T Nation

High SBHG and Gynecomastia

Hi everyone. This is my first post and its a long one. Hopefully someone can help me out here.
I got gyno from a prohormone cycle back in March 2012. It was my one and only cycle, and I got minor gyno as a result. I have tried battleing the gyno using research chem letrozole for 6 weeks followed by 2 weeks of research chem nolvadex with some success. However, as soon as I got off of the research chem nolvadex the gyno started coming back. I felt it pulsating and tingling like crazy.

At this point, it was summer 2012 and I was very busy with school during summer semester. So in order to deal with the gyno, after much research I tried taking 1mg research chem aromasin daily, and this worked at keeping the gyno at bay.

Fast forward 3 months, and I think to myself that maybe if I used pharmaceutical drugs instead of research chems, then maybe the gyno would stop growing and/or reverse. So I order some pharm grade nolva, and started taking it at 20mg’s a day for about the next 2.5 months (mid november until end of January). The nolva had the effect of making me more forgetful and slower, which I combatted with caffiene.

The nolvadex worked great in terms of keeping the gyno dormant and shrinking it significantly, but as soon as I got off of it, very slowly but surely I was getting growth again, this time in both nipples. I decided to stay off of anything and stop self medicating for an entire month in hopes that my body would resolve the issue itself, but unfortunately the growth continued.

I decided to get a bloodtest to see what the matter was. On march 8th, after about a month off of nolva (after taking nolva at 20mg’s a day for 2.5 months), I tested for: Testosterone, Serum ; Luteinizing Hormone, Serum; Follicle Stimulating Hormone, Serum ; Estradiol, Serum; and SBHG serum. I made it a specific point to get tested 6 hours after I had woken up, so I would have an idea of how low my testosterone drops by the middle of the day.

these were my blood test results. (March 8th)

After seeing my testosterone at 349, which is literally 1 point away from being the lower bound of the range and my SBHG, which was at 71 and way out of range it became very clear to me as to why I still had gyno growth. The low testosterone combined with the extremely high SBHG was creating an environment which fostered gyno growth.

It was also clear to me why I had such high SBHG: Nolvadex is known to raise SBHG, and since I had just been on it for 2.5 months followed by a one month break it made sense that my SBHG would be high. I just thought that the SBHG would have dropped down to normal since I was off of everything for 1 month, but I guess not.

I decided to try to use some pharm grade aromasin in order to drop my sbhg. I took about 3mg of aromasin just one time and I felt like shit for about a whole week. I felt extremely unmotivated, I kept pissing out anything I drank within minutes, and I got bad leg cramps. After I lost a ton of water especially on my chest, I saw how my right nipple simply had a lump the size of a small marble.

By the end of the week after I had tried only aromasin, my left nipple started tingling and pulsating,especially before I went to sleep. Whenever I would wake up, I would find that my nipples had become puffier (the gyno gland had grown while I was sleeping).

In an emotional decision I decided to try nolvadex 20mg + aromasin 25 mg per day for about 1 month to try to reverse the gynecomastia which had formed. The gyno was showing signs of decreasing again, until I decided to take a sleeping aid containing doxylamine succinate on March 22 to help me fall asleep. This sleep aid pretty much knocked me right out, but as I fell asleep I felt my right nipple pulsating and growing like never before.

When I woke up the gland under my right nipple grew significantly overnight. After researching what could have happened, I found out that if you take antihistamines like benadryl or doxylamine, it could make the nolvadex much less effective because it changes the way the nolvadex is metabolized.

Here are blood tests from the next morning, after about 2 weeks of nolvadex+aromasin

After seeing these blood tests, I realized I was in over my head and there was no way I was ever going to reverse the gyno. My testosterone and estrogen numbers were very good. However, my sbhg went up by a little bit despite using 25mg aromasin for 2 weeks (probably because of the 2 weeks of 20mg nolvadex use at the same time).

What I found most “interesting” was that I had very rapid gyno growth the night before the second blood test as a result of using doxylamine despite my good testosterone and estrogen numbers.

These drug treatments are very taxing on me and I am at the end of my rope with this. I don’t have health insurance and make $10/hr so I don’t have the money to blow on an endocronologist, which is why I was self medicating with all these drugs. Now I am completely ready to have this bullshit come to an end, which is why I am coming here to ask for help. I threw away the rest of my aromasin because of how shitty I felt while on it and because I am fed up with this whole ordeal.

Right now, I am taking 20mg of nolva again daily to essentially keep the gyno growth dormant. At this point, I am not sure of what to do.

I know that I already tried going off of everything for a month, but the gyno kept growing.
Now I am thinking that maybe I did not wait long enough to allow my body to normalize. My main fear with going off of nolva permanently is that I will have gradual gyno growth over several months or even years until the gyno becomes very noticable which may require surgery. Perhaps the gyno might never stop growing, I don’t even know.

This has been my living hell for the past year. What should I do?

Age: 21 yrs old
Weight: 163 LBS/ 15 % bodyfat

------More info:

-age: 21
-height: 69 Inches
-waist:: Unsure, but
-weight: 163
-describe body and facial hair: Can grow facial hair just fine. I shave every 2-3 days. Chest hair also grows, but very slowly.
-describe where you carry fat and how changed: mainly in stomach.

