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د. بشار نعمات فاضل سهر

Hi. To the contrary testosterone injections can worsen breast enlargement in males.If u have a breast enlargement then u have to do some series of blood tests to know the cause including:1) Serum testosterone, estradiol, LH,FSH.2) Prolactin.3) TSH,T4.4) Breast ultrasound.5) HCG, Alpha fetoprotein. Testicle ultrasound.Medications such as Nolvadex at a dose of 10 mg BD can be helpful.Hope u find it useful.

الأجابة

د. بشار نعمات فاضل سهر

Hi. Essential hypertension is the most common cause of high blood pressure in the public. Essential means no known distinct cause. It is thought to be due to interplay between dietary, genetic and stressful life condition.  However in ur case we need to look for other possibilities of what we call it “surgical hypertension” that is a high blood pressure due to hormonal imbalance that can be corrected by surgery. In regard to the TSH level. Ur current level is 5.4 which is in the zone of thyroid under activity.  However, It is mentioned that u r taking “carbimazole” and carvidolol. Since how long ?? Have u ever been diagnosed with over active thyroid before? If that is the case then u need to reduce the dose of carbimazole to allow TSH to return back to normal. Aldosterone of 47 could be normal or high depending on the unit of measurement. U need to specify the unit of measurement. Is it pmol/l or ng/dl. U need to send the unit of measurement and u have to do another test called serum renin and more hormonal tests called serum metanephrine and nor metanephrine to look for surgically correctable causes of hypertension. Hope u find it useful. 

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د. بشار نعمات فاضل سهر

Hi. Based on the description in the new ultrasound report u need to redo the biopsy from the largest thyroid nodule on the right side that measures 1 cm in the maximum diameter. The next step depends on the biopsy result. Changing shape of the nodule is significant but bear in mind that ultrasound reports is subjected to operator bias and there may be a misclassification from the beginning rather than a true change in the shape of the nodule.  Hope u find it useful. 

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د. بشار نعمات فاضل سهر

Hi. In order to correlate between your symptoms of cough, neck discomfort  and thyroid nodules we need to proceed doing neck CT scan and a puff test to see if there is any genuine compression on your wind pipe and esophagus (the tube that connects your mouth with stomach). If the CT scan reveals a compression then one can consider sending you for surgery. Otherwise the best next step is to go for FNAC biopsy from all nodules greater than 1 cm in diameter and decide what to do based on the results. Please do TSH T4 T3 as well. Hope u find it useful.