Not recommending this but....

[Wood]

August 20, 2004
Raloxifene, tamoxifen reduce persistent pubertal gynecomastia
By


NEW YORK (Reuters Health) - For teenage boys with persistent gynecomastia, inhibition of estrogen receptor action in the breast with either tamoxifen or raloxifene appears to be a safe and effective means of reducing breast size, according to a new study.

About 10% of cases of pubertal gynecomastia do not resolve on their own within 3 years, researchers at the University of Ottawa explain in an article in the July issue of the Journal of Pediatrics. Led by Dr. Sarah E. Lawrence, they conducted a retrospective chart review of patients treated at their clinic between 1995 and 2000.

Included in the review were 15 patients treated with tamoxifen for an average of 5.2 months, 10 with raloxifene for an average of 4.9 months, and 13 with no specific therapy other than reassurance. At baseline, the diameter of the breast nodule averaged 4.6 cm, 3.8 cm and 4.7 cm, respectively.

Tamoxifen treatment was associated with a mean decrease of 2.1 cm (45%) in mean diameter of the breast nodule, compared with 2.5 cm (66%) in the raloxifene group (p < 0.0001 for each). A response rate of at least a 50% reduction in size occurred in 41% and 86% of breasts, respectively.

There appeared to be no adverse events, and no significant changes in levels of luteinizing hormone, follicle-stimulating hormone, testosterone, estradiol or liver transaminases.

The authors contacted subjects in 2003. None of those who had been treated reported a relapse, but 40% in each treatment group went on to have mammoplasty. Among those treated only with reassurance, 50% reported spontaneous resolution.

"A randomized controlled trial using standardized measurements of glandular tissue, such as breast ultrasonography, is needed to further evaluate the use of estrogen inhibitors as medical therapy for boys troubled by persistent pubertal gynecomastia," Dr. Lawrence and her associates conclude.

J Pediatr 2004;145:71-76.

[archive_Mr. Nobody]

Wonder if they cruised the bobybuilding chat rooms and bulletin boards before they came up with this......our boards seem to be the newest research tool for the scientific community.

Hey Ulter, how about applying for some grant money, since we have the biggest lab there is (with lots of willing and able lab rats no less )

__________________________________________________ _____________________________________

Disclaimer:
Mr. Nobody is presenting fictitious opinions and does in no way, shape or form encourage, use nor condone the use of any illegal substances or the use of legal substances in an illegal manner.
The information discussed is strictly for entertainment purposes only and shall not take the place of qualified medical advice.

[macdaddy]

So, if someone wanted to give their 16 yr old tamoxifen because of pubecent gyno, how much would he give him?

[Wood]

Good question Mac, I need to go to pubmed and look up the entire article and see what doses they gave. But it would be best to allow an endocrinologist to do it - I understand taking research chems oneself, but giving research chems or UG tamox certainly is not recommended,.

[Jonny Organon]

I wonder how the legal issues of prescription could change with this?? I remember a while back my doctor was on the fence because he felt that it would be possible illegal mal-practice to prescribe a "breast cancer" drug to a male without breast cancer. At least thats what he said.

If this was to get more attention could they just go to the books and pencil in "oh yeah, tamox has one more use".????

[archive_Bjaarki]

Thanks, Wood.

Mr. N, your idea has been anticipated.

[E2]

<BLOCKQUOTE class="**-ubbcode-quote"><font size="-1">quote:</font><HR>Hey Ulter, how about applying for some grant money, since we have the biggest lab there is (with lots of willing and able lab rats no less )
<HR></BLOCKQUOTE>

I could use some grant money

[Pharm Animal]

<BLOCKQUOTE class="**-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by macdaddy:
So, if someone wanted to give their 16 yr old tamoxifen because of pubecent gyno, how much would he give him?<HR></BLOCKQUOTE>I'm NOT a n expert on the subject at hand, but I have read abstracts from about 5 research papers that suggest levels as high as 10 grams a day is still not remotely close to the basal toxicity dosage of Tamoxifen citrate. Generally, whatever dosage you would take to inhibit E2 receptors for gyno would suffice and wouldn't be too much, all at the same time. Like I said, I'm not an expert, but I'm confident that 40-60 mg/day would reverse pubescent gyno.

"I feel that an individual knows their body the best. If you KNOW one of my suggestions do not work for you, do not hesitate to drop that idea from your repetoire. Never blindly follow the herd." PA 2001

[Wood]

Horm Res. 2002;57(5-6):187-91.

Effects of tamoxifen on lipid profile and coagulation parameters in male patients with pubertal gynecomastia.

Novoa FJ, Boronat M, Carrillo A, Tapia M, Diaz-Cremades J, Chirino R.

