Concerned about the side effects of anastrozole

I have been taking exemestane along with zoladex and I have fatigue, brain fog, and pretty severe joint pain. I'm not sure which drug is causing the side effects.

This comes up on this forum all the time and I ask every time: if the goal is reducing estradiol below detectable levels (and you may be well above that since testing stops at 5), what difference does dose make? if a 20% dose and a 100% dose both reduce estradiol below detectable levels, and the result is side effects from estrogen deprivation are the same, what difference does it make what dose we take? I actually asking the question. I don't see my oncologist anymore but if I did I would ask it.

ps great to have 100% estrogen score- the meds should work well according to what I have been told!

My oncologist told me I could take Femara alternate days. I never did, but that is one option. They tend not to suggest cutting pills due to inconsistency of dose and not sure if it is extended release. If not extended release, maybe your doc would let you do 1/2.

Some meds are weight-based and the company uses an average weight of, say, 150 (Evenity) and when dose does matter, that is a disservice to us small folks.

I’m ER 100% and PR 60%. I’m upset that women get the same dosage of medicine without blood work being done to 1) determine your baseline Estradiol level and 2) periodically check Estradiol levels after being on an AI. Seriously, isn’t monitoring numbers all about research? My Estradiol level is already the lowest in range at < 5, why should I take a full dose of any AI? Women need to question this theory. We are all different and should be treated like individuals … not treated with standard meds. That’s not fair to anyone.

Thank you so much for your post. I don't mean to scare people, but I guess I probably do but I honestly don't mean too. I guess my experience was not what I was thinking it would be. I am 55 and was thinking I would breeze thru this, and it didn't work like that for me. I go this next Friday to my oncologist so prayers he recommends one I can take. I wish everyone who has ever been thru this horrible disease the best and thank you for your kind words.

Hope you can try a different manufacturer or even brand name. I am struggling with Evenity which others sail through. It isn't that I don't understand, believe me. And I
lost bone on Femara (doc did not want to prescribe Reclast due to afib).

But in the context of cancer, it is sometimes hard to see people scared off by posts online from even trying AI's, so I just post for balance. I did not deny the suffering and said I respect your experiences. I just hope people will at least try.

Good luck with your treatment and I hope things improve whether you try another one or go off entirely.

With all respect to those you know that had no problems, those of us, including myself have had horrible side effects. I was not the same person, joints hurt all the time, no sleep etc.
I am off Anastrozole for two weeks and then we will try another one..... I wish everyone the best but some have a hard journey with AI's.

@vkroger what was your ER score from pathology, and your PR score?

These meds reduce estradiol below detectable levels, by eliminating estradiol produced in the adrenals.

The drug insert for Femara (letrozole) states that a 20% dose achieves that undetectable level. However I am not sure what difference the dose makes and would love to see studies. To me, either estradiol/aromatase is suppressed or it isn't. Even with a 20% dose, if effective, we would have the same symptoms since the symptoms are from estrogen deprivation, right?

That said, try switching manufacturers or switching to a different AI. I ended up taking brand name Femara though at the end I found one generic I could tolerate.

I took Accord brand for five years very few side effects except diahrea but I have a bad stomach before some hair loss otherwise got through it

I took Accord brand name throughout my five years. Dry few side effects some loss of hair trouble with dishes but the. That has always been a problem. Otherwise found it to be totally bearable

absolutely!!! I had 3 months on anastrozole. I started my next 90 days on it again with a renewal of my prescription. The side effects made me quit after two weeks. What happened with the second batch?? I think it's the manufacturing. I found a lot of different manufacturers on line. I've said this before, but it's worth repeating for new people to this site. I think it depends of the manufacturer.