Gyno developing even with high dose AI

[jm100]

Hey everyone

So I started on TRT about a month ago (yes I realize I am young, I've had test levels of 100-200 for about 2 years modifying diet, training regimen, etc. with no improvement before finally going back on TRT).

Current routine:
Test Cyp 60 mg E3D
Adex 1 mg ED

I have small pubertal gyno lumps already and am gyno sensitive so my doc put me on 1mg Adex ED (Doc said he can add HCG to the regimen if needed, but that at my dose of test some people don't notice testicle shrinkage and that we should wait and make sure my estro is under control first). I take L-dopa (via mucuna puriens) to keep my prolactin down as well.
(as a side note: My doc had actually given me the choice between adex and tamoxifen and said anecdotally he's seen adex shrink existing gyno even though it's not proven with research-- I picked Adex for the reduced side effects but have been debating giving tamoxifen a shot anyways since my gyno is pubertal and there's debate whether tamoxifen might be able to shrink that anyways).

Anyways, I'm about 1 month in and and the past day or two my left nipople is extremely sore and definitely has had some growing of the existing lump.
I have been taking Lean Xtreme for about 5 days since I'm cutting, could this be what's flaring up my gyno? I don't see how my estro could be flaring up with 1mg Adex ED especially at the low dose Test Cyp I'm on.

Does anyone have suggestions? Should I call and ask my doctor to write me a script for Tamoxifen and/or Cabergoline since it's flared up? (I'm a bit nervous about bloodwork since I threw in an extra dose test cyp the first few weeks as a loading dose to get my blood levels up to where they should be)
Or should I wait and see if dropping the lean xtreme has an effect (which I still don't get how it would cause such a problem especially since I'm already taking adex).


Any suggestions would be much appreciated Sorry if I left out any details.

[Far from massive]

I would dump the Lean Extreme ASAP, there seem to be many people who feel that it has led to there gyno or pre-gyno (sensitive nipples etc) symptoms. Better safe than sorry. Also if you alreay know that you are gyno sensitive you definatly should not have frontloaded your TRT a gradual change in hormones is a lot easier for the body to adapt to than a rapid one.

In the mean time eat clean and stay away form alcohol, marijuana or anything else that will/may increase estrogen.

[HRTstudent]

That is indeed a relatively large dose of arimidex .

I'm willing to bet that eventually it will bring your E2 to near-nothing. But the fact that you just started TRT, you took a large shot at first (didn't say how big, but more T = more aromatization), and you're gyno sensitive then I think you body could just be in a large state of flux and it "might" be a transient thing to self correct.

If it were me, I would go about it a couple ways including ask for a short protocol of tamoxifen (like a month), or keep taking the arimidex and slightly lower the T dose. 140mg isn't exactly a small dose, and I don't know why anyone would start that high. Most docs start at 100 per week, and there is even some movement amongst numerous experts to go even lower. There is good reason for it as well.

I have no idea what lean extreme is, but unless truly believed in the company and product, I generally think supplements are a waste of money and effort.

[jm100]

Thanks for the advice! I didn't do a severe load or anything, just did 180 mg/week for the first 3 weeks instead of 120 mg/week (plus my insurance took a while to cover the test. so I was taking the Adex for about a week before I even started the testosterone so I figured I would be safe with the estrogen since it'd had some time to build up in my system).
I know it probably wasn't the smartest move but I was a little overeager to get back to normal (and a bit overconfident that I could notice gyno side effects early since I've had it flare up before & since I work in the medical field myself)

I'll ask the doc about Tamoxifen for a month or so and definitely drop the Lean Xtreme.

Thanks again both of you!

[Vettester]

That dose of Adex is downright dangerous. You will put yourself at serious risk if you continue with it, and I mean SERIOUS!!! Change your course immediately!! I can't imagine any physician overseeing that protocol. Please get with a qualified physician ASAP!

[jm100]

That dose of Adex is downright dangerous. You will put yourself at serious risk if you continue with it, and I mean SERIOUS!!! Change your course immediately!! I can't imagine any physician overseeing that protocol. Please get with a qualified physician ASAP!

That's what I thought! I figured with a dose that high that bumping up the cypionate by 60 extra mg/week would be no big deal. People running cycles with 5x as much testosterone as I am don't even use that much adex.
I even called the office as soon as I got the prescription to make sure the pharmacy hadn't messed something up on the label.

