Androgel and Gyne

[StevenC]

I have a congenital problem that causes that low or no Testosteron is produced within testicles. Kallmann's syndrome it's called.

I am using Androgel, but I'm afraid gynecomastia can result from that. I already had a littlebit breast before treatment with Androgel, but I donno if it grew larger as a result from treatment. How can Testosteron cause breast growth and how do I prevent it? What has Estrogen to do with that??? If I switch over from Testosteron Gel to Testosteron Intravenous, will this prevent breast growth??

I'm seeing a doctor, but he does not provide me with much  information.

Fortunately, I do not have the breasts size of woman, but still they look a bit pointy. Next month I got a x-ray scan sheduled. And then I'm seeing this doctor again.

[Hypo-is-here]

Hi StevenC,

You need an experienced endocrinologist who has experience in this specific area of medicine- many endocrinologists specialize in other areas and do not fully understand the medicine they practice.

Testosterone does convert into estrogen and can and often does result in gynecomastia development.

What you need is to have your SHBG and estrogen levels checked.

If estrogen (estradiol is a type we refer to) measured and it is in the upper third of the male range or higher then you need it lowered via aromatase inhibitor like arimidex.  If SHBG is too high then you need a change of TRT or a SHBG lowering medication.

Info here

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

Help at hypogonadism forums here;

http://health.groups.yahoo.com/group/hypogonadism2/

and here;

http://www.andropause.org.uk/signin_forum.asp


Go to the info and forum pages and get try and become more informed so you can get better treatment.

I hope that helps.

[Needhelp]

My Endocrinologist is putting me on Androgel because I have low testosterone levels (265) but my original reason to to seek help was for my gynecomastia.

Has anyone hear ever heard of Androgel as a form of treatment for gynecomastia. Everything I've read so far says Androgel could enlarge the breast and create pain around the nipple.

[Hypo-is-here]

Androgel/testosterone converts to estradiol and can increase the
development of gynecomastia in some individuals. In others
individuals it can help reduce gynecomastia and in yet others it has
no effect at all.

The reason for this that we all have differing hormonal chemistry.

What you need is for all the important hormones to be evaluated
prior to treatment and you need a diagnosis to be nailed down
first and foremost. This means that you would probably be better
having a full assessment of the HPTA (dynamic testing) and an MRI
prior to treatment.

Knowing exactly what your situation is pre-treatment will make
things much easier to understand on treatment for you and your
doctor should gynecomastia continue to be an issue. It will empower
you and your doctor and allow you to compare the vital hormones and
balances and how they are being affected by treatment.

So you need

Dynamic assesment of the HPTA which means a morning in hospital and
the taking of bloods at intervals after being primed with various
test substances such as GnRH.

You need a full hormonal panel;

LH
FSH
Free Testosterone or total testosterone
SHBG
Estradiol
Prolactin
IGF-1
DHT

Given the gynecomastia it is also worth having additional hormonal
testing to exclude other issues.

TSH
freeT3
FreeT4
Liver function test
Kidney function test

Along with the above you need a physical from the endo and detailed
list of symptoms.

Once you have all the above you will hopefully know why you have low testosterone, something that is important. You will know the nature of the
diagnosis, you will know whether SHBG is high or estradiol
causing issues, whether there is more to your situation such as low
GnRH/LH and pituitary issues etc etc

I promise.....although this sounds long winded it is by far the
best thing to do. Leaving all this and just jumping into treatment
is fine if all goes well. But if you do that and things do not work
out trying to ascertain why things are not working can then be VERY
difficult.

If you remain off testosterone post diagnosis you will have an increased chance of developing diabetes (1 in 3 men with type 2 diabetes has low testosterone).  You will have an increased chance of osteoporosis which can kill (I have it as a result of long term untreated low testosterone.  You will have an increased chance of cardio vascular disease, and increased risk of stroke of developing dementia or alzeimer's.  You will also be fare more likely to suffer from depressiopn and anxiety as well as increased obesity.

You absolutely need some form of testosterone replacement therapy froma health point of view.  But you need a full assesment and definitive diagnosis first and you need to know what all relevant hormone levels are prior to treatment- not just testosterone


I hope this helps.....go see the links in my prior mail they can offer help.

[Needhelp]

Hypo'

Thank for your post.

My Endocrinologist did request I get an MRI which I made an appointment for and then cancelled.

You made some excellent suggestions and I'm planning to follow up on many of them.

I didn't realize the low testosterone levels could be lead to so many problems. It may be my gynecomastia is the least of my worries.

In general I'm in excellent shape and feel pretty good. There comes a point when you think all these test are not necessary. Plus all the medications now prescibed are the root to more complications.

I'm not sure you saw my some of my earlier post that all my problems started when I received side effects from statin drug I took for cholesteral.

Its just frustrating

[Hypo-is-here]

You can't presume anything is the cause of low testosterone even if something seems probable.

You need a definitive diagnosis and you need to know what hormones are prior to treatment.

If you have already been put on treatment then your doctor is irresponsible and does not understand these matters properly.

If this has happend then you still need an MRI and a full hormonal assesment.

You might have high estradiol or SHBG, Prolactin etc that that is causing the gynecomastia.  Many men in this situation have additional treatment.  Men men with elevated estradiol due to TRT are prescribed arimidex for example.

Good to hear you are in good shape- to stay that way you need correct treatment.

One thing for sure if you went undiagnosed and/or untreated with low testosterone for many years you would have a real chance of developing some of the problems I mentioned.

Something you don't even want to contemplate.

[Needhelp]

Hypo

I should of told you some testing of the homones testing was done. Not sure how complete but I did receive a copy.

Prolactin was 5.8
Testosterone was 268
Hemoglobin was  5.5 which is borderline but not Diabetic <6.0%

Not sure what other test if any but she put me on the Androgel

[Hypo-is-here]

Not much there as you can see when comparing what you have listed in comparison to what I have listed.

All I can see is that your endo might have ruled out prolactin as an issue.

If the endo has performed more tests- relevant ones as I have listed then you need to find out which ones and what the levels were.

Your endo is being far from transparent in explaining your situation and has probably just chucked you on treatment without a full assesment.

You need to ask more questions;

What else has been tested?

What were the results and accompanying reference ranges?

What has the endocrinologist diagnosed in terms of hypergonadotropic or hypogonadotropic hypogonadism and what is their diagnosis based upon?

You also need a full hormonal assesment (the tests I mentioned) now that you are on treatment to see how you are fairing.

If your endo is not helpful and keeps their finger in their ass you need to fire them and go and see someone more competant.