Hormones fine now what?

[patrickwkimball]

Hi, I have a history of gynecomastia and had surgery 3 years ago to remove it.  My hope was that it would not reoccur but unfortunately it has and I pretty much deal with growing glands on a consistent basis. 

My plastic surgeon suggested I find a good endocrinologist to find out what is happening with my hormones which I did.  After months and months of testing and tinkering and trying different med's ie, femara, trying different proton pump inhibitors, etc.. we cannot identify what's causing it.  One thing is clear though after numerous tests, my testosterone levels are low, mid 300's, but not low enough to warrant TRT and my estrogen levels are consistently between 30-35 which is not unusual I'm told. 

So now my endo is telling me we've done as much due diligence as possible and it's time to go back to my surgeon to explore other options.  He said something about the possibility of having the surgeon test "cells" to determine the origin??? 

Are any of you familiar with this and I guess moreover, what are the next steps I can take at this point because I am completely lost and just want the breast growth to stop.  Thanks.

[Dr. Elliot Jacobs]

You may not have had a complete workup for your gyne.  Have you had your prolactin and thyroid levels checked as well? Are you on any other medications which could cause gyne as a side effect??

Also, you should consider that the re-growth you have experienced may not be re-growth of breast tissue but rather exuberant scar tissue, which can be treated with a simple cortisone injection.

Dr Jacobs

[patrickwkimball]

Thank you for the reply Dr. Jacobs and yes included prolactin and thyroid in the testing and levels are consistently normal.

I can see how scar tissue could have similar characteristics but I don't believe that to be the case.  I've experienced gyno since I was in my early 20's and these symptoms are no different.

I've been to 3 different endo's and none seem to have an answer.  Starting to feel like I have a highly unusual case which is making me pull my hair out. 

So are you saying that without a diagnosis from an endo, a surgeon can't really help with figuring out what's causing it?

Thanks again for the reply.

[Litlriki]

If all of your studies are normal, it's difficult to understand why you would have recurrence.  As Dr. Jacobs suggested, it may not actually be recurrence, but rather scar tissue. Another possibility, which was the case in a patient I treated recently, who had theoretically undergone removal of his gynecomastia four years ago, is that the tissue was never fully resected in the first place.

Rick Silverman