Important information for gynecomastia

[Logic]

I also have gynecomastia, I am seeing an endcrinologist next week where I will be asking to be prescribed Arimadex in the short term and put on a waiting list for an operation on the NHS (uk health system).

Did you get the Arimidex prescribed at that time?

[hypo]

Yes.

It did not reduce or resolve my gynecomastia but it did stop it from getting any worse.

The problem with Arimidex is that A) there have not been any controlled studies using it (at least none that I am aware of) so B) there is no way of knowing what dose would be successful if any in the successful treatment of gynecomastia.

That is not to say Arimidex can not be a successful treatment, just that at a given dose in one person namely me it was not successful (but I do not constitute a clinical study).

It would be very useful if such controlled studies were conducted so that its rate of success in the treatment of gynecomastia at varying doses could be compared to that of dihydrotestosterone, Clomiphene Citrate and Tamoxifen etc.  

[Logic]

Doesnt surprise me that it didnt improve your condition.

Actually I am surprised you got it prescribed in the first place.

[hypo]

Please explain?

[Grandpa Bambu]

Please explain?

Yes, please explain...

[Gine2D]

Arimidex is a powerful drug.  Its results are different for each person.  It stops the conversion of Testosterone into Estrogen.

One tablet per day may be correct for one person & 1/4 a tablet a week may be correct for another.

If the Estrogen E2 is driven too low then the body has many more problems.

So it is very serious to use it.

It may stop the growth of breasts, but will not reverse the growth.

It may cause other more serious to your actual health problems than breasts.

Don't play with hormones without a doctors help & lab tests to check the levels.

Other drugs can be used to lower E2, but they also need to be used with tests to get the proper dosage since they vary from person to person.

I now have my E2 levels at 21 in a range of 21 - 52.
Total Testosterone at 540 in range of 230 - 800.
2% free testosterone.

Without the drug I am taking of 1/2 tablet a day, the E2 goes over 75 & the breasts start to grow again.

It is not Arimidex, it is much too powerful.  Arimidex was developed to prevent breast cancer in women.

G

[hypo]

Hi Gine2D,

I was put on arimidex by my specialist for a while and it did lower my E2 to a good level but I agree with your concern regarding its use.

Its affects will differ person to person as you rightly say it should only be used by those who have had it prescribed.

Can I ask what makes you think quote

It may stop the growth of breasts, but will not reverse the growth.
unquote

I haven't seen any medical trials regarding its use so cannot comment one way or the other.   Apart from saying that in those who have just had breast development- I would have thought it could lower estrogen status and reduce/resolve gynecomastia.

Whilst arimidex wasn't developed for its use in this setting it is being used by endocrinologists across the world as is tamoxifen which was also developed for to prevent breast cancer in women.

Primary licenses are not the issue though

e.g

Aspirin is used world wide to thin the blood in people who are at risk for strokes- but its not what it is licensed for.  
 
There isn't a single drug in the UK that is licensed for use in children they just adjust adult doses.

The real issues are the effectiveness and viability of any given therapy and on that note the jury is out on arimidex.

Not disagreeing with you much though just weighing up the situation out loud- I agree with much of what you have said as its spot on.

[Gine2D]

Hypo,
The quote you asked about,  I have no direct evidence or study, only talk from guys that have tried it.

It did reduce their E2, & sometimes too much.
E2 is what is mainly  involved in breast growth. They quit because it was too had to control the E2 levels.

Once mammary glands are grown it will not make them go away according to the guys that used it for months.  It did stop the futher growth.

I use IndoPlex DIM & Zinc.  It lowered my E2 by 60 points in 2 weeks with a tablet a day.  I then cut it to 1/2 a tablet per day & 50 mg Zinc.  But breast were not reduced.

Some studies in Canada & I think at the Mayo Clinic showed tha in puberty small doses of testosterone & some method of lowering E2 would stop & reverse breast growth.  But it was in 12 to 15 year olds.  The research is new & on going.

