Meds, Toxins, and Obesity Cause Breast Enlargement in Men and Boys

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Meds, Toxins, and Obesity Cause Breast Enlargement in Men and Boys
Gynecomastia. You may not know the term, but you can easily recognize this common male health disorder. It’s enlargement of breast tissue in men or colloquially known as “man boobs”. It’s not often talked about, yet it is frequently terribly embarrassing and sensitive as the invisible elephant in the room. This phenomenon of increased breast tissue in men has risen considerably in the last few decades and is a common modern day concern. To see evidence of this, just compare the present physique of men and boys to TV shows, movies, and photographs from 30 years ago and older and you will see a marked change in male physiology.

There are a number of reasons for this change. Some of the reasons include several medications, diabetes, obesity, and xenoestrogens like plastics and environmental toxins wreaking havoc with the endocrine system. Even exposure to environmental estrogens during pregnancy can impact the health of boys and men later in life. Knowing how to help the men in your life or yourself with this concern is essential in today’s challenging environment. It is not just a problem for today’s generation, but it will affect future generations.

[Jump to: Nutritional Options]

Causes of Enlargement of Breast Tissue in Men


Gynecomastia is the enlargement of breast glandular tissue in men and boys. Enlargement of the male breast tissue may occur during infancy and puberty or old age. The medical field considers it “normal” and temporary, or idiopathic, if no other reason is found for the change. Underlying medical causes may include chronic kidney disease, liver disease like cirrhosis, adrenal tumors, hyperthyroidism, hypogonadism, or other endocrine disorders. If the issue is present, get evaluated by your medical provider to rule out major medical problems. It is more likely though that medication, environmental chemicals, obesity, insulin resistance, and elevated leptin are at the root of breast enlargement in boys and men.

A current study with VA patients 65 years of age and older reflects just how much the medications and weight management problems are intertwined with gynecomastia development. The average BMI (body mass index) of these men was 29.7. This is considered overweight and borderline obese. Ninety-two percent of the participants were using multiple medications associated with breast enlargement as a possible side effect. Medications were considered the cause of the problem in over 79 percent of the participants. Only 13 percent had gynecomastia because of underlying medical conditions.

This “normal” enlargement is due to an increase in the supporting connective tissue in the breasts, but the breast ducts are not increased like in women. Male breast enlargement occurs when the estrogen-to-testosterone ratio in men is disrupted. The physical reasons for this change in the structure are thought to be due to a decrease in androgen hormone production and an increase in estrogen production. It may be that the androgen hormones are blocked by something like a drug or there is a decline in testosterone production relative to estrogen levels. In addition, hormone receptors (sex hormone binding globulin - SHBG) that bind onto estrogen may be blocked, causing estrogen to go elsewhere in the body.

Androgens
are hormones related to the presence of masculine features. Insufficient androgens lead to gynecomastia along with erectile dysfunction, increased fat mass, muscle loss, bone density loss, hypogonadism, low testosterone and reduced libido. We have seen that a change like this in androgen receptor function definitely relates with increased prostate cancer risk.

Medications and Substances Linked to Gynecomastia


Numerous medications are known to cause male breast enlargement or gynecomastia. Here are some of the known common drug causes.

• Antiandrogen (drugs that inhibit androgen synthesis or activity) are often used to treat prostate cancer

• Antimicrobials – Efavirenz, ethionamide, isoniazid, ketoconazole (antifungal), metronidazole/Flagyl (antibiotic)

• Antineoplastic/Cancer drugs – alkylating drugs, imatinib, methotrexate, vinca alkaloids

• Cardiovascular drugs – ACE inhibitors (captopril, enalapril), amiodarone, methyldopa, reserpine, spironolactone/Aldactone (diuretic)

• CNS-acting drugs – diazepam, haloperidol, methadone, phenothiazines, tricyclic antidepressants

• Antiulcer/Antacid drugs – cimetidine/Tagamet, ranitidine/Zantac, omeprazole/Prilosec

