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Don't Let Me Down Liver!

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Hello everybody,

I've been looking at this site for years, so it's high time I posted something. I've had moderate but extremely persistant acne since the beginning of high school. I've been seeing dermatologists since graduation, and I am now a junior in college. Like mostly everyone else, I've tried everything: BP, antibiotics, BCPs, natural/herb things, dairy-free diet, all 3 types of differin, ziana, and now finally Accutane. I've been on it for 2 months, and I think I might be finally clearing up a little. The side effects are easy to deal with. I have dry lips, of course, some eczuma on the back of my hands, no more oily hair (yay! I used to be uncomfortable if I went more than a day without a shower), and a few sporadic but mild headaches and backaches. My problem is that after 1 month on 40 mg/day at 116 lbs, my liver enzymes were elevated! They were supposed to be 40 or under, but mine was 65. They cut my dosage in half for the second month, but I'm still freaking out that I won't be able to continue with it. I didn't drink alcohol, caffiene, protein shakes, nothing that would mess it up. I even sat on my butt for the week before the test because I didn't want to increase them by exercising. I had a cold last time, so could that have messed them up? I'm healthy now and I have another test on friday. Please let me know if anything like that has happened to you, and more importantly, did your levels go back down? I really want to continue with this medication!

Oh, and disclaimer: yes, I do know why it is important to go off the medication if it's too harsh on my liver. Some people get the impression that I think my face is more important than my health. Rest assured that I didn't go on Accutane lightly- that's why I tried so many other options before I chose it!

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Hi!

I had no idea that your liver enzymes can increase from working out. I'm so glad I read your blog before I joined a gym!

Good luck with everything!smile.png

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Thanks for the reply! Don't use that as an excuse to not work out at all (although that's tempting, i know haha). Excercise can help with blood flow to your liver and helps to flush all the bad stuff out of your system. I think it's only a few days prior to the blood tests that you're allowed to be lazy.

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Update time!

It's the day of my blood test, and I feel like I'm getting sick again. I had a cold for 2 weeks when I first started Accutnae. That one I caught a few days before. Then 2 weeks after I got over that one, I got another cold for a week, this time in my sinuses instead of my throat. And now, 8 weeeks in, another one is coming :( I can't tell exactly how bad it'll be, but I'll ask the derm about it. It is the middle of cold and flu season (everyone get your flu shot!), but I'm going to check just to make sure. I'm ok with toughing it out if it's not anything dangerous. As for my face, I can't tell if it's still on the IB stage or starting into the clearing stage. It could go either way at this point. Wish me luck on my blood test!

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Went to the derm yesterday, and my liver labs are back to normal- thank god! They put me back on 40mg a day, although apparently that's still a very low dose for me. I'm a little afraid they will go back up again on the higher dose. The derm couldn't really explain to me why my liver freaked out in the first place. Even before Accutane I rarely drank, and i didn't do drugs or smoke. I don't even drink coffee! Do I just have a crappy liver? Or maybe did my time on antibiotics damage it? I was on solodyn for 6 months a few years ago and on doxycycline for 2 months a little bit before I started Accutane (cant remember the dosages). Fun fact, you can live with 3/4 of your liver gone, but I would really it rather not come to that. Does anyone have any ideas as to what's going on?! Please help!!!

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My doctor called again today, she wants me to get my blood drawn in two weeks to check on my liver. Since going back on the 40 mg, my lips have gotten drier again and my face is breaking out like no tomorrow. I'm not even sure if they are really big whiteheads or cysts at this point. I'm drinking tons of water and trying to eat healthy, but I feel like there really is no magic formula to convince my liver to behave. If anyone's reading, I could really use some words of encouragement :/

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I think its good that your doctor is keeping an eye on things, accutane is a serious drug. If anything I wish my derm demanded more blood tests, had the initial blood test but didn't have one on my one month checkup and wasn't told anything about one before my next checkup, though initially she did say there would be regular blood tests. I'll definitely be asking for one next checkup (3 months). I should say that my side effects have been mild otherwise, my initial bloods were fine and my dosage wasn't increased and is relatively low for my body weight, 40mg @ 76kg/165pounds.

I'm also not drinking whilst on my course, and didn't for a good several months before, pretty much only drink water and milk and eat a relatively healthy diet and don't think there's much else I can do to try to keep my liver healthy whilst on accutane. Maybe I could eat more vegetables? I don't think you should worry too much as your last labs came back fine and you had a cold the first time, just keep doing what your doing.

