shakamunya,
The breast study that you pointed to had a complete response rate of 61.1 percent, the 83.3 percent success relates to reductions as well as resolutions unless I am missing something.
Not that that is to be sniffed at in any way at all, it is a promising study and you were right to bring it to people’s attention.
Clomiphene Citrate was shown to have reductions of 95 percent at one dose (although another study had less successful results in terms of the amount breast size reduction).
At a higher dose the complete response rate was 64%- that is comparable to surgery if shown in greater numbers.
But you are correct to draw attention to the lack of numbers in that study also, what is good for the goose is good for the gander.
I’ll come back to the numbers of patients …
I would also say it is too easy to look at the therapies and just see the statistical success rates, but what lies behind these rates of success and failures is of equal importance.
We have the issues of side effects and contraindications;
Like I said Tamoxifen is promising in the hands of an endocrinologist like all these therapies, but given that approx 9% on this board will have underlying liver or renal problem, Tamoxifen won’t be appropriate for some of these people and in fact would be downright dangerous for some of them.
Also if the aetiology of the gynecomastia has not been investigated or the individual is still experiencing pubertal changes, the rebound effect of all the anti estrogens is a potential problem something that isn’t quite the case for dihydrotestosterone or the aromatase inhibitors.
The number of patients…..
We need controlled studies with serious numbers to draw firm conclusions, these are words often repeated by the endocrinologists themselves in the conclusion to such studies.
The problem is and has been that the pharmaceutical companies are the only ones with the funds capable/likely to instigate such studies and so far they have not seen a big enough profit margin/market in order to conduct them.
Like I said we had low numbers involved in these kind of trials twenty years ago so it is sad that things haven’t taken off as yet…
One look at the history of Viagra shows how fast large scale studies can be put together if the motive of money is apparent.
I am not at odds with some of the things you have had to say, I welcome information, studies etc, the more the better! And you are an agreeable person to speak with so?
I am not even at odds with you regarding which individual medical therapy is the best. We have limited information and I think it a little pointless pushing that issue too far, certainly we know that they ALL work to varying degrees and offer hope to people with gynecomastia.
All these medications can be weapons in the armory of good forward thinking endocrinologists, although I hope the drug companies start seeing dollar signs in ‘this’ as that would allow for a future where all endocrinologists would know of their value and realize that they are appropriate in this setting in the right patients.
Different drug therapies can be obtained from forward thinking endocrinologists.
If people spent as much time researching how to get hold of such an endocrinologist as they did on how to self medicate, they would generally be much, much better off!!!!
I know this is self evident but I feel it must be said.
This is not an affront to you as you have mentioned you are not able to see an endocrinologist at this time, but I wish for your sake that that wasn’t the case and you could see…… a good one;)
When I speak of these therapies I do not include rebound as it has not been studied at all!!!
So it has no efficacy/safety record at all in this setting.
As started the fact that it is close in composition to a well know anti estrogen means little as is evidenced by history and the similarities between other chemically similar substances such as testosterone (safe) and methltestosterone (unsafe).
P.S
A note for all!!!!!!
In all instances short term courses of medications will only work if there is no continuing underlying cause. So the need for endocrine investigations for gynecomastia will remain despite any advances in therapies.
In basic English you need to check yourself out with a good endo to make sure you don’t have a problem otherwise if you are one of the 25% of gynecomastia sufferers that has an underlying problem, no short term medication (self medicated or otherwise) is likely to make a difference in the long term.
Topic: PHOTOS: Rebound XT work in progress (Read 10805 times)
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