Reversing Gynecomastia - Bloodwork Follow Up

[DankMemes]

Hey guys here's my original thread

viewtopic.php?f=127&t=8415

Here's my blood work from a few months ago

https://imgur.com/a/edn01

And here's this week's bloodwork, slightly more extensive

http://imgur.com/a/EnhH1

As a lot of you have guessed my prolactin is quite high, my doctor would like me to get a follow up blood test and then an MRI to check for a pituitary tumor if both tests are elevated. There's a few shocks, I was expecting my testosterone to be on the lower side which would explain my symptoms and I was not expecting my TSH to be that low or trigs to be so high.

The triglyceride level is what's worrying me most now, high prolactin may be unfun but it won't kill me.

I was a bit reckless with my thyroid supplement, I'm hoping that the high trigs are just temporarily elevated as my thyroid settles.

I actually feel a lot better since I made my first thread, I've made the following changes in the past week

• Cut milk in favour of cheese - too much liquid was causing bloating and milk was giving white coating on tongue (which is now gone)
• Stopped thyroid supplement completely
• Haven't gone to the gym this week - I'd like to go back but maybe just twice a week
• Coffee consumption down as a result of lowering milk intake - I might look into caffeine pills
• More lambs liver - increasing vitamin A was a common suggestion, I'm doing about an oz each day, might cut back
• No aspirin this week
• No cypro this week

I'm going to keep eating fruits but I'm a bit scared of refined sugars now that my trigs are so high. Maybe I'll get the red bull and opt for some juice (anyone drink appletiser?)

The gynecomastia is still there but I'm not stressing about it as much, there's not a lot I can do about it right now so why freak out. I think I may have brought it on myself by chugging 3L of milk everyday when I clearly didn't tolerate it, going too fast on the thyroid might have increased estrogen or something too.

Anyway any advice is welcome, I'm particuarly interested in what people have to say about the 2nd pic, I don't really understand what any of those liver enzymes mean and I know Peat has a different take on Urea.

 

[lexis]

A higher dose of Vitamin A is needed to bring TSH and prolactin down

 

[DankMemes]

Oh also when I eat liver I take a 25mcg of zinc, I figured it's the best time to take it so I don't overdose on copper and iron.

 

[tara]

post 109474 high prolactin may be unfun but it won't kill me

Most likely not, but very high prolactin can occasionally indicate dangerous processes.

If you were short on thyroid before (high TSH), and now you figure you overdid it, it may be that somewhere in between would be good.

 

[Nicholas]

the prolactin is high, but not really high eneough to point to a pituitary tumor. Your range is more relative to metabolic syndrome and general energy disorder. waiting a couple weeks for things to level out since you've only very recently come off aspirin, cypro, and thyroid seems like a good idea. as i've discussed in your first thread, i wouldn't be concerned with the ingestion of any one macronutrient....the area to be concerned about is the ratio of the macros.

 

[DankMemes]

post 109494

post 109474 high prolactin may be unfun but it won't kill me

Most likely not, but very high prolactin can occasionally indicate dangerous processes.

If you were short on thyroid before (high TSH), and now you figure you overdid it, it may be that somewhere in between would be good.

You did warn me about taking thyroid slowly, I'm hoping I didn't do any permanent damage.

post 109495 the prolactin is high, but not really high eneough to point to a pituitary tumor. Your range is more relative to metabolic syndrome and general energy disorder. waiting a couple weeks for things to level out since you've only very recently come off aspirin, cypro, and thyroid seems like a good idea. as i've discussed in your first thread, i wouldn't be concerned with the ingestion of any one macronutrient....the area to be concerned about is the ratio of the macros.

Yeah my prolactin could have just been pushed outside of normal range because I was stressed or even the stimulation of my nips increased prolactin before the test. My libido is back since making these changes so that's a good sign that everything is improving, I always assumed I had low testosterone because I struggle to lose fat, gain muscle and don't grow a beard/body hair very well, but this test says otherwise. Could prolactin be inhibiting my testosterones effect?

