Glaucoma And Low Eye Pressure

[Bokasso]

Hello everyone,

my mother-in-law (63 yrs old) was diagnosed with an excavation of the optic nerve for about three years
now. The doctors call it a 'low pressure glaucome', though she has a normal interoccular pressure. They
claim that the nerve is somehow not supplied properly, but they don't care about it. They even tried to
lower the pressure more, in order to avoid any further damages, they are convinced that the pressure is
the problem...The doctors say, soon she will be completely blind and there's nothing we can do, except trying to lower the pressure (which didn't work
yet...).

Does anybody know how to regenerate or re-establish the supply? I remember Ray talking about
Niacinamide and Red Light.

Here are 'a little' extra, helpful informations:
* multiple operations on her jaw and still her occlussion is not right
* She suffers from 'fibromyalgia'
* Took alendroic acid for her osteoporosis
* Has to take Thyroxine and blood pressure lowering meds
* Has painful flatulences
* Takes anti-depressants (SSRI), because of her depressions
* Has Chronic insomnia
* Has Stenoses and multiple disc prolapses
* Tinitus
* Small lump in her thyroid
* Hashimoto's and Sjogren's Syndrome
* Had PMS (painful menstruations in her youth)
* Got her ovaries removed because of (benign) tumor
* Suffers from rheumatiod arthritis
* May not take Aspirin, because of diagnosed bleeding tendency (no
one knows the reason for that...)

Thanks for every hints or recommendations!

 

[SQu]

I've been looking for clues about high IOP, so not your mother in law's situation, but there seems very little out there. Here, Giraffe shared some good info about urea and there are threads and interview transcripts on the forum. Conventional treatment seems to be surgery, or eye drops of prostaglandins, beta blockers or adrenergics. All of which would seem (as i understand it, could be wrong ...) to go against what peat thinks good for health though locally, who knows.
Sorry I can't be of more help. My husband is taking urea, taurine, dhea, pregnenolone, b 1, b3, magnesium. We don't even have an update on this 6 week long journey yet not having returned for retesting yet.
Your mom in law has quite a list of issues and it is often suggested here to address the basics first which would be diet, and look into thyroid and progesterone. I understand the urgency regarding her eyes and am sorry I can only offer some feedback for high IOP approach, nevertheless, if it was me, I'd try and find out whether urea might be helpful anyway; also I'd look into taurine and magnesium. At the same time, I'd read on the forum about thyroid, progesterone, digestion as starting points.

 

[Bokasso]

Well, thanks a lot SQu for the suggestions! I asked Ray Peat directly, and he responded:

"Her symptoms and history are very suggestive of hypothyroidism.
Progesterone, which protects the optic nerve, is low in hypothyroidism.
Progesterone and vitamins D and K protect against excessive nitric oxide.
Agmatine (a natural parallel to aminoguanidine) is another substance
that lowers NO and eye pressure."

Have you tried that yet? Meanwhile, I remembered, that she had her ovaries removed in 2012 because of
a beninge tumor. And I guess, about one year later, it was 2013, the two excavations
(first on the left and a few years later on the right eye) occurred! The IOP is and always
has been normal. I already replied to Ray Peat and will post the results soon.

 

[SQu]

Thanks for the update, this helps me too. Great ideas there to follow up! Especially for a woman, sounds like progesterone would be very, very helpful and not just for her eyes. I am going to look up agmatine. Look forward to your updates and best of luck!

 

[SQu]

@Bokasso , how is your mother in law? did you try the agmatine? What dose? And the progesterone? I am starting my husband on agmatine. The package says 1g but examine.com says less:

".1. Eyes
In vitro, agmatine is able to protect retinal ganglion cells from apoptosis[334] and this has been noted with topically applied agmatine (reducing 55.44% cell death down to 18.65%) which appears to be associated with a reduction in intraocular pressure.[335] This protective effect appears to extend to ischemic ocular injury as well.[336]

Agmatine, applied topically, appears to be protective of the eyes; the implications of oral supplementation is not yet known"

And later...

