building muscle. But what about using it along with Nolvadex for PCT?

To understand why Aromasin may be useful in conjunction with Nolvadex while both Letro and A-dex suffer reduced effectiveness, we’ll need to first understand the differences between a Type-I and Type-II Aromatase Inhibitor. 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 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 (11).

Before we close the book on Aromasin, it’s worth noting that you can (and should) still use one of the non-steroidal AIs during your cycle to reduce estrogen, if necessary. When you are ready for PCT, you can then switch over to Aromasin and still experience the full effects of an AI, since there is no cross-over tolerance experienced between steroidal and non-steroidal AIs (9). Since Aromasin is about 65% efficient at suppressing estrogen (10), it’s certainly a very powerful agent, especially considering you won’t experience reduced effectiveness because of your concurrent use of Nolvadex or from any sort of tolerance developed by using other AIs on your cycle(9). There is also a decent amount of preclinical data suggesting that Aromasin has a beneficial effect on bone mineral metabolism that is not seen with non-steroidal agents, and it may also have beneficial effects on lipid metabolism that are not found in the non-steroidal Letro and A-dex (9).

Finally, as we’re going to be using Nolvadex for PCT anyway, and we ought to be using an AI with it for maximum recovery…I think Aromasin- considering it’s compatibility with Nolvadex and beneficial effects on bone mineral content and lipid profile, has finally stopped being the black sheep of AIs and found a home in our Cycles.

BigdaddyEdDiesel
05-17-2010, 07:51 PM
All this being said, does anyone know the recommended dosage of exemestane during PCT?

liljo
05-19-2010, 06:36 PM
20 -25 mgs a day ?

superbeast22
05-19-2010, 07:03 PM
anthony roberts is a FUCK head

BigdaddyEdDiesel
05-20-2010, 05:38 AM
So, should I take the info he stated with a grain of salt? He sure as hell makes it sound like he knows what he's talking about? But hey, you're the colonel, lol, I'm just a Sargent Major?

BigdaddyEdDiesel
05-20-2010, 05:44 AM
Pharmacology and pharmacokinetics of the newer generation aromatase inhibitors.

Buzdar AU.

The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030.

The newer generation aromatase inhibitors (AIs) as a class show efficacy and tolerability benefits over previously established treatments inpostmenopausal women with advanced breast cancer. At clinically administered doses, the plasma half-lives of Anastrozole (1 mg once daily), Letrozole (2.5 mg once daily), and exemestane (25 mg once daily) are 41-48 h, 2-4 days, and 27 h, respectively. Time to steady-state plasma levels is 7 days for both Anastrozole and exemestane and 60 days for Letrozole. Androgenic side effects have only been reported with exemestane. Anastrozole treatment has no impact on plasma lipid levels, whereas both Letrozole and exemestane have an unfavorable effect. From indirect comparisons, Anastrozole shows the highest degree of selectivity compared with Letrozole and exemestane, in terms of a lack of effect on adrenosteroidogenesis. To date, there are no data suggesting any major differences in clinical efficacy between the newer generation AIs Anastrozole and Letrozole. Based on the observed pharmacological profiles, however, it cannot be assumed that the AIs will display the same tolerability and safety profiles when given for extended periods of time in the adjuvant setting. The effects of Anastrozole, Letrozole, and exemestane are being investigated in the adjuvant setting, and these data will elucidate the possible long-term consequences of the pharmacological effects reported after short-term exposure.

BigdaddyEdDiesel
05-20-2010, 05:45 AM
Aromasin ORAL
Pharmacology & Chemistry

Exemestane is an irreversible, selective steroidal aromatase inhibitor structurally related to the natural substrate androstenedione.Unlike nonsteroidal (type II) aromatase inhibitors (e.g., aminoglutethimide, Letrozole), steroidal inhibitors such as exemestane (type I aromatase inhibitors) act as false substrates and are converted by aromatase to reactive alkylating intermediates that bind covalently to the substrate binding site of the enzyme; this binding to the active site of aromatase is irreversible, resulting in its inactivation (i.e., “suicide” inhibition).As a result of these differences, there appears to be a lack of cross-resistance in susceptible cancers between type I and II inhibitors.Exemestane selectively inhibits the conversion of androgens to estrogens.Because estrogen acts as a growth factor for hormone-dependent breast cancer cells, reduction of serum and tumor concentrations of estrogen inhibits tumor growth and delays disease progression.In postmenopausal women,ovarian secretion of estrogen declines and conversion of adrenal androgens (mainly androstenedione and testosterone) to estrone and estradiol in peripheral tissues (adipose, muscle, and liver), catalyzed by the aromatase enzyme,is the prinl source of estrogens.Exemestane selectively inhibits the synthesis of estrogens and does not affect synthesis of adrenal corticosteroid, aldosterone, or thyroid hormone.In dose-ranging (0.5—800 mg) studies, 25 mg was the minimum dose to exhibit maximum suppression of plasma estrogens.A single 25-mg exemestane dose reduces plasma estrogen (estradiol, estrone,and estrone sulfate) concentrations in postmenopausal women by as much as 85—95% within 2—3 days, with maximal suppression persisting up to at least 4—5 days after dosing.After 4—12 weeks of exemestane therapy (25 mg daily) in postmenopausal women, plasma estrogen concentrations were suppressed by an average of 91—95%,and whole body aromatization was suppressed by 98%.Although an apparently lower suppression (e.g., by 60—70%) of plasma estrogens has been reported in some studies, these studies used a less-specific assay method (i.e., RIA) than the method (i.e., HPLC) used in studies reporting higher levels of suppression.A dose-dependent decrease in sex hormone binding globulin (sex hormone binding globulin ) has been observed with exemestane dosages of 2.5 mg or more daily.Slight, dose-independent increases in serum luteinizing hormone (lh - leutenizing hormone - ) and follicle-stimulating hormone (FSH - follicle stimulating hormone - ) concentrations have been observed even at low dosages as a result of negative feedback on the pituitary gland.At dosages up to 25 mg daily, no clinically important effect on circulating concentrations of testosterone, androstenedione, dehydroepiandrostenedione sulfate, or 17-hydroxyprogesterone is observed; however, at dosages of 200 mg or more daily, testosterone and androstenedione concentrations are increased.17-Hydroexemestane, a metabolite, exhibits substantial intrinsic androgenic activity, which may become clinically important at high (e.g., 200 mg daily)exemestane dosages.Exemestane is prinlly metabolized via oxidation by the cytochrome P-450 (testosterone cypionate) 3A4 isoenzyme.Serum exemestane concentrations increased by approximately 40% after a high-fat breakfast.Unlike aminoglutethimide, exemestane does not adversely affect plasma total homocysteine concentrations.

Invrt
05-20-2010, 06:16 AM
What are you supporting with your references ?

I just started using 12.5mg aromasin ED year round on TRT or on cycle.

johnurse
05-20-2010, 12:46 PM
bump im taking 12.5 ed till i get my e2 levels under control, no cycle atm, no trt for me yet so this was a good option as theres no estro rebound from what i understand