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I think its good that your doctor is keeping an eye on things, accutane is a serious drug. If anything I wish my derm demanded more blood tests, had the initial blood test but didn't have one on my one month checkup and wasn't told anything about one before my next checkup, though initially she did say there would be regular blood tests. I'll definitely be asking for one next checkup (3 months). I should say that my side effects have been mild otherwise, my initial bloods were fine and my dosage wasn't increased and is relatively low for my body weight, 40mg @ 76kg/165pounds.

I'm also not drinking whilst on my course, and didn't for a good several months before, pretty much only drink water and milk and eat a relatively healthy diet and don't think there's much else I can do to try to keep my liver healthy whilst on accutane. Maybe I could eat more vegetables? I don't think you should worry too much as your last labs came back fine and you had a cold the first time, just keep doing what your doing.

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Oh and before I forget- Do you guys know if the times that you take your pills matter? I take mine with breakfast and dinner, but sometimes my schedule puts those really close together. Could that be making the medication levels spike? I'm going to try to take them at least 10 hours apart for the next two weeks, but I think I'll need to get some more food for late-night accutane snacks.

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I'm pretty sure it's better to take with food than to take it exactly every 12 hours, so I just make sure I take it with breakfast and dinner every day.

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Ok then, I'll keep trying to spread my meals far apart. I'll ask my doc and see what she says next appointment.

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Good news this time- my liver enzymes are normal! I can stay on my 40 mg dose for now. Now they just have to stay that way for the next two weeks. I hope I don't have to get blood tests that often for the rest of my treatment, that'll be a pain (I'm currently relying on friends to drive me the half hour there and back, and I hate asking for rides).

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Question for everyone: How do you deal with nosebleeds?

My nose is weird in the first place from genetics, so I'm used to getting a few nosebleeds every winter. But now, 3 months into accutane and 3 colds later, I'm getting nosebleeds pretty much every day :( it's not painful or anything, just really annoying. I need some way to let it rest and heal in a moist environment. I blast my humidifier every night, I recently got some saline spray that's helping a little, and I put a Q-tip with bag balm up my nose every night (I should be using vaseline, I know, but I haven't had a chance to get that yet). Any other ideas?

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Ranting time...

One of the most stressfull things about this medication is not the side effects, but the logistics of the iPledge program. I am stuck on my campus without a car, so I have to rely on friends every month to get me to the doctors office a half an hour away. After a week of asking a half-dozen people for rides, no one could take me today. I had to call the office 5 times in one morning to get them to reschedule for monday. I just ran out of my pills today- do you know if it's ok to go 3 days with no pills?

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3 days is no biggie. You'll find people on here who have missed a week and not had a big effect on their course. Next time, if you think you'll run out, you can lower your daily dose to make your pills last longer.

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Ok, thanks, that's good to know. I had a feeling that I was going to run low, so I only took 20 mg on Thursday and Friday. I'm glad that's all settled. Now if only my uncomfortable pustules would go away...

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Had another doctor's appointment yesterday. The PA told me that my liver levels will probably stay down- they were at baseline when I got them tested two weeks ago. However, they do want to keep me on my low dose of 40 mg until the weather starts getting warmer/less dry. She said I could stay on it for up to 5 more months! Guess I'll be hanging around here for a while longer. I've been looking at my pictures (I take some every month), and it looks like I am slowly improving on the 40 mg dose. However, I found at least 3 nodules on my jaw. I've never had those before :( It's a very slow process. I'll look like I'm improving for a day, break out for another week, and then repeat the cycle. I can't wait until I actually see significant improvement!

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Just puked up my pill :( I made the dumb@## decision to take it with just a yogurt and some cheerios. That was NOT enough food. I should have known, my stomach is pretty sensitive. Make sure you remember to protect your precious stomach lining everyone! Also, my cheeks are covered in nodules. This is a pretty rough night.

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My face has calmed down a bit for the time being, but I think I have two big zits coming up on my chin. I'm attending a formal dance on friday, does anyone know how to at least make them 2 dimensional? I've had a lot of problems with popping zits, and I know that they'll just be a big mess if I try it now. Any advice?

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Just in case anyone is actually reading this...

My face has calmed down a lot since my last appointment (I'm officially 4 months in now). Most days, I don't get those uncomfortable zits all over anymore! I asked my derm about the scarring on my face, and she said that the majority of it is just red marks that will fade with time. I'm glad about that, I'm not thrilled about the prices for scar treatments. They bumped me up to 60mg for this month, so I'm hoping that that'll get rid of all my little comedones too. I'm still getting some nosebleeds, but that usually happens when I forget to use my humidifier or my aquaphor or something like that. I'm so glad that it's finally working!

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