"There are no standard dosages for agmatine because of the lack of human evidence for its effects. However, a single human study used 1,300-2,670mg of agmatine, daily for the treatment of neuropathic pain. The estimated human dose for improving cognition is 1.6-6.4mg/kg of agmatine, taken orally. This is based off of the 10-40mg/kg dosage range for rats, and is equivalent to 217-435mg for a 150lb person. Supplementation should not exceed 6.4mg/kg of bodyweight."

Also did you consider B3? My husband has no nerve damage, very fortunate, and takes b3 daily, maybe it's protecting him.

 

[Bokasso]

Hi @SQu ,
thanks for asking. Unfortunately, she doesn't want to use neither Agmatine nor Progesterone. She only believes in what doctors tell or sell. It is nearly impossible to convince her to try something new. Not even the B3. It was a hard act to let her take Magnesium Malate instead of the citrate. I don't know, maybe this is some kind of symptom?

Meanwhile, she has been in the hospital for two times, in order to monitor her IOP. And guess what, it oscillates like crazy over the day. There are times of 13 mmHg, and sometimes it exceeds 18-19 mmHg, maybe because of her great fear of blindness.

Which supplement (brand) do you use? And what were your criteria for choosing this? Maybe I can convince her, when she sees the package

 

[SQu]

Which supplement (brand) do you use? And what were your criteria for choosing this? Maybe I can convince her, when she sees the package

That's a pity, but I think most people choose to follow the doctor even when there's a lot at stake. My family has no choice but to listen to me if only to stop the nagging, but beyond my immediate family there's almost nobody. Most people are bored by the subject even as they battle with health problems. Or they haven't the energy even to think about more. She's lucky to have you.
Unfortunately I can't help much with brands as I use a small local brand of progesterone, and I found the Agmatine at a body builder's supplement store. Not very reassuring to an older lady I don't think! Its agmatine sulphate and I didn't have a choice, it was the only one I could find. Perhaps some of the people who use progest-e or other popular brands could give you more feedback on the progesterone, but the Agmatine is a new one for me and there's not much on the forum yet about it. I'm also considering defibron and am waiting for lisuride but all of this seems to be pretty much new thinking. In your position I think if it was me I'd look into things I thought she might be open to, so, familiar things or easy things. Another thing that might help could be reading the fine print on contra indications of medicines. That's how I just discovered that cypro heptadine is contra indicated in glaucoma, as is cortisone. FYI, here's a list of things that are contra indicatedi that I copied during my research:
topical anticholinergic or sympathomimetic dilating drops, tricyclic antidepressants, monoamine oxidase inhibitors, antihistamines, antiparkinsonian drugs, antipsychotic medications, and antispasmolytic agents.
Medications prescribed for a variety of systemic conditions (eg, depression, allergies, Parkinson disease) can produce pupillary dilation and precipitate an attack of acute angle-closure glaucoma in anatomically predisposed eyes that have narrow angles. [1] Dietary supplements have also been reported to induce acute angle-closure glaucoma.
Antihistamines: Chlorpheniramine, Hydroxyzine, Meclizine, Promethazine
Antipsychotics: Chlorpromazine, Clozapine, Thioridazine
Antispasmodics: Dicyclomine (Bentyl), Hyoscyamine, Oxybutynin
Cyclic antidepressants: Amitriptyline, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline
Mydriatics: Cyclopentolate, Homatropine, Tropicamide

 

[crestind]

Glaucoma Treatment: Eye Drops and Other Medications

One type of medication used in treating glaucoma is eyedrops that constrict the pupil... One thing that also has the same effect as these medications is... sunlight. The kind you get exposed to when you are outdoors all the time. (I am NOT suggesting she stare at the sun. I'm suggesting she just be outdoors more.) Worth looking into it. Reading now I see lots of articles claiming glaucoma is caused by excess sunlight, but maybe it is actually caused by the opposite, a lack of sunlight, resulting in a constantly dilated pupil.

 

[Spartan300]

I created another glaucoma thread because I had misinterpreted from that the issues being discussed here were associated with too low IOP..

Long story short is that I am extremely keen to get off the prostaglandin/beta blocker eye drops I am having to use because my health has declined since starting them.

My mood, androgenicity, weight and gym performance /recovery ability has all taken a turn for the worse since starting the eye meds.

