Gynecomastia 30 y/o

[SmoothSTL]

Hello Everyone,

I am new to this site. Here is my situation. I was diagnosed with Low Testosterone when I was 28 years old. My Test came back as 241 Total testosterone. I was placed on Androgel 1%. After taking this for about a year, the Endo Doc sugested I stay off it for 6 months then get tested to see if it regulated. I tested about a month ago at 454. About 2 weeks ago, i started getting breast soreness and puffy nipples. My Primary Care Physcian put me in for a Mammogram, which came back as Gynecomastia. I have a Referral back to the Endo Doc. My PCM tested my HCG(Testicular Cancer) and my markers where normal. She put me in for a Basic Metabolic Panel(Sometimes kidney issues can cause this, so can liver) But everything came back normal. I was put in for FSH/LH? Still waiting for results. I had this done last year and it was normal. My Prolactin was in normal range(Pituitary MRI was normal, no Tumor). I just dont know what else could cause this. My official diagnosis was Hypogonadism with idiopathic reason(Not known yet). Cortosil/ACTH level was normal(For Cushing) Is there any other tests that they can conduct, Im just at a loss..

[SmoothSTL]

Also note, my sex drive was fine all the way up to I started having issues. Im still able to have sex, but my drive is lacking.

[Paa_Paw]

I am not wanting to sound like this is a joke, This truly is a serious issue. But, the most common cause of Gynecomastia is: "I Don't Know."

Several things come to mind, but your statements do a pretty good job of eliminating the things I was thinking of.

[SmoothSTL]

My FSH/LH came back at 2.0. So i still in limbo....We will see how the Endo appt goes on Monday

[greatlakes]

454 is not bad, but not great either. Normal ranges are very wide (too wide in my book). Something like 250-830 is the acceptable range for T.  I would think you would enjoy the 5-600's better.

You did not mention it but what is your estrogen level doing?  T to E ratios are worth looking at.

Also how is your weight doing?

[SmoothSTL]

Still waiting on my estridol test results. they also ran another Testosterone check. I will post results as I get them. I will also let everyone know how my Endo appt went on monday. Good day!

[SmoothSTL]

I made a error. My free testosterone is 88. Not sure what mt T/E ratio is. Maybe the Endo will test it monday. Here is a picture of me. as you see, im dealing with stomach and chest fat.

[SmoothSTL]

It would be great if i could get some other ideas of what causes hypogonadiam/gynecomastia

[anon111]

i can relate to this and am looking for some of the same answers. i'm 28 years old., 5'11" and 175 lbs. i'm quite lean and have 10-12% body fat. i work out regularly, have never used steroids or drugs of any kind, including marijuana, and to my knowledge don't eat copious amounts of soy, etc.

six months ago i noticed some soreness and growth near my right nipple. after seeing several doctors, i was diagnosed with gynecomastia. i think that i've had puffy nipples for a long time, at least since my early 20's, but the new growth is alarming. i've been more concerned that it's a symptom of a bigger problem and went to see an endocrinologist.

in a nutshell, here's what i learned:

- total T = 288
- free T = 83
- estradiol = 35
- prolactin, thyroid, FSH, HCG, etc all tested normal
- a urologist ruled out testicular cancer

my first endo said that everything tested normal and that perhaps i have a "increased sensitivity to estrogen," and prescribed tamoxifen. i was alarmed by my T results, which he described as the "low end of normal" and decided to rerun the tests and get a second opinion. i'm awaiting my results.

note that i've been under chronic stress and anxiety and the addition of gynecomastia only added to it. i think that my worry led to a mild case of adrenal fatigue, from which i'm recovering. the second endocrinologist is also checking my cortisol levels.

a few questions for those in the community who might know:

- could chronic stress interfere with my testosterone production enough to trigger gynecomastia?
- what are the side effects of tamoxifen? if my T levels turn out to be normal, would tamoxifen curtail the growth? could it decrease the the gyne? would i need to stay on it permanently to remain free of gyne?
- if my T levels turn out to be low, what are the side effects of testosterone replacement, such as androgen? could increasing T be enough to eliminate the presence of gyne, or would i need to pursue surgery in addition?
- is there the risk of gynecomastia returning after surgery? how can i be sure that it's no longer growing before surgery?

[SmoothSTL]

Had Endo APPT. My Testosterone is now at 563 and free at 109. He said the Gynecomastia came from the Androgel I was taking. He said it should go away. He tested my Prolactin again and all the other hormones, but my HCG came back normal, Along with Estridol. He said I was on the road to recovery. I think that STRESS AND ANXIETY caused my low T. I went through a period of ALOT of stress.