T Nation

Possible Gyno Worsening


#1

I’ve been on therapy for 3 weeks and this is my protocol.

Here is my protocol.

-Testosterone Cyp 200 mg/ml –inject 0.35 ml IM/SQ twice weekly (25G, 5/8” needle/ (1cc syringe Luer only)

-HCG 500 iu inject SQ twice weekly to reverse/prevent testicular atrophy

-Anastrozole 0.125mg twice weekly – h/o elevated E2, titrate on follow-up

-DHEA 25 mg at bedtime

-Vitamin D3 5000 iu daily

-Fish oil 3-4 g daily for HDL support

I feel like I’m carrying a lot of water around my breasts and my nipples feel hard/sensitive.

I am taking my AI but read that HCG can cause the testes to make Estrogen in some men in a way that circumvents the AI.

Should I call defy Medical and ask their advice.

I have wondered if I had gyno or pseudo gyno for years since I’ve been about 15 lbs overweight and have a lot of breast fat/carry a lot of fat their. It runs in my family, the torso fat.

What should I do.?

Thanks


#2

I think you would know if you had gyno, it would be obvious and I think your mind might playing tricks on you. I started a new protocol 3 weeks ago today and yesterday I had sensitive nipples and would get hard on and off do to hormonal fluctuations, it’s expected during the first 6 weeks of either starting TRT or starting a new protocol in the future.

HCG can increase estrogen and AI’s can’t affect estrogen produced inside the testicles, it’s one of the reason why I prefer starting TRT in isolation as there are less moving parts to analyze, otherwise you’ll never know what’s doing what.

DHEA also can increase estrogen production, so you have two other variables to consider and I think at least calling Defy is a good idea as they have more training than myself.

I’m a Defy patient as well and they know there stuff.


#3

Your protocol looks good. Water retension and even itchy nipples is pretty normal for men starting TRT.
You don’t get gyno in 3 weeks. Just relax and don’t make any changes for the next 3 weeks and do a mini blood test. TT/FT/E2/SHGB/HCT post those numbers up and we can give you much better advice.
TRT takes forever nothing happens over night. Just sit back relax and let your body start healing.


#4

Thank you for your input.


#6

I called Defy about what’s going on and they are going to relay it to the doctor and bump my AI. That sounds reasonable. I guess we can reassess at my first labs. I just am embarrassed even when wearing a t-shirt which I’ve never been. I’m committed either way as I feel a lot better since going on therapy. I had considered getting surgery last year to tighten up my chest. Going on therapy has motivated me and helped me to very quickly start doing things I could not or would not do before. I am eating very clean and working out and I can tell my body is responding better as my strength has increased nicely. The titty fat is going one way or another. It’s just very inconvenient and demoralizing to be embarrassed when wearing a t-shirt…


#7

The doctor replied apparently and I’m going to go from .125 to .25 mg of Armidex.

Anyone know how long it would take to see the swelling go down if it’s due to estrogen?

The swelling in my left breast is in an area I’ve had fat and makes my left breast look round and full. It’s looks horrible with a t-shirt on. I’m losing weight and gaining strength also btw.

I am doing a tabata workout of pushups, 20 seconds on 10 off for 2 minutes, crunches 20 seconds on 10 off 2 minutes, dumbell curls 20 seconds on 10 of 2 minutes and tricep extensions 20 seconds on 10 off 2 minutes. I plan on adding sprints and maybe some planking.

My body is responding phenomenally strength wise to this quick toning workout and I am itching to start doing a more comprehensive workout.


#8

Can you post a picture? bellybutton to chin. You might just have water weight which goes away pretty quick once your TRT protocol is stable.
If you truely have gyno I am not sure anastrozole will reverse it. Anastrozole stops the production of E2 and can also reduce prolactin. Both can give you gyno over time. If you truely have gyno surgery is the only fix I know of.


#9

I will post a pic. I will wait until I lose about 10 more lbs to make a final assessment. I started thinking about surgery last year regardless of if it is gyno or not. The only concern there is I have seen some after photos where guys nipples get butchered and everything just looks completely wrong. I think your odds of having a good outcome are probably better if you control it as much as possible through weight loss before going under the knife. I’m guessing that the closer your are to normal when they start cutting the less likely they are to completely screw you up.


#10

Is it possible the HCG is causing the swelling of my left breast? Are there any strategies as far as dosing to minimize the issue I’m having?


#11

The issue is with the left breast (left when you are looking at the picture too due to the mirror. What’s there is not hard but it is rounding out. I have a lot of fatty tissue around the nipple. It’s not hard but it’s quite a bit. I have pretty decent pecs but the shape is obsurec by the fatty tissue around the nipple. I don’t like it and am hoping to lose weight and maybe go get the fatty tissue removed.

As you can see I am still in the process of losing the weight around my gut and torso. I’m getting there with very disciplined eating. Except on Christmas Eve and today, which is Christmas of course. Merry Christmas by the way if that’s how you roll.


