Is this Gynecomastia? Starting TRT, advice needed

[TransitPoloce]

Hi Guys,

I've had what I think is mild Gyno since 13yo. I've always been 'skinny fat' and have never gotten to a super low bodyfat level - so unsure what it would look like at a lower bf%

I got down to 15%bf at 85kg working with a good physique coach last year pre TRT (I was at 28%bf before) and I queried him on it - he said it didn't look like Gyno and not to worry as fat was coming off every week from the skin fold tests on my pecs.

He said Gyno would have a hard lump and is generally much worse from other clients he had worked with - I just held a lot of fat around my chest, and seemed to be the last place it comes off for my body.

I don't have a hard lump or disk underneath, but it feels a little different than typical muscle/fat tissue.
It isn't particularly sensitive - although slightly uncomfortable if I press my nipples hard.






Any advice is appreciated on how you would adjust a TRT protocol to be extra cautious of pre-existing Gyno from teenage years.

Thanks again

 

[Re-Ride]

You might consider getting an ultra sound to see if that gives a better idea of tissue growth. It's nothing to panic about. You might well see improvement on TRT. Not long ago high E2 was thought to be the sole cause of gyno. Other hormones may be involved. I'm no nowhere near ready to call that gyno , mild or otherwise. Since becoming more aggressive with my own care I can tell you that I've seen the shape of my breasts change. Get a good panel and post it. I'd be highly optimistic for improvement on TRT if done correctly.

 

[Vince]

Yes please post your labs, to me it looks like Gyno .

 

[Mountain Man]

Yes please post your labs, to me it looks like Gyno .

It does, but I'd also suggest you could put on more muscle in addition to getting the gyno under control. You have some room for some solid growth. I'd also guess you think it's worse than it is. I don't think it's that bad.

 

[Nelson Vergel]

I would love to see your:

Total and Free T
Sensitive estradiol
TSH, free T3 and free T4
IGF-1

Yes, it looks like a combo of fat and gyno.

You probably have low T.

 

[TransitPoloce]

Thanks for all the replies guys - appreciate it.

@Vince
My labs are about 15 pages long as I've requested various tests at different times when I began to investigate TRT.
Is there a preferred way to format these in a post? I only have physical copies.

From my other Intro Thread:

Total T: 217 ng/dl Ref 249 - 836
LH: 1.78 mIU/ml Ref 1.7 - 8.6 mIU/ml
FSH: 2.7 mIU/ml Ref 1.5 - 12.4 mIU/ml
HCT: 36.8 L Ref 43.5 - 53.7
LDL 172 mg/dl Ref <130
HDL 39 mg/dl Ref >40
TSH: 0.779: uIU/ml Ref 0.27 - 4.2uIU/ml
Fasting Glucose: 75 mg/dl
SHGB: 20.72 nmol/L Ref 18.3 - 54.1
PSA: 0.522 ng/ml Ref 0.00 - 4.00


@Nelson

October 28th:
Total Test: 267 ng/dl Ref 249 - 836 ng/dl
TSH: 0.779 uIU/ml Ref 0.270 - 4.2
Free T3: 2.5 pg/ml Ref 2.0-4.0
Free T4: 1.37 ng/dl Ref 0.93 - 1.7

Follow up Nov 6th:
Total Test: 217 ng/dl Ref 249 - 836
Free Test: 4.92 ng/dl Ref 5.71 - 17.84 ng/dl

Estradiol (E2) 6.3 pg/ml Ref 25.8 - 60.7 pg/ml (checked after beginning TRT)

I began TRT on Nov 11 and only checked my E2 a week after beginning TRT. There was no option for Sensitive E2 here in Thailand. Is there another name for the test?

I haven't had IGF-1 checked.

Thanks

 

[Vince]

Just Got Lab Results Best way to post lab results?


https://www.excelmale.com/forum/showthread.php?7478-Best-way-to-post-lab-results

 

[CoastWatcher]

A quick answer to your question o on the estradiol test - you will not find the sensitive test outside of the US.

 

[johndoesmith]

Thanks for all the replies guys - appreciate it.

@Vince
My labs are about 15 pages long as I've requested various tests at different times when I began to investigate TRT.
Is there a preferred way to format these in a post? I only have physical copies.

