6 Types of SERM and AI to Use to Treat Side Effects of TOT
By Jay Campbell
November 15th, 2018
Testosterone Optimization Therapy (TOT) is hailed as one of the best ways to optimize testosterone levels. However, each man is unique and so is his body and its level of testosterone. It also means that TOT can influence you differently and in some cases cause side effects. Luckily, all of them are treatable. Patients use ancillary medication, like Selective Estrogen Receptor Modulators (SERM) and AI (Aromatase Inhibitors) during TOT to increase benefits and reduce the side effects of the treatment. And when it comes to pharmaceuticals that work, there are six types of SERM and AI you should consider:
- Nolvadex (SERM)
Nolvadex has quite a few applications for TOT users. The most common one is for the prevention of gynecomastia (male breast tissue growth). Nolvadex binds to the receptor site in breast tissue, safely preventing estrogen formation, and ensuring that some estrogen is still left floating around for proper functioning of the immune system. The standard dosage of Nolvadex is 10-40 mg per day or EOD (every other day) until the symptoms disappear. The half-life of Nolvadex is between 5 and seven days.
- Clomid (SERM)
Clomid works by blocking estrogen’s actions in the pituitary gland, which secretes higher levels of luteinizing hormone (LH). In turn, higher LH levels stimulate the Leydig cells to synthesize more testosterone, restoring the body’s natural production. Some TOT physicians now prefer Low-dose Clomid therapy. They have achieved excellent results using Clomid at 12.5 to 25 mg EOD (every other day) to restore normal testosterone production. However, Clomid increases Sex Hormone Binding Globulin (SHBG), and this ultimately decreases free testosterone. Some men do not respond well to Clomid, and others experience significant side effects.
- Toremifene Citrate (SERM)
Toremifene has several well-known effects. Most important is its testosterone to estrogen ratio five times that of Nolvadex. We find Toremifene to be an excellent supporting medication to use after long periods of TOT usage, and has been known to deliver a ‘jolt’ to your sexual desire and feelings of intimacy. A daily dose of 30 mg for two to three days in a row (until libido and feelings of sexual desire restore) has been useful for some patients.
- Raloxifene (SERM)
Raloxifene is the newest SERM at the disposal of TOT physicians and their patients. Raloxifene is in the same family of compounds as Novaldex but has about 10x the binding affinity for estrogen receptors in breast tissue. It virtually eliminates the possibility of any estrogen reaching a receptor and exerting an undesired effect. An optimal dosing protocol is 60 mg daily until the gynecomastia is gone, which ends up working for most patients. The half-life of Raloxifene is 27 hours.
- Arimidex (AI)
Arimidex is known as a “competitive inhibitor,” which means it competes with estrogen for binding to the aromatase enzyme. Arimidex works by actively blocking the aromatase enzyme from coupling to an androgen (testosterone) to prevent the body’s ability to produce estrogen. An optimal dose of Arimidex while on TOT is 0.25 mg once per day (between 1-3 days a week.) Some men need to go as high as 0.5 mg EOD to prevent water retention, moodiness, and a lowered libido. Unfortunately, Arimidex can and does reduce HDL (‘good’) cholesterol levels, which can lead to an increased risk of heart disease, and lead to decreased bone mineral density issues.
- Aromasin (AI)
Aromasin attaches to the aromatase enzyme and permanently disables it. At 12.5–25 mg a day will raise testosterone levels by about 60%. It also increases the free testosterone to bound testosterone ratio by lowering levels of SHBG in the body by 20%. However, it suppresses estrogen more strongly than Arimidex, rendering the aromatase enzyme inactive and allowing other ancillary medications to work. TOT physicians rarely prescribe this medication. TOT has the potential to improve your confidence and performance, but you must use it according to your body unique constitution for maximum success. If you want to find out how to improve sexual drive in the healthiest way possible; purchase The TOT Bible.