Gyno while on arimidex?

[Bridger]

I have a tangible lump behind my left nipple(sometimes tender) and also a tender(sometimes) spot below the nipple towards my armpit. Here are the meds i take:

test cyp 55mg/3 days
arimidex .5mg 2x/wk
levothyroxine 75mcg day

lithium carbonate
seroquel 50mg nightly (a known side is increased prolactin levels)

I don't think its estro induced gyno, I have been steady on the adex since i started test and my last lab showed low levels of e2.

I wonder if its prolactin gyno from the seroquel, except i've never had a discharge. Just varying degress of tenderness and lumps.

I had an ultrasound done in 2008 on the left breast, there was something noted that was found. but wasn't enough to warrant any further imaging or biopsy. Im thinking another ultrasound might be something to consider again, but can't afford it right now.


Any thoughts or suggestions?

 

[Bridger]

Bump for ideas


I have been doing subq every 3 days, about 55mg each time, for about 9 months. I realize this method is said to help limit E2 conversion, but im curious if it makes any difference or if it possibly is contributing in some way to my gyno symptoms. Previously, I did 100mg every 5 days, IM. I might try going back to that schedule and see if there is improvement.

 

[CubbieBlue]

Bump for ideas


I have been doing subq every 3 days, about 55mg each time, for about 9 months. I realize this method is said to help limit E2 conversion, but im curious if it makes any difference or if it possibly is contributing in some way to my gyno symptoms. Previously, I did 100mg every 5 days, IM. I might try going back to that schedule and see if there is improvement.

It was my understanding that subq injections led to more aromatase than IM...I have nothing to back that up however.

 

[Bridger]

It was my understanding that subq injections led to more aromatase than IM...I have nothing to back that up however.

I think you bring up a good point, something about there being more aromtase enzymes in fat tissue.

This was quite a hotly debated topic last year, IM vs Subq. Jansz was a huge advocate of it then, was said to reduce E2 or reduce the need for arimidex. So, i thought id give it a try. Assuming my memory is correct, which it might not be.

 

[CubbieBlue]

I think you bring up a good point, something about there being more aromtase enzymes in fat tissue.

This was quite a hotly debated topic last year, IM vs Subq. Jansz was a huge advocate of it then, was said to reduce E2 or reduce the need for arimidex. So, i thought id give it a try. Assuming my memory is correct, which it might not be.

It seems that most people that use gels don't have to worry about E2 too much, so that may be another option.

 

[biceps72]

It seems that most people that use gels don't have to worry about E2 too much, so that may be another option.

As a androgel user-- notsure that is true--- still don't know what is best to minimize E2-- i guess using the mimimal dose of test to get you were you want to be.

 

[Michael Scally MD]

I have a tangible lump behind my left nipple(sometimes tender) and also a tender(sometimes) spot below the nipple towards my armpit. Here are the meds i take:

test cyp 55mg/3 days
arimidex .5mg 2x/wk
levothyroxine 75mcg day

lithium carbonate
seroquel 50mg nightly (a known side is increased prolactin levels)

I don't think its estro induced gyno, I have been steady on the adex since i started test and my last lab showed low levels of e2.

I wonder if its prolactin gyno from the seroquel, except i've never had a discharge. Just varying degress of tenderness and lumps.

I had an ultrasound done in 2008 on the left breast, there was something noted that was found. but wasn't enough to warrant any further imaging or biopsy. Im thinking another ultrasound might be something to consider again, but can't afford it right now.


Any thoughts or suggestions?

I think you are right on target with the offender Seroquel. I have attached the package insert (PI). While not eliminating other factors, this is my number one cause. Overall, these drugs are to be used carefully, very carefully. [ DailyMed: About DailyMed ]

5.14 Hyperprolactinemia

Like other drugs that antagonize dopamine D2 receptors, SEROQUEL elevates prolactin levels in some patients and the elevation may persist during chronic administration. Hyperprolactinemia, regardless of etiology, may suppress hypothalamic GnRH, resulting in reduced pituitary gonadotrophin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male subjects.

 

[Bridger]

I think you are right on target with the offender Seroquel. I have attached the package insert (PI). While not eliminating other factors, this is my number one cause. Overall, these drugs are to be used carefully, very carefully. [ DailyMed: About DailyMed ]

5.14 Hyperprolactinemia

Like other drugs that antagonize dopamine D2 receptors, SEROQUEL elevates prolactin levels in some patients and the elevation may persist during chronic administration. Hyperprolactinemia, regardless of etiology, may suppress hypothalamic GnRH, resulting in reduced pituitary gonadotrophin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male subjects.

Is it as simple as getting labs done for a prolactin level?

Can increased prolactin, enough to cause gyno symptoms, occur without nipple discharge?

