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

I wanted to read this study, but the address is ‘not found’. I too was prescribed an AI and declined, due to standard protocols and dosage. I am 74, weigh 108 lbs (with partial Osteopenia) and have good health (exception BC with recent lumpectomy followed by 5day rad) My Oncologist has been outwardly upset with me and my husband for refusing any AI. At the time of my surgery and post treatment, I was given a choice, radiation or AI or both. I choice radiation. I am closely monitoring my breasts and praying no recurrence. The standard protocols call for a one-size treatment for all BC sufferers.

The dosage for Letrozole was discussed here on another thread maybe a year or so back. Because of that discussion I asked my oncologist and he agreed to put me on a half dose. I will look for the research. In the meantime I found this research on Anastrazole. I'm providing the link, but I've also cut/pasted the most pertinent paragraph. The parenthesis content is my addition.
https://www.drugs.com/pro/anastrozole.html

(estradiol=estrogen)

Mean serum concentrations of estradiol were evaluated in multiple daily dosing trials with 0.5, 1, 3, 5, and 10 mg of Anastrozole tablets in postmenopausal women with advanced breast cancer. Clinically significant suppression of serum estradiol was seen with all doses. Doses of 1 mg and higher resulted in suppression of mean serum concentrations of estradiol to the lower limit of detection (3.7 pmol/L). The recommended daily dose, Anastrozole tablets 1 mg, reduced estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing. Suppression of serum estradiol was maintained for up to 6 days after cessation of daily dosing with Anastrozole tablets 1 mg.

Thanks for posting this info and link! I would really like to find the original article with the clinical data. I came across a 1996 article, very small groups, also about dosing and am wondering about the 'below level of detection' difference betw .5 and 1 mg of Arimidex, but which is mentioned that result found 24 hrs after last dose...so doesn't explicitly mention if that was also the case during the 14-day testing period....(study funded by Zeneca, btw)

Arimidex (ZD1033): a selective, potent inhibitor of aromatase in postmenopausal female volunteers
RA Yates', M Dowsett2, GV Fisher', A Selen3 and PJ Wyld4 'Zeneca Pharmaceuticals, Alderley Park, Macclesfield, Cheshire SKIO 4TG, UK; 2Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK; 3Zeneca Pharmaceuticals, 1800 Concord Pike, Wilmington, USA; 4Inveresk Clinical Research Ltd, Riccarton, Edinburgh, UK.
Summary
Two multiple-dose studies were conducted in healthy post-menopausal female volunteers to investigate the pharmacokinetics and effects on endocrinology of Arimidex (ZD1033). Volunteers in the first trial were dosed with 3 mg of ZD1033 daily over 10 days to assess the effects on endocrinology of ZD1033 and establish the pharmacokinetic profile. In the second trial volunteers received 14 daily doses of either 0.5 or 1.0 mg of ZD1033 to assess the pharmacokinetics of ZD1033 and the effects of low doses of ZD1033 on serum oestradiol concentrations. Following multiple dosing a significant reduction in the concentration of serum oestradiol of approximately 80% of baseline was obtained with all three doses; no recovery in oestradiol was apparent for up to 144 h after the last dose. There was no overall difference in the level of oestradiol suppression between the 0.5 or 1.0 mg doses of ZD1033. However, comparison of the number of volunteers with oestradiol concentrations below the limits of detection of the assay, 24 h after the last dose of ZD1033, suggested that 1.0 mg was the minimal dose required for maximal suppression of oestradiol.

I too am curious on the drugs given after surgery and radiation. I am post menopausal and honestly am dreading the drugs thinking they may break down my body more instead of really helping it. Why is there not a discussion of foods we eat and possibly other herbs etc that we are taking talking points when it comes to Estrogen suppression. For instance if one where to cut out all possibly hormone containing foods, for example meats that have hormones or dairy, and any other herbal/vitamin supplement that elevates estrogen along with testing our estrogen levels to see what they are dealing with for each patient on an individual basis instead of prescribing the one size fits all drug treatments. For me my weight and bmi index is good but I do work at it and have for years. I am sure the 2 lobular cancer masses in my right breast (grade 1) were happily growing from the hormone therapy I was doing, but if all that had been cut out and diet completely looked at and reviewed, then do we need all the after drugs? It is giving more anxiety then the actual surgery.