#12

It is hard to tell to be honest. I am guess you are at 20-25% BF.
To me it looks like fat yes your left breast looks bigger but it could still be body fat
google: ( pictures of gyno Cruise )
Cruise is doc that offers surgery for gyno look at the before and after pictures.


#13

I saw the pictures. It seems to vary a lot how guys turn out. I’m on the east coast however and can’t see going to LA for this surgery. I traveled for a vasectomy reversal but that was more life or death as I was in excruciating pain and the doctor in Tuscon was probably the best in the country.

If I need it I do want to go to someone I’m comfortable with and that would be someone that has an excellent reputation regardless of cost.

I will stick with my plan of losing at least another 10 lbs first.

I’m very amazed and happy at how well I have responded to the limited workouts I’ve done.


#14

I was not suggesting you go to that guy. He just posted good example of what real gyno looks like. Way too many guys feel a little itch in their nipple and think gyno right away.
Many guys get gyno from years of being obese eating shitty diets which sends the E2 and prolactin thru the roof.
If you have a history of high E2 and prolactin that would be a big clue you have some gyno in your left nipple. I am sure there are many good doctors on the east coast that can check you out and offer treatment. Last I checked it was ~2K per nipple for gyno surgery.


#15

This is probably me plus some medications I’ve taken over the years at various points in time.

I think it’s a combination of things for sure and genetics. My dad kind of has a lot of tissue there and he is a fairly slim teetotalling ex-runner… I have fairly large pecs and right now they are pretty solid from lifting. Around the nipple it’s jelly. It’s such a pain in the butt dealing with this.


#16

You have a long life ahead of you and judging by that picture you have a ton of potential. If you can afford it look into the surgery. Could be somethng you’d use your tax refund on. Find the right doctor and maybe some or all of this could be covered by your major medical insurance.


#17

Our best friends, my wife and I, are a couple that are former Navy vets. One was a corpsman and both have been surgical nurses. The husband works in the office of one of the DC areas best cosmetic surgery practices. He’s closing/suturing up women’s new/modified breasts pretty much every week so I’m lucky I won’t have to look far.

I was on Youtube today and watched a doctor reading letters and the guy that wrote him was in a similar situation to mine. He had just started TRT recently and it was aggravating existing possible gyno and he was not sure what to do. One of the things the doctor recommended was to “break the glass” and get on Tamoxifen. He said it might have some “diagnostic use” in the guys case. I did not get to watch it all because my kid had gotten out of practice and jumped in the car so I missed the entire thing and will rewatch tonight.

At this point I just want to minimized the damage and get the water retention/swelling or whatever it is down. I ordered a compression top on Amazon. Thanks for the input. This does blow. I’m happy with how I feel on TRT so far other than this. More energy, more focus, a libido and the ability to train and get results. Seems like it’s always some damn thing with me.


#18

Nolvadex is very popular with the T cyclers(body builders). Check out the pharma section of this forum and Nolva has been around for years. I don’t believe it can reverse gyno if you have grown the breast tissue but it can stop gyno from developing if you don’t have it. Once the breast tissue has grown surgery is the only way to remove it.


#19

Since I’m only 5 weeks in it had to be pre-existing. I will say I hate how my chest feels in general. My nipples don’t hurt spontaneously but if I push on them if I had to use a word I’d say crunchy. They are sensitive when pressed. I never had big nipples or areolas as a young guy.

I’m guessing a lot of guys that end up on T have had pre-existing endocrine issues that may have pushed them into clinical gynecomastia. Again though, I just want to minimize any damage or exacerbate the issues. The nipple thing is bothering me a lot.

On the other hand, I have read that when you start on TRT breast/nipple sensitivity is something that just happens as your hormones are in a state of flux. I just don’t like the idea of being an out of state patient and not being able to get an exam or be in closer touch with the doc. This is the only problem I’ve had so far but I know it is one at the top of the list that guys worry about.

Any input on how I should deal with this would be appreciated. I may have to have some tissue removed and I’m okay with that but the nipple stuff is bothering the crap out of me. I am on .25mg Anastrozole 2x a week.


#20

I agree. many and I mean many young guys with low T for all the reasons you can have low T also seem to have high E2 and prolactin issues and endup getting gynecomastia over time. I think guys with low T loose motivation and energy so they put on weight and fat make E2. Do that for 2-3 years and you end up with man boobs.

I don’t think Defy does breast surgery. You would need to find another doctor to do that anyway. Defy might be able to find you a good one in your area and there is a very good chance your med ins would pay for it.


#21

Thanks for your input. I really appreciate it. Do you know if there is a good forum on t-nation to get some input on surgery? I suppose I could just search. I do have an in with a top plastic guy in the area through our friends. Apparently they use a technique where they don’t have to do any external cutting around the nipple and can go in and shrink down and excise the glandular tissue through the armpit area. Might minimize issues with distortion/puckering etc.