I tend to crave a lot of protein like I could easily do 200g a day but it's too expensive to get from quality sources, and wouldn't much raise cortisol for gluconeogenisis?

I like taking a coconut oil with starchy meals but lately i've been eating just fruit without any protein or fat, if I avoid fat and protein at night I fall asleep very easily.

 

[EIRE24]

post 109483 A higher dose of Vitamin A is needed to bring TSH and prolactin down

I thought high Vitamin A would suppress thyroid rather than bring it down? I suffer with acne and have been taking doses of vitamin A around 7'000 IU's a day and my acne has only gotten worse. I might try to raise Zinc and see if it helps like OP is doing.

 

[Nicholas]

post 109499 Could prolactin be inhibiting my testosterones effect?

i don't know, and blood labs will never give you the answer. but you're right that testosterone is not the only factor in muscle/hair growth and fat loss.

post 109499 I tend to crave a lot of protein like I could easily do 200g a day but it's too expensive to get from quality sources, and wouldn't much raise cortisol for gluconeogenisis?

not getting enough protein can be just as negative for one's health as not getting enough carbs. Quality fruit is expensive, too. I just choose to not get high quality anymore. I haven't really noticed a difference besides taste. I don't buy pastured eggs or pork or chicken anymore and just get the best option at the grocery store....i do stay away from farmed fish, though. grass-fed beef is not that expensive in the whole scheme of things. Greek yogurt is expensive, but cottage cheese is not. You are eating cheese, which is a pretty expensive protein source....but also has *potential* problems in being high fat..if it's a primary protein source. The track records for high carb and equal fat diets generally lead to more complications than high carb/low fat. I have to eat a lot of protein, too (150g/day)....and so do many other people around here. Yes, too much protein will raise cortisol and other things...........but.........so will too little. : ) I remember being in a state similar to yours and finding things starting to turn around when i started getting higher protein. (and starch)

 

[Nicholas]

post 109505

post 109483 A higher dose of Vitamin A is needed to bring TSH and prolactin down

I thought high Vitamin A would suppress thyroid rather than bring it down? I suffer with acne and have been taking doses of vitamin A around 7'000 IU's a day and my acne has only gotten worse. I might try to raise Zinc and see if it helps like OP is doing.

excess vitamin A, like you are most certainly getting, does suppress thyroid. A is not the only vitamin that affects skin health. vitamin c does, too.

 

[EIRE24]

post 109508

post 109505

post 109483 A higher dose of Vitamin A is needed to bring TSH and prolactin down

How would you know I'm getting an excess of vitamin A? Have you had acne issues that you have cleared up and if so what worked for you?


I thought high Vitamin A would suppress thyroid rather than bring it down? I suffer with acne and have been taking doses of vitamin A around 7'000 IU's a day and my acne has only gotten worse. I might try to raise Zinc and see if it helps like OP is doing.

excess vitamin A, like you are most certainly getting, does suppress thyroid. A is not the only vitamin that affects skin health. vitamin c does, too.

 

[slayers]

Maybe i missed why stop thyroid completely? Im guessing your TSH will come back up to were it was?

I'm following since i have a bit of gyno myself

I thought gyno could only be removed surgery?

 

[DankMemes]

post 109531 Maybe i missed why stop thyroid completely? Im guessing your TSH will come back up to were it was?

I'm following since i have a bit of gyno myself

I thought gyno could only be removed surgery?

I'm hoping diet alone would have dropped TSH these past months. If it does go back up, I may try again but only something like 1/2 a grain a day.

There's testimonials for cabergoline and letrozole getting rid gyno, though I imagine these testimonials actually mean lipomastia, which is excess fat that can cause cone shaped nips, gynecomastia is when breast tissue starts to form behind the nips which requires surgery. I figure I'll at least attempt to fix all my hormonal problems before surgery (if I need it), it would suck to dish out thousands on surgery then have it reappear because my hormones are still messed up.

 

[tara]

post 109506 not getting enough protein can be just as negative for one's health as not getting enough carbs. Quality fruit is expensive, too. I just choose to not get high quality anymore.

