How do I know if I'm stable?

[hatemymoobs]

As the subject says- how do I know if m gyne is stable and not still slowly growing?
I've had labs done by an endo and my T is low "normal" (in range but pretty low for a guy my age) and my first Estradiol was high "normal" - right at the top of the range. My second lab the Estradiol was much better, in the mid range about 22 or so.
That being said- I dont know if my gyne is still slowly growing, or if I'm done.

The doctors I've seen don't seem to think my low T and maybe high E is a problem, however my list of symptoms make me feel like they're just not wanting to put a 28yr old healthy guy on TRT if that would be the given route to go...

I really want to get surgery done this year, but I can't tell if it's growing or not.
Soreness? Yea, sometimes they feel a bit sore, but then again so does all of my body parts sometimes. They are never tender to the touch.

I have noticed they've gotten more bothersome this year, however I've lost about 15lbs which could make them more pronounced, and also i could have grown more self conscious- not sure whether it's growth or in my head.

Any way to tell for sure? How high would my E have to be before I worry about further growth?

I've been self conscious about the size of my chest as long as I can remember to some degree, so it's not a completely new issue. But it's definitely a growing concern as it bothers me more and more.

Help?

[Litlriki]

Since the stimulus for growth of gynecomastia tissue is a function of the relationship between testosterone and estrogen in the body, a single number or measurement isn't especially helpful. Also, test results can vary based on time of the day, activity and other factors, so unless you have several tests, which show a trend over time, I think you should be cautious about jumping into hormone supplementation (and it sounds like your doctors are being cautious).  If you are back to normal on your testing, you might want to wait a few more months, check it one more time, and then proceed with surgery if everything remains stable.

Rick Silverman

[hatemymoobs]

Sorry I meant stable with gynecomastia, not stable for HRT.

I've only had 2 tests, both showed low "normal" T levels, however according to a study I have the T of the average 85-100 yr old man.
My E2 levels were on the high end of the scale (47 on a scale of 13-54) the first test and the second was 22.

The doctor didn't even order the second E2 test, I circled it on the sheet because I wanted it re-tested.

I don't think this doctor knows what he's doing because he should have been concerned that my first test showed a close ratio between T and E2. T was 276 (250-850) and E2 was 47 (13-54) So basically low T and high E2...
Second test was better, different T test which came in at 360 (250-1100) and E2 22 (13-54).

I have my follow up appointment today with the endocrinologist, hopefully he'll order more blood work, and hopefully this time he'll order all the appropriate tests together to see them at one given time...


Regarding my question though- how do I know if my gynecomastia is stable? And is gynecomastia ultimately caused by high estrogen? If so it seems like keeping those levels in line would reduce any risk at regrowth?

Thanks- any other feedback very much appreciated...

[Litlriki]

If you haven't noticed any change in your gynecomastia over time, then it's probably stable.  But you've never revealed any basis for your endocrine issues, and depending on why your levels are off, you might still be subject to fluctuations that could stimulate recurrence.  As an example, patients who used anabolic steroids at a young age are at greater risk of low testosterone levels as they age.  That history is important to me in advising patients of the risk of recurrence.

RS

[hatemymoobs]

I'm not sure if my gynecomastia is changing, or if I'm becoming more and more obsessed with being self aware of it. I know I'm more self conscious- but not sure if it's because they've grown, or I caught a glance at certain angles and it stuck with me...

I have no idea why my T levels are low, and why my E2 level went from 47 to 22 between the tests. The doctor wasn't concerned with E2 since it was in range.

I saw him for a follow up today. He's suggesting we try 3 months on T gel to see if my other symptoms go away. He said it's possible the gynecomastia may reduce starting around 3 months after treatment.

In 1 month I go in for a lab to check my T and E2 levels, if all is well I continue until my followup in 3 months in which we'll discuss my options for long term treatment.

I wish I could order my own labs so I could keep a really close eye on my T and E2 levels, for the gynecomastia's sake. The doctor said we could draw blood 10 minutes apart and get pretty different results on these tests. I suppose that makes hormones a pretty hard thing to balance properly...