Horrible Gyno with Low Estrogen / SHBG

[Maca]

I've having extreme problems with Gyno that I just can't seem to control. It only happens on my right breast and I've got a lump under my chest that I've had for a long time but recently it has started to grow and a second lump has formed.

I've used this does of testosterone for a long time with no issues, in fact i've done more Test in the past without issues. 87.5mg Test Enanthate per Week - E3D Injections. No HCG, No AI. My bloodwork all looks the same as in the past when I didn't have issues.

My right chest is puffy, sensitive and itchy. It's definitely aromatising and the lumps are growing. I've tried lowering my test dose and this does reduce the aromatisation although I do I get anxiety, my joints start to hurt and I struggle to focus and work. I've also tried using an aromatise inhibitor at very low dosages and I get similar side effects. I believe this is due to already having low estrogen and while going lower helps with gyno its not enough for mental wellness, etc. So i'm stuck with where to go next.

BLOODWORK
Test Total - 9.2ng/mL (2.8-8.8)
Test Free - 10.3 pg/mL. (9-35)
Estradiol - 33 pg/mL (<50)
SHBG - 24.5 nmol/L (17-77)

Albumin - 4.6 g/dL
DHEA-S - 435 ug/dL (167-590)
Progesterone 0.5ng/mL (0.0-0.4)

Liver/ Kidney, thyroid checks also all in range.

Although my free test is on the lower end of the scale and my total test is above the range. Could this have anything to do with it?

---

Going to get prolactin tested next, although any other suggestions would be well appreciated.

 

[madman]

I've having extreme problems with Gyno that I just can't seem to control. It only happens on my right breast and I've got a lump under my chest that I've had for a long time but recently it has started to grow and a second lump has formed.

I've used this does of testosterone for a long time with no issues, in fact i've done more Test in the past without issues. 87.5mg Test Enanthate per Week - E3D Injections. No HCG, No AI. My bloodwork all looks the same as in the past when I didn't have issues.

My right chest is puffy, sensitive and itchy. It's definitely aromatising and the lumps are growing. I've tried lowering my test dose and this does reduce the aromatisation although I do I get anxiety, my joints start to hurt and I struggle to focus and work. I've also tried using an aromatise inhibitor at very low dosages and I get similar side effects. I believe this is due to already having low estrogen and while going lower helps with gyno its not enough for mental wellness, etc. So i'm stuck with where to go next.

BLOODWORK
Test Total - 9.2ng/mL (2.8-8.8)
Test Free - 10.3 pg/mL. (9-35)
Estradiol - 33 pg/mL (<50)
SHBG - 24.5 nmol/L (17-77)

Albumin - 4.6 g/dL
DHEA-S - 435 ug/dL (167-590)
Progesterone 0.5ng/mL (0.0-0.4)

Liver/ Kidney, thyroid checks also all in range.

Although my free test is on the lower end of the scale and my total test is above the range. Could this have anything to do with it?

---

Going to get prolactin tested next, although any other suggestions would be well appreciated.

You are only injecting 87.5 mg T split every 3 days and hitting a robust TT roughly 900s ng/dL and seeing as your SHBG is only 24.5 (not very low) then your FT should be much higher.

The mistake you made was the testing method used for FT is most likely inaccurate and you would need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where your FT level truly sits.

Doubtful it is as low as your blood work states.

When was blood work done after your injection?

We want to know the true trough which in your case would be 72 hrs post-injection as you are injecting every 3 days.

If you have developed a lump which you have had for a long time then you will most likely need surgery to remove it.

I would look into seeing a specialist and your best bet would be to have it removed permanently.

Look into retesting your TT/e2 using LC-MS/MS and FT using Equilibrium Dialysis or Ultrafiltration so you can see where your TT/FT/e2 levels truly sit on such protocol (dose of T/injection frequency).

Where do you live?

 

[Maca]

You are only injecting 87.5 mg T split every 3 days and hitting a robust TT roughly 900s ng/dL and seeing as your SHBG is only 24.5 (not very low) then your FT should be much higher.

The mistake you made was the testing method used for FT is most likely inaccurate and you would need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where your FT level truly sits.

Doubtful it is as low as your blood work states.

When was blood work done after your injection?

We want to know the true trough which in your case would be 72 hrs post-injection as you are injecting every 3 days.

If you have developed a lump which you have had for a long time then you will most likely need surgery to remove it.

I would look into seeing a specialist and your best bet would be to have it removed permanently.

Look into retesting your TT/e2 using LC-MS/MS and FT using Equilibrium Dialysis or Ultrafiltration so you can see where your TT/FT/e2 levels truly sit on such protocol (dose of T/injection frequency).

Where do you live?

Hey manman, thank you for taking the time to respond.

This bloodwork was taken on day 2 (24 hours after injection) as I was trying to get the peak of my levels to find out if my estrogen was out of control during this period as normally I would get my bloodwork done on Day 4 (trough), when my next injection was due.

