question from a user
In instances where E2 is high and patients don’t respond well to AI, have you had success with other alternatives such as DIM, CDG, and/or Zinc? And if so, at what dosages?
AlphaMD's Answer
With those options, DIM does work. It is much less robust than prescription AIs, but you may be able to further lower your E2 a bit by adding 300mg/day. We do this with patients who are on the cusp of needing an AI but would rather not use it or would rather try this first. We wouldn't recommend these if you are wildly high on E2 though as a standalone.
Some other approaches would be swapping to Subq, increasing/spreading out dosing frequency, decreasing total dose, and avoiding alcohol.
Non pharmacological alternatives are not very strong, but are still slightly effective. Adding zinc, CDG and DIM might amount to lowering E2 levels by 8-10 pg/mL even when combined at max dosing (150mg/day, 500mg/day and 300mg/day respectively)
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