Gyno flare-up. Low E, "Normal" T. What next?

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KarlHungus

New Member
Went to my GP for gynecomastia flare up (firm, tender sub-areolar lump, no fluid draining). I had dabbled with prohormones in the past (at least 10 years ago) with lousy PCT, hence the gyno. She ordered some preliminary labs (at my urging) and a mammogram (her idea) which I have had years ago. The previous mammo showed gyno. I am 55 years old, 5'10", 170#, exercise regularly and eat clean, not on any meds.

Here are my labs:

TT 390ng/dl (220-716)
Free T 6.29ng/dl (4.7-24.6)
SHBG 47.3nmol/L (11-78)
Estradiol <10 (11-44)

As you may have noticed, the estradiol was not the sensitive test. Also, I am having low-t symptoms: losing muscle mass, low libido, irritable (per my wife), lack of drive/focus, mental fog, sleep issues, etc.

Question: what is my next move? Do I focus on getting the gyno under control? Push for additional labs. Start looking at TRT options?
 
Last edited:
Defy Medical TRT clinic doctor
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CoastWatcher

Moderator
KarlHungus said:
Went to my GP for gynecomastia flare up (firm, tender sub-areolar lump, no fluid draining). I had dabbled with prohormones in the past (at least 10 years ago) with lousy PCT, hence the gyno. She ordered some preliminary labs (at my urging) and a mammogram (her idea) which I have had years ago. The previous mammo showed gyno. I am 55 years old, 5'10", 170#, exercise regularly and eat clean, not on any meds.

Here are my labs:

TT 390ng/dl (220-716)
Free T 6.29ng/dl (4.7-24.6)
SHBG 47.3nmol/L (11-78)
Estradiol <10 (11-44)

As you may have noticed, the estradiol was not the sensitive test. Also, I am having low-t symptoms: losing muscle mass, low libido, irritable (per my wife), lack of drive/focus, mental fog, sleep issues, etc.

Question: what is my next move? Do I focus on getting the gyno under control? Push for additional labs. Start looking at TRT options?
Click to expand...

If gyno is comfirmed, I would arrange a surgical consultation and discuss having the gland - the entire gland - excised. Then I would sort out my hormonal challenges. TRT, with the possibility of it recurring, is too much of a challenge (in my opinion).
 
C

CoastWatcher

Moderator
KarlHungus said:
I'll check on that, but I believe my insurance considers it a "cosmetic surgery", ie. no coverage. I'll look into it though.
Click to expand...
The clear advantage is an end of the problem. If the gland is removed, all of it, gyno simply can't recur. Presenting as it seems to be doing now, it may well be a thorn in your side as you work to balance your hormones.
 
C

CoastWatcher

Moderator
By the way, based on the reference range quoted, your doctor ran the incorrect estradiol test for men. You'll want the sensitive, LC, MS/MS, assay performed. It's the only one that men can rely on.
 
K

KarlHungus

New Member
CoastWatcher said:
By the way, based on the reference range quoted, your doctor ran the incorrect estradiol test for men. You'll want the sensitive, LC, MS/MS, assay performed. It's the only one that men can rely on.
Click to expand...


Yeah, by the time I noticed she ordered the wrong one, it was too late. Am I correct that the main problem with the standard lab is that the results are falsely high? I'm also gonna ask the doc about tamoxifen since I've read a few research articles that report very high success rates against lump gyno.

Really was looking forward to hooking up with Defy, but I'll need to get this taken care of first. I did a successful self treatment of the other side a few years ago. Lump completely gone. Just can't figure out what triggered this. I expected my T/E ratio to be much lower. When it happened on the other side my test was in the low 300s and Estra was 20.
 
C

CoastWatcher

Moderator
KarlHungus said:
Yeah, by the time I noticed she ordered the wrong one, it was too late. Am I correct that the main problem with the standard lab is that the results are falsely high? I'm also gonna ask the doc about tamoxifen since I've read a few research articles that report very high success rates against lump gyno.

Really was looking forward to hooking up with Defy, but I'll need to get this taken care of first. I did a successful self treatment of the other side a few years ago. Lump completely gone. Just can't figure out what triggered this. I expected my T/E ratio to be much lower. When it happened on the other side my test was in the low 300s and Estra was 20.
Click to expand...
Tamoxifen can turn things around if introduced early. Defy certainly could help with this if you choose to treat it medically, there's little they've not seen. The issue is the time it may take to see one of the medical staff once you're in the system. It would be worth calling them, explaining your situation and seeing what they suggest. At the very least, it would line you up for full-on treatment.

As as far as the e2 test, you may well be at a different level than that test reports. Typically it is higher, unless it's not. Not trying to be snide, just pointing out that it's unreliable for men.
 
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