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Reports suggest that women with specific alterations in the CYP2D6 enzyme, which correlate with reduced enzyme activity and lower endoxifen levels Desta et al, 2004; Borges et al, 2006, may have less benefit from tamoxifen treatment and fewer hot flushes than women with a normal enzyme activity Goetz et al, 2005 <a href=http://accutane.buzz>losing hair on accutane</a>