38 replies to this topic

[SweetJade1980]

A percentage of people seem to weave intolerance, allergy, & sensitivity together when they are not the same things. As such, when someone mentions how diet cleared them, one immediately assumes that they either are a "raving idiot" or that it "must be an allergy", well in the case of Insulin Resistance Syndrome, Metabolic Syndrome and well, we can go ahead and throw Glucose Intolerance in here, that is not the case.

Allergy = an immediate autoimmune reaction to a glycoprotein that the usually isn't harmful to most, but the body feels it is an invader. Immediate could mean instantly or within 24 hours. This is something you can go to a doctor and test for, but the most accurate measure (not the easiest) is through an elimination diet. Associated signs include: rashes, itching, trouble breathing, inflammation

Intolerance = a delayed reaction (can build intolerance over a period of years) to a glycoprotein (i.e. casien, gluten) or sugar (i.e. lactose) in the body due to lacking a sufficient enzyme to metabolize it. The enzyme may be defective, in too low a quantity, or missing. Once intolerant, an intolerant reaction presents itself as a delayed reaction meaning it could take several hours, days, or weeks before you feel the effects of consuming something that you are intolerant to. Again, this is something you can go to a doctor and test for, but the most accurate measure (not the easiest) is through an elimination diet. Associated signs include: gastroentestinal discomfort, gas, swelling, inflammation (cystic acne?), weight loss, poor growth, IBS, certain health problems (some are autoimmune disorders).

Sensitivity = this is something that may be tested for or you may once again discover through an elimination diet, also known as a more strict form of "triall and error". Usually one may find that they have a chemical sensitivity to certain chemicals such as MSG, Aparatame, Tartrazine (yellow no. 5), etc Associated Signs: Headaches, Hyperactivity, or other Neurological Problems.

Now somewhere around here is a nice long list of foods that happen to fall under the Allergy AND Intolerance Food List. Yes, some of us happen to be avoiding foods that fall on this list, but it isn't because we are allergic to that food. If we are discussing the Acne-Insulin Resistance-Diet connection, then it is not because we are Intolerant to those foods either, but yes some of those foods we are intolerant to. However, as the title of this thread mentions, there IS another form of Intolerance that doesn't have anything to do with lacking an enzyme (may lack other things) and this results in something known as Glucose Intolerance.

Like others have mentioned, this has been exhausted and beaten to a pulp by myself and others, but if we are to make allowances for others because they have an "allergy", why can't we make allowances and provide the same amount of respect for those of us that happen to be Glucose Intolerant? Meanning that those of us that avoid specific foods because of their glycemic index/load & insulin response (not always connected) do so because we have varying degrees of problems handling carbohydrates, which is what created a supportive environment for our skin to develop acne.

Funny thing, or rather the sad thing, is that most people don't know that they are. Since, I'm fairly certain that Glucose Intolerance and Insulin Resistance are interchangable in which case, statistics show that 25% of Adults & 4% of Teen U.S. populations are Insulin Resistant and that 6% of those that are Insulin Resistant will become Type II Diabetics. Now, it is estimated that there are over 16 million people in the U.S. with Type II Diabeties (the most prevelant form comprising 90% of all forms of diabetes), BUT around 5 million don't know that they are! Furthermore in the UK around 2.4 million people have diabetes BUT 1 million don't even know it, with up to 10% of those that are Glucose Intolerance becoming a Type II Diabetic. Here's the most alarming fact, they suspect that over 10 million more people in the UK are Glucose Intolerant!

So who cares? Well while a small percentage of those that are Glucose Intolerant develop Type II Diabetes I'm guessing that the rest of these individuals end up developing other age related health problems such as rheumatoid arthritis, obesity, high cholesterol, prostate problems, and unfortunately certain cancers. I could be wrong but this is something that has been going on for so long that they are starting to realize how much Insulin Resistance plays a role in most "preventable diseases of lifestyle" that are on the rise today! Unfortunately, because this is something that appears to be asymptomatic, since it's OBVIOUS people can exist with this disease and not know it, that anything that can be indicatior would be a blessing, right? Well so far the the only official indicator is Acanthosis Nigricans (a pigmentation disorder on the folds of your skin), but for some of us, I believe that another indicator is having acne.

[SweetJade1980]

Skin problems have long been indicators of one's "good health" and this is no different. You can be the healthiest person in the world, never getting a cold, etc, but if you've got acne, and it's not something you are putting on your skin, it may very well be something that is going on inside of you. It could be due to some sort of toxin in your food (dioxin) or air, it could be that you have some sort of other problem with a food you eat or a nutrient defficiency, or it could be due to a completely unrelated hormonal disorder (some are related to dietary intake). So obviously this is where puberty comes into play, as puberty is definately a time when your body is going through a temporary hormonal imbalance, and well, it's also going through temporary insulin resistance. Once puberty ends, insulin resistance ends, and the hormones correct themselves, the acne goes away, but this doesn't happen for all of us =(

Therefore the reason why people still say that diet doesn't cause acne is because if you aren't susceptible to developing acne in the first place, you won't get acne, but you may get some other problem down the line. So, what maks one susceptible? Ha, wish I understood that one, so I'll go with the easy answer, Gene AND Environment (diet, toxins, nutrients, poor sleep, stressors, sedentary lifestyle etc) Interactions provide the end result of things that we now define as obesity, cancer, diabetes (type II) and yes even acne.

So for those that chose to fight back as best they can by altering their environment, as your environment can increase or DECREASE your risk for developing certain problems, I commend you. The acne sufferer may be defficient in a variety of things listed below, so it's good to see that some of you have already discovered you can fix some of these by just by taking a supplement!

Apolipoprotein A1 (helps form HDL or good cholesterol) - if this is lower, that means that LDL may be higher. If LDL is higher that means IGF-1, Inflammatory Prostaglandins and other Inflammatory Products may be increased.

Zinc - antibiotic, anti-inflammatory, anti-androgenic (enhances SHBG binding), 5-alpha reductase inhibitor, apart of the process of converting Vitamin A into 13-cisi retinoic acid

Glutathione - liver detoxifier, induces apoptisis of cells by reducing IGF-1, involved blood sugar control. NAC, ALA or K-RALA, Silbinin (Milk Thistile), etc

Vitamin A - This converts into 13-cis retinoic acid which is accutane so it also has the potential ability to act as an anti-androgen and 5 alpha reductase inhibitor, and possibley increase IGFBP-3.

SHBG - Known as Sex Hormone Binding Protein, which has a higher affintinty for binding Free Androgens so that they don't convert into DHT or just wreck havoc by inducing additional events neccessary for acne formation. This is decreased in the presence of too much insulin as well as in the presence of too much androgen (as it's supposed to bind that excess androgen).

