Cant figure out why im getting GYNO. All labs seem to be good. Input please?

[tc80]

I had a previous post that was all over the place and didn't have all the necessary info. After gathering and even balancing all my levels i'm still having an issue and cant figure out why. Ill post all my tests and any input would be greatly appreciated:


Prior to starting TRT

9-27-2016
Testosterone 337 (Range 348-1197)
Free test 9.2 (Range 8.7-25.1)
Prolactin 7.4 (Range 4.0-15.2)

Started TRT 10-16-2016 (200mg dosed at 100 twice a week)
Ran out on 12-28-16 and doctor couldn't see me so next shot was 1-10-17

1-7-17 (after missing shot for 13 days)

Testosterone 445 (range 249-836)
Free test 92.63 (range 48-250
% Free Test 2.08 (range 1.29-2.87)
SHBG 31.1 (range 19.3-76.4)
PSA 0.590 (range 0-4.0)
Hematocrit 49.7 (range 39-52)
Estradiol- doc said no need to test even though I specifically said I felt every symptom of high E2

1-31-17 (still 100mg twice per week=200)

Testosterone 1226 (range 249-836) HIGH
Free Test 23.28 (range 4.25-30.37)
DHT 929 (range 106-719) HIGH
Progesterone 0.30 (range <0.16) HIGH
PSA 0.62 (range <4)
SHBG 19 (range 10-57)
Estrdiol Sensitive 49.5 (range 8-35) High red flag
*Showed doc gyno seems to be forming for week or two and E2 slightly high, she said I cant give you breast cancer meds (AI's). Ordered them online but didnt have till 2-20-16 ). DHT high, Progesterone high, Estradiol high




2-20-17 Lowered Test dose to 130mg (65 twice per week)
10mg Aromasin every day
20mg Nolvadex everyday
Gyno seemed to almost regress then come back for a week or two. Now it always looks evident and growing


2-28-17 Ultrasound showed no gyno but they said it wont def show. Possible mammogram or surgeon consult needed to confirm. But I am sure, I have pictures I can share showing def gyno and have always been lean and cut since I was a kid never any pre gyno or chest fat.


3-16-17 (Test dose 130, 65 twice per week, for a month now)


Testosterone 770 (range 249-836)
Free Test 16.05 (range 4.25-30.37)
Progesterone 0.13 ( range <0.16) Borderline high still
DHT 632 (range 106-719)
SHBG 19 (10-57)
Estradiol 10.46 (7.02-49.06)

So now my numbers are all in range but again I am still on 10mg Aromasin Everyday and 20mg Nolvadex everyday and my gyno problem is still getting worse instead of better or stable. I just don't understand why. I have read some things about prolactin and only have that first test but from most information out there everyone focuses on estrogen when dealing with testosterone and mine was never very high and is actually too low right now. Except the ratio of T to E was bad when I had no shot for 13 days. 430 test to 50 E2. I am not on nor have I ever done any AAS and this is doctor prescribed cypionate in cottonseed oil. Anyone have any info to possibly add or other things to look at?? Thanks for your time

 

[ERO]

With your E2 at 10.46 and with that much Aromasin and Novaldex every day its hard to imagine how you could still have gyno symptoms. Your prolactin is low as well, so I would not think that to be an issue. Is it hereditary at all?

I know this is not answering your question, but my 2-cents - get a new TRT doc. This guy is not doing you any favors and his refusal to prescribe "breast cancer meds" is indicative of a serious lack of TRT knowledge. At least get a consult with someone like Defy Medical even if you don't switch. They can use the bloodwork you have if it is under, I believe, 30 days old.

 

[tc80]

Thanks for the response. Not hereditary. Everyone in my family is lean and normal shaped chest. The old out of shape males have a slight belly if anything. The prolactin was from pre-trt so I'm not sure if I should get that retested again. I did half join defy so I can get bloodwork through them because I'm in NY and that's where the estrogen test was done through. I had seen a highly rated endocrinologist two weeks ago who wanted nothing to do with it and said of course your going to grow breasts your doing steroids(trt) and should stop. But I did see a wellness doc which is where I got the last half of my tests done that said of course I need an AI on that level estrogen and will prescribe it when I run out of mine. Just to keep this short I'm trying to decide why if I stopped trt I wouldn't have an issue. But on it I'm having these effects. I feel if I had surgery tomorrow I would have the same problem again like something is off with me somewhere that I'm not seeing.

 

[Vince Carter]

Sure you're not overly concerned about a little nipple itch or stiffness here?

 

[tc80]

The last pic with the phone in my hand is prior to TRT you can see normal shape with small nipple size. Now both sides have growth occuring.

 

[johndoesmith]

View attachment 3393View attachment 3394View attachment 3392View attachment 3395
The last pic with the phone in my hand is prior to TRT you can see normal shape with small nipple size. Now both sides have growth occuring.

Looks lie a normal nipple.

I'd recommend bench pressing. That will fill out the chest a bit and make that awkward skin issue kinda go away.

 

[tc80]

I workout often and bench 315. The bottom pic is normal from before TRT. ive always been lean 5'9 165lb. but do you see on the top one to the outside of the nipple is a growth it almost looks like a lump of fat. That is growing there and behind and and i havent gained weight or anything to make a sudden growth occur during the same period i just happen to be using testosterone for the first time in my life. (doctor prescribed TRT). I know there is a problem im just trying to figure out why. I dont mean that in a mean way either and i appreciate your response.

