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Male Body, Slim With Breast Growth. What Tests Should Be Followed?

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Posted on Mon, 25 Jun 2012
Question: am male 25 years slim body..i have noticed my breast area has increased over the years..i suspect it is due to some hormonal imbalance..it looks weird if i wear tight t-shirt...how should i proceed to find out what is wrong?? what tests should be done??
doctor
Answered by Dr. Radhika (1 hour later)
Hi,
Thanks for the query.

You seem to be suffering from a condition called gynaecomastia. Gynecomastia is caused by a decrease in the amount of the hormone testosterone. The cause for this will be conditions that reduce testosterone level or conditions that increases your oestrogen level. These include:
a.     Medication use including use of anabolic steroids or androgens, antibiotics, AIDS medications, anti-anxiety medications, tricyclic antidepressants, ulcer medications, and anti-cancer drugs.
b.     Certain health conditions, including liver and kidney disease, thyroid disease, hormonally active tumours, alcohol, drugs like Marijuana, Heroin can also cause this.
c.     However, in almost ¼ of the cases, no abnormality can be identified.

I would suggest that you get yourself evaluated by an endocrinologist who can perform a detailed evaluation and perform certain tests like:
1. Blood tests including free or total testosterone, luteinizing hormone (LH), estradiol, and dehydroepiandrosterone sulfate levels
2. Mammogram.

Treatment will be done on the basis of the cause identified by these tests .You might require hormonal therapy or if any underlying disorder is present, then you will need medications according to that. Reduction mammoplasty is a surgical option available.
Hope I have answered your query. I will be available for follow up queries. Please accept my answer in case you have no follow up queries.

Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Radhika (57 minutes later)
hello Doctor,

thanx for the reply. As you said that it can be because of lack of testostrone..is there any way to increase testostrone by diet?? and please suggest me some whole body tests which i should undergo to check for any tumour, cancer, etc..i have lost some weight also over the years..may be its also related..
doctor
Answered by Dr. Radhika (2 hours later)
Hi,
Thanks for the follow up.

Lack of testosterone can be detected by blood tests and also the treatment is by taking hormonal tablets to increase it.

Diets XXXXXXX in testosterone will be foods XXXXXXX in vitamins B1, B6, B12, niacin and folic acid and zinc. Foods high in vitamin B include whole grains, fish, seafood, meat, eggs, avocado, beans, peas, dairy products and leafy XXXXXXX vegetables. As for zinc, oysters are one of the best dietary sources. Additional zinc-filled foods include most meats, beans, nuts and milk. Some breakfast cereals may also be fortified with zinc.

It can rarely be caused by cancer, weight loss necessarily does not cause cancer always, it is a misconception. Here below are the tests for detection of tumors, cancers.
1. Chest X-rays.
2. Computerized tomography (CT) scans.
3. Magnetic resonance imaging (MRI) scans.
4. Testicular ultrasounds.
5. Tissue biopsies.

Please visit your physician who can advised the investigation based on positive findings on evaluation.

Hope I have answered your query. I will be available for follow up queries. Please accept my answer in case you have no follow up queries.

Regards.
Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
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Follow up: Dr. Radhika (3 days later)
hello Doctor,

As you suggested I have done my blood tests and x-ray. My TSH levels are high 8.9 whereas normal should be upto 5. The endocrinologist suggested to start with thyrox 12.5 mg medicine.

My query is that is this TSH/THYROID problem related to gynecomastia? Will this excess mass on chest reduce if I bring back TSH levels to normal? or surgery is the only option? And kindly guide me is it really necessary to take medicine for this tsh as am suggested that this medicine would have to be taken everyday and for whole life. So am quite skeptical in starting with this tablet. Is there any diet changes which can help, I want to avoid taking medicine for this if possible.

rest report is normal.x-ray is fine. So please guide further action.
doctor
Answered by Dr. Radhika (5 hours later)
Hi,
Thanks for the follow up.

Your TSH (Thyroid Stimulating Hormone) is 8.9, which suggest Hypothyroidism. This does not cause Gynecomastia. You will need to take medications till your level comes back to normal. Otherwise there will be other problems like fatigue, depression, weight gain, cold intolerance, sleepiness, coarse hair, constipation, dry skin.

Vegetables like broccoli, cauliflower, XXXXXXX spinach, radishes, soybeans, peanuts, pine nuts, peaches and millet should be avoided in those who have Hypothyroidism.

Fish, dairy, oats, sesame seeds, bananas, avocados, and almonds are all good sources for increasing thyroid levels.

You need to take medications along with dietary changes. Since diet alone will not help you.

You have mentioned your reports are all ok. Are your testosterone levels, luteinizing hormone (LH), estradiol, and dehydroepiandrosterone sulfate levels normal?

If all hormonal tests and x-rays are normal then you might need to talk to your Endocrinologist regarding other treatment modalities like Surgery.

Hope I have answered your query. I will be available for follow up queries. Please accept my answer in case you have no follow up queries.

Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Radhika (1 hour later)
for testosterone levels also blood test is required? My endocrinologist suggested CBC, TYROID FUNCTION TEST, ca/ph, sgot/ast/glucose,urine,creatinine etc..In this report testosterone test is not present..So should i go for testosterone test again?? is this related to Gynecomastia?
doctor
Answered by Dr. Radhika (27 hours later)
Hi,
Thanks for reverting.
No, even though low testosterone levels may be a cause for gynaecomastia, a test is not necessary at this point in time.
I would suggest that you adhere to the advice given by your endocrinologist and get only the tests, that you have mentioned, done as a part of your initial workup. This is so because your endocrinologist has performed a detailed evaluation and is in a better position to advise you.
Further, the tests that I had mentioned earlier are used as a part of the evaluation for a condition called feminization syndrome which is one of the causes for gynaecomastia.
The testosterone levels may be done at a later stage, as per the advice of your endocrinologist.
I hope I have answered your query. Please accept my answer if you have no further queries.
Regards
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Radhika

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Practicing since :2005

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Male Body, Slim With Breast Growth. What Tests Should Be Followed?

Hi,
Thanks for the query.

You seem to be suffering from a condition called gynaecomastia. Gynecomastia is caused by a decrease in the amount of the hormone testosterone. The cause for this will be conditions that reduce testosterone level or conditions that increases your oestrogen level. These include:
a.     Medication use including use of anabolic steroids or androgens, antibiotics, AIDS medications, anti-anxiety medications, tricyclic antidepressants, ulcer medications, and anti-cancer drugs.
b.     Certain health conditions, including liver and kidney disease, thyroid disease, hormonally active tumours, alcohol, drugs like Marijuana, Heroin can also cause this.
c.     However, in almost ¼ of the cases, no abnormality can be identified.

I would suggest that you get yourself evaluated by an endocrinologist who can perform a detailed evaluation and perform certain tests like:
1. Blood tests including free or total testosterone, luteinizing hormone (LH), estradiol, and dehydroepiandrosterone sulfate levels
2. Mammogram.

Treatment will be done on the basis of the cause identified by these tests .You might require hormonal therapy or if any underlying disorder is present, then you will need medications according to that. Reduction mammoplasty is a surgical option available.
Hope I have answered your query. I will be available for follow up queries. Please accept my answer in case you have no follow up queries.

Regards