GP prescribed Amitriptyline for mood/insomnia which helps sleep a bit but increases IOP.

I'm going to look at agmatine and increasing B3. Thanks for those recommendations.

 

[SQu]

I'm going to look at agmatine and increasing B3. Thanks for those recommendations.

I was going to reply to your thread but ran out of time. Glad you found this one which has most of the details anyway. Another IOP med is Trusopt which works on the carbonic anhydrase inhibitor principle like diamox which Peat discusses, I suggest you search diamox in his articles and radio interviews.
Also, do you have glaucoma or high IOP? I understand the latter is the highest predictor of the optic nerve damage that defines glaucoma, but progression to the actual disease is 17% or so. So high IOP should definitely be lowered but it's not actually glaucoma. I am really frustrated with the loose way in which our opthalmologist is calling high IOP glaucoma. When his own regular, thorough testing reveals no nerve damage. I think it's unscientific fuzzy thinking and fear mongering. It's caused a lot of stress and worry for us. Next visit my husband is going to ask him to clarify. In my experience chances are good that simply asking this question will slow down his current step by step leading of the patient down the path towards surgery that he may not need and may not be in his best interests. As has happened before with other issues and other specialists.

 

[Spartan300]

Thanks SQu, I'll look into diamox & Trusopt.

My condition is high IOP at this stage. No field of vision impact so far. I've had iridotomy (laser holes) to both eyes but pressures have not been sufficiently lowered.

I'm fortunate enough to have a brother in law who is an optometrist so I can experiment & have him keep an eye on pressures. At this stage I'm looking to experiment with the things proposed in this thread. Is Trusopt/diamox prescription only do you know?

Appreciate the suggestions. I'm convinced current medications have caused my wider systemic problems.

 

[SQu]

Trusopt/diamox prescription only do you know?

I think so. We started with diamox (actually a generic of diamox) orally and that's what I'd do again. In my husband's case he didn't feel great on it so we stopped, but it might be worth revisiting. The reason we started there was because of what Peat says about it, that it was the standard approach until I suppose the patent expired.But while that's a good reason to change if you're a pharmaceutical company, it's not a good reason if you want the best treatment for your eyes. And the generic might have been inferior. Hardly anyone's heard of it though. Except for altitude sickness.

So the Trusopt is the fancy new and more recently patented version of an old winner. Like Nexium I guess. Hence caution may be needed. It's in the form of eye drops.

But I'd put B3 top of my list because of the nerve protection.

I'm fortunate enough to have a brother in law who is an optometrist so I can experiment & have him keep an eye on pressure

That's a great idea.

As you mention, reversing the systemic bad effects of your current treatment would also be right up there in terms of priorities. Which can only be good for your eyes in the long run. Not that your doctor is likely to think there is a connection.
According to ours, the eye is quite separate from the rest of the body.

 

[Spartan300]

I agree with regard to the doctor comment. No-one seems to have the time or inclination to look at the bigger picture.

I've found some sources of agmitine but they're all bodybuilding products which isn't necessarily a problem as I need to recover some lost muscle mass but they seem to promote/enhance NO which I thought was anti-Peat? That bit I'm finding confusing.

I may just bite the bullet & pay for a private session with a consultant to explore options & talk things through sensibly. If you don't mind me asking what was the problem for your husband with the Trusopt? I'll not be offended if you'd rather not say.

I would really like to find a solution which didn't involve drugs of any kind. I know cataract surgery where the lens is replaced with a smaller artificial one drops the pressures but I don't know whether that is a permanent fix or whether pressure starts to build up again over time.

 

[SQu]

If you don't mind me asking what was the problem for your husband with the Trusopt

No problem. It was effective for over a year but then the IOP rose and the doc put him on "the next class" of drugs. Prostaglandins, yay

All of this is very much still in progress. I'm hoping next appointment (next week) IOP will be lower and we can ask to go back on the Trusopt. Hence the Agmatine attempt.

but they seem to promote/enhance NO which I thought was anti-Peat? That bit I'm finding confusing

Search Agmatine on this forum, it is explained somewhere that there are various forms of NOS like eNOS and iNOS ( if I recall correctly) and the one Agmatine raises (eNOS I think) isn't bad. Confusing I agree and all the more so since NO (via Viagra) joined the infamous list of things that are good for profits therefore the public must be taught that bad is good and good is bad. Like serotonin and estrogen.

I would really like to find a solution which didn't involve drugs of any kind.

That is my aim too. I don't trust surgery as apparently it always works (until afterwards when you hear how often it fails). Finding your way on your own can be daunting but i want to encourage you to keep going, because you might achieve your aim by raising your overall health. And even if you can't ultimately get off the drugs, it's very very likely you can improve your health overall anyway which is gold. Very rewarding.

 

[ecstatichamster]

@Sergio this is the issue that my family member faces, but only in one eye.

I believe it is crucial to measure cause and effect. So we bought a (expensive, unfortunately) tonometer, the iCare, that lets you measure pretty accurately at home.

We can see that her medication level is right, and if things are not working or they are. It's been interesting.

She is also taking 1000mg of thiamine. But that doesn't seem to increase her CO2 enough to not need the drops. She is taking Truopt which is a carbonic anhydrase inhibitor, and also one drop of a beta blocker which was added when the Trusopt didn't lower pressure sufficiently.

Anyway, point is that it is useful to measure at home and see what's going on.

BTW, she had acute angle glaucoma and that can lead to retinal damage within a few days. It is fairly rare, but do not try to treat this at home or you can easily lose vision. The pressure skyrockets acutely and only a few days is all it takes for permanent damage or even blindness, apparently.

 

[Spartan300]

Thanks ecstatichamster, my brother in law can keep an eye on measurements on a regular basis in a similar fashion.

Has your family member experimented with anything other than thiamine and the prescription meds? If so did anything make a difference?

Your post implies that you believe the answer could be upping co2 levels?

Thanks

 

[ecstatichamster]

Thanks ecstatichamster, my brother in law can keep an eye on measurements on a regular basis in a similar fashion.

Has your family member experimented with anything other than thiamine and the prescription meds? If so did anything make a difference?

Your post implies that you believe the answer could be upping co2 levels?

Thanks

I think CO2 levels are crucial. But easier said than done.

My relative, when she exercises, her pressures drop. She always exercises with mouth closed, so that accounts for it, the increased CO2 drops IOP.

Thiamine doesn't seem to do that for her very much.

We're now giving her thyroid and liver and trying the Peaty things she is willing to try, for a long term effort to further improve health and hopefully IOP.

 

[Spartan300]

That's interesting. I need to pay more attention to not mouth breathing when exercising. Currently I'm dialling back the intensity of my exercise sessions which might allow me to do the same.

I'm avoiding PUFA & eating liver & getting plenty of vitamins AED&K (Estroban).

I've now started paying attention to applying the eye drops by keeping eyes closed & blocking nasal drainage to minimize systemic absorption. I'm hoping this will help. Studies show this can reduce systemic absorption by 67%.

 

[SQu]

An update :

16 days on agmatine (aiming to get a bit less than 800mg or as close as we can estimate)
a couple of days on a teaspoon or two of MCT plus a teaspoon about an hour before testing

IOP that was 24 and 25 a month ago is 14 and 15 now.
So, very promising!
Could also be the prostaglandin eye drops
A few factors...

Will continue the above, and redouble attempts to avoid pufa
Next appointment in 6 months only. Goal would be to move back to Trusopt drops if we are lucky enough to keep the IOP low and the doctor is prepared to try them again. In his book it's a one way path though, ending with full blown glaucoma. But he probably hasn't come across patients who know about pufa, etc. Not that we've said ... not that he's asked... maybe one day.

(Mods should we move all this to another thread on high IOP?)

 

[Spartan300]

Hi SQu, that's a big drop and good to hear. I hope it continues.

I think your doctor is a little pessimistic, my father is 89 this year & manages his pressures in the mid-teens with a prostaglandin drop in each eye with no glaucoma/field narrowing.

I have some agmatine on it's way from US (I'm in UK) so I'm hoping that could help me too.

At the recommendation of Salmonamb and corroborated by Haidut who recommended carbonic anhydrase inhibitors I have also purchased thiamine & biotin which I have just started taking.