This makes sense to me (within limits - if there exceptionally high levels of know toxins, I'd be avoiding them if I could).
I think Peat has made the point that animals have more effective detox systems than plants. I took from his discussion of that that it may be more important to try for organic or spray-free plants than organic meat meat and milk, when budget is tight. But if you can't afford organic, getting enough is still important.

post 109506 You are eating cheese, which is a pretty expensive protein source

I guess these things vary from place to place, but where I am, cheap and delicious aged cheeses by bought by the kilo is probably the cheapest source of bulk protein easily available, other than beef liver, grains and legumes (which neither Peat nor I would recommend for majority of protein when there is anything better available). Certainly cheaper than cottage cheese, yogurt greek or otherwise, milk. Next cheapest would probably be skim milk powder, free-range (but not pastured) eggs, and cheap frozen fish when there is occasionally a good deal on. If they agreed with me, I'd be eating a bit of both cheese and milk powder because they are both cheap, convenient, and keep well. I usually eat some fish once or twice a week, and free-range eggs every day, along with cheap cuts of meat.

post 109606 I figure I'll at least attempt to fix all my hormonal problems before surgery (if I need it), it would suck to dish out thousands on surgery then have it reappear because my hormones are still messed up.

I can't think of any good health reason to even consisder such surgery. I don't recommend unnecessary cosmetic breast surgery for women either, or surgical facelifts, or any other very stressful surgical procedure that healthwise is all cost and no benefit. Surgery is for serious health issues that can't be resolved in safer ways.

I looked at your picture on the other thread. Whether it's gynecomastia or not, it is totally trivial, from my point of view. Not saying you shouldn't attend to improving your health, and if this is an indicator for you, then by all means use it for that. But I really hope you wouldn't consider surgery for this, even if there were 5 or ten times as much of it. Surgery is very stressful for the body. Sometimes it is necessary and worthwhile to save life and limb, but otherwise it is likely to do much more harm than good. (Ask Blossom if she thinks it is safe to get unnecessary medical or surgical procedures. :) )

 

[DankMemes]

post 109641 I can't think of any good health reason to even consisder such surgery. I don't recommend unnecessary cosmetic breast surgery for women either, or surgical facelifts, or any other very stressful surgical procedure that healthwise is all cost and no benefit. Surgery is for serious health issues that can't be resolved in safer ways.

I looked at your picture on the other thread. Whether it's gynecomastia or not, it is totally trivial, from my point of view. Not saying you shouldn't attend to improving your health, and if this is an indicator for you, then by all means use it for that. But I really hope you wouldn't consider surgery for this, even if there were 5 or ten times as much of it. Surgery is very stressful for the body. Sometimes it is necessary and worthwhile to save life and limb, but otherwise it is likely to do much more harm than good. (Ask Blossom if she thinks it is safe to get unnecessary medical or surgical procedures. )

I agree but the mental stress this is causing is very high too and now that we're moving into summer here I can't just put on another layer! I'm not sure if it's true gynecomastia, maybe it's just estrogen/prolactin promoting storage of fat around there instead of actual glandular breast tissue.

I still have a lot of things to try anyway, I think I'll try drop a bit of weight, try taurine/k2 for liver health and let my hormones normalise after thyroid. There's several testimonials for topical progesterone too, but after using thyroid I'm a bit reluctant to mess around with hormones again.

There are a few case studies where hyperthyroidism causes gynecomastia and treating the thyroid problems puts the gynecomastia in regression, so maybe now that I've stopped thyroid I just need time to reach homeostasis and it will disappear on its own.

 

[tara]

Yes. :)

post 109736 I agree but the mental stress this is causing is very high too and now that we're moving into summer here I can't just put on another layer!

Do you hang out in places where none of the other men have more than that? Maybe if you find some normal people to hang out with, it won't seem likle such a big deal? When I go to a crowded beach in summer, I expect to see lots of men with much bigger 'man-boobs' than yours. Not hiding under clothes, either.

post 109736
I still have a lot of things to try anyway,

post 109736 There's several testimonials for topical progesterone too, but after using thyroid I'm a bit reluctant to mess around with hormones again.