From my other Intro Thread:

Total T: 217 ng/dl Ref 249 - 836
LH: 1.78 mIU/ml Ref 1.7 - 8.6 mIU/ml
FSH: 2.7 mIU/ml Ref 1.5 - 12.4 mIU/ml
HCT: 36.8 L Ref 43.5 - 53.7
LDL 172 mg/dl Ref <130
HDL 39 mg/dl Ref >40
TSH: 0.779: uIU/ml Ref 0.27 - 4.2uIU/ml
Fasting Glucose: 75 mg/dl
SHGB: 20.72 nmol/L Ref 18.3 - 54.1
PSA: 0.522 ng/ml Ref 0.00 - 4.00


@Nelson

October 28th:
Total Test: 267 ng/dl Ref 249 - 836 ng/dl
TSH: 0.779 uIU/ml Ref 0.270 - 4.2
Free T3: 2.5 pg/ml Ref 2.0-4.0
Free T4: 1.37 ng/dl Ref 0.93 - 1.7

Follow up Nov 6th:
Total Test: 217 ng/dl Ref 249 - 836
Free Test: 4.92 ng/dl Ref 5.71 - 17.84 ng/dl

Estradiol (E2) 6.3 pg/ml Ref 25.8 - 60.7 pg/ml (checked after beginning TRT)

I began TRT on Nov 11 and only checked my E2 a week after beginning TRT. There was no option for Sensitive E2 here in Thailand. Is there another name for the test?

I haven't had IGF-1 checked.

Thanks

Best way then is to take pictures and upload them to imgur.com

That E2 test, did you only have E2 checked or were there other tests ordered?

E2 is extremely low, I mean extremely.

 

[TransitPoloce]

@johndoesmith - That E2 test I got on it's own from memory.

My Dr. did suggest getting E2 retested.

Will a regular E2 (not sensitive) test give any useful information? I've heard they are usually higher than what a sensitive test will show.

It's 4 weeks since I began TRT so am getting most of my labs retested today before my next injection. Will post updated labs later on.

Am testing the following:

Lipid Profile
Complete Blood Count
Estradiol
Insulin Growth Factor (IGF-1)
Comprehensive Metabolic Panel
Testosterone (Free) , Serum (Equilibrium Ultrafiltration) With Total Testosterone
Prostate-Specific Antigen (PSA)
Thyroid Profile
SHGB

Anything I've missed?

 

[johndoesmith]

@johndoesmith - That E2 test I got on it's own from memory.

My Dr. did suggest getting E2 retested.

Will a regular E2 (not sensitive) test give any useful information? I've heard they are usually higher than what a sensitive test will show.

It's 4 weeks since I began TRT so am getting most of my labs retested today before my next injection. Will post updated labs later on.

Am testing the following:

Lipid Profile
Complete Blood Count
Estradiol
Insulin Growth Factor (IGF-1)
Comprehensive Metabolic Panel
Testosterone (Free) , Serum (Equilibrium Ultrafiltration) With Total Testosterone
Prostate-Specific Antigen (PSA)
Thyroid Profile
SHGB

Anything I've missed?

That E2 was while on TRT? Jeez, that is mighty low.

prolactin since you're concerned about gyno.

 

[CoastWatcher]

@johndoesmith - That E2 test I got on it's own from memory.

My Dr. did suggest getting E2 retested.

Will a regular E2 (not sensitive) test give any useful information? I've heard they are usually higher than what a sensitive test will show.

It's 4 weeks since I began TRT so am getting most of my labs retested today before my next injection. Will post updated labs later on.

Am testing the following:

Lipid Profile
Complete Blood Count
Estradiol
Insulin Growth Factor (IGF-1)
Comprehensive Metabolic Panel
Testosterone (Free) , Serum (Equilibrium Ultrafiltration) With Total Testosterone
Prostate-Specific Antigen (PSA)
Thyroid Profile
SHGB

Anything I've missed?

In regard to the standard estradiol test, if that's all you have to work with, and if you're outside the US it will be, then that's what you have to work with. It is unreliable when it come to testing men. Typically, it over estimates the estradiol level, but we have seen instances where it comes in low. It is a challenge, to say the least. Symptom management is going to be even more important as you go down the road.

Thyroid - not simply the TSH, but t3, t4, rT3, and antibodies all are important pieces of the hormonal puzzle. They are being checked? Has DHT been addressed? And DHEA? Your A1C values?

 

[TransitPoloce]

@johndoesmith and @Coastwatcher

I have just got blood pulled and added to above list:

Prolactin
DHEA
A1C
Thyroid profIle included "TSH, T3, T4 and Free T3, FreeT4"

There was no rT3 test available. Is there other names it goes by?

DHT test was available but with a 30 day wait, will get it done at my Dr who seems to know the quickest labs for each test.

Thanks again.

Ps: Why is sensitive E2 only available in USA?

 

[CoastWatcher]

@johndoesmith and @Coastwatcher

I have just got blood pulled and added to above list:

Prolactin
DHEA
A1C
Thyroid profIle included "TSH, T3, T4 and Free T3, FreeT4"

There was no rT3 test available. Is there other names it goes by?

DHT test was available but with a 30 day wait, will get it done at my Dr who seems to know the quickest labs for each test.

Thanks again.

Ps: Why is sensitive E2 only available in USA?

Re: the sensitive estradiol test - doctors resisted the idea that estradiol needed to be monitored at all, now they resist accepting the fact that the standard test is of no value in monitoring men...so the labs don't run the test.