i have very low testosterone

[TigerPaws]

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. =\

I would suggest caution when using Saw Palmetto as this is one of the herbs most often used by many men in the transgender community to enhance breast development.

The human endocrine system is unbelievably complex and varies greatly from person to person. More often that not genetics plays a big part as will being overweight.

Generally once gynecomastia develops you are going to be more or less stuck with what you have developed unless you correct the underlying root cause then have some form of surgical procedure.   

[greatlakes]

I have found Tamoxifen to be covered by insurance the times I have tried it, I am considering Arimidex, as it is a true AI blocker, where as Tamoxifen blocks absorption. Not sure if insurance would have an issue or not with Arimidex.

I am not big on any type of herbal supplements but I am trying Natures Way DIM for E2 moderation.

This has been a good discussion.

[Dr. Robert Wilcox]

You are correct in saying Arimidex is an aromatase inhibitor and it is only FDA approved for female cancer treatment.  It is not FDA approved even for the 1% of breast cancer patients who happen to be male.  That is because the drug companies have to set up very expensive studies with large numbers of patients to earn the FDA Approval.  However, physicians are allowed to prescribe medications in situations that are not FDA approved, such as Arimidex for gynecomastia.  This is called "Off Label Use" and is the very normal standard of care for many, many prescriptions and perfectly proper. 

Unfortunately, it gives health insurance companies more leeway to deny coverage for some treatments, particularly expensive drugs such as this one.

Dr. Dr. Dr. Wilcox

[mandystorm]

For very low testosterone levels, you should eat a healthy diet that's full of proteins and monounsaturated fats. Work out on a daily basis. Ageless Male is a dietary supplement that boosts testosterone levels and even increases energy metabolism. If you wish, go through Ageless Male reviews to find out how men have successfully used this product. A word of caution here - gynecomastia can be a side effect of testosterone therapy and boosters. Even though you have undergone surgery and have rid yourself of this condition, it's very important that you discuss with your doctor before you take any testosterone boosting supplement. youtube.com/watch?v=UvDMVJv9SOk

[tpuk]

Mine is the lower end of the UK scale but still considered normal by the endo at 12 on a scale 9-28. That is what a 90 year old gent would have apparently.

I've had g since teens (now 39). The Endo did another blood & sent a letter saying everything is normal.

My GP was baffled by my thinking that low T could have had some part in development of the gyn.

I certainly don't feel confident in the endo/GPs here in the UK regarding T-replacement.

I think the US are further ahead in terms of controlling aromatisation of excess T into estrogen by using e blockers & regular, comprehensive blood work.

So even though i feel t-therapy would help me (i suffer bad lethargy, brain fog, poor muscle mass, less secondary male characteristics like full beard etc) I will likely hold out on treatment until I speak to a medic who knows at least as much as me about the subject.

I got my bone density checked after some reading & that is low (as I reasoned it would be). I will be seeing a specialist about that.

Check out LowTguy on youtube, he also has a forum. There is alot of info on there.