 

[Michael Scally MD]

Is it as simple as getting labs done for a prolactin level?

Can increased prolactin, enough to cause gyno symptoms, occur without nipple discharge?

Yes. I am not excluding other factors, but this is Numero Uno until proven otherwise.

 

[HeadDoc]

I have a tangible lump behind my left nipple(sometimes tender) and also a tender(sometimes) spot below the nipple towards my armpit. Here are the meds i take:

test cyp 55mg/3 days
arimidex .5mg 2x/wk
levothyroxine 75mcg day

lithium carbonate
seroquel 50mg nightly (a known side is increased prolactin levels)

I don't think its estro induced gyno, I have been steady on the adex since i started test and my last lab showed low levels of e2.

I wonder if its prolactin gyno from the seroquel, except i've never had a discharge. Just varying degress of tenderness and lumps.

I had an ultrasound done in 2008 on the left breast, there was something noted that was found. but wasn't enough to warrant any further imaging or biopsy. Im thinking another ultrasound might be something to consider again, but can't afford it right now.


Any thoughts or suggestions?

I assume that you are taking the seroquel for bipolar d.o. Have you and your doc considered using another class of meds? Lamictal? Not w/o it's own problems---but not these.

Also, despite what others may think, if you have watched your E2 fluctuate w. TRT, the arimidex and continued monitoring is worth doing. Our old buddy Jansz just completed prostate surgery.

 

[BBC3]

Just swoopin in from my observational perch, and off the wall. I have some personal thoughts that once gyno is in place, it is quite a life force to deal with. So, did you develop the gyno solely on these type doses, or do you think it started with any past megadosing? The point is, while Adex will lower overall E2 concentration, plenty still remains. So short of a blocker, like nolva, the breast tissue you have in place, will probably find a way to feed.... I dont know how progesterone/prolactin plays into this. I would assume NOLVA does not block those. I am not sure how they are "blocked" on a site basis, or how they are addressed in breast cancer either.

 

[Bridger]

Yes. I am not excluding other factors, but this is Numero Uno until proven otherwise.

I guess the next step is to request lab orders for prolactin? anything else which might help confirm or deny?

The seroquel has been in the back of my mind for some time now, have wanted to get off it for a while for a number of reasons.

 

[BBC3]

Further, I noted where you mentioned the ultrasound and decisions made at the time. I recently went harping on the obviosly elevated cancer risk in men who naturally come about breast lumps. However, isn't that what breast tissue is, and aren't we simply developing breast tissue abnormally due to the excessive estrogen? In the male that gets lumps, and especially lumps that report leakage (it would seem), there appeared to be a high rate of cancer. Clearly that does not apply to men with natural gyno on a broadscale basis, and is most likely localized to males reporting symptoms like soreness, unilateral behavior, leakage, and other symptoms.

So I am guessing the primary question for males supping hormones should be, how do breasts develop normally in females? Are these tiny bb sized lumps that we seem to find sooner or later, NORMAL when considering normal female development, or not?? Second there should be considered what NORMAL profile of hormonal exposure associated with breast growth really is. Obviously, in men the profile will not be all that similar to women, but my point is; Is there a certain threshold of hormonal (Estrogen or progesterone) that "normal" tissue can stand prior to DNA corruption? And what is it in men?

Do men with breast cancer, as a general, even necessarily have ANY breast tissue developed? Or did they just get a freak cancerous growth that may be comprised of it, OR NOT? I wonder. Were those men just going to get that cancer regardless of their propensity to develop breast tissue. But I do think its called "male breast cancer" due to the fact that its female type BREAST tissue. SO I would assume breast tissue is present in all male breast cancers.? Else they would call it "male pectoral muscle cancer", right? Does our hormone overload increase our propensity to cancer, or are men with that type cancer just predisposed to it???

Maybe Doc Scally could shed some light?

 

[Bridger]

I assume that you are taking the seroquel for bipolar d.o. Have you and your doc considered using another class of meds? Lamictal? Not w/o it's own problems---but not these.

Also, despite what others may think, if you have watched your E2 fluctuate w. TRT, the arimidex and continued monitoring is worth doing. Our old buddy Jansz just completed prostate surgery.

yes and no. I started the seroquel a few years back for insomnia. tried the sedative-hypnotics with little success and most other common sleep meds. So, mainly it has been used for sleep, with the added benefit of mood stabilizing.

I tired lamictal for a short time, developed some kind of rash on it, not sure if it was 'the one' so we discontinued. and a few other meds. lots of trial and error you know. lol. About this time last year I was motivated to discontinue seroquel(cognitive difficulties) and tried a few natural sleep alternatives. Its definitely something i need to discuss with my doc, she just isn't as knowledgeable on meds as i like.

Hope jansz is doing well and the surgery was successful.