See this thread for similaritites. Nolva is a SERM.

You always need to taper off of a SERM, never stop suddenly. Using an AI with a SERM is a good idea and continue with low dose AI after the SERM. AI dose needs to match T levels.

You might find anastrozole better. Have not seen anything to indicate that RC products are ineffective.

Have you read the stickies?

SHBG is made in the liver in response to mostly estrogen levels. You are indicating that Nolvadex can lead to higher SHBG. I did not realize that. The result is that your FT levels will be lower.

AI will prevent T–>E2 aromatization. But it does not work inside the testes. For some, SERMs lead to high T–>E2 inside the testes. Some find that 1/2 the suggested SERM dose can be effective.

You need to use an AI to keep E2 levels lower. But if too low, you will feel like crap.

See if you can get tested for prolactin. That could explain lower T levels and gyno tendencies. Prolactin + estrogens is a major problem.

Are you getting good prices on lab work?

Hook24, Thank you for the link. It is very helpful.

KSman, I get my labs through privatemdlabs.com, which I think has ok prices. Their SBHG test costs about $45 and their female hormonal panal costs $60. On top of that there is 15% off promo code.

I do not believe I have a problem with prolactin because when I squeeze my nipples I do not have any discharge. I can get tested for $45 if necessary.

My main concern is my very high SBHG. In the first bloodtest which was taken after being off of nolva for 1 month, I did not taper off of nolva but rather just quit it completely one day. I was taking 20mg’s a day and I simply stopped taking it one day after taking 20mg’s for 2.5 months. The reason for this is that I read that because Nolva has such a long half-life (2 weeks), there is no need to taper it because it does so itself. :
http://imageshack.us/a/img15/2319/march8bloodtest.jpg

Your suggestion to taper off of the SERM makes a lot of sense to me when I think about it:

I strongly believe that the high SBHG is the cause of gyno growth. The main problem is that SBHG takes several months to actually decrease. By quitting the Nolva suddenly, my breast glands were exposed to an environment which fostered gyno growth.

Now I am thinking that if I taper the Nolva down to 10mg (from 20mg) while monitoring my SBHG, then perhaps my SBHG will gradually decrease over time from less Nolva in my system, while at the Same time the nolva prevents my gyno from growing. However, I am not really sure if this will work, and even if it does it could take several months. My latest bloodtest showed that my SBHG was at 77, and decreasing SBHG simply by taking a lower dose of a SERM seems like it would take a long time to see results.
http://imageshack.us/a/img687/8859/march23bloodtest.png

Now I am considering my options to lower SBHG. After research, I found that Stinging Nettle Root Extract may work. It is very cheap and OTC.

Alternatively, I found out that danazol may work as well for lowering my SBHG, but because I am not on TRT it will suppress my HPTA and likely will not have any overall benefit because of the decreased total T.

Any ideas with how my protocol should be to taper off of the nolva, and how long I should taper for?

The main thing I need help addressing in the protocol is my high SBHG, especially when you factor in my naturally low T (from the first blood test). This is just speculation, but I feel like if I am able to knock down my SBHG down to mid 30’s (middle of the range), then I should have no more symptoms even with the same T and E numbers as from the first blood test.

I am able to obtain danazol, Femera, Arimidex and other meds from iop’s (indian generics) in addition to research chems, but would much prefer to not take any harsh pharmaceuticals.

Regarding using an AI while also tapering off of Nolva, my main concern is that in the first bloodtest ( a month after discontinuing Nolva), my E2 was at 22. This is not very high, and the only supplement I was using in order to control estrogen was 50 mg zinc daily. My T:E ratio was about 16:1, which is pretty low.

I know that supplementing with an AI like Arimidex would improve my T:E ratio and additionally this could speed up lowering my SBHG, but what then? At this point would I keep taking only Arimidex continuously?
I know that if I discontinue arimidex, I would get an estrogen rebound and would probably be right back to where I started.

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When you stopped SERM, E2 may have been a problem that shut down your HPTA, then later you have low T and lower E2 is expected. With E2=22 and low T, you are getting estrogen dominant.

There are not hard rule for how long to taper off and other timing or dose issues.

??? emale hormonal panal costs $60???

Prolactin can lower your T, mess with your libido, create depression, lead to or contribute to gyno, all with no lactation! You are jumping to conclusions. When prolactin increases, dopamine and mood goes down.

Just as an update, I started taking DIM and am cotinuing Nolva. There is definetly a difference with the DIM. My goal now is to go off of the Nolva, continue taking DIM while my hormones normalize, then go off of DIM.
I will post bloods next time I get a blood test done.

The reason I am not messing with arimidex is because when I go off of arimidex, I will most likely get an E rebound. DIM should be easier to taper off of and not have a rebound.

You can taper off of Arimidex too. Some will cruise on low dose if that is what is needed to manage there estrogens or gyno. Glad to here that DIM feels right.

