Endocrinologists?

[Houstonian]

what does a typical trip to a endocrinologist go like?

how do they test you?

[GodWasAngry]

well i was there yesterday
he told me to lay down, lift my shirt up, he touched my nipples a bit and said it's gonna pass with time.. i bet he's wrong though

[Zippy211]

How much does a trip cost?

[ruggedtoast]

About the same. They do a lot of blood tests then contact you later to tell you theres nothing wrong with you. I think for most people an endo is a preliminary on the way to seeing a plastic surgeon.

[Houstonian]

yeah blood tests... thats what i was afraid of  :-/

[Hypo-is-here]

About the same. They do a lot of blood tests then contact you later to tell you theres nothing wrong with you. I think for most people an endo is a preliminary on the way to seeing a plastic surgeon.

Not quite.

They do a lot of blood tests and discover that 25% of gynecomastia sufferers have underlying causative conditions that require treatment.

There have been many cases of people having surgery without going to see an endocrinologist and then having re-growth of gynecomastia post op.

Why?

Because they didn't get checked out and treated before hand.

The importance of going to see an endocrinologist cannot be emphasized enough.

Better safe than sorry.

[brm]

You're quite right Hypo  though I think that a GP is about as fit as an endo to decipher the bloodtest results, particularly in the case of gyno where 3 or 4 data are enough to make an opinion. Agree? Moreover, the reference numbers vary with labs...and with docs!!

[jc71]

You're quite right Hypo  though I think that a GP is about as fit as an endo to decipher the bloodtest results, particularly in the case of gyno where 3 or 4 data are enough to make an opinion. Agree? Moreover, the reference numbers vary with labs...and with docs!!

I'd disagree. I think that not only GP's but most endo's aren't  fit to accurately decipher blood work as it relates to gyne causation.  You need an endo that specializes in reproductive endocrinology.

[Hypo-is-here]

JC71 is quite right IMHO and experience.

Further more the AACE (American Association of Clinical Endocrinologists) concur and highlight this problem in the 2002 guidelines on Hypogondism (low testosterone).

I quote them verbatim

Conclusion
The recognition, evaluation, and treatment of hypogonadism in the male patient are often dismissed by the patient and overlooked by the physician.
Unquote

In short these matter should only be considered by an endocrinologist who has an interest in reproductive endocrinology as this is the only way to ensure correct diagnosis.

Gynecomastia is the physical manifestation of a hormonal imbalance be it temporary such as pubertal imbalance or more permanent via hypogonadism or liver disoders etc and endocrinologists are experts in hormones and their investigation.

Plastic surgeons ARE experts in gynecomastia removal but NOT experts in the causes or investigations of gynecomastia.

An appropriate endocrinologist should evaluate the reason as to why an individual has gynecomastia and a surgeon should remove it if that is your wish.

Any other advice is questionable.

[Allan7865]

So in short... a doctor cant tell if anythings wrong with your hormones?

[GodWasAngry]

i took a blood test before i went to the endo and everything was OK with my hormones

[brm]

OK Hypo. After all, I'm no doc. But there remains the problem of the labs. Extraction methods vary from one lab to the other and bloodtests can give very different results...regardless the fact that the brackets are always very wide and make things even more confuse. For instance, I had my blood tested for TSH more than once. On the 15 of january 05 one lab said 8.2. On the 2nd of february (2 1/2 weeks later), another lab said 2.5! Such a slip was improbable. And docs? One told me that hypothyroidism was from 4 and under. Another told me 2 and a last told me 0.5/1. What's your opinion about the variability of data from bloodtests. How can they be circumvented?

[Hypo-is-here]

Hi brm,

Your questioning of the reference ranges is nothing less than understandable.

Of course I cannot comment on your situation specifically, just generally as I am not aware of the nature of the tests that you had.

What I can say is that differing hospitals use differing techniques for assays/tests, having differing levels of sensitivities and equipment calibrations and this often accounts for differing results found.

What is important is that the reference ranges for any given test are based around these individual tests/sensitivities/calibrations etc.

Without the correct accompanying reference ranges it is impossible to correctly interpret the nature of the test results themselves.

Differing methodologies can also be a factor when looking at test results, this is particularly true when there appears on the face of it bizarre discrepancies in the expected results, results that on the face of it do not seem to make sense.

The above accounts mostly for the confusion of the lay person/patient in trying to interpret their test results.

Of course tests are also open to error, some more so than others and doctors too are capable of misinterpreting their results.  In fact there are many ways of misinterpreting results.

Last of all a top endocrinologist will understand the limitations of blood pathology and will understand the need not to rely on them exclusively, but rather to use them as a tool or guide in combination with symptomatology and examination in order to arrive at a correct diagnosis.

This last point is a very important one- I have detailed the problems that occur when doctors strictly interpret pathology to the exclusion of symptoms in my second post in the thread below.

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=1;action=display;num=1135945949

That is a little convoluted I know but I think you are someone that prefers explanation to excuses, so hopefully it gives you an idea of the issues at play.

The bottom line is a good endocrinologist who has an active interest in reproductive endocrinology, a doctor who has studied and qualified in the study of hormones is best placed to investigate these matters and arrive at a correct diagnosis.

Like I say it is better to be safe than sorry.  

The majority of people will simply be told that they are well and that their gynecomastia has no underlying cause; that is a statistical reality.  

But there is a significant minority who do have underlying causative factors that require diagnosis and treatment and for those people it is important to get the correct diagnosis.

And of course no one knows what boat they are in until they have had their situation covered via a consultation.


See an endo have your gynecomastia checked out, then IF you wish for it to be removed see a surgeon- in that order.