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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Gynecomastia

WHITE MALE, 23 years of age. I have visited an endocrinologist recently regarding my development of gynecomastia. A little over 2 years ago I took a pro-hormone supplement to work-out with; I am assuming this is the cause. Shortly after starting the supplement I developed a breast-bud in only one side of my chest. I had it operated on but returned. Now for some reason (2 years later) the other side is now developing. In fact, it went from non-existent to worse than the other side in a matter of 3 weeks! At this point I made an appointment to get blood work done with an endocrinologist. My results are as follows: Free Test: 64 normal range (35-155) Total Test: 325 normal range (250-1100) FSH: 1.3 normal range (1.6-8.0) LH: 1.7 normal range (1.5-9.3) I immediately thought I should do something about my total Testosterone (325). From what I have read, a male my age should have double, or even triple that value. However my endocrinologist 325 is normal, and continues to tell me nothing can be done for me due to my normal Free Testosterone value (64). My LH is low and my FSH is very low, which indicates that I have secondary hypogonadism. He did not test my ESTRADIOL levels. What are my options? I do not want to have to take hormone replacement therapy because I am told it is for the rest of my life. And according to my dr. it will do more harm than good. Should I can my estrogen/estradiol levels checked? And if my estrogen is too high, what do I do about it? I asked him if estrogen inhibitors or aromatase inhibitors were an option and he continued to say NO. I am constantly tired but I do not sleep well. I look like I am losing muscle mass yet I am gaining weight, especially in my midsection (despite A LOT of exercise). These are all tale-tale signs of a hormonal imbalance. Despite these problems, my dr. says that I must live with it and to just get my cosmetic surgery. Like I said previously my first surgery was unsuccessful and I do not want to spend that money without some sort of solution first. How to I fix my low LH/FSH? And would lowering my estrogen levels help boost my testosterone. Any help/suggestions would be greatly appreciated!
Wed, 14 Aug 2019
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General & Family Physician 's  Response
Hello,

You are suggested to first get properly diagnosed for Gynecomastia. Visit ER, get physically examined. Gynaecomastia commonly presents with swelling & tenderness (pain) in the breast gland tissue, the areola may increase in diameter & chest tissue may get asymmetric.

Your treating doctor will ask you to go through blood tests, mammograms, CT, MRI, Testicular USG & tissue biopsy. Other conditions that may look like gynecomastia are mastitis (breast abscess), breast cancer or fatty breast tissue.

If gynecomastia is detected you will be treated with tamoxifen (soltamox), raloxifene (Evista), etc. They help in blocking the female hormone.

Your treatment will depend upon the severity of the pathology detected. It can be treated with Liposuction or Mastectomy.

You are suggested to cut on & quit on taking illegal drugs(heroin, marijuana, it triggers developing gynaecomastia. Avoid taking certain medications that may trigger gynecomastia like antipsychotics, aldosterone antagonists, Digoxen, ketoconazole, etc.

Avoid food that may cause the development of gynecomastia, avoid any Soy products, beer & alcohol, packaged food(prefer eating fresh food), beetroots and dairy produces.

Take food that will help raise testosterone levels like, asparagus, eggs, figs, almonds, nuts, brown rice, salmon, avocados, figs help raise testosterone levels & help reduce gynaecomastia.

Maintaining hormonal balance is the key. You can see a better endocrinologist who will treat the hormonal imbalance.

You can take testosterone boosting supplements like Vitamin D, D-Aspartic acid, DHEA, Aswagandha, Ginger, fenugreek, etc.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Nupur K, General & Family Physician
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Suggest Treatment For Gynecomastia

Hello, You are suggested to first get properly diagnosed for Gynecomastia. Visit ER, get physically examined. Gynaecomastia commonly presents with swelling & tenderness (pain) in the breast gland tissue, the areola may increase in diameter & chest tissue may get asymmetric. Your treating doctor will ask you to go through blood tests, mammograms, CT, MRI, Testicular USG & tissue biopsy. Other conditions that may look like gynecomastia are mastitis (breast abscess), breast cancer or fatty breast tissue. If gynecomastia is detected you will be treated with tamoxifen (soltamox), raloxifene (Evista), etc. They help in blocking the female hormone. Your treatment will depend upon the severity of the pathology detected. It can be treated with Liposuction or Mastectomy. You are suggested to cut on & quit on taking illegal drugs(heroin, marijuana, it triggers developing gynaecomastia. Avoid taking certain medications that may trigger gynecomastia like antipsychotics, aldosterone antagonists, Digoxen, ketoconazole, etc. Avoid food that may cause the development of gynecomastia, avoid any Soy products, beer & alcohol, packaged food(prefer eating fresh food), beetroots and dairy produces. Take food that will help raise testosterone levels like, asparagus, eggs, figs, almonds, nuts, brown rice, salmon, avocados, figs help raise testosterone levels & help reduce gynaecomastia. Maintaining hormonal balance is the key. You can see a better endocrinologist who will treat the hormonal imbalance. You can take testosterone boosting supplements like Vitamin D, D-Aspartic acid, DHEA, Aswagandha, Ginger, fenugreek, etc. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician