Low Testosterone, Medical Advice Needed

Hello everyone,

I am new to this forum and seek advice for a medical issue of mine. My main problem is that my eyes produce few lipids (meibomian gland dysfunction). To put it simply, the sebaceous glands in my skin produce either too little or too thick sebum and I don’t really care about my skin but my eyes are the problem. too few lipids mean my tears evaporate fast and so I have a particularly annoying dry eye problem. I have seen countless opthalmologists and I barely got help. The only thing helping me is hot compresses on my eyes that melt the thick oil of my glands in my eyelids.

Why am I posting this here? Because I strongly believe that this is hormone related as sebum production is linked to androgens.

Two years ago I started taking saw palmetto and (theaflavins) and a few times beta sitosterol for a hair loss issue (they are supposed to lower DHT). I was also on minoxidil. I never took finasteride. I suddenly had some redness in my face and I thought maybe I am allergic to some of the supplements so I stopped them all. After about one month symptoms in my eyes started. Maybe it’s related maybe not.

One year passed and symptoms were getting worse.

So one year after (one month ago) I got tested for T… My first test was 242 on a range of 240-827. Way too low for my age (I am 25). Both LH and FSH were close to 3. My free T was 45 (50 was lower limit). Prolactin was low. DHT was 55 and range was 35-80.

I go see my andrologist last week, he orders a sperm check that comes out perfect. Does an ultrasound to my testicles, they are great. He asks me if I have symptoms (low libido, losing body hair, low energy, low mood, erection problems, putting on a lot of weight). I said I had nothing and he told me not to bother.

I had serious suspicion that the first lab was shitty so I go see an endocrinologist that orders a new T and free T test along with a GnRH stimulation test in a respected lab.

My T was 420 . Range was 300-900. LH and FSH was at around 3. My free T was 15 and range was 8.5 to 50. (they measure it with different units than my first test). Test method was RIA (radioimmunoassay) Then I got a gnrh injection and he measured my LH and FSH response at 30 and 60 mins. My pituitary responded great with an increase in both hormones (LH was a lot higher). My doctor saw the tests and he concluded I have no medical problem. He told me that 420 is a bit on the lower side for my age but it’s normal and not pathological. He also told me my pituitary and testicles are working fine. He ruled out giving me T as he said my testicles would atrophy. I asked him about clomiphene and he said it would not hurt me but he thinks I don’t need it.

I must state here something VERY important. After the gnrh injection and the LH,FSH surge, about 2 hours after that I felt GREAT. So ALIVE and powerful! I felt manly, and I believe my eyes and skin became more oily. Maybe it’s placebo (as I knew that my T would increase after the gnrh) but I really felt that way for a couple of hours.

I never worked out in my life consistently. I am not fat but I do have a small belly. The last two years I worked out like 5 times. I mostly sit in my desk (I am a computer engineer). I do have sex, about 3 times a week and maybe masturbate 1 or 2 times a week. I have a lot of stress about various issues but mostly about my eye problem.

Thing is, I need to fix my problem and doing so I need advice as to how to increase my T and more specifically to make my skin more oily. I would like to try it the natural way and avoid taking clomiphene if possible. I already take fish oils and evening primrose oil (for GLA). I tried taking some zinc here and there but not consistently.

But my worst problem maybe affecting my hormones is that I get anxiety attacks about my eyes issue and I worry too much at times and get depressed. I try hard not to take any Xanax or valium…

Thanks in advance for reading my story.

Wow, I had a feeling that it might have something to do with it. I’ve never had any eye problems, but right around the time my T started dropping I developed the same thing! I would wake up with my eyes almost shut with that stuff. I did the compresses for months. Tried topical antibiotics and steroids. Nothing helped.

The topical stuff just made it worse- swelling it up. The only thing that I found helps it is fish oil, and this stuff called lecithin. Try that too. I take a good bit of both- that kinda controlled it a little for a few months, but never really healed it.

I figured there had to be a connection, especially since it’s nearly gone now, 3 or 4 weeks after I started TRT and an oral antibiotic i got at the same time. Didn’t know if it was the antibiotic or the TRT, but now I’d guess it was TRT.

was the antibiotic named doxycycline?

Could you please describe your eye symptoms? Did you feel them burning but not literally dry?
After hot compresses did the excrete a lot of oil? Was their oil too thick before?

Also… did you by any chance notice that your facial oil glands were clogged with thick oil?
Your answers mean a lot to me as I believe we have the eye problem in common and you getting better is the answer to me getting better as I probably will follow the same hormone treatment.

was the antibiotic named doxycycline?

