Amitriptyline (50mg for 10 years) and how it affects Gyne if at all

[John16102]

For diabetic neuropathy in my feet and lower legs, my Dr. put me on Amitriptyline 10 years ago. I recently read how this drug can cause Gyne so I was wondering if this is why I went from an A cup to B cup in the past few years.

Also, I am on Testosterone injections every two weeks and the dosage is the minimum for a 2 wk cycle. I was diagnosed Low T 3 years ago. My breast are somewhat larger in the first 8-9 days after an injection. I was wondering how my T injections could be affecting my breast size?

Thanks for all of your help.

[John16102]

After all of this time, I don't guess you doctors know anything about my question.

[Litlriki]

John,

Sorry you haven't gotten a response up until now.  Your initial post suggests that you have a lot of medical issues going on in your life, and gynecomastia is just the manifestation of some of those issues. While Amitriptyline may be associated with gynecomastia, it's not the top of the list, and as soon as you mentioned testosterone treatment, you drifted into the world of hormone imbalance as your most likely contributor.  I am not an endocrinologist, but I have treated a lot of patients who got their gynecomastia from "recreational" steroid use primarily as an aid to athletic performance.  This is a little different from hormone replacement therapy, but some common issues apply, and one of those issues is how best to dose the drug depending on the formulation.  Esters of testosterone are used to provide shorter and longer acting forms, but in many cases, an injection every other week for the sake of convenience may lead to greater fluctuation of hormone levels, thereby leading to more variation in the testosterone:estrogen ratio, which is what will stimulate breast tissue growth.  You might explore a change in your dosing pattern to once a week or a switch to testosterone gel or a patch, in order to smooth out fluctuations in your level. 

I hope that's helpful.  Good luck.

Rick Silverman

[John16102]

Dr. Silverman,

Sorry I have been away for a while and did not thank you for your reply.

I appreciate your detailed reply. Yes I do notice that my Gyne gets worse at times during the two weeks between shots. At some point I can fill up a B cup bra then at some point they will shrink a little. My gyne was always there its just that now my breasts are bigger after testosterone replacement therapy. What's funny is that before I started on the testosterone, I thought that my breasts were going to shrink but instead the opposite happened.

I will schedule an appointment here in Houston with an Endo or Urologist that specializes in male hormones.

At some point though, I will have surgery and at 49 years old, time is of the essence wouldn't you agree?

Thanks again,

John