Department of Endocrinology, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain. jnovoa@cicei.ulpgc.es

BACKGROUND/AIM: The estrogenic actions of tamoxifen on lipid profiles and hemostasis have been extensively demonstrated in women. Due to limited experience with this drug in males, it is uncertain whether these effects are also present in men. The aim of our study was to assess the response of blood lipids, lipoproteins, and coagulation parameters in a group of men taking tamoxifen. METHODS: We studied 15 healthy boys with pubertal gynecomastia who were given 10 mg tamoxifen per day. Total testosterone, sex-hormone-binding globulin, estradiol, serum lipids, apolipoprotein B, apolipoprotein A-I, lipoprotein(a), fibrinogen, antithrombin III, von Willebrand factor, and markers of activated coagulation and fibrinolysis were determined at baseline and 1 and 3 months after beginning of the tamoxifen treatment. RESULTS: Total cholesterol and lipoprotein(a) showed moderate but significant decreases from baseline. Low-density lipoprotein and high-density lipoprotein cholesterol concentrations as well as triglyceride and apolipoprotein B levels became lower, but these changes were not statistically significant. Among clotting parameters, antithrombin III was reduced, and von Willebrand factor increased significantly. Markers of activated coagulation and fibrinolysis remained unchanged throughout the period of therapy. CONCLUSIONS: The effects of tamoxifen on blood lipids and hemostasis we found in this group of healthy young men were qualitatively similar, but lesser than those previously described in women. Copyright 2002 S. Karger AG, Basel

[Wood]

Int J Adolesc Med Health. 2003 Oct-Dec;15(4):359-63.

Tamoxifen treatment for pubertal gynecomastia.

Derman O, Kanbur NO, Kutluk T.

Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara-Turkey. drderman@hotmail.com

We evaluated the efficacy of the tamoxifen treatment in 37 patients with pubertal gynecomastia. All had distinct, easily palpable breast swellings with a diameter of over three cm. Pain, tenderness, and swelling associated with gynecomastia were reported by six patients. Eight of the patients were obese. One patient also suffered from varicocele. Pain and size reduction was seen in all patients with tamoxifen treatment. No long-term side effects of tamoxifen were observed. The dose of tamoxifen was increased in three patients due to poor response. Two of the treatment group had recurrence problem at follow-up. We did not need to refer any patient to surgery. Tamoxifen treatment is relatively non-toxic, may be beneficial and we think it should be considered for pubertal gynecomastia.

[Pharm Animal]

Wood, thanks for posting those. Oops, I guess I didn't think of effects on lipid profiles.

[Wood]

One of the ugly sides I don't like about Tamox is that it can increase the tendency to clot (increased Von Willebrands and reduced antithrombin)

[Wood]

Anastrazole seemed to work too and it did not mess up their testo levels- again not recommending it for kids
===================
Horm Res. 2004 Jul 20;62(3):113-118.

Treatment of Pubertal Gynecomastia with the Specific Aromatase Inhibitor Anastrozole.

Riepe FG, Baus I, Wiest S, Krone N, Sippell WG, Partsch CJ.

Division of Pediatric Endocrinology, Department of Paediatrics, Christian-Albrechts-Universitat Kiel, Kiel, Germany.

Gynecomastia can be detected in up to 70% of boys during puberty and in about one third of adult males. An imbalance of estrogen to androgen tissue levels is believed to be the major reason for the development of gynecomastia; as a result most medical treatments so far have tried to lower the estrogen level. Five boys with pubertal gynecomastia and breast tenderness were treated for 6 months with the selective aromatase inhibitor anastrozole. Initial plasma levels of estradiol (E(2)), testosterone (T), androstenedione, dehydroepiandrosterone sulfate (DHEA-S) and gonadotropins were normal. DHEA-S showed a significant rise during treatment. T and androstenedione showed no significant change during treatment. E(2) decreased with therapy, although to no statistically significant extent. The E(2)/T ratio decreased significantly during the treatment. Breast size decreased in 4 out of 5 patients, and in 1 of these 4 boys glandular breast tissue disappeared completely. The longer the duration of gynecomastia before anastrozole administration, the smaller was the reduction of breast size. Breast tenderness was resolved in all boys within 4 weeks. No adverse effects were recorded. Since the aim of medical treatment is the total disappearance of breast tissue, anastrozole, as previous aromatase inhibitors, is of limited effect. However, anastrozole seems to be of benefit for the treatment of tenderness in gynecomastia and for patients in whom surgery is particularly risky. However, as spontaneous disappearance of pubertal gynecomastia is common, further double-blinded, placebo-controlled trials are necessary before a definite conclusion can be drawn about the effectiveness and the side effects of this therapy. Copyright 2004 S. Karger AG, Basel

[Wood]

Anastrazole did not effect lipids like letro and exemestane, it reaches steady state in a week and has a half life of about 2 days. Letro took about 2 months to reach a steady state
=============
Clin Cancer Res. 2003 Jan;9(1 Pt 2):468S-72S.

Pharmacology and pharmacokinetics of the newer generation aromatase inhibitors.

Buzdar AU.

