Can Testosterone Cause Retinopathy?

[crash1270]

Hello All. I'm new to Excel male. I'm 43 yr old. Been taking TRT since January of this year. Recently added anastrozole because estrogen levels were higher than normal. Also started HCG for testicular atrophy.

First the good....This has been a great experience so far. I am a serious weight lifter and athlete. I can't tell you the comments I have received since starting TRT. I have shredded fat and gain enormous amounts of muscle mass. Libido is off the charts. Energy levels and attitude is great. I feel like I'm in the best shape of my life. I run, ride mountain bikes, lift weights, etc., I have at times almost felt guilty for the gains and condition I am in and wonder if they would be the same without TRT. I have told a few friends but not made it front page news to co-workers and other peers and business associates.

Now the bad...last week I noticed blurred vision in my left eye and getting dark grey spot directly in the center of my left eye vision. At first I couldn't decide or decipher what was happening. It came on suddenly and took me a few days to figure out exactly what the symptom was I wasn't sure if my vision was just getting worse or if something else was going on. I went to the optometrist Thursday. He took a picture of the inside of my eye and told me it looked like CSR or central serous retinopathy. He asked me if I had a stressful lifestyle and I told him yes(I own my own business that is struggling, and I am dealing with a close relative that is a drug addict and it is tearing our family up), he said this happens mostly to males age 20-45 who have stressful lives(airline pilots, stock brokers etc) Not limited to this demographic but happens mostly to men. He sent me to see a retina specialist and I went straight over. They took my medical history and right off the bat...."This condition can be linked to steroids or testosterone." Bam...holy cow, my hear sank and I crapped a brick right there. They went through all the tests dilated my eyes took tons of pictures and confirmed that it was CSR, then told me again this was linked several times to TRT and they suggested testosterone was over-prescribed and I should stop and see if my eye heals.

Basically CSR is fluid behind the retina leaking in for whatever reason in small amounts but it forms a bubble behind the retina and distorts vision. It goes away on its own in 95% of the people it happens to but can recur over and over.

I've done a little research in the last few days. It not only happens to men of high stress levels but, also those who use caffeine, lots of stimulants, exercise excessively, steroids, ......Guilty, guilty, guilty on all accounts your honor.

So since this has happened I am reaching out to this forum! Bring on the suggestions or similar situations. Has this happened to anyone on here. What did you do? Any suggestions. All input is appreciated. Thanks

 

[Gene Devine]

Hi Crash - Steroid induced CSR can happen but in medically managed TRT it's almost never the reason.

What you should know is that Corticosteroids are known for causing CSR. I've never heard of Testosterone serum levels in the healthy range causing CSR to happen.

You can't just stop your TRT protocol "cold turkey" as you are now HPTA suppressed and you will crash and HPTA won't restart on its own.

Did you have the Ophthalmologists consult with your TRT Specialist before you halted your protocol?

If so, what was the outcome.

It it were me, I wouldn't have stopped my TRT unless there was definitive proof that it was the cause.

I really want to know what your TRT Physician said on the matter.

 

[crash1270]

I have not seen my TRT physician yet, I will tomorrow(monday). I found out the diagnosis on Thursday. I was not planning on stopping cold turkey. I am pretty sure my TRT physician will tell me not to stop the therapy cold turkey or at all if he thinks it is not linked to the csr. I was considering tapering off TRT in a healthy safe way. Trying to remove as many possible causes of csr and hoping it would subside. So considerations are not working out for a while, not taking pre-workout stimulants, trying to take it easy and not get stressed out and tapering off TRT the right way. I have only been taking HCG for two weeks. So I'm not sure what else I would do to taper off TRT if that is what I choose to do.

 

[HarryCat]

Hi Crash, I too have (chronic) CSR, none of my specialists have ever mentioned to me that being on TRT can be the cause of or be an ongoing problem with CSR. Cortisol is the steroid hormone of concern with CSR. So you want to avoid any medication OTC or otherwise, that has hydrocortisone in it.

As with most docs and TRT, most retina docs are pretty clueless when it comes to CSR, it is a pretty rare condition and most don't keep up to date with the latest research. I'm trying to find a new retina doc myself for this reason.

It is also associated with PDE-5 inhibitors. So if you can, steer clear of these as well.

This is the best summary page I've found on CSR:http://www.retinalphysician.com/articleviewer.aspx?articleID=107233

Hopefully your's will resolve on its own, mine never has completely. Most insurance companies won't pay for the treatment options that are available.

