Quote from SecondLifeGuide on July 30, 2024, 7:22 am

INTRODUCTION

It may be troubling to learn that Accutane treatment can come with some particularly harmful effects on hormone production. Studies measuring this impact have found varying degrees of effect, especially on pituitary hormones. A study on 47 acne vulgaris patients, with a mean age of 21 years old identified a suppression in Thyroid Stimulating Hormone (TSH), Luteinising Hormone (LH), and total testosterone. [1] The samples were taken 3 months after a 5-month course of Accutane at doses ranging from 0.5-0.75 mg/kg bodyweight. This effect on total testosterone, a 30% drop, might especially concerning for young men for whom testosterone is necessary for the development of secondary sexual characteristics such as body hair and muscle development. This result was slightly less pronounced than that found in a 2019 study by Nasrallah et al. These researchers measured an average 40% reduction in total testosterone across 113 male patients following six months of 0.5mg/kg a day. [5]

Acta Derm Venereol 2011; 91: 31–34 [1] This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 

HYPOTHALAMIC-PITUITARY-TESTICULAR AXIS

The hormone that stimulates the synthesis of testosterone in the testes is LH and is released from the pituitary gland. A drop in LH levels could possibly explain the statistically significant reduction in total testosterone, by disrupting the Hypothalamic-Pituitary-Testicular axis (HPTA). This is the complex feedback mechanism by which the body regulates hormone production to achieve homeostasis. Interestingly, when the researchers divided the cohort into sex, they found that the drop in LH in men was not statistically significant – although they attribute this to a loss of statistical power. Nonetheless this presents the possibility that the drop in total testosterone is instead a consequence of Primary Hypogonadism, where the issue originates from the testes.

Richard E. Jones, Kristin Lopez., CC BY-SA 4.0, via Wikimedia Commons

Testosterone production is highly dependent on oxidative stress in the testicles, and increased oxidative stress is one of the triggers of declining testosterone with age. [2] It should not be too surprising therefore that Accutane, with its extensive evidence of elevating ROS (Reactive Oxygen Species), could be having a similarly harmful effect on the testes. [3] ROS cause DNA damage and trigger cell death. A 2022 study in rats sought to elucidate this possibility by directly examining the tissue sample of testes following 21 days of treatment with the acne drug. [4]

The dose used was equivalent to a very low dose in humans, approximately 0.2mg/kg. At the end of the treatment the Accutane group had a dramatically lower testosterone compared to control, with 0.6 ng/ml in the Accutane cohort against 1.54ng/ml in the control. Interestingly the Accutane group also experienced an increase in LH production, which could be explained as a the body attempting to achieve homeostasis. Examining tissue samples under an electron microscope revealed damage to the testes, with the Accutane group having disturbances in the seminiferous tubules (which generates sperm). Compared to the control group they had decreased tubular diameter and increased inter-tubular distance.

 

OMEGA- 3 FATTY ACIDS

Al-Shahed et al. were able to substantiate the notion that these changes to testicular tissue, and subsequently testosterone, as being a consequence of increased oxidative status. They did this by including a third cohort that as well as being treated with Accutane, also were also supplemented with omega-3 polyunsaturated fatty acids. This was dosed at 400mg/kg each day, which is equivalent to 70mg/kg in humans – or around 5g for a 70 kg man. This cohort experienced a more minor suppression in testosterone levels, measured at 1.1ng/ml post treatment compared to 0.6ng/ml in the Accutane only group. This difference was also borne out in the tissue samples. This third group had almost the exact same tubular structures as the control group. This normalisation in tissue health was matched with the appearance of healthy sperm with the characteristic flagella. This group also had only a slight elevation in LH compared to control which further confirms a restoration in the HPTA axis.

To determine the increase in oxidative stress in response to acne treatment, the researchers also sampled Malondialdehyde (MDA). The Accutane group was found to have 3.5 times the serum concentration compared to control, however the Omega-3 supplemented group only had a minor elevation. These findings strongly implicate the toxic effects of Accutane on testicular tissue, and the remediating role of Omega-3 fatty acids by reducing oxidative stress.

For references, and more articles on Post Accutane Syndrome visit: https://secondlifeguide.com/2024/07/30/quick-read-can-accutane-damage-your-testicles/