IGFBP-1 or 3 - Known as Insulin-like Growth Factor Binding Proteins that bind IGF-1. IGF-1 is a growth factor that is present to reduce the amont of insulin in the blood stream, but it is also 10x more powerful than insuline. As such it plays a role in cell growth, overgrowth and thus with growth comes more activity for that particular gland. A good example would be enlarged sebaceous glands, thus more oil production IGF-1 prolonged prescence also induces a host of inflammatory products (IL-1, IL-6, etc) that want to suppress it's presence, BUT they are inflammatory (acne, cystic acne)!

I know there's a few more, but it's late so I'll finish the rest of this list tomorrow. Of course there's a nice list of things that the acne sufferer happens to produce in excess, some of which we can take a prescpription or supplement to supress or balance and other times we will have to follow a particular diet to do so. However the point of my long post was that while sugar can be the precursor to a nice long chain of events staring with Insulin, it is indeed due to the presence of Insulin in our blood stream that initiates the Hormone Production & sometimes Inflammatory Products processes. This is why when discussing diabetes we should try to differentiate between the various forms as Type I Diabetes is not as strongly associated with this problem as they don't make enough (functional) insulin in response to the huge amounts of sugar in their blood stream. They must take insulin to control their blood sugar levels where as anyone that is Insulin Resistant or worse, a Type II Diabetic, already produces insulin in response to the sugar in the blood stream, but the problem is that we can produce too much!

Thus, if you can eat all the sugar you want, and NOT raise your insulin levels beyond the "normal" amount, you wouldn't have to go on these low or moderate carbohydrate diets, etc to control your acne. Unfortunately it's because that's not something a percentage of us can do successfully with a ton of pills, that the diets are neccessary for an increasing number of us. So that leads me to the question of are you really genetically glucose intolerant or is it that due to your environment, you are just (unknowingly) consuming above and beyond the neccessary amount of sugar (& trans fats) that your body begins to perform as if it were???

The minimum amount of carbohydrates needed to be healthy & prevent ketosis is 100 - 150g/day, yet a moderate carbohydrate diet should be healthy for most people (40% - 55% carbs). So have you ever sat down and counted the amount of carbohydrates that you consume, including all hidden sources? I did and I used to consume 400 - 600g a day, after changing a few things, now I consume 200 - 300g a day and I still eat how I want. Unfortunately, based on the Food Pyramid, even the new one, you could consume as much as 800g of carbs a day or more if you aren't careful because most of us tend to eat more than 1 serving of certain carbohdyrates over others (grains vs. vegetables, simple vs. complex).

Piece-By-Piece: Researching Glucose Intolerance

Medical understanding of glucose intolerance increases every year. Each finding adds to the broader base of knowledge. Here are some of the more recent discoveries about the nature of the disease. Some are larger pieces of the puzzle than others, but all bring us closer to an understanding of glucose intolerance.

Polycystic Ovary Syndrome and Glucose Intolerance

One study examined the frequency of glucose intolerance among women at risk for polycystic ovary syndrome, or PCOS. Poor insulin production is one of the side effects of the syndrome. Women in the clinical trial ranged in age from 14 to 44. All were fed the same diet for three days before undergoing oral glucose tests.

The tests revealed higher rates of glucose intolerance among women of comparable age and ethnicity who suffered from polycystic ovary syndrome, suggesting that the syndrome may be more of a diabetes risk than other factors, including weight, for young women.

Food Shortages and Impaired Glucose Tolerance

Obesity is most often linked to glucose intolerance, but studies in the Netherlands suggest that food deprivation at a young age may also increase the risk of blood sugar problems. Children born in the Netherlands during the Nazi occupation seem to have developed unusually high rates of glucose intolerance and hypertension in later life, a statistic that has been linked to food shortages earlier in life.

Complications and Syndrome X

Syndrome X is a term used to describe the health risks associated with insulin resistance, which include hypertension and glucose intolerance. Such complications have been traditionally ascribed to type 2 diabetes. As glucose intolerance research continues, it has become evident that these health concerns actually become risks before diabetes manifests itself.

What does this mean for health care? Glucose intolerance is finally being seen as a disease in its own right, rather then just a precursor to diabetes. This shift in perception makes it easier to get treatment. The earlier blood sugar related health risks are treated, the better the chances that they will not progress to life-threatening diseases.

And Finally, Cats

That's right, cats. Cats and chromium, a dietary supplement that claims to improve glucose tolerance in humans. One study has discovered that chromium does indeed make small improvements in feline glucose tolerance. Further studies will determine whether chromium diets improve the health of older, obese cats.

Obviously, just because chromium makes a difference for cats doesn't mean that it works for humans. But veterinary studies such as this one do point to the possibility that the mineral may have some benefit for glucose intolerance sufferers. Whether or not that benefit exists, or will be enough to be useful, remains to be seen. http://www.glucose-intolerance.co.uk/html/...3#ResearchingGI

Yeah, didn't you know that our pets can have the same "preventable" diseases as us....ever wonder why? Ever checked the ingredients your feeding them?

Impaired glucose tolerance (IGT) is a condition that affects about twenty million Americans. The presence of impaired glucose tolerance is an important indicator of an increased risk of developing type 2 diabetes. With the alarming rise of diabetes in America, the research community is paying close attention to contributing factors, such as obesity and impaired glucose tolerance.

Syndrome X and Impaired Glucose Tolerance
Rarely a stand-alone condition, impaired glucose tolerance is actually one of a number of conditions collectively known as syndrome X. The presence of each of these conditions contributes individually to the development of diabetes.

obesity
insulin resistance
hyperinsulinemia (high blood insulin levels)
impaired glucose tolerance
hypertension (high blood pressure)
dyslipidemia (abnormal levels of fat in the blood).
Insulin resistance, hyperinsulinemia and impaired glucose tolerance are also associated with the development of polycystic ovary syndrome (PCOS) in both obese and lean women.

Obesity has long been related to obstructive sleep apnea (OSA). According to the results of a new study, whose results were published in the March 2002 issue of the American Journal of Respiratory and Critical Care Medicine, OSA is also associated with insulin resistance independent of obesity.

Risk Factors for Impaired Glucose Tolerance
The causes of impaired glucose tolerance are similar to those identified for full-blown diabetes. As with many diseases, one's risk of developing glucose intolerance and insulin resistance appears to involve both genetics and lifestyle.

Certain ethnic groups are more likely to develop impaired glucose tolerance than others. African Americans, Native Americans, Hispanic Americans, Asian Americans and Pacific Islanders are all at greater than normal risk. The occurrence of type 2 diabetes is also more common in these populations.

Women are more likely to develop impaired glucose tolerance than men, and women with a history of gestational diabetes are at higher risk than other women.

A family history of diabetes could indicate that you have a genetic predisposition to problems involving glucose metabolism and put you at an increased risk of impaired glucose tolerance.

Some medical conditions contribute to the development of impaired glucose tolerance, insulin resistance and diabetes. These include:

obesity
liver cirrhosis
end stage kidney disease
certain endocrine disorders (i.e., hyperthyroidism, Cushing's disease)
certain exocrine disorders (i.e., cystic fibrosis, pancreatic cancer, hemochromatosis)
certain genetic disorders (i.e., Down syndrome, Turner syndrome)
gestational diabetes.

