Help with Blood Test and Gyno

[ztm88]

Hi Everybody,

I posted a couple of years ago with gynecomastia issues and was able to resolve it using arimadex. I had a normal total t, a semi-low free t and borderline high e2. The arimadex resolved my issue and I was able to cease with no issues. Fast forward 2 years, everything has been great, I graduated college and am now working full time. I starting having gynecomastia issues again. I went to Discount Labs, ordered a blood test and here were the results:


Testosterone Total- 780 ng/dl

Testosterone Free- 17.6 pg/ml

DHT- 77 ng/dl

Thyroxine T4 Free, Direct- 1.21ng/dl

TSH- 1.9 uIU/ml

Prolactin- 8.8 ng/ml

Estradiol Sensitive- 21.5 pg/ml

Triiodothyronine Free- 3.1 pg/ml


I did not think there was much to be worried about with the results. The ony things that I was taking prior to the gyno symptoms were:

Multi
Zinc
Holy Basil (stress, I am a cost estimator)
Lions Mane Mushroom (improves cognition for work)
Tumeric (inflammation)
Occasional NAC if I planned to drink alcohol (rare a couple times a month).

I was eating well and working out regularly with weights and HIIT. I ceased all supplements except for the Tumeric and added in DIM, Calcium D Glucarate and Choline.

I scheduled an appointment with an endocrinologist and continued on. The gyno got worse and it now hurts along with the nipples being puffy. I continued to do my research and decided to get my SHBG tested suspecting that is was low (I was thinking that I have too much bio-available E). My SHBG test came back high at a 70. I was pretty surprised. I do not have any other symptoms besides the gyno. Does anybody have any advice as to what could be causing this? I have arimadex left from the episode before, should I begin using it? Any and all advice would be very appreciated, thank you all so much.

 

[HealthMan]

Are you on TRT? Please post lab results with ranges

 

[Vince]

Gynecomastia: Clinical evaluation and management

As it is explained on the attached clinical nomograph, the diagnosis of the cause of a certain cases of gynecomastia (breast tissue growth in men) is complex and not necessarily explained by high estradiol blood levels.​

https://www.excelmale.com/forum/showthread.php?1816-Gynecomastia-Clinical-evaluation-and-management

 

[BayArea]

As someone on this board once told me, maybe you are e2 sensitive. Twice I have had gyno and twice I knocked it out with an AI. My e2 was low the last time I had gyno and I probably "crashed" my e2 with the AI, but I felt zero symptoms from low e2. I would start an AI if it was me. I would rather risk low e2 than the pain from gyno. The e2 will come back, but the gyno may not go away without intervention.

 

[FeelingLost]

I thought once you develop glandular tissue (true gyno) only surgery can remove it. There is no pill to unmake gland tissue.
I would look into pseudogynecomastia or titty fat.

 

[Vince Carter]

Youre labs don't indicate an issue that I can see, this Gyno...have you been diagnosed by a Dr with gyno or not?

 

[BayArea]

I thought once you develop glandular tissue (true gyno) only surgery can remove it. There is no pill to unmake gland tissue.
I would look into pseudogynecomastia or titty fat.

Good point and I think worth discussion. EARLY gyno for me (sub clinical) presents as a painful lump behind the nipple. It may not be diagnosed on a mammogram or ultrasound, but the mass exists and can be palpated. I have been told by my doctor the lumps will always be there, but I cannot palpate them once the pain is gone after an AI. Did they shrink? BTW - I think the longer you go with it the more risk you have of developing permanent (clinical) gyno. With pseudo, I don't think you usually have a painful lump behind the nipple. Regardless of whether it's clinical or not, if it responds to an AI, does it matter?

 

[FeelingLost]

Good point and I think worth discussion. EARLY gyno for me (sub clinical) presents as a painful lump behind the nipple. It may not be diagnosed on a mammogram or ultrasound, but the mass exists and can be palpated. I have been told by my doctor the lumps will always be there, but I cannot palpate them once the pain is gone after an AI. Did they shrink? BTW - I think the longer you go with it the more risk you have of developing permanent (clinical) gyno. With pseudo, I don't think you usually have a painful lump behind the nipple. Regardless of whether it's clinical or not, if it responds to an AI, does it matter?