I tested myself to see if my thyroid was causing my gyno because hyperthyroidism has been known to cause it. Here are my results:

T4,Free(Direct) 1.30 ng/dL 0.82-1.77

Triiodothyronine (T3),Free,Serum 2.4 pg/mL 2.0-4.4

Thyroxine (T4) 7.9 ug/dL 4.5-12.0

TSH 1.610 uIU/mL 0.450-4.500

Everything came back perfect, except T3 is kind of low but still nothing is out of range. Also, just as an update the gyno is still continuing to grow at an extremely slow pace. When I go to bed right before I fall asleep I always feel it tingling and growing, which is kind of weird.

Right now to manage it as best I can I eat brocolli and take DIM. The brocolli has I3C, DIM and glucuric acid, which is the same thing as calcium d glucurate. I did not eat brocolli for a couple of days, and my gyno (right nipple) got really puffy but after I ate brocolli today it went down in swelling. Now I am going to try a calcium d glucurate supplement to try to stack with DIM, and hopefully that will control the gyno. I think that the gyno is just extremely sensitive to e2 or something and swells whenever my e2 gets too high.

I am also on 20mg Nolva a day still, but that does not seem to have much effect for some reason. I think that the DIM interferes with the efficacy of the Nolva since it aids in estrogen metabolism and Nolva is an estrogen, but am not sure.

I just got blood tested on April 20th taking Stinging Nettle Root, calcium d glucurate, and eating at a 500 calorie surplus (2000 calories), taking vitamin d3, taking b-6, and lifting 4-5 times a week for the past 3 weeks. The good news for me is that my testosterone literally more than doubled from my previous test. However, my gyno still continued to grow over this period at a very slow rate (I am definitely sure that it increased in size). Now my main problem is my Free Testosterone Levels:

Prostate Specific Ag, Serum 0.3 ng/mL 0.0-4.0

Roche ECLIA methodology
Estradiol 22.6 pg/mL 7.6-42.6

DHEA-Sulfate 347.4 ug/dL 211.0-492.0

Free Testosterone(Direct) 8.4 Low pg/mL 9.3-26.5
Testosterone, Serum 769 ng/dL 348-1197

The last time I took Nolva was 3 weeks prior to the test, so I am pretty sure that it is not the reason I have higher T levels. I specifically made it a point to get good sleep, eat at a calorie surplus (or at least not at a defecit), supplement well and lift heavy over the past 3 weeks to make sure I have good T levels. Anyways, I desperately need to lower my SBHG to get my Free Testosterone to double (so it is at least at mid-range). Does anybody have any suggestions for me?

BTW I am 100% certain that my maintenence is 1500 calories (If you do not count going to the gym). I have a desk job and am sitting for most of the day. I try to hit the gym about 1 HR everyday, but aside from that am not very active.

Any advice? Currently I am planning to eat 60 grams of saturated fat per day (from coconut oil) because there are studies that show that Sat. Fat. raises free testosterone. Before this my fat source was mainly monounsaturated fat from natural peanut butter (and I ate at least 30 grams of fat just from peanut butter per day).

I got the idea from this website: stronghealthtips.com/butter

Right now what I am doing is as follows:
-Taking 200mg b6 (this definetly has an effect. My nipples literally are never puffy anymore. It is like they are pretty much always “cold”. But on the other hand they stick out a bit and I can see the gland more. (it is not really noticeable unless you know what to look for)
-Taking 5000 iu d3
-taking 2000mg NOW brand stinging nettle root
-taking 3000mg calcium D glucurate (source naturals 6 pills all taken right before bed)
-Lifting at least 4x a week and burning off any calorie surplus at the end of the week with 1 “cut” day where I go in a 1000 cal defecit for a day by doing 2 hours of cardio.

I am pretty sure that I have low free T due to the high SBHG as a result of doing Nolva for several months. Anybody have any advice I can use to increase my free T? I would much rather exhaust all possible routes with diet, exercize, and supplements as opposed to going a pharmaceutical route.

I researched some pharmaceutical possibilities which might help me (just for knowledge), and I found that a low dose of femera (2.5mg / week) was found to raise the free Testosterone in obese men from the below normal range to supraphysiological levels after 6 months.

I was considering that a dose at half of that (per week split into daily doses) might work for me, since I am not obese and my T levels are normal. I also got the idea from this thread where the guy was taking 180mcg of femera per day ( he had a pharmacy compound his):

I really do not want to go this route and mess around with my endocrine system because when I come off of femera there is a good chance that I could be in a place worse off than when I started. Are there any supplements which I am not currently taking or any foods I should eat which can improve my situation? If anybody has any advice I would love to hear it.

Nolva: is that Rx or underground/RC?

Any AI that lowers estrogens in young normal virile males will increase T. So why are you not using anastrozole?

You will get an E rebound with a SERM if you do not taper off because SERMs increase serum E2. AI lowers serum E2, totally different story. You need to do more to understand these basics.

The nolva I am using is an indian Rx that I ordered online (tamoxifen citrate 20mg pills).
I am not using AI’s because my e2 levels are fine where they are and I also do not want to experience the sides associated with AI’s such as lethargy, cognition problems, and dry joints.