• Hormones – androgens, anabolic steroids, estrogens, human growth hormone. This includes designer anabolic steroids for body building

• Recreational drugs –amphetamines, alcohol, heroin, marijuana

• Miscellaneous drugs –auranofin, diethylpropion, metoclopramide/Reglan, phenytoin/Dilantin, penicillamine/Cuprimine, sulindac/Clinoril (NSAID), theophylline (asthma/bronchodilator)

Alcohol consumption increases the sex hormone binding globulin activity which reduces free testosterone levels. Because of how alcohol affects the liver, it increases the removal of testosterone. In addition, alcohol is toxic to the testes. The bottom line - alcohol will lead to decreased availability and amount of testosterone changing the balance with estrogen.

There are two essential oils that can lead to gynecomastia if there is excessive exposure or use. They are lavender and tea tree oil.

Environmental Toxins – BPA and Phthalates


Besides the medications that lead to challenged estrogen and androgen function in the male body, xenoestrogens may play an even more sinister, subtle role in male breast enlargement. Several animal studies found that bisphenol A (BPA) caused gynecomastia. BPA is an estrogen mimicking compound found in plastic that is known to wreak havoc on endocrine function and contribute to obesity.

One study demonstrated that when female animals were exposed to common environmental doses of BPA during pregnancy, it affected the male offspring into adulthood. The male offspring’s breast tissue was analyzed several times during adulthood. They found direct correlation with fetal BPA exposure and alterations of the male breast tissue in adulthood. Even exposure during pregnancy without other exposure during development led to the changes in the breast tissue in adulthood.

A more recent animal study found that low level exposure to BPA during pregnancy increased the likelihood of developing breast cancer during adulthood long after the BPA exposure had stopped. Male breast cancer is a possible underlying issue linked with gynecomastia, but is considered rare. It was found that early prenatal exposure altered breast tissue formation that affected the animals into adulthood.

The authors also hypothesized that the BPA exposure affected the hypothalamus in the brain and its ability to regulate hormones even after BPA exposure had subsided. The hypothalamus orchestrates hormone function in the body especially during puberty. This animal study questions if these physiological changes hold true for humans. Another animal study showed that low level BPA exposure changed estrogen metabolism and genes leading to developmental changes and breast cancer risk. This sets up the risk for breast structure changes and enlargement.

Phthalates are also deeply involved with the development of gynecomastia related with puberty. Phthalates are a group of chemicals that are used to make plastics and vinyl softer and more flexible. They are used in the plastic wrap for food coverings and packaging, baby bottles, pacifiers, sippy cups, teethers, shower curtains, perfume, shampoo, soap, detergents, plastic plumbing pipes, medical plastic tubing, building materials, and more.

Research has found that children entering puberty who had higher levels of phthalates in their blood stream were more likely to have gynecomastia. Expecting mothers, infants, and children are known to be more susceptible to these compounds. Strong evidence exists that phthalates have a significant adverse impact on development and adversely affecting reproductive hormone levels and function. Animal studies have showed that phthalate exposures can have serious, irreversible changes to reproduction and development when exposed before puberty. Chronic low level exposure of the modern world’s chemical soup affects unborn children, infants and young children more dramatically than adults at the very core of human reproduction and development, yet the risky effects persist for much longer than expected.

Elevated Leptin Hormone


Elevated leptin levels have also been found in boys who develop enlarged breasts during puberty. Decreased testosterone and elevated leptin levels and leptin resistance are seen in adult men too. This disrupted balance sets the stage for breast enlargement, prostate disease, obesity, and metabolic syndrome in men with gynecomastia. Research suggests that high levels of leptin relates to increased levels of estrogen or alters the androgen/estrogen ratio. This affects adipose and breast tissues leading to increased sensitivity to estrogen and resulting in the growth of breast tissue.

