So far so good with the women's health doctor's regimen of the Saw Palmetto/Chasteberry tincture. I started using it after I noticed my PMS flare ups starting up again, and I already feel less oily. Only side effect was for a few nights I was feeling really tired, but then I remembered that I felt really tired when I started SP the first time - both SP and Chasteberry are known to have a sedative effect.
Before I started it, I got a hormone blood test, just to see what's going on with me 2 weeks prior to my period. I decided not to do the saliva hormone test - if money was no object I would do it, but my doctor seems to have a good idea of what's going on. She's actually not a doctor - she's a midwife who specializes in women's health issues. She's also an herbalist. I lucked out in finding her - she accepts my insurance and she's given me great advice - her name is Hilary so I'll just refer to her by her name. In retrospect, the first naturopath I saw was just trying to get money out of me. Instead of recommending a treatment she was going to draw everything out. Either that, or she really doesn't have experience with herbs and was being overly cautious. The multi-vitamin pack she sold me seems good though - it's designs for health twice daily essential packets.
Anyway, this past week I've also upped my chromium intake. It's in my multi-vitamin, but I've also started taking it after most meals, so I've been taking around 800 mg per day. I have noticed a decrease in my anxiety. I'm reading up on it and I think it's another missing piece in the acne/depression puzzle.
So my plan is to continue the SP tincture - maybe take it only once a day after my period starts, and take the chromium after every meal, take my twice day multi vitamin pack, and also supplement with milk thistle or add dandelion root to my tea/coffee for my liver.
My theory is this: I am prone to acne because of a sensitivity to androgens, I am prone to insulin resistance and my liver could use help flushing out excess estrogens, etc. So acne is my body's way of telling me that there is something wrong internally. If I didn't have acne, maybe I would high cholesterol or diabetes. All of it is interconnected and I finally understand what is happening - in the past I would take supplements without a clue whether they would work for me.
So I will continue on this path. I also plan to try low dose accutane and see how far I can get on it. I have lots of trapped sebum in my skin and I believe accutane will purge a lot of it out. Chromium is good for lowering triglycerides and milk thistle/dandelion is good for my liver so I don't think I'll have a problem using those supplements while on accutane and I think they will lessen any side effects. My theory is that accutane basically seals up the sebaceous glands, forcing all of the gunk inside the bloodstream which can cause all kinds of internal problems. I will also stick with the Saw Palmetto/Chasteberry tincture because I can't find anything that says this is a dangerous combo (I'm going to keep looking though). I know if I tell my derm, she'll say to stop every supplement. Anyway, I am going to stick with a low dose - my derm says 20 mg a day, but I may just do 20 mg every other day.
My skin looks okay, despite the little flare up I experienced earlier this week. The only thing that is really bothering me is the cyst that I had on my cheek hasn't completely healed and there are still pockets of sebum trapped under the skin and it just looks like i have a circular lump that isn't inflamed or red. I think it has turned into sebaceous hyperplasia, and I remember getting this kind of thing pretty regularly when I was younger. They take forever to go away, but using retin a on it seems to be helping. I was trying to squeeze out the remaining sebum but that just made it worse. When in doubt, leaving my skin alone always helps it heal. I need to learn to leave it alone! But that's where the chromium will really help (and already is helping) - if my anxiety is reduced, I won't feel like I need to attack every imperfection on my face. Anyway, because I'm prone to sebaceous cysts and hyperplasia, I think accutane is a good idea for me and I feel like I have a pretty good plan in place.
Here's more info about the depression/acne connection:
Acne vulgaris, mental health and omega-3 fatty acids: a report of cases