What Is Insulin Resistance?
In some people, insulin levels may be normal or even high, but the body stops responding appropriately. Because insulin is necessary in order to use glucose as an energy source, insulin resistance leads to elevated blood sugar levels. The exact mechanism of insulin resistance is unknown, however, doctors and scientists have discovered that the condition is more common in overweight individuals and that a genetic predisposition exists. Studies have shown that diet and exercise can help restore insulin sensitivity. Lowering the amount of fat and calories consumed and getting thirty minutes of aerobic exercise several times a week can reduce the risk of insulin resistance and the development of type 2 diabetes. http://www.diabetes-and-diabetics.com/abou...e-tolerance.php

Notice how liver cirrhosis is mentioned? Well I imagine any liver damage can induce a variety of problems such as poor hormone elimination (if you produce too much this wouldn't help things), poor detoxification, along with glucose intolerance. So I guess that's another push in favor of liver flushing. Also, did you notice how the ethnic groups all had American after their name? That's because more and more foreigners that move to the United States arrive with no health problems and eventually after several generations, they end up having the same health problems as those that have always lived here. There may indeed also be a greater risk, but doesn't that make you wonder WHAT is it about the united states that would induce health problems in people that didn't previously have any (& in their country) over a period of time?

Oh and to further support the above statements, here's another article that (finally) connected the dots:

Type A insulin resistance: In addition to glucose intolerance, patients with type A insulin resistance (absent or dysfunctional insulin receptor) may have certain clinical features such as (1) acanthosis nigricans, which is hyperpigmentation and skin thickening of flexural areas, or (2) features of hyperandrogenism, of which some variants may be characterized by thin or muscular body habitus or acral enlargement (pseudoacromegaly).

http://www.emedicine.com/med/topic897.htm

Hmm ...so:

Diet = Glucose/Fructose = Insulin = Cholesterol = Steriod Hormones = Androgens, Growth Factors & Inflammatory Products = Sebeceous Gland OverGrowth, Sebum overproduction, Skin Cell Hyperkeritinzation = Clogged Pores & Inflammation = Acne

(for simplification not in exact order).

Anyone still not believe or understand how diet can play role?

[clayjar]

Sorry for this long post.

Well SweetJade, I have to say that I am more on your side than not, but all of this dieting is almost as stressful if not as stressful as dealing with acne.

I wouldn't mind nearly at all going on an elimination diet starting with the freeacnebook.com diet as the base and going from there, if I was overweight already looking to lose a few pounds. Unfortunately, I am extremely tall and thin, and being too skinny is another hard body image issue to deal with.
Is physician testing reliable, and how do they test?

I enjoy working out to build muscle but have such a hard time due to my super high metabolism. Even when I eat enough calories, I still struggle with putting on lean body mass. A raw food only diet (which sounds like the only one that will help me) would be impossible and too burdensome/discouraging. I've tried gluten-free, low fat, low animal protein, and all seem to help a little. But I need to eat!

I went to the derm yesterday after twelve years of not seeing him. He told me that out of his 20 yr practice, I am the only patient who has not responded well to anything he's tried, including Accutane three times (one time with a huge dose he said). He's done all of the antibiotics and creams. He said that over the years he tells his colleagues that there has only been one patient in his career who has baffled him, me.

He went on to tell me that there was another patient who told him that when he went on a vegan diet, his skin would be clear. He said maybe I could try it but that I would waste away because of the small amount of calories in the diet. I cannot do this. If the opposite sex isn't repulsed by my acne (which they don't tell me), they are telling me I'm too skinny.

The derm said that probably it's not too much testosterone I have, but the sensitivity of my androgen receptors. Other than another try at Accutane (but at a lower dose over an extended period of time -I won't touch the stuff again though), he said the only other thing we could try is spironolactone. He cautioned that I could develop man boobs, which could be irreversible. He said to watch for them closely and at the first sign, stop the med. I don't know about this. I desperately want to stop my acne, but I love to work out (build testosterone), don't want man boobs (! ya think?!), and hate chemicals. He said I could go on a low dose.

I am a nursing student and so have researched spiro a little and found that it is listed as inhibiting aldosterone, a mineralcorticoid produced by the adrenal glands to balance water/electrolytes. It is a potassium sparing water pill used for people with congestive heart failure. Do I really want to be messing with my electrolytes?
My resource said nothing about inhibiting testosterone, just aldosterone. Do I want to mess with my hormones like this?

I am sorry for rambling or not making much sense, but I am just so fed up with my skin after 17 years of this crap, and left the derm basically being told that I am cursed genetically. He even said that the chances of growing out of it are slim . Maybe I just need to deal with my skin and accept it painfully.

[blackbirdbeatle]

Great post. Ties most things together better. In my opinion insulin resitance is all well and good for other, more serious issues but what it didn't explain(Or else I missed), was that how it affects keratin production, or better yet, why when we overproduce keratin do some have abnormal keratinizationand others don't? Again, you can have all the oil in the world, or just a little(You will always produce a little), but even that little bit will still form acne if you have abnormal keratinization.

The key to acne IMO is to normalize keratization. If that happens everythign else is just bothersome such as oily skin. You can control oil and some inflammation response with strict diets but how can it explain exfoliation? I am acne free but still have the same oil as I did before.

If you would include somethign that says how diet affects keratinization I would feel better because so far there is only a few things I've found that can do this and they are really hard to get in a diet.

[clayjar]

blackbirdbeatle,
How did you normalize your keratization enough to be acne free with oily skin? I'm assuming not through diet.

[blackbirdbeatle]

No, not though diet. I was one of the lucky ones that wasn't affected by diet. It was either three things.
1. I grew out of it(Age 21) and somethign happened. Perhaps after everything balanced out(Hormones and all), my body stopped overproducing so much keratin. I'm guessing the keratinocytes balanced out as well. It was funny because the hormones in the last few years has wreaked havoc on me, acne being the least of my worries. SOme other ones were bruxism, which has all but gone and mild HH, which was brought on by anxiety, which has subsided.

2. THe other option was that I stopped usig so many damn products. I'm not sure if this would be a big enough factor by itself because I would still be producing tons of keratin.

3. I started using NDGA in products. It's basically the only thing they have now that isn't drying like sulphur yet normalizes keratin by inhibiting the proliferation of keratinocytes.

I'm guessing I just grew out of it because I don't use NDGA products anymore and I tried overwashing with many things as an experiment and indeed, I didn't break out. I'm just curious because if there was a way to permanently stabalize the keratinocytes or just the production of keratin no one would have acne. They may have oily faces but that's easier to face than acne. PLus that is where all the other successful acne solutions come from like Jades post and the B5 post,etc....

Retin A and others are supposed to regulate keratinization but they irritate many and it's just maintenance, nothing permanent.

Sorry to hijack your post Jade.