Medical Treatment


The medical treatment of gynecomastia depends on treating the underlying medical cause if possible. However, traditional medicine offers nothing in the way of healthy detoxification and management of insidious “normal” gynecomastia. Medical treatment may consist of different medications like antiestrogen/ anticancer drugs like Tamoxifen or liposuction or mastectomy may occur to remove the breast tissue. (Tamoxifen was reported to increase the risk of highly aggressive hormone receptor-negative breast cancer by 440 percent.) In the case of medications causing the adverse enlargement of breast tissue, the medical industry recommends removing these drugs if possible. Drug-induced gynecomastia has resulted in litigation and class action lawsuits.

Detoxification of Estrogens and Nutritional Support


The development of gynecomastia is a process. Risks start in pregnancy and continue through life with the chemical exposure, obesity, leptin resistance, metabolic syndrome and medication adverse effects. There are some key steps to take with family planning, detoxification, testosterone and androgen support. Additional support may focus on improving leptin resistance, blood sugar, and weight management concerns. It is imperative that in family planning, a person removes plastics, phthalates, BPA and other endocrine disrupting compounds (EDCs) as much as possible.

Several steps can be taken to reduce the exposure and to detoxify these compounds in men,women and children. In-depth information may be found in the article, Endocrine Disruptor Compounds and Natural Solutions. Critical compounds to incorporate for essential detoxification include indole-3-carbinol (I3C), diindolymethane (DIM), selenium, NAC, silymarin, MSM sulfur, and R-alpha lipoic acid. Make sure to include a diet rich in cabbage, broccoli, onions, radish, asparagus, etc. to help the daily work of detoxification.

Testosterone production may be naturally enhanced with acetyl-l-carnitine, saw palmetto, and panex ginseng. Healthy functions of androgen receptor site and androgen hormones (masculine features) require several nutrients. This includes selenium, glutathione, zinc, fish oil, saw palmetto, curcumin, calcium, vitamin D, and tocotrienols. Reducing inflammation and improving blood sugar function also positively impact androgen balance. Getting the hormone leptin back under control is fundamental at all ages. Start by following The Leptin Diet. Blood sugar support like cinnamon and chromium is recommended if any concerns are present.

This common disorder often causes enormous distress of adolescent boys and men. The suffering and shame surrounding this physical entity described as “normal” and idiopathic disorder is anything but normal. It reflects a problem from numerous challenges as a result of the twenty-first century that traditional medical care will flounder at. From unborn baby boys to your grandfather, the problem is real. Choices pertaining to personal care items, organic foods, removal of problematic medications, and nutritional support are essential to take care of the elephant in the room affecting the boys and men in our lives.

Nutritional Options


DIM and I3C – These natural compounds derived from cruciferous vegetables are well known estrogen detoxification nutrients. If you fail to have broccoli, cauliflower, asparagus, or other cruciferous-rich foods in your diet, then supplementation is essential.

Silymarin – Silymarin is well known for its ability to help the liver with detoxification in Phase I and II. It is considered fundamental to help the liver with daily toxic insults like plastic, xenoestrogens. Silymarin helps make the most important antioxidant enzyme, glutathione.

Selenium – This trace mineral is vital for several detoxification pathways. Inadequate selenium compromises the function of glutathione. Modern agricultural practices and foods are often lacking in selenium.

Pananx Ginseng – Pananx Ginseng offers a safe, natural way to enhance testosterone production. It may also help improve performance and sex drive.

Zinc – Growth, puberty, and poor digestion increase the need for zinc. Breast enlargement happens at opportune times of puberty and senior citizen age. Digestive efficiency often worsens as we age and requires zinc to function. Zinc is also essential for detoxification, prostate, and sex hormone production.

Chromium – Chromium is a trace mineral that is essential for blood sugar and insulin function. Modern agricultural practices, food quality, and high carbohydrate foods leave us with inadequate chromium to manage blood sugar well. This leads to obesity, leptin resistance, insulin resistance, and increased problems with estrogen dominance.

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