 

[HarryCat]

Well, I never heard of testosterone being associated with CSR until today. I found this study: http://www.nature.com/eye/journal/v20/n4/full/6701905a.html

but the guy was given supraphysiological doses of T. Have you found any studies that show normal levels of T associated with CSR?

 

[Nelson Vergel]

Thanks guys. I have never heard about this. I am so sorry that it happened to you. It is definitely a rare side effect that I have never heard about but which I will keep in mind from now on in our education efforts. I wish there was a way to predict it.

 

[crash1270]

Harry thanks for the two links. I had seen the second link you posted just yesterday when I searched for CSR + TRT. It did not seem definitive that they were linked just that it needed to be investigated. But again thanks for the two links. The first link said something about aspirin possibly helping so I may start taking a dose of aspirin for a week and see what happens. Mr. Vergel just wanted to confirm that I was merely repeating what the retina specialist had stated. I don't actually know for sure yet that it is a proven side effect. I will update this thread when there is more information.

If I chose to stop TRT for a brief period to reduce as many possible causes what are the suggested methods for stopping. I am meeting my Low-T doctor tomorrow and would like to be informed as much as possible. Thanks in advance.

It is really a relief to have found EXCELmale.com to have a place to go and be informed and get information.

 

[HarryCat]

The research on aspirin is mixed. There was this study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921298/ that got people excited about using aspirin but then this study came out: http://www.webmd.com/eye-health/news/20130118/aspirin-blinding-eye-disease
which kind of suggests aspirin is a bad idea.

My own take on it is that it is worth a short term trial. I tried it, but it did nothing for me.

Eplerenone is the new darling medication among CSR physicians after a French study came out last year showing some startling results. Some additional studies that came out earlier this year did not show it to be as effective. I have not had time to dig through the studies to try to figure out why there is such a difference.

I could go on about photodynamic therapy, but I'll save that for another day.

 

[crash1270]

Thanks for the info...I don't think I will try it for 15 years, but I will give it a try and let you know.

 

[crash1270]

I went and met with my TRT doctor today. I left it up to him to guide me in the right direction on what to do. He thought it was the best to stop the TRT. He said that slowly over the next few weeks my body would metabolize the last shot that I had been given and I would most likely be at a level near where I started in January. My starting level was 150. I will still be taking the HCG shots 2xweekly 120. How does this compare to what some might recommend for stopping TRT.

Hello excel male community please give me your oppinion.

 

[Nelson Vergel]

Crash, to be honest this is so new to me. Let me talk to my cousin who is an eye doctor since I hate when I find out things after 20 years of reading and working with TRT.
That HCG dose will not bring you up much by itself, by the way.

 

[HarryCat]

FWIW, here is a study that looked at cortisol and testosterone levels is CSR patients and found no correlation between testosterone and CSR, but did find a correlation between cortisol and CSR: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812758/

 

[Gene Devine]

Corticosteroids are known for causing CSR in rare cases and where other contributing factors exist.

I have not read where TRT, when medically managed, can cause CSR or any eye disorder.

If someone can find clinical research on this I'd like to read it.

 

[HarryCat]

This study is kind of interesting: The potential role of testosterone in central serous chorioretinopathy

primarily because in the conclusion it states: "We even postulate that a relatively high level of testosterone may be a risk factor for CSCR in general, as androgen receptors have been found in human retinal pigment epithelial cells."

In my own case the vision in my eye that is affected by CSR has definitely gotten worse since I started TRT. How much of this is due to the CSR and how much is due to natural aging, I don't know. My CSR was not diagnosed until a little over 2 years ago, about the same time I started TRT. However, I was having some difficulty in that eye before this. The best I can figure out it started about the time I tried hydrocortisone for adrenal fatigue. My retina exams since I was first diagnosed have been "stable" in the words of both my optometrist and retina specialist, which means that the fluid in my retina has neither increased nor decreased and I have no leakage.

My total T before starting TRT averaged in the low 300's and dipped into the 200's before I initiated TRT. Since being on TRT I'm now on the 600-800 range so I'm at least double where I started. Total speculation here but I wonder if this has inhibited my CSR from resolving completely. I'll need to think about possibly cutting my dose down to see if it helps resolve the CSR, although it would take months to know. Either that or I am going to find a retina specialist who is willing to prescribe eplerenone.

 

[HarryCat]

Another (very small) interesting study using Finasteride: Finasteride for Chronic Central Serous Chorioretinopathy

They got some positive, although not dramatic, results. I guess the take away is that DHT can have some impact on the fluid balance in the retina.

