High IOP: BLOOD TESTS, Any Clues?

[SQu]

A few days ago my husband who's been experiencing dry eyes, a gumminess to them (nothing visible, just how they feel), and finds driving a strain with the glare, went to get glasses. When they felt worst was at the tail end of the dry season during a terrible drought. Since then we've had rain and they feel better.

Protruding eyes run in his family and I've wondered before about hypothyroidism and Peat's quote: "hypothyroidism very predictably tends to cause bulging eyes, because the thyroid stimulating hormone from the pituitary causes a mucousy material to form in the area behind the eyeball, causing a protrusion of the eyeball."

The optometrist gave him lubricating eye drops so that addressed the discomfort.

But she was very worried about high intra ocular pressure. Also fluctuating. He does not have high blood pressure. Although not tested for a long time. She saw no damage on her testing. It was just the pressure.

She immediately made an appointment for an ophthalmic surgeon for today. She scared my husband with talk of going blind etc without telling him the exact thing/s that she was worried about, which I presume is glaucoma.
I later found she says the iop was twice what it should have been.

My husband doesn't like being stampeded into panic mode and in my experience dealing with many hospital visits for parents the past few years, it is never a good idea to go into panic mode. Never. Because she also mentioned hypothyroidism, I told her we would postpone the opthalmic surgeon visit and address hypothyroidism etc first with our usual doctor. We are going to see this doc (a good one) tomorrow.

The optometrist continued to pressurize us, warning against ignoring it. We're not ignoring it. I've spent days now looking into iop and glaucoma. I don't like the look of their medicines. Eye drops with prostaglandins/beta blockers/alpha adrenergics. I know from first hand experience that if my husband goes to that opthalmic surgeon he'll come out with one of those and/or surgery. I know from my dad with prostate issues, whose urologist's approach is also what I would call back to front in terms of what would really heal and rebuild and support health, I'll end up trying to cancel out the bad effects of that approach in order to stop the decline.

On the other hand I'm very worried about his eyes too, though he has no symptoms affecting his vision, (though I know those may not show till far advanced). And no damage seen on examination by the optometrist.

I've searched this forum and posts by @haidut and further afield and so far I have these on my list of possibilities:
T4+t3
diamox
Pregnenolone
Progesterone
Aspirin
Clonodine?
More salt but not just yet as it might temporarily raise blood pressure.
Taurine came to mind immediately
Glycine
B1
B3
Bag breathing
I've read about bicarb in eye drops, also salt, also DMSO

I would be very grateful for advice here. It's a whole new area of scare mongering and bizarre approaches for me.

 

[Giraffe]

INTRAVENOUS UREA THERAPY IN GLAUCOMA

 

[SQu]

@Giraffe thank you so much, this looks very promising and is very encouraging. I happen to have urea. 1.5g/kg is a lot and as they say, rather bitter, but nevertheless I'm going to look into it 3x a day as they say pretreatment level is reached after 7 hours. I'm also going to reread peat on urea. I'm so grateful for your help!

 

[Giraffe]

@SQu, I hope your husband gets better soon. :)

 

[SQu]

Thank you! I just listened to the two urea kmuds. Peat mentions 120g in divided doses as high but quite safe. So he'll probably start with that. Especially as it will be more palatable. I am very keen on the urea idea.

We went to the nice doc who agreed re hypothyroid possibility and is testing that and a bunch of stuff which I'll post when we get results. It's interesting - I would attempt to avoid most tests with most docs for fear of then wrestling with them over pushing unwanted statins etc. Nice change.

Bp is great, 130/80. She agreed that no panicking required.

Thanks for your input and support. I'm going to volunteer to transcribe a urea kmud as I now have the mp3s downloaded.

 

[SQu]

BLOOD TESTS

I'd be very grateful for some input on my husband's blood tests done last week, especially with regards to high intra ocular pressure.

Renal
High sodium, 153 mmol/l (range 136-145) what does it mean?

Also, high ADH means high blood pressure and given that high ADH means low sodium this means people with high blood pressure will tend to have low blood sodium and vice versa.

This is precisely the case; he has BP of 120/70. So is slightly high blood sodium a worry? He salts to taste, generously.
Low creatinine, 73 umol/l (range 80-115).
Rest of renal in range but chloride only just, 1 point above bottom of range.

Liver
All in range, albumin near top, think that's good?

Lipids
Total cholesterol 7.5 = 135 mg/dl
Triglycerides 1.45mmol/l ( range <1.70)

CRP is high 5.3 mg/l but if I recall, Peat not fond of this test??

Blood sugar
Hba1c 5.7%, 39 mmol/mol, estimate average glucose 6.5mmol/l, doc happy with that

Homocysteine 7.7 umol/l (range 0-14.4l)

Thyroid
TSH 1.48, s-ft4 14.4pmol/l (range10.16-22) doc will not prescribe thyroid though symptomatic, and there's a hypothyroidism connection with glaucoma.

