Lying Test Results?

[toolhead]

I visited an endocrinologist not long ago. The doctor took several tests, of which, measured my Total Testosterone and Estrogen levels. When the results came back, the doctor announced that my Testosterone level was normal for a 21 year old male (which at 740, I guess is debatable) and that my estrogen level was undetectable, which again, the doctor stated was normal.

Yet, I have gynecomastia. If it is not my hormone levels, what could be the cause? Could it be that my hormones were once messed up, so that they caused my gynecomastia but then improved but not in time to rid me of gynecomastia?

P.S. For anyone interested: Regardless of the findings, my prescription was to take an anti-estrogen twice daily for three months. It was 10mg of Tamoxifien Citrate and it had little to no effect on my chest. Although, I must admit, while on it I felt more energetic.

[Dr. Elliot Jacobs]

Doctors usually claim that the cause of gyne is an imbalance of hormones -- most often during puberty.  This is difficult to prove because most boys do not go in for hormonal testing until/if they show signs of gyne -- and then the hormonal imbalance may have passed and not be detectable by blood tests.

Recently I had a young man come to see me -- his father was an endocrinologist.  And the dad had performed the requisite blood tests on his son.  Guess what!  The kid had gyne and there had never been any hormonal abnormalities.

Now one example does not make a case -- but it is interesting.  This almost sounds like your own case -- gyne with normal hormone levels.

I have always felt that there was an inherited genetic pre-disposition towards gyne. 

Dr Jacobs

[DrBermant]

I visited an endocrinologist not long ago. The doctor took several tests, of which, measured my Total Testosterone and Estrogen levels. When the results came back, the doctor announced that my Testosterone level was normal for a 21 year old male (which at 740, I guess is debatable) and that my estrogen level was undetectable, which again, the doctor stated was normal.

Yet, I have gynecomastia. If it is not my hormone levels, what could be the cause? Could it be that my hormones were once messed up, so that they caused my gynecomastia but then improved but not in time to rid me of gynecomastia?

P.S. For anyone interested: Regardless of the findings, my prescription was to take an anti-estrogen twice daily for three months. It was 10mg of Tamoxifien Citrate and it had little to no effect on my chest. Although, I must admit, while on it I felt more energetic.

For gland growth in either men or women, it is the interplay of hormones in the body.  Discovering a specific Cause of Gynecomastia is an art form. Blood testing is just one factor and a snapshot at levels that vary through out the day and with emotion, stress, and activity.  Weight gain will increase the fat component of the breast.

As with surgeons, not all endocrinologists have the same skills. Some problem cases can prove elusive.  From a surgical prospective, I am looking for a stable problem to sculpt since surgery does not prevent breast regrowth. Also as a surgeon, I do not often get a chance to see the success stories of medical treatment, just the failures.  Typically antiestrogens can reverse active stimulation effects and the effects of hormonal swelling. Evolved gland tends to not change under such treatment.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[toolhead]

Doctors usually claim that the cause of gyne is an imbalance of hormones -- most often during puberty.  This is difficult to prove because most boys do not go in for hormonal testing until/if they show signs of gyne -- and then the hormonal imbalance may have passed and not be detectable by blood tests.

So, it is entirely possible that a hormonal imbalancement in the past can cause permanent gyne, regardless of the fact that the once imbalanced hormones are now fixed? Because I've had my gyne since I was about 12 and just recently tested my hormone levels.

Also, would it be that since the gland has "evolved" it officially becomes a part of the body, regardless of what created it or how it was created and therefore hormones/steroids will have no effect on it?

I wonder if an endocrinologist was to prescribe something that increases testosterone and also prescribed an anti-estrogen if it would create a hormonal atmosphere that would destroy gyne. There is a story on this website's steroid section that hints at it, "replaced that flabby chest with one of iron." http://www.anabolicsteroids.com/cypionate.html

However, in the case above, the user obviously abuses the steroid and has no professional help.

Just curious, thanks for the responses doctors!

[DrBermant]

So, it is entirely possible that a hormonal imbalancement in the past can cause permanent gyne, regardless of the fact that the once imbalanced hormones are now fixed? Because I've had my gyne since I was about 12 and just recently tested my hormone levels.

Also, would it be that since the gland has "evolved" it officially becomes a part of the body, regardless of what created it or how it was created and therefore hormones/steroids will have no effect on it?

I wonder if an endocrinologist was to prescribe something that increases testosterone and also prescribed an anti-estrogen if it would create a hormonal atmosphere that would destroy gyne. There is a story on this website's steroid section that hints at it, "replaced that flabby chest with one of iron." http://www.anabolicsteroids.com/cypionate.html

However, in the case above, the user obviously abuses the steroid and has no professional help.

Just curious, thanks for the responses doctors!

Just as the balance of hormones during pregnancy can leave a woman with larger breasts after stopping breast feeding, the same is true for gynecomastia. Gland is gland in both male and female mammals.  When the stimulating hormones stop, some shrinkage of gland occurs. But it is a matter of degree.  Antiestrogens in this capicity only go so far. The papers on this topic in the literature are quite poor in demonstrating the degree of improvement and they do not define how effective medical management is for existing non stimulated gland component.

A patient with low testosterone such as an untreated Klinefelter's Syndrome or a Congenital Adrenal Hyperplasia needs the Endocrinology treatment to establish a normal hormone environment. Without such treatment, the gland will regrow after surgery.

Such issues are best explored with an experienced Endocrinologist.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction