*note that I did not see DrB's reply to me until now, but have included it here.  My response is that I agree with him...and it does not detract from my points that 1) we have no study that was intended to address the population in question, and 2) all we can say at this point is that there is a pathway by which HGH improves vision - whether or not that can apply to a non-palliative case is still to be determined.  But certainly there is nothing to dis prove it, and we have at least some evidence that it's worth thinking about.

Steroids and Vision

I am not aware of any credible evidence that steroids improve vision.  If you can show me they do from a study in a peer reviewed scienific journal, I'd be interested in seeing it.

by DrBGiantsfan on Wed Aug 08, 2007 at 10:19:14 PM PDT
[ Parent ]

    Well

    i see what you are saying...no proof, especially not peer-reviewed.

    But the problem is that there is a often a lag time between when a theoretical mechanism is proposed and the publication of a study that tests the hypotheses (I know you are an MD and thus are obvuously all-too-familiar with this).  So lack of a peer-reviewed study is hardly conclusive proof that a pathway that appears logical and makes sense based on reasonably-informed hypothesis isn't correct.  Basically, lack of a test on a specific user group doesn't mean the hypothesis is wrong.

    But I don't mean that as a cop-out.  There are tons of peer-reviewed studies that show the palliative benefit of steroids on restoring eyesight that has been damaged thru illness or trauma - clearly, steroids improve vision in some subsets of people, both injured and aging-related illnesses (or diabetes).  Whether or not some of these same benefits are known to apply to age-35 athletes (whose decline in hitting may or may not be due to eyesight that is diminished through normal or illness-accelerated causes) As always, it also a a little slippery to try to test drugs on humans that have no diagnosed ailment (which is why we can never say that Agent Orange definitely affected Vietnam vets - we can't design a peer-reviewed study that would dose a bunch of otherwise-healthy 20-yr-old men to it).  I don't know enough about eyesight itself to know if the kinds of "normal" vision decreased have any sibling relationship with the kinds of ailments that steroids are used to treat.

    But clearly, steroids are well known to improve vision in at least some patients, so there is a mechanism in place between the injection into the body and the performance of the vision.

    A few citations:

    Brusaferri F, Candelise L. Steroids for multiple sclerosis and optic neuritis: a meta-analysis of randomized controlled clinical trials. Journal of Neurology, 2000; 247(6): 435-442

    Eye (2005) 19, 747-751. doi:10.1038/sj.eye.6701636 Published online 10 September 2004
    Intravitreal triamcinolone improves vision in eyes with chronic diabetic macular oedema refractory to laser photocoagulation.  A K Negi1, S A Vernon1, C S Lim1 and K Owen-Armstrong1

    Br J Ophthalmol 2001;85:1061-1064 ( September )
    Scientific correspondence.  Steroid management in giant cell arteritis Colin C K Chan, Mark Paine, Justin O'Day
    (note that one review of this reads "While limited by its retrospective nature, this study adds significant weight to the argument that steroids can improve vision...")

    A random quote I lifted from the Mayo clinic:
    Dr. Mark J. Kupersmith, director of Neuro-ophthalmology at Beth Israel Medical Center in New York City, said, "Most MS doctors would prefer their patients to take a course of steroids to bring their vision back quickly."      

    by siddfynch on Wed Aug 08, 2007 at 11:03:18 PM PDT
    [ Parent ]

        [new] Disease

        Each one of those references refer to the treatment of disease with cortisol and related chemicals.  Cortisol is not even in the same class of drugs as anabolic steroids that are used as PED's. That is vastly different than trying to improve something that is normal already.  

        Here's an interesting question:  Let's just say that Kirby Puckett's vision could could have been saved by use of an anabolic steroid if it was given in time.    Would that disqualify him from playing baseball because performance enhancement was a side effect?

        by DrBGiantsfan on Thu Aug 09, 2007 at 07:25:19 PM PDT
        [ Parent ]

I've looked at pictures and I don't think they prove anything. That's why the fact that you drag out this accusation anytime anyone mentions Hafner annoys me a little. Heck, you could even be right, but I just think it's ridiculous to bring it up every time his name is mentioned. Facially I see it a little, but I don't see any evidence of it anywhere else in his body. I would think for it to have affected his facial appearance, he would have had to have been dosed either at a young age or over a very extended period of time. There have been numerous allegations of other athletes having used HGH and none of them seem to have any facial alterations which would suggest that Hafner was (or is) a long-term abuser. If that is the case, shouldn't some of the other bodily changes have occurred as well? Skeletal abnormalities? Over-sized hands and feet? But I don't see anything other than a vague resemblance to these photos which even you admit is proof of nothing...

Paul Wight, AKA the Giant or The Big Show.

I'm not familiar with that.