[arrshixerrr]

I realize that I break out after I work out hard, with cyctic/nodular acne. Could it be the workout it self, or the fact Im trying to gain weight/muscle mass with the diet Im doing, or both?
I dont want to stop working out and I know from experence that I cant be 100% clear while working out with weights, but I at least want to be somewhat clear and be able to take my shirt off this summer. Isn't that what getting into shape is for!!!?!?!

[SweetJade1980]

Sorry for this long post.

Well SweetJade, I have to say that I am more on your side than not, but all of this dieting is almost as stressful if not as stressful as dealing with acne.

  I wouldn't mind nearly at all going on an elimination diet starting with the freeacnebook.com diet as the base and going from there, if I was overweight already looking to lose a few pounds.  Unfortunately, I am extremely tall and thin, and being too skinny is another hard body image issue to deal with.
Is physician testing reliable, and how do they test?

  I enjoy working out to build muscle but have such a hard time due to my super high metabolism.  Even when I eat enough calories, I still struggle with putting on lean body mass.  A raw food only diet (which sounds like the only one that will help me) would be impossible and too burdensome/discouraging.  I've tried gluten-free, low fat, low animal protein, and all seem to help a little.  But I need to eat!

  I went to the derm yesterday after twelve years of not seeing him.  He told me that out of his 20 yr practice, I am the only patient who has not responded well to anything he's tried, including Accutane three times (one time with a huge dose he said).  He's done all of the antibiotics and creams.  He said that over the years he tells his colleagues that there has only been one patient in his career who has baffled him, me. 

  He went on to tell me that there was another patient who told him that when he went on a vegan diet, his skin would be clear.  He said maybe I could try it but that I would waste away because of the small amount of calories in the diet.  I cannot do this.  If the opposite sex isn't repulsed by my acne (which they don't tell me), they are telling me I'm too skinny. 

  The derm said that probably it's not too much testosterone I have, but the sensitivity of my androgen receptors.  Other than another try at Accutane (but at a lower dose over an extended period of time -I won't touch the stuff again though), he said the only other thing we could try is spironolactone.  He cautioned that I could develop man boobs, which could be irreversible.  He said to watch for them closely and at the first sign, stop the med.  I don't know about this.  I desperately want to stop my acne, but I love to work out (build testosterone), don't want man boobs (! ya think?!), and hate chemicals.  He said I could go on a low dose.

  I am a nursing student and so have researched spiro a little and found that it is listed as inhibiting aldosterone, a mineralcorticoid produced by the adrenal glands to balance water/electrolytes.  It is a potassium sparing water pill used for people with congestive heart failure.  Do I really want to be messing with my electrolytes?
My resource said nothing about inhibiting testosterone, just aldosterone.  Do I want to mess with my hormones like this?

  I am sorry for rambling or not making much sense, but I am just so fed up with my skin after 17 years of this crap, and left the derm basically being told that I am cursed genetically.  He even said that the chances of growing out of it are slim  .  Maybe I just need to deal with my skin and accept it painfully.

LOL this is the 2nd time you have apologized to me for a "long message", beleive me, you don't have to apologize to me for that. ;-)

Anyway, I went back and read your PM and so that helped answer a few questions I had for you. So far this is what I'm aware of:

17 years of acne (how old were you when it started?)

Cystic acne (face & body), any other types?

Trouble packing on muscle, despite suspecting high androgen levels

Accutane 3x and didn't work (at all?)

Antibiotics failed (of course)

Prescription Creams failed (retina, azelex, etc?)

Dietary changes helped only a little bit (low-fat, gluten free, no dairy, ALL at once or seperately?)



Well, when it comes to your diet we could dig around some more as ONE thing in your diet that you're body does not favor, can very well mess up your results. That's why I mentioned the difference between Intolerance and Allergy, but those are also different from just following a diet to balance your sugar levels. You mentioned cysts and from what I've gathered from others, including myself, foods that fall on the intolerance list are BIG suspects for giving members around here cystic acne. Other suspects for cystic acne would be trans fats and fructose sweeteners. The places that you described having acne in your PM are the places that nuts and fructose sweeteners gave me very stubborn cystic acne. So it may turn out after testing or from adding things back into your diet (using wai or some other elimination diet), that you only needed to eliminate 1 or 2 food items instead of permanently overhauling your whole diet. For your sake I hope so because otherwise, it would be very tough for you to be successful at building muscle if you had to alter your diet beyond what you've already tried.

Now, as for what you should get tested for, you are looking into Food Intolerance Testing (not allergy). Somewhere around here is a post including some places, but off the top of my head there's:

http://www.nowleap.com/
http://www.yorkallergyusa.com/ (also in other countries)
http://www.surescreen.com/
http://www.alcat.co.uk/
http://www.medichecks.com/ (europe)

What the heck, I looked some up for ya. Anyway, if you have health insurance certain parts of their programs, the lab work, should be covered by your insurance just talk to your doctor.

Your other question was about what to say to your dermatologist or endocrinologist and well, give him the above stats about your results based on your prior treatment methods. There's quite a few possibilities here, and hyperandrogenism hasn't entirely been ruled out. When you get your referrel to see an endocrinologist, give him your health history as well as your family's health history. So if there are any health or hormonal disorders that your family has, they need to be mentioned. If there's any cancers, diabetes (the type), arthritis (the type), wieght issues, digestive issues, allergies, etc ALL need to be mentioned. This will help your endocrinologist narrow down some of the testing that he/she may run on you initially. There's a lot things that can malfunction and be the source/aggrivator of your acne and they can involve not just your liver & pancreas, but your pituitary, thyroid, adrenal, as well as your gonads (testes or ovaries). There are tests for all these and a good website to look at most of thest tests are at: http://www.labtestsonline.org/

Now there are tests that you may want to ensure that you do get tested for and these would be your Cortisol levels & associated enzymes, Thyroid Hormones, Androgen Hormones, as well as a Liver Panel and Lipid Profile. There's some other stuff that would fall under a Complete Metabolic Profile, but if you are curious as to whether there's an IR connection then you'll need to get a few different glucose tolerance tests run. Sounds like a lot, but I recall when I met my 3rd & last endocrinologist he ran 32 tests on me that required 17 tubes of blood and a take home gallon jug for 24 hour urine collection!!! He's such an awesomely good endocrinologist that everyone in the lab always knew who were his patients because they usually got tested for quite a few things. ;-) I'm grateful to him because he tested me beyond what other endocrinologists and regular doctors did and I wouldn't be here without him.

Oh, and since you mentioned accutane failing, well yes I would expect that anyone with a hormonal disorder would not ever be "cured" by accutane. In fact there have been a few studies, involving males, where it showed that those that didn't respond indeed had either Hyperandrogenism (probably from Insulin Resistance) or an Adrenal Disorder. So when I think about males and the drugs that you would take, I wonder if males would do better on drugs to treat adrenal disorders vs. hyperandrogenism. Bear in mind an adrenal disorder can make you hyperandrogenic and such disorders that can do this are Cushings Disease (hypercortisolism), Addison's Disease (hypocortisolism), and Non-Classical Congenital Adrenal Hyperplasia (NCCAH/LOCAH). With the NCCAH, there's actually 5 possible enzyme defects that can lead to this, but virilization (overmasculinatizion) is usually a sign. Of course one doesn't always hae to have all the signs, so those are some you can look into.

