A: Different SERMs in fact work somewhat differently from each other. All of them block estrogen receptors in the hypothalamus and in breast tissue, for example, but some also block estrogen in the pituitary while others actually act like estrogen there.
Nolvadex (tamoxifen) is an example of a SERM which blocks estrogen receptors in the pituitary, while Clomid (clomiphene) is a SERM which is estrogenic in the pituitary.
Both of these SERMs have a long track record of successful use when used alone for PCT. My personal impression is that Clomid is the somewhat better performer both for speed of recovery and for sexual performance during PCT, but Nolvadex is also a fine choice.
Toremifine works about equally well as either Clomid or Nolvadex. It is my second choice to Clomid. A reason for a given person could prefer it to Clomid is if he has adverse mood effects from Clomid.
I’m not aware of a value to combining toremifine with either Clomid or Nolvadex, but this could be simple lack of knowledge.
With regard to combined Clomid and Nolvadex use, while it isn’t generally necessary to do so and I’m perfectly comfortable with PCT plans using either one drug or the other, Dr Michael Scally conceived that it could be advantageous to combine Clomid and Nolvadex, so that there would be neither a strongly estrogen receptor blocking effect in the pituitary as with Nolvadex alone, nor a strongly estrogen receptor activating effect there as with Clomid alone.
I’d encourage anyone with androgen-induced hypogonadotropic hypogonadism to follow Dr. Scally’s advice exactly. For general PCT, if wishing to employ this idea, I recommend using half the usual doses of Nolvadex and half the usual dose of Clomid, or specifically, to use Nolvadex at only 10 mg/day or 20 mg every other day, and Clomid at only 25 mg/day or 50 mg every other day. Frontloading amounts are also cut in half. There is no need to use full amounts of both drugs, and doing so in my opinion increases risk of developing vision problems.