Gynecomastia in Teen Age Boys

At the outset I will say that the information I am providing is not based on a thorough medical history, clinical exam or comprehensive lab analysis.

Having said that, large breasts and a distended belly in a teen age boy is likely due to hypogonadism (primary or secondary) or impaired liver detoxification of hormone metabolites.

You mention low testerone.  Is this a serum level or a salivary level?  You say his testosterone is better.  Is he receiving testosterone replacement therapy?

If your son has hypogonadism, testerone injections are definately the treatment of choice, and even though there are some "natural" replacement therapies, synthetic testerone injections are the best treatment route.

However, if this is not the case, and it is just a matter of living in an estrogen dominant world (of plastics, dental sealants, pesticides, dairy products, etc.), then the following could help:

1)  Doing a liver detox.  Or at least, eating a low estrogenic diet as indicated on Heathy Diet. Definitely no dairy products (even if there are no added hormones to the milk, there are many excessive natural hormones).

2)  Taking DIM.  (Indole-3-carbinol).  This will help the liver process estrogens.  Even better, sprouting broccoli sprouts, and eating lots of kale and collards will help this.

3) NO ALCOHOL.  This is the quickest way to slow down the metabolism of hormones in the liver.

4)  Milk Thistle is a great liver herb for detoxification and repair.

5)  Getting food allergies/sensitivites checked for is helpful, as certain foods for certain individuals can muck up liver detoxification processes and impair adequte hormonal regulation.

6)  Natural Testosterone (bioidentical cream) is a possibility.  But it's much better to treat the root cause (of course, unless the root cause is related to hypogonadism, then testosterone would be the treatment of choice as previously stated).

I would make sure your son had his thyroid levels checked, as well as his liver function tests done.

I know that Propiolnyl-L-carnitine and Acetyl-L-carnitine are two safe natural metabolites that help increase testosterone levels in older men naturally.  I do not know about helping increase testosterone levels in teen age boys, however.

This is the most information I can provide without actually having seen your son.  Seeking out a naturopathic doctor in your area may be quite helpful.