i have very low testosterone

[nomore-jiggles]

I just got my blodd test results back and found that my level of testosterone was at 60.  pretty dam low.  My problem is that I already got the operation about 6 months ago.  My gynecomastia has already been corrected with surgery.  It doesn't look 100% better, but I do look way better than before. I'm comfortable with my chest now.  If I start taking testosterone to even out my levels, will it bring back the gynecomastia in any way?  (And I'm just curious, Does taking testosterone help guys with gyne/low levels of T. rid themselves of this horrible condition?)  Your replies are greatly appreciated.

[xelnaga13]

Testosterone replacement therapy can absolutely cause a return of gyne. Your endo will be monitoring your hormone levels to ensure that they are in the proper ranges.


It's also possible that your low T levels caused your gyno in the first place.

[TigerPaws]

While I was on medication for an enlarged prostate, my "T" levels dropped below that which is considered "normal" for a 16 year old girl. That and DHT blockers allowed my natural estrogen to become dominate which caused the dormant estrogen receptors to "wake-up" and multiply. Besides developing normal firm 38C breasts, my skin became very soft, my testicles shrunk to about the size of small grapes and I became sterile. But at 56 I was not concerned because I am not going to have another child.

There were/are other subtle change which I will not go into unless you ask, but I do not mind those.

As to what you can do a highly qualified endocrinologist should be your first stop.   

[hammer]

Gotta beat! Before we found out that my testicles had died my T level was 3! My testicles became like a wet sponge, very soft.

Like TigerPaws I wasn't planning on anymore kids, I had father 5 already so I had them removed and tried to move on with my life, but other problems came up and made low T not a problem at all!

Good luck!

[fsugrad]

While I was on medication for an enlarged prostate, my "T" levels dropped below that which is considered "normal" for a 16 year old girl. That and DHT blockers allowed my natural estrogen to become dominate which caused the dormant estrogen receptors to "wake-up" and multiply. Besides developing normal firm 38C breasts, my skin became very soft, my testicles shrunk to about the size of small grapes and I became sterile. But at 56 I was not concerned because I am not going to have another child.

There were/are other subtle change which I will not go into unless you ask, but I do not mind those.

As to what you can do a highly qualified endocrinologist should be your first stop.   

TigerPaws,

What were the other changes if I may ask?  Also did you ever start testosterone replacement therapy and if so did it have any effect?

[greatlakes]

T replacement would be a good idea. At that level your going to need regular injections. You will need to monitor Estradiol (estrogen) and other blood levels while on it. Good luck.

[Alchemist]

T replacement would be a good idea. At that level your going to need regular injections. You will need to monitor Estradiol (estrogen) and other blood levels while on it. Good luck.

I've been on testosterone replacement for 12 years.  I started with Androgel and went to injections after about a year.  Injections work better when done weekly but 10 days are not good.  I am totally 100% sterile, not a wiggler to be seen under a microscope, as a common effect of testosterone.  A 10% lower dose and erectile function goes away.  As I already have a pair of D cups and nothing has affected them at all except gaining and loosing weight a little, I'm not at all concerned about side effects of increased breast size.

My low testosterone appears to have been caused by years of chronically low b12 and folate.  That is pretty common.  Good luck.

[TigerPaws]

A lot depends on your age and the condition of your prostate, as men age their prostate usually enlarges. Testosterone aggravates an enlarged prostate which can led to cancer. DHT blockers and estrogen have been proven to reverse this process and reduce the possibility of cancer and needing to have your prostate surgically removed. This will leave you impotent and sterile. Testosterone can after 50 cause a number of problems from an enlarged prostate, to high cholesterol and cancer, while reducing "T" and increasing estrogen along with progesterone in the correct proportions often will significantly improve a mans health. But there are always trade-offs, such as developing breasts and .....     

The side effects of this treatment are numerous but manageable and not life threatening, in fact there are a number of benefits for men over 50.

If you would like a more complete description please feel free to PM me.    
 

[greatlakes]

I think I kind of avoided directly answering your question. T replacement (or supplement) can lead to excess estrogen and can then lead to gyne.

This occurs when

1) A person uses too much T (abuse). Bodybuilders are an example.
2) T is not administered properly leading to spikes and valleys (example going more than 2 weeks between injections)
3) You get/or are fat or older as these conditions cause T to be converted to excess E.
4) You have a body which simply converts the replacement to E at a higher rate than normal.

A proper T to E balance can prevent gyne from returning. Beyond T replacement, there are ways to also control E levels as well. However, if you got gyne, or get it for more than a year or so, no amount of any chemicals will take it away.

There is alot of debate on the ideal levels of T and E to have. And the risks and benefits of these two hormones in your body.

h ttp://tnation.t-nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/harvard_study_more_test_is_better_healthier;jsessionid=1877F69070B2AD287D6582500468D809-mcd01.hydra


As mentioned, please seek out a good doctor who specializes in this.

[Alchemist]

Testosterone made a huge difference for me.  From low energy to better, from depressed to better, from unable to maintain or repair muscles to being able to repair and restore them, from almost complete lack of sexual functioning with Viagra/Cialis barely helping for 15 years to normal functioning without the drugs.

I have had zero noticeable ill effects, no enlarged prostate, my cholesterol has been steady for 20 years and is lower now than 30 years ago.  I started at 52 and am 64 now.  My BP which was 145/90 9 years ago is 110/65 now.  I'm 200 pounds instead of 285 pounds. Another 10 pounds and I'll be down to my smallest waist size of 34 with a 47 inch chest, with D cups. I sink in a swimming pool instead of float with my lungs emptied.

Testosterone has been nothing but a blessing and helped me recover from dying from congestive heart failure and a whole lot more.