Although all previous blood (taken on trough) is in line with this, TT around 900, estrogen around 30 so I can't see it being significantly different

I do know the blood testing method used to get the Free T, there is no mention of it on the results print out, so would have to call the lab. Although at this point my main concern is getting control of the gyno, without crashing my estrogen.

I've got surgery booked to remove the gyno, but I would like to understand what is causing it.

Also in reguards to the Free T not being as low as stated, I've never been successful with TRT and don't feel particularly great on it. Yes better than before but I still have low libido, fatigue etc so it could line up and be a representative value.

Also I saw a video today

where it was said gyno can be caused in guys with low T and normal estrogen values because there is not enough androgens to couter-act the aromatising activity. Which sounds very similar to me. I wonder if I might have low DHT too

 

[madman]

Hey manman, thank you for taking the time to respond.

This bloodwork was taken on day 2 (24 hours after injection) as I was trying to get the peak of my levels to find out if my estrogen was out of control during this period as normally I would get my bloodwork done on Day 4 (trough), when my next injection was due.

Although all previous blood (taken on trough) is in line with this, TT around 900, estrogen around 30 so I can't see it being significantly different

I do know the blood testing method used to get the Free T, there is no mention of it on the results print out, so would have to call the lab. Although at this point my main concern is getting control of the gyno, without crashing my estrogen.

I've got surgery booked to remove the gyno, but I would like to understand what is causing it.

Also in reguards to the Free T not being as low as stated, I've never been successful with TRT and don't feel particularly great on it. Yes better than before but I still have low libido, fatigue etc so it could line up and be a representative value.

Also I saw a video today

where it was said gyno can be caused in guys with low T and normal estrogen values because there is not enough androgens to couter-act the aromatising activity. Which sounds very similar to me. I wonder if I might have low DHT too

If you tested at the peak than highly unlikely your FT would be that low.

What lab did you have blood work done?

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

We need to know where your FT truly sits and I would not rely on any other testing method for FT other than Equilibrium Dialysis or Ultrafiltration which I highly doubt was used in your case.

Would also have estradiol tested using LC-MS/MS.

Have you ever tried Nolvadex?

Regarding libido/fatigue, many other factors other than FT could be the cause.

 

[Vvs1]

I've having extreme problems with Gyno that I just can't seem to control. It only happens on my right breast and I've got a lump under my chest that I've had for a long time but recently it has started to grow and a second lump has formed.

I've used this does of testosterone for a long time with no issues, in fact i've done more Test in the past without issues. 87.5mg Test Enanthate per Week - E3D Injections. No HCG, No AI. My bloodwork all looks the same as in the past when I didn't have issues.

My right chest is puffy, sensitive and itchy. It's definitely aromatising and the lumps are growing. I've tried lowering my test dose and this does reduce the aromatisation although I do I get anxiety, my joints start to hurt and I struggle to focus and work. I've also tried using an aromatise inhibitor at very low dosages and I get similar side effects. I believe this is due to already having low estrogen and while going lower helps with gyno its not enough for mental wellness, etc. So i'm stuck with where to go next.

BLOODWORK
Test Total - 9.2ng/mL (2.8-8.8)
Test Free - 10.3 pg/mL. (9-35)
Estradiol - 33 pg/mL (<50)
SHBG - 24.5 nmol/L (17-77)

Albumin - 4.6 g/dL
DHEA-S - 435 ug/dL (167-590)
Progesterone 0.5ng/mL (0.0-0.4)

Liver/ Kidney, thyroid checks also all in range.

Although my free test is on the lower end of the scale and my total test is above the range. Could this have anything to do with it?

---

Going to get prolactin tested next, although any other suggestions would be well appreciated.

Progesterone is high, and your estrogen is high despite low free T.

Are you on any other meds or natural DHT inhibitors?

 

[Fernando Almaguer]

Hey manman, thank you for taking the time to respond.

This bloodwork was taken on day 2 (24 hours after injection) as I was trying to get the peak of my levels to find out if my estrogen was out of control during this period as normally I would get my bloodwork done on Day 4 (trough), when my next injection was due.

Although all previous blood (taken on trough) is in line with this, TT around 900, estrogen around 30 so I can't see it being significantly different

I do know the blood testing method used to get the Free T, there is no mention of it on the results print out, so would have to call the lab. Although at this point my main concern is getting control of the gyno, without crashing my estrogen.

I've got surgery booked to remove the gyno, but I would like to understand what is causing it.

Also in reguards to the Free T not being as low as stated, I've never been successful with TRT and don't feel particularly great on it. Yes better than before but I still have low libido, fatigue etc so it could line up and be a representative value.

Also I saw a video today

where it was said gyno can be caused in guys with low T and normal estrogen values because there is not enough androgens to couter-act the aromatising activity. Which sounds very similar to me. I wonder if I might have low DHT too

How much for your surgery to remove Gyno... I'm in the Houston area and Ive had gyno almost all my life I'm 34. Would be really nice to get it removed too.

