So because you haven't read about it or your endos didn't mention it to you means it's wrong?
Ok I will be more precise. I have seen 3 Endocrinologists, the final one was a renowned Professor of Endocrinology and
he told me that oestrogen secreting tumours can grow at different rates. Now being a Professor of Endocrinology I reckon that makes him an expert and I would prefer his knowledge and experience over any other.
I did actually say in my post that .. "They (Endos) told me that some oestrogen excreting tumours can be slow growing and some fast".It is very important to mention here that there are many causes of gynecomatia and tumours account for only a very small proportion of them. The following causes of gynecomastia and percentages are taken from a medical paper .. The Endocrinology of Gynaecomastia by AAA Ismail and JH Barth (Department of Clinical Biochemistry and Immunology, Leeds General Infirmary, England.)
Cause (%)
Idiopathic (unknown) 25
Puberty 25
Drugs 10-20
Cirrhosis or Malnutrition 8
Primary Hypogonadism 8
Testicular tumour 3
Secondary Hypogonadism 2
Hyperthyroidism 2
Renal Disease 1
Others 6
If a person wants to read a little deeper on the subject then I suggest they Google this paper and download it.
As for not going to an endocrinologist, I'm not saying it's a bad thing to go to one. If you have really good insurance or else a ton of money laying around waiting to be spent, then go for it! I don't think in Mizuno's case it's necessary because there's already an explantion for why he got gynocamstia and why it got worse, from him losing weight. AND he has no other symptoms of hormonal problems. He already seems like he's overly paranoid about it and you're just feeding the fire. Now the poor guy is going to waste $600 or however much the tests cost.
We can only go on what we are told by people who post on here; Mizuno said in the second post on this thread that
at the age of 35 his gyne is getting worse. I was careful to say that if his gyne was glandular as opposed to pseudo (fat), he should get it investigated. I base this again on my consultations with Endos and on the above medical paper which says in it’s summary ....
“It (gynecomastia) must be regarded as unusual in pre-pubertal children and all young and MIDDLE AGED men.” Most of us would put a man in his middle 30s as in the bracket of young to middle aged.
So my reply was based on what Mizuno tells us, my 3 years of experience of consultations with Endos including a Professor, and on the medical papers that I have read and quoted, I still think the best advice is to see an Endo. Now you may think that I’m feeding his “paranoid fire” (your words not mine) by suggesting that he gets some medical expertise in investigating this, but I call it common sense. If a person thinks they have a medical problem then a wise person seeks a medical opinion. You and I are not doctors and least of all not Endocrinologists, so we can’t offer a medical opinion. What we can offer is advice based upon experience and my advice is ..
if in doubt seek expert help.
Which brings us onto your next point.
Oh, and just because you get a test doesn't mean it will catch a problem. Even if it's done by a certified endocrinologist, endocrinology is a relatively new science and the measurements aren't anywhere close to being precise. There have been a ton of guys on this forum who have all the symptoms of low testosterone and the test puts them in the normal range.
I believe that some of what you say is correct here but I don't think you paint an accurate picture of the situation. It is important to find a suitably qualified and experienced Endo. Most Endos deal with the more common hormonal problems such as diabetes and thyroid problems: a gyne patient does need to hunt around and find an Endo who specialises in male reproductive issues.
You may have a point in saying that Endocrinology is a relatively new branch of medicine, for instance the UK Society for Endocrinology was set up in 1946
but that is over 60 years ago. However in those last 60 years Endocrinology has helped to produce remarkable advances in the treatment and understanding of diseases and conditions relating to diabetes, thyroid pituitary and many cancers,
so I wouldn’t write off Endocrinology so quickly.I disagree with you when you say that
"measurements aren't anywhere close to being precise". There are issues with
some of the oestradiol assays, but what level of precision (accuracy is a better word) do you want? The accuracy level that the lab I use quoted me that their results for oestradiol will have a maximum error of 10% of the true value. For instance my last oestradiol result was 105 pmol/L (lab range 0 – 274), so even if that was 10% in error it really doesn’t make a huge difference to the assessment my Endo makes of my hormone health as he is looking at the wider picture of levels, balances and symptoms. By the way, for other hormones the lab I use quotes 2%.
No measurement of anything will be exact, there will always be a statistical standard deviation from the “true” value for one reason or another.
A good and experienced Endo will know the problems with measuring oestradiol levels and base his or her judgement on the hormonal health of the patient knowing the accuracy level of the oestradiol test. He will not just be looking at the lab ranges, as he will know that the said lab ranges cover males right across the age spectrum whose “normal” values will vary greatly. Most importantly the Endo will be looking at balances between different hormones even if they fall within the lab ranges. A simple GP or other doctor might just say that if a person results fall within the lab ranges then the patient must be fine. That is why it is important to see a good Endo and not any old doctor who doesn’t have the knowledge or experience in this area of health.
It is important also to say that an Endo doesn’t just run a blood test and push you out of the door 3 minutes later. At the initial Endo appointment he will take a full medical history, give a thorough physical check up (including an examination of testicles, chest etc) and run a series of blood tests. Basically the patient should be getting a thorough going over.
I take on board what you say c17361736 even if I think it to be a little cynical and inaccurate, but my advice to Mizuno is still the same .. namely ... If a middle aged man has growing glandular gynecomastia then he should get himself checked out by a suitably experienced Endo, preferably one who specialises in the male reproductive problems.
I base my advice to Mizuno on what has happened to me, my ongoing experience with Endos and an Andrologist and the medical paper I quoted earlier. To me it is simple. If I think I have a medical problem, I seek medical advice from an expert. You and I can argue the toss about which test is the best or more accurate, how long the science of endocrinology has existed, or even if the whole thing is a waste of time, but personally I’m not prepared to discount the whole medical investigative process because a test might (at worst) only be correct within 10% of its true value. I firmly believe that the only way an individual is going to know the true state of his hormonal health is to see a good Endo, get properly examined, tested and assessed. Just looking at physical symptoms, or blood results on their own aren’t enough; it’s the whole package that an Endo offers.
Finally I would say that it is of course eventually down to the individual to assess the advice he has been given and make up his own mind.Mizuno .. good luck to you and keep us posted as to what you do.