He's the only good Endocrinologist in the area (the only other one in the area is an idiot who I saw when I was 19 and she put me on 300 mg test cyp every 2 weeks which was a hormonal roller coaster -- then she refused to give an AI or cabergoline when my prolactin and estrogen got high and worsened my gyno and gave me crazy water retention... she just pulled me off everything cold turkey and said to see if it got better on its own...I know other people who have seen her and had worse experiences as a result.)

The current doc seems pretty open to my suggestions and a good doctor, I think he was only doing the high Adex dose at the beginning to see if it could shrink the existing gyno (which he said he's seen happen before with a few patients. I had plastic surgery planned and he said we might as well try the cheaper medication route first even if the chance of it working is slim).

[Babyslim]

Do you have prescription insurance? I know my doctor couldn't write the script for anything other than 1mg per day or more. Just because it says once per day, doesn't mean that's what the doctor wants you to take.

[HRTstudent]

it's also worth noting sometimes the doctors call for more drug for X days, then drop it.

Such as 1mg arimidex for 1 week, then something smaller thereafter.

Then again, lots of docs just don't know what they are doing.

[jm100]

Nah he had me on 1mg adex on purpose. The lump started to go away on its own so it looks like HRTStudent was right and my body was just in a state of flux from starting the testosterone , but the doc still put me on tamoxifen for a bit to make sure everything stays normal.
He said not to take the adex and tamox together (which i'm assuming is because of the data on tamoxifen reducing adex's effectiveness?) which will be annoying to deal with the bloat for the next few weeks till i'm back on adex since tamoxifen isn't good for controlling estrogen bloat, but better that than gyno I suppose

Thanks all for your help!

[Juced_porkchop]

That's what I thought! I figured with a dose that high that bumping up the cypionate by 60 extra mg/week would be no big deal. People running cycles with 5x as much testosterone as I am don't even use that much adex.
I even called the office as soon as I got the prescription to make sure the pharmacy hadn't messed something up on the label.

He's the only good Endocrinologist in the area (the only other one in the area is an idiot who I saw when I was 19 and she put me on 300 mg test cyp every 2 weeks which was a hormonal roller coaster -- then she refused to give an AI or cabergoline when my prolactin and estrogen got high and worsened my gyno and gave me crazy water retention... she just pulled me off everything cold turkey and said to see if it got better on its own...I know other people who have seen her and had worse experiences as a result.)

The current doc seems pretty open to my suggestions and a good doctor, I think he was only doing the high Adex dose at the beginning to see if it could shrink the existing gyno (which he said he's seen happen before with a few patients. I had plastic surgery planned and he said we might as well try the cheaper medication route first even if the chance of it working is slim).

since you have has this from puberty and it may not go away, if it bothers you that much your option may be to get the glands cut out (MAKE SURE you do your research on the DOC, i have seen gyno removal that you could not even tell, then others where it was like they used a steak knife while blind folded to take it out)
i say try the high dose AI for a few weeks then taper down to a normal amount for a few more. if still an issue then taking out gland may be the option.
and a good thing is it should not come back ever if the gland tissue was taken out right. (i have seen/heard of cases where some came back, prob due to not getting all of it out though)

GOOD LUCK MAN!

[Juced_porkchop]

Nah he had me on 1mg adex on purpose. The lump started to go away on its own so it looks like HRTStudent was right and my body was just in a state of flux from starting the testosterone , but the doc still put me on tamoxifen for a bit to make sure everything stays normal.
He said not to take the adex and tamox together (which i'm assuming is because of the data on tamoxifen reducing adex's effectiveness?) which will be annoying to deal with the bloat for the next few weeks till i'm back on adex since tamoxifen isn't good for controlling estrogen bloat, but better that than gyno I suppose

Thanks all for your help!

I would have started you on both then taken away the tamox after a lil bit. just me.

he could just be worried about it looking bad on his part possibly.
seems like he is somewhat on point though. MUCH better then the female doc you mentioned before.

[kelkel]

Op did I miss it somewhere but what was the diagnosis for your low T? Primary, secondary, pathology? Fixable? And I agree, that amount of adex if on-going will cause serious issues.

[jm100]

Op did I miss it somewhere but what was the diagnosis for your low T? Primary, secondary, pathology? Fixable? And I agree, that amount of adex if on-going will cause serious issues.