That doesn't mean that there are not side effects for some people and it may matter WHY one's T drops.  It needs to be used at the proper levels as prescribed and have testing to make sure everything is working well regularly.  Like so many things, too much is a big problem.  Too little was a big problem too.

[hatemymoobs]

I just got my blodd test results back and found that my level of testosterone was at 60.  pretty dam low.  My problem is that I already got the operation about 6 months ago.  My gynecomastia has already been corrected with surgery.  It doesn't look 100% better, but I do look way better than before. I'm comfortable with my chest now.  If I start taking testosterone to even out my levels, will it bring back the gynecomastia in any way?  (And I'm just curious, Does taking testosterone help guys with gyne/low levels of T. rid themselves of this horrible condition?)  Your replies are greatly appreciated.

I also have low T, however not that low. Mine sits around 250-350.
Getting on TRT will only result in gynecomastia if your other hormones are not kept in check. Specifically, keep an eye on E2 and Prolactin.

Once you get the dosing right, you should get your blood levels checked every 6-12 months to be sure things are balanced.

Before going on TRT, investigate thoroughly to be sure there is no underlying issue.

How old are you?

[Dr. Robert Wilcox]

Some thoughts on Testosterone therapy first.  Proper analysis requires a Total T level and Free T level.  Typically, about 95% or more of total T is bound to Binding Globulin and biologically inactive.  The smaller portion that is "Free" in the circulation and is avilable to be bound by cell receptors and transported into the cell nucleus to affect the changes of maleness known to all.  In our reference lab, total should be between 240-950 and free should be between 9-30. 

Recognize that when a woman has a mastectomy it is not possible to remove 100% of the breast tissue, even with this radical open approach.  Similarly, gynecomastia surgery cannot remove all male breast tissue.  The tissue is so intimately adherent to the underside of the nipple/areola that total removal would likely kill the circulation to the nipple and kill it.

The problem is that with Testosterone in the body, whether produced by the testicles or by prescription supplement, is that a portion will be converted by fat cells into Estrogen, primarily Estradiol. This process is called aromatization. Estradiol can then potentially cause the remaining glandular tissue to regrow.

Therefore, to your question, you may be fortunate and tolerate the replacement T with no recurrence.  Most patients are in this category.  You can improve your risk profile by losing fat/weight.  Reduce alcohol consumption.  Aromatase is a drug used most often for breast cancer patients to block conversion of androgens (male hormones) to estrogens, which might stimulate breast cancer cell growth.  It can also be used with TRT to block aromatization to Estradiol.  You and your physician would need to decide whether taking an additional drug is worth the risk/trouble/expense.

I hope this has been helpful to you.

Dr. Dr. Wilcox, MD

[xelnaga13]

[quote author=Dr. Dr. Dr. Wilcox link=topic=26166.msg171697#msg171697 date=1346101565]
Some thoughts on Testosterone therapy first.  Proper analysis requires a Total T level and Free T level.  Typically, about 95% or more of total T is bound to Binding Globulin and biologically inactive.  The smaller portion that is "Free" in the circulation and is avilable to be bound by cell receptors and transported into the cell nucleus to affect the changes of maleness known to all.  In our reference lab, total should be between 240-950 and free should be between 9-30. 

Recognize that when a woman has a mastectomy it is not possible to remove 100% of the breast tissue, even with this radical open approach.  Similarly, gynecomastia surgery cannot remove all male breast tissue.  The tissue is so intimately adherent to the underside of the nipple/areola that total removal would likely kill the circulation to the nipple and kill it.

The problem is that with Testosterone in the body, whether produced by the testicles or by prescription supplement, is that a portion will be converted by fat cells into Estrogen, primarily Estradiol. This process is called aromatization. Estradiol can then potentially cause the remaining glandular tissue to regrow.

Therefore, to your question, you may be fortunate and tolerate the replacement T with no recurrence.  Most patients are in this category.  You can improve your risk profile by losing fat/weight.  Reduce alcohol consumption.  Aromatase is a drug used most often for breast cancer patients to block conversion of androgens (male hormones) to estrogens, which might stimulate breast cancer cell growth.  It can also be used with TRT to block aromatization to Estradiol.  You and your physician would need to decide whether taking an additional drug is worth the risk/trouble/expense.

I hope this has been helpful to you.

Dr. Dr. Wilcox, MD
[/quote]

That explains a lot! I always thought the only reason for leaving some breast tissue was for aesthetics.

[fsugrad]

Dr. Dr. Wilcox brought up a great point regarding the importance of Free T levels.  My endo said that while my Total T looked great at 650 (250-1100) it did not relate to my low T  symptoms.  When she checked my Free T and Bioavailable T levels both were at the very bottom of the normal range.

[hatemymoobs]

Normal total T with low free T could mean high SHBG (sex hormone binding globulin) or excessive aromatase, the enzyme that converts testosterone to estradiol. (which would then mean you'd likely have higher e2 levels)
I suppose it could possibly mean excess conversion to DHT as well... not sure about that one.

My TT and FT are both appropriate (ratio wise) so my doctor and I didn't discuss much about what to do in that situation. He did mention Saw Palmetto and Nettle Root can help lower SHBG and free up some testosterone, but these are herbal supplements and their results seem to be hit or miss as far as I know.

Just to add to what Dr Dr. Wilcox mentioned- pretty sure he meant Aromatase Inhibitors, such as Arimidex, which is a drug to help block conversion to estradiol. Unfortunately AI's are not FDA approved for use in men to control e2 levels, so men usually have to pay 100% out of pocket, and it is NOT a cheap drug.  As Dr Dr. Wilcox said it's a drug primarily used in female breast cancer patients. =\