There are others (and threads) with much more info on progesterone for men than I have. But I think the general case is that when men benefit from progesterone it is often at lower doses than women. So if you do try it, take it easy and don't swig the whole bottle in the first fortnight. :)

post 109736 There are a few case studies where hyperthyroidism causes gynecomastia and treating the thyroid problems puts the gynecomastia in regression, so maybe now that I've stopped thyroid I just need time to reach homeostasis and it will disappear on its own.

Maybe. But the thyroid doesn't have to be lots or none. Before you supplemented thyroid, your TSH was highish, so the homeostasis you reach there may not be quite what you are wanting - it wasn't before.

 

[franko]

post 109474As a lot of you have guessed my prolactin is quite high, my doctor would like me to get a follow up blood test and then an MRI to check for a pituitary tumor if both tests are elevated.

I also had high prolactin after seeing an endocrinologist about gynecomastia and my doctor also had me get an MRI for a pituitary tumor. It came back negative. And it almost cost me $2,000 — luckily I shopped around and found an imaging center that did it for $250. That had to be paid in full because I had not reached the maximum of my health insurance deductible (I am in the USA).

Also, haidut had this to say about it:

With prolactin below 50, there is less than 1/1,000,000 chance of you having prolactinoma so not sure what that endocrinologist was thinking,

That's in units of ng/mL, but the reference range is 4.0 - 15.2 ng/mL so I would assume the reference ranges are the same or close and you are not that far above the normal range.

There's a few shocks, I was expecting my testosterone to be on the lower side which would explain my symptoms

Did you not get your estrogen checked. It would be useful to know your Testosterone:Estrogen ratio. This is especially relevant to gynecomastia. Your Testosterone is high-normal but if your estrogen is also very high it could still be contributing to "Low T" symptoms.

I was not expecting my TSH to be that low

That's from the thyroid. It's the expected negative feedback mechanism for your body's endogenous thyroid production, but it's not a "bad thing." In fact, I've heard people around these parts say that a TSH less than 1 is a good thing. I did the same thing, btw — took a lot of thyroid because I thought it was not working. But it was working I just didn't "feel" it. Glad I got bloodwork to check. I've settled on 1 grain a day and it provides me with "regularity" but not necessarily any other noticeable symptom improvements.

The triglyceride level is what's worrying me most now.

I suggest that you shouldn't be that worried about your cholesterol/triglyceride levels. Do your own research, of course, but the mainstream view of cholesterol and the mainstream prescription leave much to be desired. I recommend you listen to the cholesterol part towards the end of this podcast with Haidut and Danny Roddy. http://www.generativeenergy.com/main/episode12

I also have high cholesterol/triglycerides and high prolactin and I am more focused on lowering prolactin, because prolactin is actually an indicator of tissue estrogen levels. Search around this forum for more info on that.

This could also help explain why so many guys on the internet have gynecomastia (or puffy nipples) but call it "prolactin gyno" or insist that prolactin is involved because they have high prolactin but normal blood estrogen levels. But others insist that breast development only comes from estrogen, but that could still be an accurate theory, because the prolactin may be an indicator that tissue levels of estrogen are high even if blood levels are not.

Also, Haidut advised me to ask my doc for liver and kidney tests:

Prolactin below 50 is usually hypothyroidism, liver, or kidney disease, or low carb-diet combined with endurance exercise (in that order).

And it looks like you have had a couple liver tests (ALT, AST, ALP) with high results so you may want to look into that further.

And since my symptoms and bloodwork are similar you might benefit from reading my thread about it here: viewtopic.php?p=106315#p106315

 

[youngandold]

Very low doses like 1/2 tab bromocriptine a week and 1/8 of a 20 mg tamoxifen tab can work nicely if given enough time yet such low doses would likely cause no side effects.

 

[DankMemes]

post 109896 That's in units of ng/mL, but the reference range is 4.0 - 15.2 ng/mL so I would assume the reference ranges are the same or close and you are not that far above the normal range.