Testosterone
12.5 nmol/l total
Free testosterone 346 pmol/l
DHEA 2.44 umol/l (range 1.3-9.8)
Doc to wants to treat; just started on dhea5 mg+pregnenolone 15mg; x 2 / day

S-prolactin 4.9 ng/ml (2.6-18.1)
Haidut:
"Prolactin is a good measure of both estrogen and serotonin. In addition, here is a study showing prolactin increases cortisol and cortisol (as is prolactin itself) is one of the strongest promoters of the enzyme aromatase, which synthesizes estrogen in tissues of both men and women.
Prolactin Increases Cortisol Secretion"
S- Cortisol 188 nmol/l (range AM 101-535) tested fasting 8a.m. doc feels this is too low, adrenal fatigue, but I think maybe it's the 4 mg cyproheptadine at bedtime, could too low be a problem? He has belly fat suggesting cortisol excess.
SHBG 17.10 pmol/l (range 180-739)
Full blood count all in range, magnesium red cell 1.98 mmol/l (range 1.65-2.65)
There are more but all in range, didn't succeed in uploading attachments.

Doc also prepared to prescribe diamox, started low at 125mg x 2 a day + b1, tad concerned to see peach tint to urine (hint of pink plus orange tone) after just 1 day but he did have a few whiskies last night so there's that. Dropping it to once a day and watching very closely, may drop entirely and just go for 1500 mg b1, bag breathing.

Tablespoon urea twice daily, taurine, glycine, bl, b3, p5p, mg, A, D, K7 (best I can do) (D started today. D tested at 42, she'd prefer 60-80, see, good doc!)
Diet peaty, 2l fat fee milk, eggs,sugar, fruit, meat, coconut oil, avoiding most starch for weight loss (124kg, 5" 11, 55yo).

If it weren't for high IOP I'd be content with his health status but they do panic you with their warnings of blindness and glaucoma which we would rather guard against, on our own terms, hence this thread! Thank you for reading :)

 

[SQu]

So ... the urea (24-48g a day) &/ diamox (250mg a day) &/ dhea (10mg a day) +pregnenolone (30mg a day) - something there is not going down well. Energy drops, feelings of nausea, poor sleep, headaches, constipation worse.

We're going to switch diamox for 1.5g b1, because I read a post of @haidut that it can replace diamox though I'm not sure it's in every context, ie for high ocular pressure?? ??

I'm also pretty sure the urea is contributing to this malaise.

I think taurine (2tsp a day, too much??) is helping. It lowered his blood pressure from an already very good 130/80 to 120/70 in a week and I'm hoping, (though not finding evidence in support) that it might be good for high ocular pressure too.

The worry of vision loss has hung over us this month so we need to get this right so I'm disappointed by the urea&/diamox difficulties.

 

[Giraffe]

Total cholesterol 7.5 = 135 mg/dl

135 mg/dl = 3.5 mmol/l according to this converter.

Which one is right? (135 mg/dl is very low.)

 

[SQu]

Hi giraffe, thanks for reading. Apologies for the error, it's 7.5mmol/l which is 290 mg/dl on your converter, very high (his was always very normal before, luckily this doc is not having a cow about the levels which is why we go to her). But because tsh didn't test out of range she won't prescribe thyroid so the obvious answer, supplement thyroid, isn't an option at the moment. We've been peating 3+ years and I was wondering if he should go easier on the sugar when not from fruit/ juice.

Forgot to mention: I see on urea thread, @goodandevil taking much less urea, 2g a day i think. Maybe this is worth a try.

 

[Sheila]

Dear Squ
I regret, I did not see this thread earlier and I hope that your husband is going along better and that you are well also.

FWIW, I have used strong black tea eye baths for hypothyroidic and hyperthyroidic swollen eyes to good effect, always the same principle of strengthening the tissue so that water is reduced and functionality returns - external will influence internal, I have found, given time and repetition. The tannins in tea can be annoying to some, I have not found this to be the case so far. Alternatives are perhaps chamomile or weaker black teas in that case. It can be difficult to put salt (my prefered anti-sweller-external of choice) directly into that tea because that certainly can sting a weakened eye (any swollen tissue is weaker) so I found that soaking a make up remover pad in a strong solution of cold salt water and applying it to the closed eyelid for 5 minutes worked also. It needs to be wet but not so that it gets into the eye directly - unless the person can stand such things (like those who can open their eyes under water in the sea). And if the eyelids tend to get dry, a smear of olive oil should restore.

Of course I would prefer that, by now, you are in no need of such suggestions.

Best regards
Sheila

 

[Matt1951]

It is good to get a second opinion from another optometrist. However. Your husband should be using medication as prescribed by a doctor while you are debating what to do. If he has problems with the medication, work with the doctor. You, and your husband, are not qualified to treat his problem.

 

[SQu]

FWIW, I have used strong black tea eye baths for hypothyroidic and hyperthyroidic swollen eyes to good effect, always the same principle of strengthening the tissue so that water is reduced and functionality returns - external will influence internal, I have found, given time and repetition. The tannins in tea can be annoying to some, I have not found this to be the case so far. Alternatives are perhaps chamomile or weaker black teas in that case. It can be difficult to put salt (my prefered anti-sweller-external of choice) directly into that tea because that certainly can sting a weakened eye (any swollen tissue is weaker) so I found that soaking a make up remover pad in a strong solution of cold salt water and applying it to the closed eyelid for 5 minutes worked also

Thank you Sheila. Well timed as the dry dusty season arrives. He's doing better, much better, but soothing compresses sound like a good idea. Aside from the anti-edema effects which would be very welcome, I do think giving some relief is meaningful. For one thing it lowers stress.

It is good to get a second opinion from another optometrist. However. Your husband should be using medication as prescribed by a doctor while you are debating what to do. If he has problems with the medication, work with the doctor. You, and your husband, are not qualified to treat his problem.

Thanks Matt1951. We are working with a doctor.