I too am curious on the drugs given after surgery and radiation. I am post menopausal and honestly am dreading the drugs thinking they may break down my body more instead of really helping it. Why is there not a discussion of foods we eat and possibly other herbs etc that we are taking talking points when it comes to Estrogen suppression. For instance if one where to cut out all possibly hormone containing foods, for example meats that have hormones or dairy, and any other herbal/vitamin supplement that elevates estrogen along with testing our estrogen levels to see what they are dealing with for each patient on an individual basis instead of prescribing the one size fits all drug treatments. For me my weight and bmi index is good but I do work at it and have for years. I am sure the 2 lobular cancer masses in my right breast (grade 1) were happily growing from the hormone therapy I was doing, but if all that had been cut out and diet completely looked at and reviewed, then do we need all the after drugs? It is giving more anxiety then the actual surgery.

Thank You for giving us this information. I find it helpful to ask the questions and then find some possible answers. Many women refuse these treatments due to being a one size fits all. I think it is very helpful to understand why it is this way.

I too am curious on the drugs given after surgery and radiation. I am post menopausal and honestly am dreading the drugs thinking they may break down my body more instead of really helping it. Why is there not a discussion of foods we eat and possibly other herbs etc that we are taking talking points when it comes to Estrogen suppression. For instance if one where to cut out all possibly hormone containing foods, for example meats that have hormones or dairy, and any other herbal/vitamin supplement that elevates estrogen along with testing our estrogen levels to see what they are dealing with for each patient on an individual basis instead of prescribing the one size fits all drug treatments. For me my weight and bmi index is good but I do work at it and have for years. I am sure the 2 lobular cancer masses in my right breast (grade 1) were happily growing from the hormone therapy I was doing, but if all that had been cut out and diet completely looked at and reviewed, then do we need all the after drugs? It is giving more anxiety then the actual surgery.

Good god! So happy to hear of your analysis of one-size fits all prescription across the board. In my case it was Anastrozole.

I believe in research and I have spent hours trying to figure if I really needed this drug - if the side effects were worth the lost quality of life I was experiencing had a value.

My on line research and input from medical advisors always generally included my ongoing experiences under ‘less common’ side effects. I felt like a ‘stranger in a strange land’ - a hypochondriac at best and a fool otherwise. As my one particular debilitating side effect got worse, i continued to mentally question and research the the value and need of my taking Anestrozole. It was a lonely search until this past week when I came across 2 articles that made me feel ‘you are not crazy!’ They brought what I respectfully call my Sophie’s Choice to my decision worthy of my research and eventual decision.
I will try and forward these articles under a separate entry. Don’t want to lose this response.
Here is the address otherwise 🙏🤞

https//www.ncbi.nim.nih.gov/pmc/articles/PMC3587979/

Good god! So happy to hear of your analysis of one-size fits all prescription across the board. In my case it was Anastrozole.

I believe in research and I have spent hours trying to figure if I really needed this drug - if the side effects were worth the lost quality of life I was experiencing had a value.

My on line research and input from medical advisors always generally included my ongoing experiences under ‘less common’ side effects. I felt like a ‘stranger in a strange land’ - a hypochondriac at best and a fool otherwise. As my one particular debilitating side effect got worse, i continued to mentally question and research the the value and need of my taking Anestrozole. It was a lonely search until this past week when I came across 2 articles that made me feel ‘you are not crazy!’ They brought what I respectfully call my Sophie’s Choice to my decision worthy of my research and eventual decision.
I will try and forward these articles under a separate entry. Don’t want to lose this response.
Here is the address otherwise 🙏🤞

https//www.ncbi.nim.nih.gov/pmc/articles/PMC3587979/