I have had the painful lumps in my nipples and had to use bandaids to keep my tee shirt from rubbing them. My PCP did a blood test and it looked this.



and he put this in my file and said This could turn into gyno if I did not get my prolactin down.
I was put on an AI .125 EOD and in weeks my nipples returned to normal.

 

[BayArea]

I have had the painful lumps in my nipples and had to use bandaids to keep my tee shirt from rubbing them. My PCP did a blood test and it looked this.



and he put this in my file and said This could turn into gyno if I did not get my prolactin down.
I was put on an AI .125 EOD and in weeks my nipples returned to normal.

I would say your experience is similar to mine in terms of results. The issue for the OP is what if your e2 and prolactin are within range? BTW - in a link below, Vincent noted that 65% of adolescents with gyno were able to resolve it with an AI. I call it early gyno because I think at some point you can't reverse it.

 

[[email protected]]

Y que te Recomendaron para eso

 

[FeelingLost]

I would say your experience is similar to mine in terms of results. The issue for the OP is what if your e2 and prolactin are within range? BTW - in a link below, Vincent noted that 65% of adolescents with gyno were able to resolve it with an AI. I call it early gyno because I think at some point you can't reverse it.

I always thought childhood gyno came from eating processed foods loaded with xenoestrogens causing the body to respond. I would guess most children with gyno are morbidly obese.

If an adults E2 and prolactin are in range can you get gyno? I don't think so unless and adult exposing himself to a lot of xenoestrogens which I don't think the E2 bloodtest measures.

 

[HealthMan]

I always thought childhood gyno came from eating processed foods loaded with xenoestrogens causing the body to respond. I would guess most children with gyno are morbidly obese.

If an adults E2 and prolactin are in range can you get gyno? I don't think so unless and adult exposing himself to a lot of xenoestrogens which I don't think the E2 bloodtest measures.

If my E2 gets into mid 30s i get gyno. It really depends how sensitive you are

 

[HealthMan]

Good point and I think worth discussion. EARLY gyno for me (sub clinical) presents as a painful lump behind the nipple. It may not be diagnosed on a mammogram or ultrasound, but the mass exists and can be palpated. I have been told by my doctor the lumps will always be there, but I cannot palpate them once the pain is gone after an AI. Did they shrink? BTW - I think the longer you go with it the more risk you have of developing permanent (clinical) gyno. With pseudo, I don't think you usually have a painful lump behind the nipple. Regardless of whether it's clinical or not, if it responds to an AI, does it matter?

If the gyno is new an AI can clear everything up by itself. Adding tamoxifen worked very well for me and is well documented. If the gyno is old then the lump will always be there but once the cause is under control the pain will be gone and the lump will generally get smaller. Gyno can always flare up if hormone levels go out of balance again.

 

[ztm88]

I think you are right Bay Area, I think I am E2 sensitive. I have an appointment with an endocrinologist here soon. I would like to get clarification before I take any arimadex. Everything else is going well and I do not want to crash my E2 levels and deal with fatigue and potential rebound gyno. I am going to have surgery regardless, this is my 2nd gyno flare up and I would say it is permanent. I am going to attempt to have the surgeon remove all of the glandular tissue or most of it.

 

[FeelingLost]

I think you are right Bay Area, I think I am E2 sensitive. I have an appointment with an endocrinologist here soon. I would like to get clarification before I take any arimadex. Everything else is going well and I do not want to crash my E2 levels and deal with fatigue and potential rebound gyno. I am going to have surgery regardless, this is my 2nd gyno flare up and I would say it is permanent. I am going to attempt to have the surgeon remove all of the glandular tissue or most of it.

Hi ztm, it looks like you have a very good plan.
I hope you will report how things are going and I wish you the best if you choose surgery. You should consider before and after picts.

Here's a good pict and thread on gyno you mighht find it useful.

https://www.excelmale.com/forum/showthread.php?442-How-to-Avoid-Getting-Man-Boobs