Actually, my Texas oncologist (the one I like) RAISED the dosage. I only agreed to "try" Tamoxifen and began taking 10 mg. on April 23, and taking it every other day. That would be equivalent to about 5 mg. a day, or 40 weekly. I was on that dosage without too many bad side effects (other than a constant urge to urinate) for 2 full months, because I had read about the Italian Women's Study of 700 women who got by very successfully taking the pills in lower dosages. My doctor (oncologist in Texas) contacted me on June 23 to say that there was no clinical evidence for less than 20 mg. and I should move up to that dosage. He said that my confidence in the Italian Women's Study was misplaced, because those women had tumors that were "in situ" and mine had broken through. So, I followed doctor's orders and stepped up the dosage (as of June 23) to 20 mg. daily, which means 140 mg. a week, up from 40 mg. a week. The effect was (a) EXTREME exhaustion. I literally could only be awake and function for 3 hours a day. Nothing helped. There was no "resting up." My family and I had planned to drift down a Texas River in inner tubes, which was over 3 hours of being "up." I could not go, as I knew I would not be able to stay awake for that long without a nap. (b) the never-ending feeling that you have to pee, which went on on any dosage and (c) non-stop UTIs. The worst one hit me right before New Year's Eve. I had some Mexican amoxicillin and took that. Did nothing. I bought something from Walgreen's. Did nothing. It had now gone on for 10 days and I was becoming desperate. I called the female OB/GYN on whose schedule I had been for 9 months (vaginal ultra sound to guard against endometrial issues). She refused to see me because "I wasn't her patient yet." I pointed out that I had had an appointment to see her for 9 months, but that cut no ice. I got in my car and drove to the closest convenient card, but it was packed with Covid sufferers. (an upsurge in Texas) The office of the OB/GYN called me back and reduced me to tears with their refusal to help medicate me with something that would work. I called my oncologist, and he told me to go to the hospital and leave a urine specimen for testing, so I drove from one town to another to do so. I was given a second strong antibiotic. Took that and the feeling did subside, but was replaced by an overall "itchy" feeling. Had to go in, in person, and be seen (by a minion) and was told that the 2 strong antibiotics had given me a fungal infection (!) Was given 2 pills and told that one would probably do the job, which it did. I don't know about you, but I've had 2 friends who died from UTIs that went wild, I don't want to spend the next 10 years (hopefully) fighting UTIs, which, if they enter your bloodstream, can be deadly (especially in older people, and I'm 78). I also noted that my bloodwork from August 30 showed 10 things that were "off" since I began taking Tamoxifen. I had had bloodwork on March 7, 2023, right before I started on the 10 mg (in April) and everything had looked good. Now, everything looked worse. I quit taking everything from that point on, trusting that my 33 radiation sessions will have killed any errant cancer cells. If I were to have a recurrence, I'd try Tamoxifen again, but I would not take the full 20 mg. dosage, because that was too much for my system, whereas I think I could have stayed on the 10 mg. every other day. As it is, I am taking nothing and feeling good.