As for the possibility that it's due to an androgen sensitivity more so an overproduction, well your tests results will show this. If you are within your normal range for Free Testosterone and Total Testosterone, chances are that could be it or it's due to some other hormonal imbalance. If you are truly tired of experimentiong, go ahead and take a low dose of Spironolactone. Males are VERY responsive to this drug so you probably need something between 25mg - 100mg, where as females tend to take 50mg - 200mg (avg. around here is 100mg - 200mg). If you are beyond puberty (which you should be if you've had acne for 17 years now), then permant damamge isn't likely unless youve taken it for 2 - 3 years. So taking it for a few months should be fine unless it turns out that it drops your blood pressure too much. I've always had normal blood pressure so this wasn't something I ever had problems with, even while taking spiro, but some people have had this problem, alogn with a slight or huge decrease in libido.

Now, the thing with Spiro is that it has been used for over 20 years to treat hyperandrogenic effects, primarily hirsutism, as it BLOCKS the androgen receptor. It was and still is initially an aldosterone inhibitor, but because it happens to also look like androgen, it can act as an androgen analogue and bind to the receptor and prevent further activity! So if this is indeed your problem, Spiro should clear you....and then from there you can research to find natural alternatives to Spiro such as Saw Palmetto. Remember in your research you are looking for things that will act as an androgen analogue, something that looks like androgen, but doesn't act like androgen, in order to prevent further activity at the androgen receptor. This is something that I'm also looking for to naturally control my hirsutism, as dietary changes do not do this (helps a little). Diet can reduce you production of testosterone or inflammatory products, but your diet as a whole can't block the androgen receptor ;-)

Sorry, gotta run, but hope that helped some

[SweetJade1980]

I realize that I break out after I work out hard, with cyctic/nodular acne. Could it be the workout it self, or the fact Im trying to gain weight/muscle mass with the diet Im doing, or both?
I dont want to stop working out and I know from experence that I cant be 100% clear while working out with weights, but I at least want to be somewhat clear and be able to take my shirt off this summer. Isn't that what getting into shape is for!!!?!?!

It can be both. Cardio decreases insulin resistance, testosterone, and inflammatory products and heavy weight traning does the opposite.

[blackbirdbeatle]

I'm guessing that it's more the foods you are eating after the workout. From what many here have experienced(Or thought they have), a weightlifting diet isn't exactly their definition of acne friendly. I don't doubt that weightlifting has a role though.

[arrshixerrr]

So, I shoud combat my hard weight training with hard cardio? Can this be effective every other day? So, it would go, weights, cardio, weights, cardio, ect...?

[arrshixerrr]

Ohh, one more thing...could accutane be effective on this type of acne effect?

[SweetJade1980]

So, I shoud combat my hard weight training with hard cardio? Can this be effective every other day? So, it would go, weights, cardio, weights, cardio, ect...?

This is definately something that Blackbird would be able to help you more with, but again, building lots of muscles and preventing acne don't appear to go hand in hand for those that are naturally prone for acne. The best I'm aware of naturally through diet is 95% clear, but if you take supplements this can go up to 100% clear. Of course, it will depend on wether you are also taking supplements to aid your gains as certains supplements & proteins are (very) bad for those of us susceptible to acne.

Since you mentioned rotating between cardio and weights, I thought you mind find this helpful. I don't know anyone on the boards that follows his regimen, but maybe this might help you out.

RW - So let's talk about insulin. What is insulin and why should athletes and those involved in health and fitness care about it?

JB - The current rage in health and fitness is to manage the hormone insulin. But few people really understand this temperamental hormone. You see, insulin is an anabolic giant. It's the most anabolic hormone because it stuffs nutrients like amino acids and carbs into muscle cells to promote growth. But, while it sounds great, getting aggressive with it can lead to serious fat gain. For instance, here are some basics:

Insulin is a hormone released into the blood by an internal organ called the pancreas. Insulin functions in many ways as an anabolic or a storage hormone; in fact it's been called the most anabolic hormone. When insulin is released into the bloodstream, it acts to shuttle glucose [carbohydrates], amino acids, and blood fats into the cells of the body. "Which cells?" you ask. Well, fat and muscle cells are the important ones in terms of quantity. Now, if these nutrients go predominantly into muscles, then the muscles grow and body fat is managed. If these nutrients go predominantly into fat, then muscle mass is unaffected and body fat is increased.

So obviously if there were a way to send nutrients preferentially into muscle rather than fat, trainees would have more muscle mass and less fat mass. That's the goal of my recommended training and eating programs - to increase the muscle uptake of nutrients preferentially. Isn't that the goal of every trainee whether they know it or not?

RW - So how can one manage this hormone to promote muscle gains and fat losses?

JB - Well, this is where things get tricky. Because insulin is a storage hormone, most people think that since insulin stores nutrients, it should be avoided because it has the potential to store fat. This is a mistake for several reasons. First, there's no way to avoid insulin in the blood. Whenever you eat food, insulin is released.

Secondly, if you theoretically could eliminate insulin, you would abolish all of its anabolic effects and its ability to store energy in the muscle. In fact, type 1 diabetics don't produce insulin and as a result, if left untreated, they die.

But don't go the opposite route, either. If blood levels of insulin are always highly elevated, trouble results. Chronic elevation of insulin leads to large amounts of fat gain, risk for cardiovascular disease, and ultimately to type 2 diabetes. This second type of diabetes is characterized by obesity, cardiovascular disease, and the poor ability of the muscle to store nutrients, which leads to muscle wasting and tons of fat storage. This is called insulin resistance.

So my point is that you need insulin, but you must learn how to balance the anabolic effects against the fat storage effects; to trick it into making you muscular while making you lean at the same time. And this is done two major ways; first by increasing insulin sensitivity in the muscle while decreasing insulin sensitivity in the fat cells and, second, by controlling the insulin released during specific times of the day.

RW - Please explain the difference between insulin resistance and insulin sensitivity?

JB - Simply put, insulin resistance is bad. If you're insulin resistant, your cells - especially the muscle cells - don't respond to the anabolic effects of normal levels of insulin, i.e. they resist insulin's effects. If this is the case, the body then releases massive amounts of insulin to promote nutrient storage in the resistant cells. Remember, though, that chronic high levels of insulin in the blood are very bad and can cause type 2 diabetes.

Insulin sensitivity is therefore very good. In this case, your cells - especially the muscle cells - respond very well to small levels of insulin. Therefore, they need very little insulin stimulation to get into an anabolic state. So high insulin sensitivity at the muscle level is very desirable.

One way to remember the difference is as follows. If you're dating someone who responds or reacts to any affection you show them, then he or she is sensitive. So they're a good model for insulin sensitivity. It only takes a little affection to get a big response. On the other hand, if the person you're dating is resistant to your affection, then it takes a lot to get them going. Therefore, they're a good model for insulin resistance. It takes a lot of affection to get even the smallest response.

