Food for thought on exemestane, a post from CEMuscle:
"Ok so let me start off by saying this is quite a departure from what I used to believe re: stane dosage. I have posted it elsewhere and wanted to gather thoughts from here as well.
Its important when we look at AI's and data from studies etc its important that we use data on males. There are several key differences in an ai's effects in men and women. First and foremost is they are more effective in women at reducing estrogen. Second is they have a much longer half life in women than they do in men. Very often people misquote how much an ai will reduce estrogen based on data taken from a study on females. So when you look at studies on ai's,on males you find one thing out very quickly. There are plenty available on anastrozole and letrozole and there is essentially 1 with all inclusive data on exemestane. Luckily that one holds some very solid and applicable data for our purposes.
Key Points of Study:
1- Take Exemestane with dietary fats. They administered it this was in this study, referencing another study which showed an increase in the absorption of exemestane of 40% when taken with fats.
2- Exemestane administered at25mg/day vs 50mg/day offered minimal difference in estrogen levels. While the 50mg/day lowered levels more quickly both dosages ultimately ended up at virtually the same estrogen levels. I suspect the increased androgens of a cycle might alter this slightly and a slight more of a difference would be observed with 50mg/day over 25mg/day it is very obvious that 25mg/day is the optimal therapeutic dose for this drug.
3- Exemestane had either no negative effect or a positive effect on igf and lipids at either dose (25 or 50mg/day). Its interesting in and of itself something that lowers estrogen can have no impact on these things, the fact that there is a positive impact is pretty amazing.
4- Exemestane had a dramatic effect in reducing estrogen, but at both 25mg/day and 50mg/day while estrogen levels were low they were within the clinical range. So it is VERY difficult to "crush"estorgen levels with exemestane. This is huge as anyone that has experienced this with letrozolle or anastrozole will tell you it is no picnic and it is also very unhealthy as well.
5- Exemstane exhibits a half life in males between 8-9hrs. Because of the way ot works this is not indicative of the effective time of the drug. However it is worth paying attention too - something i have previously dismissed.
So based on my personal experience with exemestane, and all the things I read above, all the under dosed stane posts i see across the various forums, and some great discussions here, I had come to the conclusion that we are dosing exemstane too low. We have a compound here with a clear optimal therapeutic dosage of 25mg. It will lower your estrogen levels but not crush them even at a high dose. It has a positive or no effect on the normal areas of concern when lowering estrogen like igf and cholesterol. It has a very short half life.
We have a study here of males not taking testosterone, where they are taking 25-50mg/day and keeping estrogen levels low but within the clinical range. That is our exact goal! As I looked at this more and more it became apparent to me that my thoughts on dosage and administration frequency were in fact incorrect, Not only were they thoughts I subscribed too, but ones that are widely subscribed too. Why would we take less than these males when we have more androgens present? It makes no sense.Well in my opinion the answer is we shouldn't be. I decided I was going to be a guinea pig myself and play with exemestane dosages and get blood work my next cycle. I had become convinced and speculated the optimal protocol for my cycle,which would consist of a test base of 500mgs/week, would be 25mgs of exemestane/day. Broken up into 2 - 12,5 mg doses taken with fats.
Now had I not been browsing the various forums today I wouldn't be posting this. I came across a post of bloodwork from a gentleman, on cycle, 500mgs test/week , taking 25mgs exemestane per day, in 2 -12,5 mg doses with meals and his estrogen levels were safely within reference range!
That pretty much sealed it for me. I seriously think we are taking too little exemestane. I am going to do blood work when I go on cycle but at this point I dont think this is speculation. The study data backs it. The real world data backs it (good and bad), and you have a drug even at high doses that offers nothing in the way of traditional negative effects when lowering estrogen, positively impact some of those effects, and is very difficult to crash estrogen levels when taking.
I firmly believe that an increase in dosage and frequency of administration combined with taking with dietary fats will improve the effectiveness of exemestane. I really do believe that is the proper dose, taken in the proper way to ensure maximal effectiveness. It has taken some time for me to evolve this opinion and much discussion with some great guys here. Always learning.
Anyway I wanna Hear your guys thoughts on this. Oh and here is the study reference :
http://jcem.endojournals.org/content/88/12/5951.full"
AI dosage needs are, of course, individual, so it's up to the individual to experiment and decide--with labs--what dosage works with whatever load of aromitizable stuff you're using. YMMV.