Could you please describe your eye symptoms? Did you feel them burning but not literally dry?
After hot compresses did the excrete a lot of oil? Was their oil too thick before?

Also… did you by any chance notice that your facial oil glands were clogged with thick oil?
Your answers mean a lot to me as I believe we have the eye problem in common and you getting better is the answer to me getting better as I probably will follow the same hormone treatment.

Yes, the oral antibiotic i tried recently and concurrently with TRT was doxycycline.

It started with just the crusty stuff in the morning, like everybody has but about 5x worse. Then I developed what is called a chalazion, not a bad one like the google pics, but just like a stye that never goes away. After treating that with compresses and not really getting anywhere, i finally realized the dryness/irritation was what probably had caused in the first place, and was a separate issue. It had worsened so gradually I didn’t really notice it, until looking back over months of this going on. Nothing helped until I did a couple weeks of TRT- that’s another story, in my thread.

The compresses just seemed to make the gunk easier to clean off. I did months of it. Also, make sure if you want to try lecithin that you don’t get soy based lecithin. I took metric tons of it to thin the gunk over these months without realizing it was soy based, and now I wonder if that might have contributed to low T even further. Low T hadn’t crossed my mind when this started with my eye, so even if I had realized it was soy based I wouldn’t have cared. I believe there is a sunflower, or safflower, or something like that, based one that you can try. It did help with thinning it out, but never healed it.

I only did a couple weeks of TRT before this pause i’m on now, trying to get a better doc and set it up right. It’s been 3 weeks since the last injection, and my eyes are still much better.

Hey RedandBlack,
I am new here - I have been looking in the forum and came across this post. It sounds like we are in a similar situation.

I am a 37 yr old male. 5 Months ago I began experiencing no energy, bad mood, irritable, but worst of all dry eyes and a “foreign body in my eye” type feeling.

After several ophthalmologists visits, Warm Compresses daily, Fish oils, lids scrubs, - with no improvement, I finally had my T tested 2 weeks ago. The results came back 337 (332 -896). Low.

I have been reading online that the lacrimal glands and the meibomian glands in the eyes have Androgen receptors in them. The Lacrimal glands are responsible for the watery portion of our tears, and the meibomian glands are responsible for the oily portion that sits on top of our tears to keep the water from evaporating. Evidently, an Androgen deficiency (Low T) can lead to dry eyes. This problem seems to be much more prevalent in women after menopause, as they lose a lot of their Testosterone at that time. However, I have come across a few stories of men experiencing the same thing.

Just one day ago, my doctor gave me a 200mg injection of T in an effort to see if it helps with the eyes. This is the first TRT I have ever had.

Can you tell me a little more about your situation?

How long did it take you to notice a change in your eye situation after your TRT?

Would you say your eyes are now back to normal? - just improved? How significant is the change?

Are you fairly confident Low T was the reason for Dry Eye issues in your case?

Thanks much.

Well I made a reply the other day but it didn’t go through apparently.

At this point I am 100% sure the eye thing is T related. It persisted for 7 or 8 months against all kinds of treatment, went away after 2 weeks of TRT, came back after 2 weeks off TRT, and now it has gone away again two weeks after starting 12.5mg clomid every day. I think it only took about a week from the first TRT shot or from starting the clomid for it to begin to go away. I would say it is about 95% better, maybe even 100%- i’ve had this so long I can’t remember what normal was like, whether my eyes are more or less dry than they would be normally.

200mg is a lot. There’s guys here who’ve forgotten more about TRT than i’ll ever know, but that’s a pretty stiff dose i think. Seeing as you’re not much older than me, I’d try this clomid stuff if you can find a doctor to prescribe it. I printed out some stuff from google- the Dr. Oz guy’s website comes up on the search with a page about clomid and T- and that was enough for my doc.

RedandBlack,
Thanks so much for the update. I think we are in the same situation.

My first 200mg dose hit the 15 day mark today. I can’t say that I noticed much of a change really in anything over the past 2 weeks. There may have been 1 or 2 days that I felt a bit better, but nothing significant.

I followed up today with the Doc. He injected another 200mg, for the next 15 day period. He says he has had good luck with this method, as the T starts to stabilize a bit after the 2nd and 3rd shot. I will wait it out and see what happens. I know everyone is different, and I have read of several men taking weeks to months before things change for them.

Like you, my main problem is the dry eye. It can be very miserable. I am happy to hear that T helps your dry eye, and I hope I have the same outcome.

I sympathize not knowing what “normal” feels like.

Please keep us updating on how your are doing, and what things are influencing your eye situation.

Casey

Casey- how’s it going now?

So far, I can’t say I have noticed a ton of difference. My energy level and my eyes have been about the same. I had my T tested two weeks after my initial injection and it came back at 353. Not much difference from where I started (337).