 

[Nelson Vergel]

My cousin who is a great eye doctor here in Houston said today that corticoid steroids (cortisone, etc) and testosterone may cause this problem but that the problem resolves after treatment stops.

 

[Mocha]

Hi,

I'm a Glaucoma suspect. I've looked at a lot of papers on eye diseases / conditions. T therapy is definitely implicated in CSR.

However, like with most things...it's not that simple. Doctors look for direct causes, and T is NOT a direct cause. T therapy is contraindicated in Thrombosis, etc. and we know T thickens the blood.

Blood clotting is the main cause. And the BEST ways to prevent blood clotting are:

1) Keep your T at physiological levels.
2) Fast 1-2 days a week (water-only fasting).
3) Follow a diet that is heavy in plant food and that supports your mitochondria. Look up either Dr. Joel Fuhrman or the Wahls protocol.
4) Practice activities that lead to parasympathetic dominance (laughter therapy, meditation, body scan, gratitude, etc.).
5) Exercise. Light-moderate weight lifting and some jogging / running are near-perfect antidotes.

For Fasting, here's what I suggest:

1. Fast for 24-36 hours 1-2 days a week.
2. On the remaining days, use an intermittent fasting approaching by eating for 8 hours and fasting for 16 hours. (For instance, I eat from 9 AM to 5 PM (8 hours feeding), and then fast from 5 PM to 9 AM (16 hours fasting))

Fasting is incredibly therapeutic and fasting thins the blood. Look up the studies. Continuously feeding the body doesn't allow time / energy for the body to restore and clean up. The human body wasn't designed to be in a continuously fed state. The research world is replete with studies on the miracles of Fasting. Fasting also helps the mitochondria recover -- I'd argue that more than 90% of diseases can be directly linked to mitochondria failure. T therapy restores mitochondria function (as per studies).

Your body has the innate wisdom to cure your CSR -- provided you step out of the way. And Fasting does just that.

Fasting also lowers E (I remember looking at a study) and E is directly implicated in Thrombosis / blood clotting (there's an interview available on this site).

Obviously, fasting isn't for everybody. But I do believe HIV patients can fast as well.

A multi-pronged attack against your CSR is the best way forward. You will need to SLOW DOWN for 2-3 months and let your body recover. Your CSR didn't develop overnight -- and it won't go away overnight. Deep cleansing is what you need.


EDIT:

For those panicking about T and eye diseases -- let me assure that there are studies that show low T is implicated in eye diseases. T is a brain hormone, and the eye is part of the brain -- so much so, that 2014 research shows that Glaucoma is 'Diabetes of the Brain'. T fights metabolic syndrome and Diabetes.

T is exceptionally wonderful. T is not at fault here -- however, when we see things in black and white, we're seduced into believing that it is at fault, or that it is a panacea. Neither is true.

We need to support our bodies in the way they were designed to be supported -- decades of abuse cannot be cured by a few dozen T injections.

 

[DHM]

Do you have lab values during HRT?

 

[Nelson Vergel]

Keeping your hematocrit under 50 and taking a baby aspirin (81 mg) daily may also help reduce clotting (if clotting is indeed associated with the effect of testosterone or corticoid steroids on retinopathy)

 

[HarryCat]

Came across this study:

Central serous chorioretinopathy in patients receiving exogenous testosterone therapy.

Central serous chorioretinopathy in patients receiving exogenous testosterone therapy - PubMed

Exogenous testosterone may be an independent risk factor for the development of CSCR.

www.ncbi.nlm.nih.gov

Purpose: To report an association between central serous chorioretinopathy (CSCR) and
exogenous testosterone therapy.


Methods: This is a retrospective case series from two institutions. Patients who
presented with fluorescein angiography and optical coherence tomography findings
consistent with CSCR were included. All patients were concurrently being treated with
exogenous testosterone therapy and lacked other known risk factors for CSCR.


Results: Nine patients presented with CSCR after beginning exogenous testosterone
therapy. Two patients stopped therapy with resolution of symptoms and subretinal fluid.


Conclusion: Exogenous testosterone may be an independent risk factor for the
development of CSCR.

Central Serous Retinopathy/TRT - Input Requested

There is little information out there about CSR and TRT. I was recently diagnosed with CRS two months ago after ignoring the symptoms for too long. I fit the general main demographics for candidates for this condition, white male, 37 years old, Type-A personality, overly stresses out and lacking...

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