Hormones

    
      Re: Re: Re: Re: Hormones
    


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Posted by HFHS M.D.-MS on March 06, 1998 at 16:25:53:

In Reply to: Re: Re: Re: Hormones posted by KD on March 03, 1998 at 22:38:39:
  : :
  : : : I have extemely high levels of estradiol, low levels of testosterone, intense moments of spontaneous sweating, weight gain and a slight loss of body hair.  My GP did an exam as well as a MRI of my adrenal gland, but nothing was abnormal.  What sort of tests can be conducted to determine the reasons for this.  I am a 31 yo male and would like to get my hormone levels back to normal.  Thanks
  : : ==========================================================
  : : Dear KD
  : : Thank goodness you did not find a estrogen secreting tumor in the adrenal gland.  These tumors are usually very big and very aggressive. Prognosis is about 20% despite surgery.  There are a couple of other possibilities.  The estrogen secreting tumors of the testes are also rare, only one percent of tumors of the testes.  These tumors are usually benign and only metastasize in 10%.  These tumor can be very small.  An ultrasound of the testes does not detect them all but would be a good place to start.  An MRI is more sensitive but much more expensive.  Another source of estrogens are medications.  Obesity can be associated with an elevated estrogen to testosterone ratio.  An endocrinologist is a physician who specializes in hormonal disease.
  : I believe that the tumor the doctor is referring to is called a Leydig cell tumor. The information I have reads as follows:
  : "Leydig cell tumors occur in all age groups, but peak incidences are at ages 5 to 10 years and 30 to 35 years. Most patients present with a palpable testicular mass; however, several recent reports have documented the discovery of Leydig cell tumors by ultrasonagraphy in the workup of gynecomastia (growth of breast tissue)."
  : "...In adults, endocrine manifestations are seen in only 20 to 40 percent of patients. The most common sign is gynecomastia, sometimes associated with loss of libido, impotence, and infertility. Other evidence of feminization - such as loss of body hair, areolar hyperpigmentation, and testicular and prostatic atrophy - also may be present."
  : I imagine that this might also explain your hot flashes and weight gain.
  : This tumor would seem to explain all that is happening to you. A scrotal ultrasound is a simple and accurate procedure, and seems like a good next step. If a tumor is found, they will want to remove the testicle. Things get a little complicated at that point since they cannot distinguish between benign and malignant tumors, but we can save that discussion for later.
  : Good Luck,
  : Doug Bank
  : Testicular Cancer Resource Center
  
  A scrotal ultrasound showed bilaterial varicoceles and a hydrocele.  No tumors were found
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Dear KD
The next step would be to see an endocrinologist.  Good Luck
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