The first thing I discussed with my naturopathic Medical Doctor (in AZ that's a thing) is the bloodwork needs to show me, before and after starting the natural AI's, that my estradiol levels are lower after being on them for a couple of months. If you have a copy of the Femara insert, I would love to see it. I'm only aware of the difference in compliance standards in the UK and EU; not the US. First of all it's not just a natural AI approach, it's an entire lifestyle change. Avoiding acidic foods and creating an environment in my body where cancer cannot live (see the books on Radical Remission and Starving Cancer). Basically making my body and mind healthier and boosting my immune system as well as the hope that the AI's will block cancer. It's a very full throated approach I'm taking which has changed almost everything in less than a week about how I eat, drinking reverse osmosis alkaline water, moving to a raw vegetable diet, etc. Avoiding Red meat due to the hormones given to most dairy animals which also get's into cheese/milk etc.

Going this route is much more difficult and life changing than a doctor prescribing a pill which is the silver bullet for 56% of women, the rest of us are left without an option in the regular allopathic community.

Also I'm fully aware that the generics and brands have different side effects. The problem where I live is that I the medical care here is a joke and I cannot get my onco to prescribe all of the different AI's. I tried that with exemestane and brand aromasin and my onco is so short staffed have no dialogue and no way to get him to prescribe me all of the different generics or brands...I'm trying to get an appointment at Mayo which is 2.5 hours from where I live, but I get no response no matter if I call or through the online appointment app. I need a second opinion and if you can provide me a copy of your Femara info showing a 20% dose is allowable, I may be able to try that under a different doctors/Mayo doctors orders. Otherwise, where I live, it's not even a footnote as an option for me. It should be if it's in your Femara insert, but it's not. I cannot afford to have another suicidal event due to the AI's. That's a bit counterintuitive isn't it? Taking something to save my life that for me has these dangerous side effects?

And the only option with my onco is take them as prescribed once a day, or don't. There are no other options offered than tamoxifen.