Okay I think that would be ~20ng/ml on that scale (could be completely wrong though) which is still out of range.

post 109896 Did you not get your estrogen checked. It would be useful to know your Testosterone:Estrogen ratio. This is especially relevant to gynecomastia. Your Testosterone is high-normal but if your estrogen is also very high it could still be contributing to "Low T" symptoms.

Unfortunately no, I can't really pick and choose when I got to a bulk billed clinic, my doctor's words were essentially that he's not an endocrinologist and he wants to rule out a tumor then he'll refer me to an endo to sort out the gyno. I agree with the notion that the extra prolactin is a result of elevated estrogen due to poor metabolism/stressed state.

Haidut's progestene came in the mail yesterday so I've been using that topically on my nips, there's a few testimonials for progesterone therapy and gyno.

I also bought some Taurine powder and choline/inositol off iherb, I really want to get my liver in shape - I think a lot of my problems stem from that, (normal t4 but high tsh, hypothyoid symptoms, poor estrogen clearance, trouble digesting fats, weight gain etc).

Sounds like we have a bit in common, did you ever go low carb or workout strenuously? I'll keep you updated

post 109991 Very low doses like 1/2 tab bromocriptine a week and 1/8 of a 20 mg tamoxifen tab can work nicely if given enough time yet such low doses would likely cause no side effects.

I asked my doctor about cabergoline or an aromatase inhibitor but he'd rather send me to an endo for that. I've seen lots of positive testimonials for letrozole and caber.

 

[youngandold]

Go for that.
Endos are about the only kind of Drs that can handle it.

 

[DankMemes]

Rosacea, chronic constipation, hypothyroidism, gynecomastia, fatigue etc don't just come out of no where, I think I need to treat the root cause of these problems not these "symptoms".

Everything seems to point to liver health.

All of my health problems seemed to appear about 4 years ago when I went low carb paleo, at first I started breaking out and acne when I cut sugar and oats thinking carbs were poison, so what did I do to get rid of the acne? A year long cause of Accutane, cut back on carbs even more and supplement with cod liver oil. From a peat perspective I was just digging my own grave.

I've been consulting Dr Google and there seems to be a link between prolactin and NAFLD. Some articles suggest that prolactin is protective of the liver, so maybe when liver health is compromised, prolactin is elevated and an optimal sex hormone profile is no longer a priority. Maybe the reason I had a bad experience with NDT is because my liver health isn't the best so I didn't convert thyroxine to t3 properly? who knows.

My liver enzymes are only slightly elevated, but I'm only "slightly sick". My gynecomastia is very mild, my chronic constipation is very mild, fatigue is mild and I'm not even hypothyroid by conventional medicine. It's frustrating because nothing is blindingly obvious so doctors don't pay me much attention, I just suffer these annoying health problems that add up and consume my life.

My main goal now is to get my liver healthy. I've started taking choline and inositol, taurine, k2/d3 drops and am making my coffees extra strong. I've always had problems with food, I'm so desperate to find a diet that works, I actually don't care how it tastes I just want to be healthy again. I can't eat fruit because they make me bloat and cause allergies, I can't drink juice and milk because I get freezing hands/feet and constipation, I can't eat starch because the bacterial fermentation could worsen my liver problems!

I've actually added really salty pasta back into my diet as it gets my digestion moving, it's essentially homemade mac and (low fat) cheese with huge dollops of coconut oil melted in to help prevent fermentation, I might try shredding a raw carrot and adding that too. I'm also REALLY craving sweet drinks, juice just makes me cold but Red Bull and Soda doesn't seem to do this (I LOVE coca cola, but the furry feeling on my teeth makes me think there's a lot of phosphorus, thoughts?). A year ago if someone suggested I needed to eat cheesy pasta and soda to get healthy I'd think they're insane, but right now they're the only things that get me warm and improve my mood.

I think I'm onto the right path now, just eat lots of calories, carbs and protein from foods that don't cause a histamine response or bloating. Vitamins and minerals are definitely important, but whats the point of eating loads of fruit if I don't digest it properly?

Anyway, mini rant over, I'll keep you lot posted, thank you for all the advice.