Gynecomastia laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Gynecomastia is diagnosed clinically after a thorough history and physical examination. A recent onset of gynecomastia with tenderness on the examination require the following laboratory studies: Serum concentrations of human chorionic gonadotropin (hCG), LH, testosterone, and estradiol. The hormonal levels may vary depending on the underlying cause.

Laboratory Findings

Asymptomatic gynecomastia which is discovered on physical examination has a very low diagnostic yield and usually normal blood hormone levels.
Gynecomastia which is tender and of recent onset should have, following lab work up:^[1]^[2]^[3]^[4]
- Alpha-fetoprotein (AFP)
- Blood urea nitrogen (BUN)
- Creatinine (Cr)
- Dehydroepiandrosterone-sulfate (DHEA-S)
- Estradiol
- Erythrocyte sedimentation rate (ESR)
- Human chorionic gonadotropin (HCG)
- Liver function tests (LFTs)
- Prolactin
- Testosterone
- Thyroid stimulating hormone (TSH)

References

↑ Braunstein GD (2007). “Clinical practice. Gynecomastia”. N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.
↑ Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H (2007). “Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement”. J Clin Endocrinol Metab. 92 (2): 405–13. doi:10.1210/jc.2006-1864. PMID 17090633.
↑ Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001). “Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging”. J Clin Endocrinol Metab. 86 (2): 724–31. doi:10.1210/jcem.86.2.7219. PMID 11158037.
↑ Ismail AA, Astley P, Burr WA, Cawood M, Short F, Wakelin K; et al. (1986). “The role of testosterone measurement in the investigation of androgen disorders”. Ann Clin Biochem. 23 ( Pt 2): 113–34. doi:10.1177/000456328602300201. PMID 3532913.

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[pmid17881754-1] Braunstein GD (2007). “Clinical practice. Gynecomastia”. N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.

[pmid17090633-2] Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H (2007). “Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement”. J Clin Endocrinol Metab. 92 (2): 405–13. doi:10.1210/jc.2006-1864. PMID 17090633.

[pmid11158037-3] Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001). “Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging”. J Clin Endocrinol Metab. 86 (2): 724–31. doi:10.1210/jcem.86.2.7219. PMID 11158037.

[pmid3532913-4] Ismail AA, Astley P, Burr WA, Cawood M, Short F, Wakelin K; et al. (1986). “The role of testosterone measurement in the investigation of androgen disorders”. Ann Clin Biochem. 23 ( Pt 2): 113–34. doi:10.1177/000456328602300201. PMID 3532913.

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