Is Arimidex better than Aromasin? Summary of Post: Anastrozole (Adex) has the least overall impact on Lipid Values compared to that of Exemestane (Aromasin) and Letrozole (Femera) in 12 and 24 week blood test results in the particular study.
We always hear the same thing drilled over and over… Letro is worst on Lipids and Exemestane is the best. Well, this is not true and appears to me that Anastrozole has the least significant impact on Lipids overall.

There was a huge study performed on the third gen AIs. It was called the (L)etrozole, (E)xemestane, (A)nastrozole (P)harmacological Study or LEAP Study, and compiled vast amounts of data on all these AIs. I wont ramble on too much and will list the lipid parameter results.
Now, the differences between these AIs impact on Lipids is surprisingly considered “clinically” insignificant and all 3 AIs are considered to be safe with this respect. The variations in Lipid parameters are not really all that grave in this comparison but the differences are still something to note.
However, regardless of the general benign clinical assessments, I still see a statistical significance in other parameters which means quite a bit to myself, esp the negative impact Exemestane has on LDL/HDL ratio and ApoB/ApoA1. Exemestane is shown to lower total Cholesterol slightly in this study but the impact on LDL/HDL is something that concerns me personally.
My HDL is so low normally that I do not like this idea even if the drop is not grave. Letrozole, btw, has the worst impact on Triglycerides, while Anaztrozole (Adex) appears to be the most rounded, with insignificant numbers throughout the whole Lipid parameters. It appears to have the most benign effect on skewing lipids, which is not the typical info passed around the internet.
Now, this study is done on Women which measured parameters for 12 and 24 weeks, however, similar trends were found in another study where Exemestane (Aromasin) was given to young males. I say “trends”, because the Male study duration of 10 days was not long enough in my opinion to clearly elucidate greater changes.
Anyhow, here is the study graph of Lipid Parameters between L,E,A
I highlighted what I consider worthy to note between the 3 AIs: RED/neg and GREEN/pos

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