Idiopathic haha so basically they don't know

I have my own theories...I've had this issue along with occasionally high prolactin (already had a negative MRI) and other pituitary issues ever since a car accident with head trauma when I was in my late teens, and my LH at the last blood draw was only 1 (reference range was about .5-10) so if I was the doc I might have tried Hcg before test to see if my low testosterone was because of the low LH VS primary (I had other stuff happen around that time that may have damaged my testes themselves)

But the doctor does seem to know about TRT so I'm giving his course a go for a while and not telling him how to do his job, plus he went to med school and I just went to nursing school (and endocrinology was never my best unit haha). I had expressed that gyno was a big concern of mine and hcg is more prone to that, so he might have factored that in when picking my protocol.

[kelkel]

That explains it! Head trauma, testical injury can both cause it and not necessarily quickly. Glad you are on top of this!

[jm100]

So, in lieu of making another thread... the gyno seemed to settle down for a bit, but now that a few weeks have passed I'm starting to get the itching and soreness again, even though the doc currently has me on 20 mg tamoxifen (holy hot flashes!) and 1 mg adex/day
I'm kinda thinking the odds of it being estrogen-induced are pretty low with such a strong protocol, so I'm guessing it might be prolactin related?

For my 3 month appointment in about a month (I'm debating trying to get in sooner) the only bloodwork he had ordered was a CBC and Testosterone , so I did call and request the nurse try to get orders in for both an Estradiol test (duh, shouldn't they be testing all TRT guys for this?) and prolactin since mine's been high in the past. Can cypionate mess with Progesterone? I wasn't sure if it could and if I should request that they check that as well since progesterone can affect gyno.
I wish I knew what it was, but something is definitely 'off'
Are there any other blood tests I should try to get him to do?

[HRTstudent]

Can you be certain that you are actually getting gyno? Do you shave/trim your chest hairs at all? Some itching is normal afterall. When I was getting gyno the itchiness actually woke me up in the middle of the night... that was definitely abormal.

At 1mg arimidex a day and the tamoxifen , you are really on a very aggressive gyno treatment/deterrent. I have heard that progesterone can cause gyno on its own. but it seems unlikely that is the cause unless you are possibly taking pregnenolone and/or maybe hcg .

I would get the pregnenolone and progesterone levels checked just for myself. But otherwise, I would be lending myself to thinking you are being hyperaware of your breasts because of the circumstances, and maybe you're not experiencing breast growth after all. If the progesterone came back normal, I would think you are likely fine. tamoxifen is very potent at both blocking the breast receptor as well as lowering IGF-1 which is critical for any breast growth whether progesterone or estradiol induced.

Beyond that, your only real option is to stick with it or stop HRT or get gyno surgery.

[kelkel]

Your doc is going to hurt you at that adex dosage. 1mg per day is basically a breast cancer dosage and soon you will have crashed your estrogen and be suffering far more than itchy nips. Remember, for any kind of gyno to develop there has to be elevated estrogen present. Agree with HRT, sensitivity is one thing, gyno is another. Mine are relatively sensitive but I do not have gyno. Read this:

http://forums.steroid.com/showthread...d-gynecomastia

+ this:

http://jcem.endojournals.org/content/96/1/15.full

kel

[jm100]

Can you be certain that you are actually getting gyno? Do you shave/trim your chest hairs at all? Some itching is normal afterall. When I was getting gyno the itchiness actually woke me up in the middle of the night... that was definitely abormal.

At 1mg arimidex a day and the tamoxifen , you are really on a very aggressive gyno treatment/deterrent. I have heard that progesterone can cause gyno on its own. but it seems unlikely that is the cause unless you are possibly taking pregnenolone and/or maybe hcg .

I would get the pregnenolone and progesterone levels checked just for myself. But otherwise, I would be lending myself to thinking you are being hyperaware of your breasts because of the circumstances, and maybe you're not experiencing breast growth after all. If the progesterone came back normal, I would think you are likely fine. tamoxifen is very potent at both blocking the breast receptor as well as lowering IGF-1 which is critical for any breast growth whether progesterone or estradiol induced.

Beyond that, your only real option is to stick with it or stop HRT or get gyno surgery.

The itchiness doesn't bug me a ton, they were itchy for about a week before I got concerned but then the actual lump itself started to be pretty sore and a bit swollen. It's a different type of itchiness than from shaving also, it feels deeper and almost under the nipple

And thanks kelkel for the links! I definitely don't think my doctor plans on keeping me on the 1mg long term, but I'm planning on talking to him about it at my appointment

[bigboy67]

prolactin induced gyno?