E2 above 75 starts breast growth in me.  I am trying to keep it at about 22 & the Testosterone above 500

I use 2% compounded testosterone gel.  Androgel was not strong enough for my body, it is 1% testosterone.

G

[hypo]

Quote
It did reduce their E2, & sometimes too much.
E2 is what is mainly  involved in breast growth. They quit because it was too had to control the E2 levels.
Unquote

Yes certainly arimidex can lower E2 too much and this causes its own problems- your are quite right.  

It is now being questioned as to whether or not estradiol is the best indicator of estrogen status in the male given its short half life and the fact that assays are often callibrated toward female reference values.  It remains the most common test to assess estrogen status as it is often the most readily available and practical assay.  However it has been argued by some eminent biochemists studiying this that estrone sulphate may be a better guide to estrogen status in the male.

Quote
Once mammary glands are grown it will not make them go away according to the guys that used it for months.  It did stop the futher growth.
Unquote

This is important on the ground information and something I found myself- in the absensce of controlled medical studies it is all the information we have.  Of course this does not mean that it cannot reduce/resolve gynecomastia as, it just means that it hasn't in those that have used it who we know who have been prescribed it, it does of course give us the distinct impression that its effectiveness is in question though at reducing and resolving gynecomastia- (but not in preventing it).

Quote
I use IndoPlex DIM & Zinc.  It lowered my E2 by 60 points in 2 weeks with a tablet a day.  I then cut it to 1/2 a tablet per day & 50 mg Zinc.  But breast were not reduced.
Unquote

Yes DIM being a more natural route does work for at reducing and keeping E2 in check in a number of guys.  

I know that it works in the liver by converting estradiol to a weaker/less potent estrogen- something that allows for healthier metabolisation of estrogens.  I do not know whether that is its only site of action or whether or not it works at the hypothalamic level or not-I suspect not but I do not have the details of its actions.

It has not been studied in the setting of gynecomastia (at least as far as I am aware), something that would greatly interest me.   Hopefully controlled studies are on the way.  Zinc of course is a natural aromatse inhibitor and can also be useful, particularly if you are deficient in Zinc to start with, which many people are.  It is best to be taken with with copper so that copper is not imbalanced.

Quote
Some studies in Canada & I think at the Mayo Clinic showed tha in puberty small doses of testosterone & some method of lowering E2 would stop & reverse breast growth.  But it was in 12 to 15 year olds.  The research is new & on going.
Unquote

Yes- it is sad that reseach into male hormone issues is so far behind that of female hormone reasech which has recieved far more attention and money in the last twenty years.

Quote
E2 above 75 starts breast growth in me.  I am trying to keep it at about 22 & the Testosterone above 500
Unquote

Yes, it is very much an 'individual chemistry' set as Paw Paw correctly gathered with each person having different levels that represent a healthy normal for them.

Quote
I use 2% compounded testosterone gel.  Androgel was not strong enough for my body, it is 1% testosterone.
Unquote

Interesting.  Androgel has a total of 5mg of testosterone within a 50mg compund of gel per packet with a maximum dosing reccomendation from Schering of 10mgs- two packets.

What is the total testosterone quantity in your TRT.

Schering have produced an injectable TRT for Europe- not sure when it will be available in the US, but it is called Nebido.  It is Testosterone Undecanoate- a preperation that converts very little to estrogen and lasts in the system for three months.  It has a steady relases formula that avoids the roller coster levels associated with older preperations.  It may be something you are interested in...see below

http://www.nebido.com/en/index.php?flash=6

[Gine2D]

The 2% compounded testosteron gel as 10 g.

Twice the strength of AndroGel.  The dose size is 2 ml for 10 grams of testosterone.

2% AndroGel would be two 1% 5g packets and over $300.00 per month.  Compounded 2% testosterone gel is about $45.00 per month.  I use College Pharmacy online.

I put on 1 ml in the morning & 1 ml in the early evening.  That reduces the conversion to E2 factor.  

Research is also being done on the T:E2, E2, E1 & E3 ratios now for sexual & gyne problems.  But it has just started.