RW - Does insulin sensitivity vary or change?

JB - Insulin sensitivity is unique to each individual but the cool thing is that it can be manipulated by exercise, diet, and supplementation. And that's what I do with my clients to dramatically change their body composition.

Both aerobic and resistance training greatly increase insulin sensitivity through some different and some similar mechanisms. In addition, supplements like omega 3 fatty acids, fish oils, alpha-lipoic acid, and chromium can increase insulin sensitivity. Finally, moderate carbohydrate diets that are rich in fiber can increase insulin sensitivity.

On the flip side, the low-carb, high-fat diets that have become popular can decrease insulin sensitivity. That's why none of my trainees go on no-carb diets, unless they're dieting down for a show and then they'll do occasional no carb diets every few months for a maximum of 3 weeks at a time.

RW - So what are some practical ways to manipulate insulin sensitivity?

JB - Well, typically I've seen tremendous increases in insulin sensitivity with 3-4 intense weight training sessions per week, lasting 1 hour per session. These sessions should be coupled with at least 3-4 aerobic sessions lasting 30 minutes per week. To really target insulin sensitivity, you would perform these sessions separately.

After exercise, the next step would be to supplement with 600 mg of alpha-lipoic acid and concentrated fish oils containing a total of 6-10 grams of DHA and EPA, which are the most active omega 3 fats in fish oils.

Finally, your diet can make a big difference. I recommend moderate quantities - 40-50% of the diet - of fibrous carbohydrates like oatmeal, fruits, vegetables, and whole grains. I also recommend eating moderate quantities (30-40% of the diet) of high-quality proteins like casein, whey, chicken, beef, fish, dairy and eggs. And finally, I recommend eating low quantities (20% of the diet) of fats from olive oil, flax oil, fish oil, and nut oils.

All of these strategies can be combined to make the muscles more responsive to insulin while simultaneously decreasing the fat's responsiveness to insulin. This means more muscle mass with less fat gain... the eternal quest of the bodybuilder!

RW - How important is the insulin sensitivity to my progress as a "natural" bodybuilder?

JB - I think that insulin sensitivity dictates your muscle-to-fat ratio, especially when trying to gain or lose weight. If you're more insulin sensitive during a weight-gain program, you'll gain more muscle relative to the fat that you gain. For example, with normal insulin sensitivity, you might gain 1 lb of muscle for every 2 lbs of fat for a 1:2 ratio. With increased insulin sensitivity, you might gain 1 lb of muscle for every 1lb of fat or even better, 2 lbs of muscle for every 1 lb of fat.

And if you're dieting, you will lose more fat relative to your muscle loss if your insulin sensitivity is high.

Are these things important to bodybuilders? You bet they are! And especially to natural ones. Drug-assisted bodybuilders have super insulin sensitivity. In addition, the drugs enhance their muscle-to-fat-gain ratios. If you're clean, you need to use every natural means at your disposal to alter these ratios as well.

RW - So what about the other step in balancing insulin? Controlling insulin release during specific times during the day, right?

JB - That's right. Remember, insulin is anabolic so we want bursts of it every day without chronic elevation. An effective way to do this would be to plan insulin bursts after training. In addition, I recommend jacking up insulin at least twice per day, but no more than 3 times. So planning at least 2 high-insulin meals per day is the way to grow and stay lean.

To do this we need to first pay attention to something called theinsulin index of foods. If you think I've made a mistake and that what I really mean is the glycemic index, you're wrong. I mean the insulin index. Never heard of it? You're not alone. Although insulin indices are not new, they've been ignored in health and fitness for far too long.

RW - What's the difference between the well known glycemic index (GI) and this insulin index (II) you're referring to?

JB - The popular glycemic index is a measure of the speed at which carbohydrates enter the blood after a meal. A high-glycemic index means that blood sugar rises rapidly in response to a meal while a low-glycemic index means that blood sugar rises very slowly. Traditionally, nutritionists thought that the faster the carbs got into the blood, the bigger the insulin response. So in an attempt to manage insulin, they recommended always eating low-glycemic foods.

However, several studies since have shown that some low glycemic index foods have huge insulin responses! So the correlation between glycemic index and insulin response breaks down with some foods. For example, milk products have a very low glycemic index. But they promote insulin responses parallel to the highest glycemic foods. What's the deal? Well, it appears that there are several other factors that determine insulin release besides carb content and the rate of carb absorption.

This is why the insulin index was generated. This index actually measures insulin response to a food. So rather than assuming insulin response is correlated with carb absorption, these researchers decided to go ahead and measure it. And their results were eye opening!

RW - If a natural bodybuilder is planning their nutrient intake around the insulin index, what foods would they eat and what foods would they avoid?

JB - One thing to keep in mind is that there is no such thing as a bad food. Well, almost no such thing. I don't think anyone can make a case for powdered, cream-filled doughnuts, besides the fact that they taste damn good! But I hope you see my point. Since I said earlier that sometimes you want an insulin surge - especially after workouts - and sometimes you don't - especially at night before bedtime - we have to realize that we use the insulin index not to condemn foods but to decide when to eat them.

The point I want to stress is that the insulin index helps us add information to the glycemic index to make better food choices. So using both indices is the way to go. Since milk products have a low GI but a high II, these foods aren't optimal when you want to keep insulin low. Other example foods or meal combinations for this situation are baked beans in sauce, meals with refined sugars and fats, and meals that are protein and carbohydrate rich. Each of these foods/combos have low GI scores but high II scores, none of which are optimal for low insulin times. But remember, some times you want high insulin so don't relegate these foods/combos to a dark corner of your nutritional closet.

Conversely, unprocessed fibrous grains and cereals as well as fruits and veggies are great on both scales. In addition, most low-fat protein sources are also great on both scales.

RW - So what times of the day should you increase insulin levels and what times should you concentrate on decreasing them?

JB - Again, I like to spike insulin 2-3 times per day. Remember, though, that my clients are super insulin sensitive due to the training, diet, and supplementation programs I have them following. So they can handle the insulin surges and can actually grow and get lean at the same time. With this said, natural insulin sensitivity declines at night time so perhaps at night, low insulin choices are best. After training however, the goal should be to send insulin through the roof. A sensible plan is to eat 3 high-insulin meals as your first 3 of the day, and 3 low insulin meals to finish the day. This can be accomplished as follows:

1st 3 meals: Protein plus carbs with no fat
2nd 3 meals: Protein plus fat with no carbs
[Editor's note: for more information on John Berardi's eating recommendations, check out "Massive Eating, Part 1", and "Massive Eating, Part 2".]
Post-workout meals: Hydrolyzed protein, simple carbs, BCAA, free form amino acids
http://www.johnberardi.com/articles/nutrition/insulin.htm

His website has lots more information. I really like what he says about how you should eat and the supplements to take (nothing new in the acne world). That's something I find interesting is that while I know body buiilders eat to gain muscle which requires increased insulin & testosterone, yet I always find myself on some body building forum whenever I'm investigating the latest glucose controlling supplement. I suppose it's because they don't want the fat thats associated huh? Anyway, his regimen makes me feel as if I could actually have control over my weight gains if I do what he says...and not break out. Alas, I don't have the money for THAT much fish oil, but I hope it helps you some.

