Why are dosages for estrogen suppression drugs one-size-fits-all?

Posted by gldilli @gldilli, Mar 28, 2023

Why is the dosage for Anastrozole (and any other AI) the same for everyone no matter your weight or size? Does this-one size-fits-all approach have an impact on side effects, risk of recurrence, etc. I’d like to know what the medical community has to say.

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For elderly women taking Anastrozole, I found this paper on dosages. I can only access the abstract:
https://aacrjournals.org/cancerres/article/75/9_Supplement/P1-12-15/606865/Abstract-P1-12-15-Intermittent-dosing-of-aromatase
If I'm reading it correctly, it says for elderly it is best to take 1 dose every other day. There are problems if you take it every day.

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@queenofjacks

Ellie, I am right there with you. I just got back from post BC surgeon (lumpectomy) and she was quizzing me about refusing AI drugs. 2 weeks my oncologist will do the same again. What were the specifics of your BC? Mine is HR/PR+, clear margins, Invasive Ductal Carcinoma, Grade 1, slow growing & I also chose 5 targeted radiation. treatments. I am 71 , 124 lbs, in good health & The side effects scare me to death.

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I am exactly the same. DCIS Invasive, Stage 1, age 74 normal weight (until I started Anastrozole) hypo fractionated XRT 5 treatments. I did not like the side effects from the Anastrozole or how I was feeling in general. There seems to be very little data on those of us over 70 yrs. in our diagnostic group. I stopped the Anastrozole 7 weeks ago and just now feeling myself.
They seem to be treating with a one size fits all. The medical community also seems to admit that there is not enuf data for several reasons one being our age group just does not feel the need to put up with the discomforts of the AI treatments and I guess may be lost to follow up. I think the only info I could find was that the risk for 5 year recurrence with treatment is 5%;
without treatment 15%.
Good luck… would like to hear what your oncologist has to say.

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Thank you so much. Always good to hear someone else’s journey in these situations.
I’m now reading about Metformin (diabetes drug) studies. They seem to be inconclusive. I will let you know & thx again.

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@deluga

Yes, I got awful side effects from Letrozole and refused to take it any more. It seems many hospitals (Mayo Clinic, NYU Lagonne, and Memorial Sloan Kettering ) have doctors experimenting with different dosages. For Letrozole, I heard 1/2 dose, 1 dose every other day, and every every two days. I'm now on Anastrozole and am taking it every other day which my doctor doesn't like. There has been data showing that people taking Letrozole every other day have the same mortality rate as those who take it every day.
Helene

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So have you been on the Anastrozole long enough to be aware of any side effect improvement?

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I would love to hear from women on here taking AI’s and if they have any side effects. I go to the oncologist in a week and she will be urging me to take one. I have so far said no, due to the side effects, but she says 50% of her patients do not have any side effects. Thanks a million in advance.

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I have been taking Anastrozole for 19 months and the main issues are an increase in overall LDL cholesterol and less sleep. I am 63 and within “normal” BMI level. My husband says I’m grouchier too. 😒

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I assumed my estrogen levels would be tested before I was given the AI drugs (which I ended up not taking) and was told they never check your estrogen levels, which makes no sense to me. I was told the purpose of the AI drugs was to get your estrogen to "below detectable levels", when I insisted she test my level the result was "Below detectable levels" so I was already there!! How much lower than below detectable level can you get? IT is not one size fits all, would they give the same dose to someone with high levels and the same to someone like me, with none?

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@queenofjacks

I would love to hear from women on here taking AI’s and if they have any side effects. I go to the oncologist in a week and she will be urging me to take one. I have so far said no, due to the side effects, but she says 50% of her patients do not have any side effects. Thanks a million in advance.

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On another BC site, I have come across 2 people who have said that they have had no symptoms with their AI’s.
All other posts, which are many, discuss their symptoms and ask for remedies.
One doctor suggested Claritin.
I use glucosamine Chrondroitrin and hyaluronic acid plant collagen and a multi capsule with collagen, Frankincense and boron.

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@deluga

For elderly women taking Anastrozole, I found this paper on dosages. I can only access the abstract:
https://aacrjournals.org/cancerres/article/75/9_Supplement/P1-12-15/606865/Abstract-P1-12-15-Intermittent-dosing-of-aromatase
If I'm reading it correctly, it says for elderly it is best to take 1 dose every other day. There are problems if you take it every day.

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But, there is a problem doing that with Leterzole as it dissolves more quickly than some of the other AI’s and thus does not offer protection if taken every other day.
Only one AI had the possibility of taking it every other day.
Google to find this article.

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