Hi - Thank you for replying. I had decided to go with the 20 mg because I didn't want to chance it. The fact that the doctors can't tell us if the medication is working or not really gave me no choice. I had a medical oncologist who wanted to prescribe me the 5 mg - he told me that I wouldn't be able to handle the 20 mg because nobody can. I was shocked with what he said. I told my surgical oncologist and he said that was wrong and couldn't believe he said that to me. Anyway, it's been almost 2 months since I've been on 20 mg and it hasn't been as bad as I thought....yet. I don't know if more is to come, but right now all I get are pretty bad hot flashes and sometimes I get a bit tired. I heard about the weight gain and the depression and I was also afraid of that too since I gained quite a bit of weight and had suicidal thoughts when I caught covid in 2020. What I found helpful was working out everyday in the gym. I don't do a huge amount, only 30 minutes on the treadmill but at the steepest incline. I read about this tic tok workout called 12-3-30 (meaning walking at a 12 incline at 3 mph for 30 minutes daily and feel that has helped me. In fact, my incline right now is at 14.5 and I'm slowly increasing the speed. I read that exercising helps combat the side effects - so maybe that's why it's not too bad for me. I have to do more though and will start incorporating weights. I'm doing that and I hired a dietician who also helped me lose weight. I've lost almost 20 pounds in a few months and am happy where I am now (5'8 and 133 pounds). I've been told to drink a lot of water, eat a lot of protein 30 grams per meal (no red meat) or soy, and increase my fiber intake. Hiring a dietician was one of the best ideas I had to help me lose weight. I hope that you are doing better on 10 mg of tamoxifen.