MGD and hormone levels in younger patients

[Santaklauzz]

Anyone read this study?

http://www.hindawi.com/journals/isrn...y/2011/465198/

It covers (seborrheic) MGD in persons between age 23-30.
Mean testosterone and DHEA levels of patients are significantly higher than of the control group.
Of course, this doesn't imply a causality, merely a correlation.
But on the other hand, it is known that androgens control the production of sebum in the MG's.

I'm calling my GP tomorrow and ask him to check my hormone levels.
If they are way higher than normal, I might be on to something.
In fact, if this is true, I might have found the root cause. I'm really thrilled.

I still have acne, oily skin etc.. and all of that began when my MGD started too so it all makes sense.

So if you're in your teens/twenties, this might be worth checking out.

[Santaklauzz]

The mean testosterone level in male patients was 728ng/dL compared to 537ng/DL in the control group.
Assume for a minute that I got tested and have about 700-800ng/dL. (This is not the case, I don't know my level).
Is there any medication available to decrease this to maybe 400-500?
Every testosterone reducing drug I know is used almost exclusively for prostate cancer and decreases your testosterone almost to castration levels.
That's not quite what I want to be honest...
And every website that claims that this food or that food lowers testosterone is contradicted by at least one other website stating the opposite...

[alisonW]

Hi there - this is not exactly what you're asking, but yes, prescription steroids can reduce your DHEA level. I have been on one for 3 months because my DHEA levels were at 280 (female here). Normal range is 19 - 231. I have only been on a VERY low dose of dexamethasone .025 mg per day and in I just found out yesterday my DHEA is now only 7.9! So I personally do not recommend trying to mess with hormones in order to manage MGD. I don't think anyone can know exactly how to get you into the range you want.

Yes, my normally oily face is now dry but my eyes are even drier now too (didn't think it was possible). When I saw the eye doc less then a month ago, he said my miebomian glands were completely blocked on my left eye and most on my right eye (not all though) were too.

(Treatment with dexamethasone is not from my eye doc but from my GP & endocrinologist due to adrenal gland issues.)

[Santaklauzz]

Hi alisonw,

Yes, that makes sense. Your meibomian glands respond to male hormones, so if you eliminate them, your glands don't produce anything.
But how that causes your glands to get blocked, that's a mystery to me. Maybe that's because they were already blocked before your hormone treatment...?
Are your eyes or eyelids maybe inflamed?

But wow, from 280 to 7.9 on such a low dose. That's remarkable.
I guess it's best to aim for the middle when it comes to hormone levels. Instead of 280 or 7.9, it would be nice if you could reach maybe 100 or something.
But there seems to be no medication available that can be used at this kind of accuracy...

[Santaklauzz]

Yesterday I received the first test results of my hormone levels. I was very disappointed because my testosterone seems to be only 500ng/dL, which is even a bit low for a someone of my age.
I had almost reconciled with the idea that this hormone hypothesis is a dead end, but today I received the last results, including DHEA.
And as it turns out, my DHEA is more than 600ng/dL, which is extremely high! Well, it is within normal range of course, but compared to the study above, this is huge.
I'm visiting dr. Geerling next week and dr. Baudouin in two weeks to talk about other treatment options. I'm taking this with me to see if they think it's important.
From what I've read on the internet, DHEA seems to have a direct impact on sebum production. If there is a way to, say, halve my DHEA, this might very well affect my MGD.
My GP is currently looking into it as well in case neither dr. Geerling nor dr. Baudouin have interest in this. I'm very excited my expectations are (partly) true for once.

[alisonW]

Good luck and definitely let us know what they say about all this DHEA/MGD stuff.

[bakunin]

In some threads here people are discussing the relation between low testosterone levels and dry eyes.

[Santaklauzz]

In some threads here people are discussing the relation between low testosterone levels and dry eyes.

I know. Low testosterone can lead to underproduction. But that's not the problem. My testosterone is fine and my DHEA is very high.
So my guess is that my meibomian glands are clogged due to overproduction. I also have an oily skin so that would make sense.

[spmcc]

Testosterone and dry eyes.... This turned up in one of my google alerts today: http://www.cure-dryeyes.com/testoste....R50xgcgS.dpbs

[Santaklauzz]

Yes, it's well established that hormone therapy can work in people with MGD due to low testosterone.
But I was talking about the link between seborrhea (not to be confused with seborrhea dermatitis), sebhorrheic MGD and high hormone levels.
So far, the study in the first post is the only one I've been able to find on this topic.

[jads]

Santa, that's a really interesting study re MGD.

"The effect of androgens on meibomian gland function has been studied in a group of patients with an average of 70.9 years, and androgen deficiency is considered as a critical factor in the pathogenesis of MGD and dry eye"

This aspect of MGD and dry eyes in general has been known about for some time. A deficiency of androgens.

The study, however, is suggesting that an over production of androgens or DHEA is a marker for Seb MGD. This is entirely possible if your 25 and have raging testosterone levels. The key really is DHT production. Dihydro-testosterone is a potent off shoot of Testosterone. There are two enzymes largely responsible for converting T to DHT, which is found in the skin and blood stream. This is the foundation of AGA (androgenic alopecia) or hair loss. Over production of DHT and subsequent inflammation in the scalp is a factor in AGA and the market for DHT blockers is worth billions. (lets not go into that..it's a minefield)

Sebum is an oily lipid substance found in hair follicles, meibomian glands and one or two other places on the body.

Sebum production is controlled by androgens, with the most active/potent of these being DHT - in it's affect on sebum production that is. The more active the conversion to DHT, the more sebum produced. This process is the main culprit in acne and hair loss as I mentioned. The excess oily sebum clogs the pores and M-glands causing inflammation and so on. It;s no surprise that many people commonly get acne on their forehead, chin and backs as this is where the sebaceous glands are the largest and most prominent.

The question then becomes how to reduce excess sebum by turning down DHT conversion. There are multiple options that don't include some of the big pharma drugs that block the conversion process of Testosterone to it's partner DHT.

In my humble opinion, normal to high levels of DHEA are not the problem. It's the cascade of processes below DHEA with conversion to downstream hormones that are at issue. To say it's complex is understatement. When too much testosterone is being converted to estrogens via another active little enzyme called aromatase, you can get classic androgen deficient dry eyes.

Conversely, if DHT is abnormally high it contributes to an over stimulation of sebum production and resulting acne, hair loss, and potential M-gland complications. By the way, the link between sebum and DHT is well documented in dermatology papers.

Hopefully, some of that makes sense.

[littlemermaid]

Jamie, any idea which foods down-regulate or increase DHT or DHEA?

[Santaklauzz]

So you're saying that high DHEA could lead to excessive estrogen levels and that in turn could lead to androgen deficient dry eyes?
How exactly does that work? Do estrogens neutralize androgens?

Am I right when I say androgen deficiency leads to dry eye because the receptors in your meibomian glands don't receive enough androgens, and therefore don't produce enough oil?
What then about the excessive oil production on my skin? My forehead and nose is oily all the time. Imho, I don't think it's likely that my MG's do the exact opposite.
And I am after all 20 with normal T and raging DHEA.

I researched a bit, and DHEA seems to play a direct role in sebum production. A friend of mine who studies medicine confirmed this.
As you said, this endocrine stuff is terribly difficult matter, but wouldn't overproduction make sense then?
Or is there maybe a way that DHEA gets converted directly to DHT? Because normally T is the intermediate step but my T is normal.
Perhaps my MG's are just more sensitive to DHT, T... and are normal levels all that it takes to go into overdrive.

[jads]

So you're saying that high DHEA could lead to excessive estrogen levels and that in turn could lead to androgen deficient dry eyes?

No, that's not what I'm saying

Am I right when I say androgen deficiency leads to dry eye because the receptors in your meibomian glands don't receive enough androgens, and therefore don't produce enough oil?

Yes, in part. It's low T in older people (usually) that causes MG and lacrimal gland issues, not DHT. Too much DHT can increase Sebum production and be partly to blame for acne, hairloss and Seb MGD

At your age, it's common to have high levels of DHEA, Testosterone and DHT - hence high levels of sebum. But I wouldn't know about that because I'm in my 40s. Not everyone with high DHT/sebum has Seb MGD. I had acne too when I was your age, but I never had MGD. That I can't explain sorry.