My estridal came back at 33, which sounds a bit high from what I have read on this board. Low 20’s seems to be optimal.

I am focusing on shedding about 15 lbs. I am 5’9", 175 lbs. The most recent body fat measurements I have puts me at 22 percent. I know that excess body fat contributes to excess estrogen. I am thinking that even if I am taking testosterone - I am not using it optimally if I am marginally overweight. My target is 15 percent.

How have your eyes been? Anything new to share?

Have you come across anyone else that felt testosterone helped their dry eyes?

Thyroid problems can lead to dry and scaly skin. See the thyroid basics sticky, and read the others; most tribal knowledge is there.

Hair loss: It will happen to you. Be careful with meds.

Get E2 [estradiol] tested. Might be holding down your LH/FSH.

https://www.google.com/search?q=dry+eyes+testosterone
Cholesterol is a steroid and we do see some young guys who have low cholesterol which is associated with hormone problems. 180 is ideal, lower is bad.

Clomid has more literature because it was the first SERM and a lot of work was done to see what it could do. When other SERM’s came along, there was less fuss and the second born has fewer baby pictures. Clomid has horrible side effects for some, Nolvadex does not have that issue.

KSman,
Thanks for the advice.

I did have my TSH tested - came in a 1.7 . That is the first time I have ever had it tested, so I don’t have any baseline info.

I read thru the sticky, but I am still a little confused as to what an “optimal” TSH should be??? Closer to 1.0?

Also, prior to all this happening, my cholesterol was 154. I now have it back to 190. I understand the relationship between cholesterol and testosterone. I am not sure if my eye issue is a testosterone deficiency (353 on a 332 to 896 range) or if it is iodine related. I know my T is low.

My estradiol came in at 33, which puts my T to E ratio at about 10 to 1 which I understand is very poor.

Any thoughts?

Hello guys,

I am very glad that through this forum we found maybe a reasonable explanation about our dry eye problem.

I got some hormonal tests again and results are

FSH 1.9 mIU/ml ref(1.4-18)
LH 2.1 mIU/ml ref(1.5-9.3)
Estradiol (E2) 20.7 pg/ml ref(<40)
Total testosterone 6.2 ng/ml ref(3-9)
free Testosterone 19.3 pg/ml ref(8.7-54.7)
DHEA-S 338.8 μg/dl ref(80-606)
Prolactin 197.1 μIU/ml ref(60-400)

Aren’t my exams very good or is it my idea?
I must note that when I did these exams (1 month ago) I generally felt well and I had some oil in my eyes (although I wasn’t feeling well). I also had sex drive and thoughts. Right now, a month later, and after a very stressful week I feel like shit my eyes are in pain and my whole face is SO DRY that even when smiling I feel my skin and my lips like cracking.

What do you think about these tests? Do they seem okay to you?
And to Caser1 and redanblack, have you noticed any correlation of eye dryness with skin dryness? Do you see thick sebum that does not flow clogging the pores in your face especially around the lips and the chicks below the eyes. Only my nose is very slightly oily. This is very important to me and I want your opinion as I believe we have a general issue with all sebaceous glands and not only those in the eyes (meibomian glands).

Lastly, as I know myself the level of the pain in the eyes I wish to all of to get better and feel better soon. It will pass be positive.

Jonath123,
I agree, your test results actually look pretty good to me.

Personally, I have not found any correlation with dry skin and dry eyes. For me, my skin is fine. It is just the eyes. My eyes feel like they burn from time to time, and they are visually “redder” or more “bloodshot”. I have researched for months on this, and in my case, I do believe it is related to testosterone.

Regarding your situation, one thing I would check out is any possible autoimmune situation. From what I have read, there are a few autoimmune diseases that could contribute to both dry eyes and dry skin. Autoimmune diseases are much more prevalent in women, but it is possible for men to have them as well. Do some reading on Sjogren’s disease. See if any might have any of the other symptoms.

I hope this helps you out.

Dry skin. More T would help a lot. But problem may be thyroid even if TSH is nearer to 1.0. Bottom line is body temperatures as per the thyroid basics sticky. [I don’t care for two cases in one thread, makes it hard to manage.]

Jon, LH/FSH are both low and self consistent and also matches up with T levels. Prolactin is neither high nor low. Might be depressing your hormones to some extent. So you appear to be secondary. I do not see your age in your post. If younger, you should try a SERM restart. Use Nolvadex not Clomid. Search forum for ‘HPTA restart’. Do not use high doses, might do well on 1/2 dose or EOD. Use anastrozole and when you taper off land on low dose anastrozole.