 

[madman]

I would say it is excess fat.....................you definitely do not look lean in the pic you posted where you feel it looks like gyno, the tissue above your armpit does not look tight/firm as it looks soft.

No disrespect but your chest looks soft to me especially for someone who benches 315!

 

[CoastWatcher]

Keep in mind that we're giving you a best-guess. When is your next follow-up, and do you feel confident your doctor can address this with you?

 

[Gianluca Bonetti]

maybe just some water retention cause E2

 

[tc80]

No you make sense i had to take a year off cause i got a herniated disc from a car accident and lost all my left tricept for that year. so i did lose 10 muscle and gain 10 fat. My strength came back quick but my bodys still reforming. But i didnt have that side knot till after trt and started with swollen nipples then a lump then got bigger. Im no way claiming im in my best shape ever and no trying to debate that lol

 

[tc80]

I did hope it was E2 bloating as i did get a ton of bloating in my face prior to lowering my estrogen but its been down a month now and my face is pretty much back to normal. I did get a sono which they said doesnt show gyno but they said a mammogram or surgical consult is more needed to make a final determination. Just the fact that gyno starts like that and as a fat and becomes more glandular and fat is worrying to me as if it is i wanted to catch it ahead of time. Im going to have a surgical consult next week to see what they say as my doctor and the endo i went to didnt feel it even though i requested it ( they just have no experience with it, seems endos are all about diabetes and primarys have only seen what they have seen). The pics show me in worste form i was just trying to get a decent angle to show the lump.

 

[CoastWatcher]

The pics show me in worst form i was just trying to get a decent angle to show the lump.

If you are, indeed, dealing with a "lump," you're wise to have a surgeon evaluate the area. Keep us posted.

 

[Vince Carter]

You can talk Gyno all you want with pictures but the glaring thing to me is the absence of Estrogen management founded on testing...the proper LC/MS/MS testing. If this is important to you...get tested. You can't toss drugs at things because you feel this or that from one day to the next.

My Friend ERO has given you the best advice of all in this thread:
"I know this is not answering your question, but my 2-cents - get a new TRT doc. This guy is not doing you any favors and his refusal to prescribe "breast cancer meds" is indicative of a serious lack of TRT knowledge."

 

[tc80]

Gyno confimed today by gyno specialist/surgeon. He has nothing to say about the cause though. Maybe i wasnt clear that i got a good doc a while back after that and thats why my levels are all good. So besides people telling me im out of shape or maybe fat etc. If anyone has any insight to the possible chemical cause or other things to look for based on personal experience or things they have read let me know. Ive read everything i can find and talked to a bunch of docs and trt places. Read the stickys, the cases, nelsons book among others. So far im just the 25% idiopathic. Which means noone knows. I will keep trying to figure it out and to update on here to hopefully help someone else in the future. Also my liver values are fine no drugs or alcohol no weed and no meds. Im going to raise my estradiol to 20-25 changing from 10mg aromasin everyday to every other day for my bones sake, drop the 20mg nolvadex, and try raloxifene 60mg per day and see if that can shrink it. I did read a thread on here or a different site at one point that was similar to mine but was never answered. Just doesnt make sense because like all the docs say if you didnt have the problem prior then stopping TRT should stop the problem. I just need to know what is changing in my body chemistry from TRT that is making my body wanna grow some tits.

 

[Disco41]

How did doc confirm gyno? Just by looking at you? If he could confirm that, it would make sense to know, how. Why are you changing your meds when your labs are normal? You are changing your aromasin to
EOD for your bones sake? Forgive me if i missed something, are you undergoing some sort of sex change?

 

[tc80]

Doc confirmed gyno by feeling it and then he squeezed hard and I could actually feel when it got solid and he moved his hands around showing where it starts and ends and I could feel the small mass developing in my left and how much bigger it was in my right side. It hurt as well for the first time from the pressure.
I am raising my estrogen slightly because it is at sensitive estradiol 10. Which is under optimum of 20-30 but also towards the crashing end. Low estradiol causes osteoporosis=low bone mass. That's why I said for my bones sake. No I did not undergo a sex change. I'm a 36 year old 5'9. 165lbs. The doctor does several gyno surgeries per week and in fact told me he would not operate on me because it is an active thing and unless the reason is figured out and stabilized it would reoccur. He was actually a really good guy. I didn't go there trying to have surgery done just to get a final ruining on my situation. Let me just say this. If any guy has a drastic (bad) change to their chest over a three week period there is something wrong and you will know. I'm not talking about nipples I'm talking about behind them or to the sides.

 

[Vince Carter]

I know you had a Progesterone test above but in my limited research on supplementing Progesterone I know I read something about resolving Gyno. Check it out.

 

[Vince]

I know you had a Progesterone test above but in my limited research on supplementing Progesterone I know I read something about resolving Gyno. Check it out.

Interesting comment, I've never heard that before. I wonder if it's true?
progesterone against gyno??? https://www.gynecomastia.org/smf/index.php?topic=6828.0

 

[Nelson Vergel]

There are several causes of gynecomastia that have nothing to do with estradiol. Look at this thread:
Gynecomastia: Clinical evaluation and management