Trying to Determine the Cause of Returning Gynecomastia

[MidwestBeast]

This is not something I enjoy talking about, but ignoring it doesn't help the situation, either. This is not related to anabolics, but I felt it would likely get more attention in here rather than under general chat. For those who have seen me around, you may recall that last June, I had surgery to remove bilateral gynecomastia (that was pretty much known to be, but confirmed by biopsy afterward of the tissue, non-cancerous). It wasn't just puffy nips, it was actual tissue that was painful (not like boo-hoo pain; people have things a lot worse, but to say there wasn't any pain would certainly be a lie). Well, within the past month or so, it has come back. It came on substantially faster this time than it did the first time around. The initial time, it was puffy nips, then pea-sized lump that eventually progressed.

Previously, I've had my prolactin levels come back elevated and a dynamic brain MRI caught what is likely a small microadenoma/prolactinoma on my pituitary gland. There was minimal discussion on it because it was so hard to see and at least at the time, the ruling was there would be no reason to attempt surgery on it.

I've only had elevated E2 levels one time -- and that was when I was running a clomid therapy to (successfully) attempt to raise my natural testosterone levels from ~400-450 up to the 1,000 mark. However, I wasn't running an AI during that time, so while my testosterone increased by about 2.5x, so did my E2 (going from about 20 to 50). I noticed no gyno symptoms during that time. Aside from that one time, my E2 levels have always been great around the 20-25 mark.

My insurance is awful when it comes to coverage for cabergoline. What was once a $14/month Rx jumped to nearly $60/month. I ended up finding a pharmacy elsewhere and was able to get a year's worth (actual brand name) for about $120. Well, I ran out of those and they wouldn't fill my old Rx at the pharmacy (understandable, but the point was trying to avoid an appt. with my doc that now costs about $100 out of pocket due to said insurance coverage). Well, I got it, he gave me the scrip and also had my labs drawn that day for PRL along with checking up on my thyroid. All of that came back normal.

That was actually somewhat bothersome to me. My prolactin was at the very bottom and yet I still had these symptoms flare up (that draw was before I got my Rx filled). I didn't have E2 drawn, but there's never been anything indicative of that being an issue and quite a few draws.

So, considering that I paid a plastic surgeon to have the masses removed less than 9 months ago (out of pocket) and they're now back, I need to ensure the brakes are halted on this before I have surgery again (and I absolutely WILL have surgery, because I feel miserable right now; I'd forgotten how bad this made me felt). We assumed that it was under control and a non-issue with the cabergoline Rx and PRL levels squashed.

So what I'm trying to figure out, now, is if PRL is low and E2 isn't elevated -- what is causing this? I don't eat any soy; the only thing with the word even in it that I've touched is the soy lecithin granules in OL Tr1umph (and through the researching I'd attempted to do, nothing pointed at that ingredient as being a trigger for this -- I also didn't use SL beforehand). My GP asked if I was using anything with lavendar or tea tree oil and nothing came to mind. I looked at the labels on all of my supplements and nothing came back there. I'd used some left over Head & Shoulders shampoo that was around the house, but have since stopped that (I only used it probably 4 times total, anyway). I just started using a new deodorant (Dove Men+ Care Clinical Strength). Wanted to see if it worked any better than just the regular Old Spice stuff. I looked at the label on it and nothing there said lavendar or any type of tea tree oil that I could see.

In digging across some labels on foods I've eaten recently that are out of the norm, I've seen soybean oil listed on some stuff (but it was pretty low down on the list) and I'm a sucker for the stupid Great Value trail mix and I see it says "soy lecithin" numerous times on it (but the ingredients themselves are peanuts, raisins, MnM's, and peanut butter chips and chocolate chips).

I've seen some stuff saying stress can bring things on and things have been incredibly stressful lately. That may be an understatement. Probably the most I've felt since I was wrapping up grad school. But I just find it hard to believe that the onset of stress like that would cause this (I'm racking my brain to think of I was stressed when this came on the first time -- I probably was at least to some extent, but I don't know how much).

So, I guess I'm curious if you guys can think of anything else you've ever come across or any experiences you may have had.

I've run a couple PH cycles, but it's been years and this came well after those.

Thanks in advance.