G

[hypo]

Interesting Gine2d

What is the source of the reseach your are refering to- is it Dr Shippen?

I'd be interested to know the details if you have any.

The Andropause Society had a conference in London a few days ago and things may be on the move somewhat.  

[Kevin]

Hypo,

I have hypogonadism and I plan to get testosterone replacement after my gyne surgery. Living in a developing country and factoring out my budget I am left with two options: One is to take Proviron (mesterolone) 3 tablets daily for 6 mo. or until secondary male characteristics gets fully developed then lower dosage to 2 tablets daily as maintenance. Two is to order Testosterone Depot from Europe and inject it at least once every 2 weeks.

My hypogonadism is severe because not only did I have gynecomastia, when I am on the phone 50% of the time people mistakenly thought I am a female. Also my body has a female contour because fat distribution I think is being controlled by estrogen instead of testosterone. Logically when I take testosterone such as Proviron there will be fat redistribution and leaner muscle mass to form a more muscular physique.

My question is if you have a better idea on how I am going to take testosterone replacement teraphy since you are more experinced in these stuff. My budget is approx USD 64 to USD 73 per month and I have the capability to order online and have it shipped to my country.  Im wondering if you know any other options that I can pursue and where I can order it.

Kevin

[hypo]

Hi Kevin,

What concerns me is the fact that you sound as though you have been left to deal with this condition on your own.

You need expert qualified help in the form of a good endocrinologist to help medicate and review how you are medically- this is very important.

Also you need to know why you have hypogonadism because depending on the problem you have different options in terms of treatment.

Typically hypogonadism is either due to testicular problems or problems with the hypothalamus/pituitary.

Both of which can occur pre or post puberty.

If your problem is pre puberty you would need testosterone replacement of some kind TRT, but if you problem is post puberty and stems from a hypothalamus/pituitary problem then you would be able to retain fertility and use a different form of treatment.

So you need to get a good diagnosis as to your problem, it is not good enough for a clinician to just say you have low testosterone/hypogonadism.

Just to reiterate;

You need to know is the problem pre or post puberty and where does the problem stem from.

Proviron is usually not a particularly effective therapy for most people with hypogonadism.  Your budget will probably afford testogel/androgel.  This form of replacement therapy is less likely to convert to estradiol and cause gynecomastia re-development than injectables.

But again you would need pathology and good medical care to know what dosage is correct for you and you would need other hormones checked to ensure you are ok on any given dose.

To prevent gynecomastia re-development you might need estradiol (a form of estrogen) managed as well as testosterone replacement.

If you tell me where you live I might be able to help with an endocrinologist (could be difficult given where you live but I will try).

In the meantime check out this site;

http://www.androids.org.uk/index.html

And post any further questions you have to a wider group of sufferers here;

http://www.globalandropause.com/forum/disc6_frm.htm

You can private message me as to your thoughts- in fact you can answer this mail via a private message if that is your preference.

Either way I want to try and help you get a good diagnosis and treatment.

[pumpseeker]

hey hypo  Are you a Doctor(MD)

Why do you try to sound like one ?

How come you did not become a Doctor(were you too poor or stupid)?

Do you have any intials after your name?

Let the real doctors answer the Endo questios(for everyones sake)

PS -
Do you actually understand all the info that you cut and paste from the REAL DOCTORS Journal? Maybe thats why you cant explain it to people in a way where the average person can understand it.

[hypo]

I understand the information; I don't cut and paste it.

I understand the information because of my own hormone problem, the many endocrinologists I have spoken with, the many books I have read on the subject, the many pathologies I have seen and the many sufferers I have spoken to etc

I don't diagnose or treat anyone; I simply offer support and information.

That is something you will find is the case on many support sites.

e.g. The American Hemochromatosis Society is run by a very knowledgeable nice lady who whilst not being a qualified doctor, does great work to help sufferers of that condition.  

You see this is a support site :-/

Instead of mooching about this site insulting people why don't you do something productive with your time, whether that is offering support or sharing your experiences etc.

If you cannot do anything positive I would suggest leaving, which would be more positive than continuing in this vain.