@leculdesac makes an important point that Tamoxifen, AI’s, and other treatments can exacerbate underlying conditions & we need to ensure that our doctors are aware of them. My mantra at appointments is “assume nothing “, so at each appointment I bring up my conditions/concerns to the doctor. Like it or not, practitioners are seeing lots of patients and may or may not have the time to really review my history, and the intake nurse may or may not relay the information.

I declined AI’s due to osteoporosis, extremely low Oncotype, and high cholesterol.

Once you start meds, let the doctor know of anything that seems off.
I was started on 20mg tamoxifen & developed severe leg cramps that kept me from getting good sleep. I told my oncologist & she lowered the dose to 5 mg. Now I occasionally have leg cramps (once every 2 months?).
I did have brain fog & gained a couple of pounds when the cramps were keeping me from sleeping well, but when I took the low dose 5mg (baby tam) & slept better, those issues stopped.

Most importantly, know that you have time to ask questions and research your options before starting meds.

I was stage 2 HER2 negative and ER + low risk same standard of care protocol. I declined both radiation and endocrine therapy. Changed my diet fasting and juicing no sugar, taking integrative path. Can’t bear the toxicity of the post op options since I just got toxicity out of my body. Good luck with your decision.