 

[rayrock1]

what doctor do you go to to treat gyno? the urologist or someone else?

 

[madman]

Hey manman, thank you for taking the time to respond.

This bloodwork was taken on day 2 (24 hours after injection) as I was trying to get the peak of my levels to find out if my estrogen was out of control during this period as normally I would get my bloodwork done on Day 4 (trough), when my next injection was due.

Although all previous blood (taken on trough) is in line with this, TT around 900, estrogen around 30 so I can't see it being significantly different

I do know the blood testing method used to get the Free T, there is no mention of it on the results print out, so would have to call the lab. Although at this point my main concern is getting control of the gyno, without crashing my estrogen.

I've got surgery booked to remove the gyno, but I would like to understand what is causing it.

Also in reguards to the Free T not being as low as stated, I've never been successful with TRT and don't feel particularly great on it. Yes better than before but I still have low libido, fatigue etc so it could line up and be a representative value.

Also I saw a video today

where it was said gyno can be caused in guys with low T and normal estrogen values because there is not enough androgens to couter-act the aromatising activity. Which sounds very similar to me. I wonder if I might have low DHT too

Again highly doubtful with a TT 900s ng/dL and SHBG 24 nmol/L that your FT is that low!


In your situation, I would definitely retest using the most accurate assays for TT (LC-MS/MS) and FT (ED or UF).

Knowing where your FT truly sits is critical.


These are the most accurate assays (Equilibrium Dialysis or Ultrafiltration) for FT that everyone should be getting when on trt:

Total and Free Testosterone Test Panel plus Hematocrit

Lowest Cost Hematocrit, Total and Free Testosterone Test Panel for Men on TRT

www.discountedlabs.com

Testosterone, Free (Equilibrium Dialysis) and Total, MS - Most Affordable and Accurate Test

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

 

[madman]

Gynecomastia Evaluation and Treatment: EAA clinical practice guidelines

ABSTRACT Background Gynecomastia (GM) is a benign proliferation of the glandular tissue of the breast in men. It is a frequent condition with a reported prevalence of 32–65%, depending on the age and the criteria used for definition. GM of infancy and puberty are common, benign conditions...

www.excelmale.com

 

[rayrock1]

Madman thank you for the information.

 

[rayrock1]

for the free T and total T test needed from Labcorp is the lab test number 070038 the correct one to order? I did not see one that stated no upper limit.
For the estradiol test at Labcorp is test numbers 500108 or 140244 both the same? both say LC/MS, one has endocrine sciences by it.

 

[madman]

for the free T and total T test needed from Labcorp is the lab test number 070038 the correct one to order? I did not see one that stated no upper limit.
For the estradiol test at Labcorp is test numbers 500108 or 140244 both the same? both say LC/MS, one has endocrine sciences by it.

This one # 070001 (assay measurement range 2.50-5000 ng/dL)

Search Our Health Care Diagnostics Tests Menu | LabCorp

LabCorp's test menu provides a comprehensive list of specialty and general laboratory testing services.

www.labcorp.com

070001/testosterone-total-women-children-and-hypogonadal-males-lc-ms-ms




TT/FT

070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | LabCorp

LabCorp test details for Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS

www.labcorp.com

testosterone-free-equilibrium-ultrafiltration-with-total-testosterone-lc-ms-ms




Choose the cheaper option (most likely 140244)

500108: Estradiol, LC/MS (Endocrine Sciences) | LabCorp

LabCorp test details for Estradiol, LC/MS (Endocrine Sciences)

www.labcorp.com

estradiol-lc-ms-endocrine-sciences

140244: Estradiol, Sensitive, LC/MS | LabCorp

LabCorp test details for Estradiol, Sensitive, LC/MS

www.labcorp.com

estradiol-sensitive-lc-ms

 

[madman]

for the free T and total T test needed from Labcorp is the lab test number 070038 the correct one to order? I did not see one that stated no upper limit.
For the estradiol test at Labcorp is test numbers 500108 or 140244 both the same? both say LC/MS, one has endocrine sciences by it.

I would just go with discountedlabs.com (Quest)

Total and Free Testosterone Test Panel plus Hematocrit

Lowest Cost Hematocrit, Total and Free Testosterone Test Panel for Men on TRT

www.discountedlabs.com

 

[rayrock1]

madman thank you again

 

[goolapsh]

You need to check your DHT on injections. DHT is low In a fair amount of men on injections and counters the estrogenic side effects of injections. Check your dht. If it’s low may have to supplement my.

 

[goolapsh]

FYI from personal experience I got gyno from finasteride which blocks dht and converts T to E. This is how I know DHT in the right amounts prevents gyno

 

[mairomaster]

As @madman said, your Free T value doesn't make much sense. As a reference, using tru-t.org calculator (which is considered to be the most accurate free T approximation), I'm getting 31.6 ng/dL for your Free T.