Department of Breast Medical Oncology, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA. abuzdar@mdanderson.org

The newer generation aromatase inhibitors (AIs) as a class show efficacy and tolerability benefits over previously established treatments in postmenopausal 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

[Wood]

Anastrazole increases IGF-1 in women with breast ca. But again not recommending it - it may act entirely differently in pubertal boys since their chemistry is different.
==================
J Steroid Biochem Mol Biol. 2002 Apr;80(4-5):411-8.


Short-term effects of anastrozole treatment on insulin-like growth factor system in postmenopausal advanced breast cancer patients.

Ferrari L, Martinetti A, Zilembo N, Pozzi P, Buzzoni R, La Torre I, Gattinoni L, Catena L, Vitali M, Celio L, Seregni E, Bombardieri E, Bajetta E.

Nuclear Medicine, Istituto Nazionale per lo Studio e la Cura dei Tumori of Milan, Via G. Venezian, 1, 20133 Milan, Italy.

Insulin-like growth factors (IGFs) play a fundamental role in cancer development by acting in both an endocrinal and paracrinal manner, and hormone breast cancer treatments affect the IGF system by modifying circulating growth factor levels. We evaluated total IGF-1, IGF-2, IGF binding protein (IGFBP)-1 and IGFBP-3 in the blood of 34 postmenopausal advanced breast cancer patients (median age 63 years, range 41-85) treated with anastrozole, a non-steroidal structure aromatase inhibitor (NSS-AI). The plasma samples were obtained at baseline, and after 2, 4, 8 and 12 weeks of treatment. The IGFs were quantitated by means of sensitive radioimmunoassays (RIAs). IGF-1 significantly increased during anastrozole treatment (baseline versus 12 weeks, P=0.031), IGF-2 showed a trend towards an increase, and IGFBP-1 constantly but not significantly decreased; IGFBP-3 did not seem to be affected at all. The anastrozole-induced changes in IGFs and IGFBP-1 appeared to be different in the patients receiving a clinical benefit from those observed in non-responders. We have previously shown that letrozole (a different type of NSS-AI) modifies blood IGF-1 levels, and the results of this study of the biological effects of anastrozole on the components of the IGF system confirm our previous observations.

[archive_MR. BMJ]

Great post as usual WOOD!

I suppose that these studies would have been handy while in high school considering that probably 50-75% of the students at my high school were on juice. As a matter of fact I, and a lot of my friends/classmates DID use Nolva/clomid/cyclofenil/H-C-G during/after cycling. Too bad we didn't all take blood tests.

For the record, my only cycle during high school was a short 4-5 week cycle of anadrol-50 using 1/4-1/2 tab/d. This was right before a bench press meet that was put on once a year. Hahaha...I won my weight class. I always wondered if that stuff was real or not, or if it was all psychological gains.

I would still say that the benefits would outweigh the negative effects. I'd much rather, either as a user or just a teen that naturally is susceptible to pubertal gyno, have a less than optimal lipid profile than worry about taking off my shirt due to bitch titties. I never had that problem through puberty, but others did, and I know that HAD to be embarassing.

I think that maybe if there was a way to have an endocrinologist monitor these kids year-round, then they may not have to use the Nolva all-year around, therefore not causing any major sides with lipid profiles.

BMJ

[archive_MR. BMJ]

Are there any studies to date showing the effects of Aromasain in these conditions? I think that this may be a better choice, since it usually is touted as not having much +/- effects on lipid profiles. Maybe that would be a better option???

BMJ

[Wood]

<BLOCKQUOTE class="**-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by Wood:
Anastrozole treatment has no impact on plasma lipid levels, whereas both letrozole and exemestane have an unfavorable effect. <HR></BLOCKQUOTE>

Exemestane (Aromasin) had a bad impact on lipids in this study

[This message was edited by Wood on 09-06-04 at 12:33 PM.]

[archive_MR. BMJ]

Oh dear...I feel like a dipshit! Thanks for taking it easy on me, guess I should have read the entire abstracts.

BMJ

[Sean]

I know this is a bit out of the exact subject but im not really sure how this forum works since i just became a member. I was wondering you any of you could please help me with since im extremely desperate at this point. This is my post:

Hi, im a bit ashamed about this post but im going to be totally honest with you all and maybe some of you could give me some advise about this. Im a big guy(about 248 pounds exactly) And I have a rather large chest, probably about a b cup or somewhere around there. This is something that has plagued me for very many years and Im almost to the breaking point im afraid. A day doesnt go by where I don't think about it. I've been walking on the treadmill and eating less for about 2 months now and have already lost about 24 pounds but since im so overweight(248 pounds) I can't really see a big difference yet. My question is: Do any of you know if wieghtloss will really help the problem, if i lost a significant amount of weight? Thats what ive been going for this whole time. I thought maybe if i could get down to 200 or less They would shrink a good bit. If anyone has had any luck with weightloss please let me know. I only want to use surgery as a last resort, considering that i don't have alot a money, also I think that it is all mainly fat. Please if someone could give me any help at all it would be greatly appreciated. Im extremely desperete for some help. Thanks