 

[Toren]

Sorry to hear about your struggle. I guess the doctor won't give you a freebie........ :[

I'm going to throw out a bunch of info and links and hope that maybe something here gives you a different perspective or puts you on a different path to figuring this out.


In my generic research into androgen and estrogen receptors, as well as hormones and hormone mimetics, I stumbled across some general but interesting information. That information is in regards to certain plastics (many different types) and the ability of said plastics to leach into our food and beverages and act like an estrogen. These substances are often referred to as Xenoestrogens, hormone mimetics, or endocrine disruptors. In a nutshell, some plastics, such as BPA, but even beyong the headline grabbing BPA, have the ability to activate the estrogen receptor to varying degrees. Even with low or in-range estrogen levels, you may have compounds floating around in your body that will act in a similar fashion. I honestly haven't read up on it too much in recent months so the information is not the freshest for me.

So, how do you consume your food? Do you use plastic tupperware? Do you heat plastic up in the microwave? Do you use plastic containers (that come with food products in it from the grocery store) as storage or food preparation containers (microwave or freezer)? Are you careful to look at the plastic rating number on the bottom of your tupperware? Certain plastics are rated for specific things. Some are not freezer or microwave safe, or even re-usable after the initial seal of the container is broken. Are you using old tupperware that has degraded and thus will most definitely leach more estrogen-like chemicals into your food?

How do you consume your beverages? Do you consume water and juice from plastic bottles every day? If so, do you re-use the bottle over and over again?

I have almost completely made the switch to glass tupperware and stainless steel water bottles (work in progress as I do like my plastic water bottles). If you haven't done the same, that might be a good place to start. At the very least, even if it isn't playing a role in your gyno issues, making the change alway from plastics is a healthy lifestyle choice.

Beyond what I just mentioned, I would look into things such as grooming products. Everything from face creams, hand creams, shaving products, hair styling products, all have heavy amounts of chemicals. Chemicals can most definitely mimic or disrupt the actions of hormones, or even wreak havoc on hormone levels within our body. You may just be one of those individuals that has certain chemical sensitivites that go beyond what most people have. Governments and agencies that act on behalf of a government always site "safe allowable limits" of chemicals within the food supply or within cosmetic supplies that we use. What may be "safe" for me might equal trouble for someone else.

I have a link to some information from a university that touches on some of what I have mentioned and also gets in depth on human hormone receptors and hormone receptor binding and endocrine disruptors. I will link some browser search articles/studies as well...

http://e.hormone.tulane.edu/learning/endocrine-disrupting-chemicals.html

http://e.hormone.tulane.edu/learning/docking-receptor-binding.html#EndocrineDisruption


http://womeninbalance.org/2012/10/26/xenoestrogens-what-are-they-how-to-avoid-them/

https://www.sciencedaily.com/releases/2009/03/090326100714.htm

http://www.npr.org/2011/03/02/134196209/study-most-plastics-leach-hormone-like-chemicals


One last thing that just popped into my head. Have you been tested for levels of heavy metals? People who consume high levels of "supplements" that don't undergo rigourous testing or purification may find themselves at risk of having higher levels of heavy metal contamination in their body. There has been studies that show certain heavy metals can activate the ER-a (estrogen receptor alpha). I haven't thoroughy reviewed the below links yet but it should be some fun reading... :]

http://www.sciencedirect.com/science/article/pii/S0887233309000113

https://academic.oup.com/mend/article-lookup/doi/10.1210/mend.14.4.0441

 

[MidwestBeast]

Toren -- thanks a ton for your response. I greatly appreciate it and will read up on everything you linked.

I was tested for heavy metals several years ago at the onset of problems (which actually started when I was gaining weight regardless of what I did and ballooned from 208 to 300 over a couple years). Those never came back high.

I actually researched xenoestrogens and phytoestrogens at that same time. Got rid of everything plastic back then, but sadly have started using it again. I never microwave plastic, but I do use it for fridge storage quite often. I'll have to phase that back out. If I drink from anything at home, it's glass (aside from doing Sprite Zero or the like from a 2L bottle). I still use plastic shaker cups (the USP Labs ones), but that's really it.

Trail mix and other things like that come in plastic containers that I buy, but that's also not anything new.

Definitely more stuff to think on.