[arrshixerrr]

SweetJade you made my day with that post, seems like most if not all the questions I had have been answered in that article!!! I'm all amped to try the things he talked about...I will update you on how its going..Good night

[WeCanDoThis]

It can be both.  Cardio decreases insulin resistance, testosterone, and inflammatory products and heavy weight traning does the opposite.

Hey Jade.. could you link me to where it says that Cardio "descreases testosterone" cause this guy says the opposite:


"Blood levels of testosterone increase with exercise in both males and females beginning about 20 minutes into an exercise session, and blood levels may remain elevated for one to three hours after exercise."


http://www.ensureyoursuccess.net/landryhormone.html

[SweetJade1980]

Hey Jade.. could you link me to where it says that Cardio "descreases testosterone" cause this guy says the opposite:
"Blood levels of testosterone increase with exercise in both males and females beginning about 20 minutes into an exercise session, and blood levels may remain  elevated for one to three hours after exercise."
http://www.ensureyoursuccess.net/landryhormone.html

Well the thing is, whenever I discuss a decrease, there's also going to be a decrease in perhaps all or most of your other steriod hormones as well. Testosterone is directly linked to the amount of estrogen you produce, so depending on whether you are a male or female and depending on whether your aromatase enzyme (converts testosterone into estrogen) is functioning properly, when testosterone increases so will your estrogen. This is further supported here:

The amount of 17 beta estradiol secreted by the ovaries  increases with exercise, and blood levels may remain  elevated for one to four hours after exercise.

Exercise in general will increase your insulin sensitivity, which will increase your SHBG (relies on an increase in estrogen & decrease of insulin) which as I mentioned earlier will bind excess Free Testoseterone. This is somewhat supported here and if I have time I'll find the article that mentions it increasing SHBG:

An excessive insulin response causes fat production  within the cells - thus, insulin is sometimes called the "fat hormone". Many overweight people's  cells develop a resistance to insulin so that it  takes more insulin to have the same effect. This  creates a situation where blood levels of insulin  are higher than normal. This condition is often improved by losing weight and daily aerobic exercise.

Blood levels of insulin begin to decrease about 10 minutes into an aerobic exercise session and  continue to decrease through about 70 minutes of exercise. Regular exercise also increases a cell's sensitivity to insulin at rest

http://www.ensureyoursuccess.net/landryhormone.html

As for Heavy Weight training, I figured that the same rules apply as the above for "regular" exercise, but since some members were still breaking out the same, despite changing their diets it may have to do with the inflammatory response that is increased from all that weight lifting. I've NEVER broken out from exercising (even before my diet change), but whenever I have lifted weights they were girly weights (10lbs) so I can't tell you whether I could do heavy weights (ha ha) or not. What I've noticed and others have also commented on is that my skin looks healthier, has more of a glow and clarity when I exercise regularly. I used to think that it was probably due to my having to drink more water during exercise, but indeed it could also be due to increased circulation and increased insulin sensitivity. I can also post the article where I found information about it increasing inflammatory products (the same one's that p.acnes does) if you want also.

HTH =)

[WeCanDoThis]

Hey again Jade,

Thx for the extensive answer.

However, I still fail to understand why my source claims that there's an increase in testosterone while your sources claim the opposite.

Could you break it down very simple for me in no more than a few sentences, or even better; post a link that clearly states that cardio exercise is associated with a decrease in testosterone.

As you know, it is of the highest importance to clear this point up, because if we can pinpoint a particular method - such as cardio exercise - to control androgens, we can control acne.

Thx again for your extensive research on this and other topics benefitting us all; but for this particular point a brief, transparent and to-the-point answer would be much appreciated.

[SweetJade1980]

Great post. Ties most things together better. In my opinion insulin resitance is all well and good for other, more serious issues but what it didn't explain(Or else I missed), was that how it affects keratin production, or better yet, why when we overproduce keratin do some have abnormal keratinizationand others don't? Again, you can have all the oil in the world, or just a little(You will always produce a little), but even that little bit will still form acne if you have abnormal keratinization.

The key to acne IMO is to normalize keratization. If that happens everythign else is just bothersome such as oily skin. You can control oil and some inflammation response with strict diets but how can it explain exfoliation? I am acne free but still have the same oil as I did before.

If you would include somethign that says how diet affects keratinization I would feel better because so far there is only a few things I've found that can do this and they are really hard to get in a diet.

In a way you are right. I still am susceptible to ingrown hairs, but I'm far less susceptible when I make sure I'm not increasing the production of inflammatory products. I'm sure if my diet was completely balanced, full of vegetables, etc that this is something that would be completely alleviated. However not every skin problem will be alleviated by correcting that inducing health problem. Sometimes you will still have to rely on outside sources (AHA, BHA, Retina, etc) to further heal or exfoilate your skin. However, I'm also dry skinned in other places so this may also be the reason for those ingrown hairs. Anyway, here's what my theory was regarding Keritinzaition and based on what's below Fish Oil is a big helper in this dept. I've found that a few things that acne suffers take internally tend to be PPAR-alpha agonists, but very few things are PPAR-gamma agonists with the exception of Avandia (insulin sensitizer).

If that doesn't make sense, I apologize as I must go but this was something that I had written to you a bit back:

However you are correct in wondering about the hyperkeritinization as this is so far thought to be the reason for the clogged pores. Yes, once again, androgens are responsible for the initiation of a rather complex chain of events culminating in acne, one of which is hyperkeritinization.

Bear with me here, as this is rather new area for me and I must research further on it, but what I know is that IGF-1 is responsible for sebeceous gland growth and sebum secretion as well as skin cell proliferation. However Peroxisome Proliferator-Activating Receptors (PPARs) are also upregulated during this process. There are 3 or 4 types: PPAR-alpha, PPAR-beta/delta, & PPAR-gamma. In this thread here http://www.acne.org/messageboard/index.php...pic=39194&st=20 I posted more indepth info on these, but what is of particular intesterest is that PPAR-alphas & PPAR-gammas seem to suppress sebum production (they also form complexes with the retinoid x receptor), where as PPAR-beta increases sebum production. Furthermore, PPAR-beta is responsible for keritnocyte proliferation and happens to produce far more sebum than DHT alone!

