question from a user
Is it safe to use Tamoxifen to increase shbg when it’s in the single digits? I’m otherwise healthy, not obese, no insulin resistance, thyroid is good etc. Also, do you see patients experiencing anxiety when increasing the dose of testosterone…does it usually settle down?
AlphaMD's Answer
Tamoxifen has more side-effects than most SERMs, and for this reason should be used at the lowest therapeutic dose, and for as short a period as possible. Of all SERMs, it has the highest risk of blood clots and stroke. Also, it will increase your systemic estrogen level (it selectively inhibits only the estrogen receptors in breast tissue, nowhere else). And like all SERMs, it will lower your IGF-1 level, which can limit your gym gains. But yes, it will increase your SHBG. If you are on tamoxifen, please be sure to be followed closely by your doctor.
Testosterone can increase activation of the sympathetic nervous system (the fight-or-flight response). For this reason, yes, it can increase anxiety with higher doses. If it does occur, it tends to be transient, and settle with time, though you may also want to check your estradiol levels if you get anxiety, as high E2 is the most common cause for anxiety while on TRT.
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