I remember a few years ago when I first found these boards, and came across a thread discussing the wonders of Vitamin D. So I ran to my endocrinologist and told him about Vitamin D helping to clear acne and he said what type of Vitamin D? Vitamin D3? Well, at the time I was clueless, but I just bumped into an article http://www.ingentaconnect.com/content/bsc/...000004/art00017 and it mentions the use of Vitamin D3 in reducing kertinocyte hyperproliferation.... to bad I don't know that then. Sorry just a side thought for ya ;-)

So anyway, I suppose that with too much of the "wrong" sebum in conjunction with keritinocyte hyperproliferation, this would result in hyperkeritinization (?). If that's the case, then yup this is another reason retinoids are so beloved. Yet there seems to be other things that can also reduce keritinocyte proliferation and well...I'll have to investigate another day cuz I am just too sleepy, but I shall leave you with these:

The pathogenesis of acne vulgaris is multifactorial. Four key factors are responsible for the development of an acne lesion: follicular epidermal hyperproliferation and hyperkeratinization, excess sebum, Propionibacterium acnes, and inflammation.

Follicular epidermal hyperproliferation and hyperkeratinization appears to be one of the primary events in the development of an acne lesion. The follicular epidermis is hyperproliferative; abnormal production of keratins 6 and 16 could play a role. Increasing levels of the adrenally derived androgen dehydroepiandrosterone sulfate (DHEAS) are correlated with the development of the microcomedo, the primary acne lesion; therefore, these levels may trigger follicular epidermal hyperproliferation. This hyperproliferation may also be stimulated by an alteration in sebum and lipid levels in acne lesions. For example, linoleic acid levels are decreased in acne lesions, and the levels normalize after successful treatment with isotretinoin. Other factors that may lead to follicular hyperproliferation include the presence and the action of proinflammatory interleukin 1a (IL-1a) and other cytokines.

Excess sebum is also a key factor in the development of acne vulgaris. The amount of sebum produced and the degree and the severity of the acne are strongly correlated. Sebum excretion is under hormonal control. Androgens stimulate sebocyte differentiation and sebum production, whereas estrogens have an inhibitory effect. Sebocytes have nuclear androgen receptors. They also have 5 alpha reductase enzymes that convert testosterone to the more potent dihydrotestosterone. The androgen hormones bind their nuclear receptors and stimulate terminal sebocyte differentiation and the production of sebum. Most men and women with acne have normal circulating levels of androgen hormones. An end-organ hyperresponsiveness to androgens has been hypothesized.

P acnes is a microaerophilic organism present in many acne lesions. Although, it has not been shown to be present in the earliest lesions of acne, the microcomedo, its presence in later lesions is almost certain. P acnes stimulates inflammation by producing proinflammatory mediators that diffuse through the follicle wall. Recent studies have shown that P acnes binds to the toll-like receptor on monocytes and neutrophils. Binding of the toll-like receptor then leads to the production of multiple proinflammatory cytokines, including interleukin 12 (IL-12), interleukin 8 (IL-8), and tumor necrosis factor (TNF). Hypersensitivity to P acnes may also explain why some individuals develop inflammatory acne vulgaris.

Inflammation may be a primary phenomenon or a secondary phenomenon. Most of the evidence to date suggests a secondary inflammatory response to P acnes as mentioned above. However, IL-1a expression has been identified in the microcomedone, and it may play a role in the development of acne.

http://www.emedicine.com/DERM/topic2.htm

Clin Dermatol. 2004 Sep-Oct;22(5):360-6. Related Articles, Links 

 
Acne and sebaceous gland function.

Zouboulis CC.

Department of Dermatology, Charite University Medicine Berlin, Campus Benjamin Franklin, Fabeckstrasse 60-62, 14195 Berlin, Germany. christos.zouboulis@charite.de

The embryologic development of the human sebaceous gland is closely related to the differentiation of the hair follicle and the epidermis. The number of sebaceous glands remains approximately the same throughout life, whereas their size tends to increase with age. The development and function of the sebaceous gland in the fetal and neonatal periods appear to be regulated by maternal androgens and by endogenous steroid synthesis, as well as by other morphogens. The most apparent function of the glands is to excrete sebum. A strong increase in sebum excretion occurs a few hours after birth; this peaks during the first week and slowly subsides thereafter. A new rise takes place at about age 9 years with adrenarche and continues up to age 17 years, when the adult level is reached. The sebaceous gland is an important formation site of active androgens. Androgens are well known for their effects on sebum excretion, whereas terminal sebocyte differentiation is assisted by peroxisome proliferator-activated receptor ligands. Estrogens, glucocorticoids, and prolactin also influence sebaceous gland function. In addition, stress-sensing cutaneous signals lead to the production and release of corticotrophin-releasing hormone from dermal nerves and sebocytes with subsequent dose-dependent regulation of sebaceous nonpolar lipids. Among other lipid fractions, sebaceous glands have been shown to synthesize considerable amounts of free fatty acids without exogenous influence. Sebaceous lipids are responsible for the three-dimensional skin surface lipid organization. Contributing to the integrity of the skin barrier. They also exhibit strong innate antimicrobial activity, transport antioxidants to the skin surface, and express proinflammatory and anti-inflammatory properties. Acne in childhood has been suggested to be strongly associated with the development of severe acne during adolescence. Increased sebum excretion is a major factor in the pathophysiology of acne vulgaris. Other sebaceous gland functions are also associated with the development of acne, including sebaceous proinflammatory lipids; different cytokines produced locally; periglandular peptides and neuropeptides, such as corticotrophin-releasing hormone, which is produced by sebocytes; and substance P, which is expressed in the nerve endings at the vicinity of healthy-looking glands of acne patients. Current data indicate that acne vulgaris may be a primary inflammatory disease. Future drugs developed to treat acne not only should reduce sebum production and Propionibacterium acnes populations, but also should be targeted to reduce proinflammatory lipids in sebum, down-regulate proinflammatory signals in the pilosebaceous unit, and inhibit leukotriene B(4)-induced accumulation of inflammatory cells. They should also influence peroxisome proliferator-activated receptor regulation. Isotretinoin is still the most active available drug for the treatment of severe acne.

http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=15556719

(FYI: all of these factors, and then some, are affected by our diet)

http://www.acne.org/messageboard/index.php...55&#entry467955

[clayjar]

"Blood levels of testosterone increase with exercise in both males and females beginning about 20 minutes into an exercise session, and blood levels may remain  elevated for one to three hours after exercise."
http://www.ensureyoursuccess.net/landryhormone.html

From what I have read, moderate cardio helps raise testosterone initially, but something like over 30 minutes and it begins to decrease it because of the body's realease of cortisol. So extended moderate cardio does not promote muscle-building (see the bodies of marathon athletes), but short spurts of intense cardio do promote muscle gain and fat loss (see the bodies of sprinters). I've read many times that it is best to interval your cardio, such as 1-2 minute warmup, 5 minutes of balls to the wall intensity, 1-2 minutes light, 5 more minutes of intensity, etc. for a total of about 30 minutes. That should be all you need for fat loss and muscle retention. Don't do it the same day you lift weights though.

[WeCanDoThis]

From what I have read, moderate cardio helps raise testosterone initially, but something like over 30 minutes and it begins to decrease it because of the body's realease of cortisol. 

That sounds interesting and promising in relation to acne. Could you post a link please?