I think low progesterone can affect acne a lot, even. I'm not an expert when it comes to this, but I've understood that progesterone somehow "balances" or neutralizes the effects of other sex hormones. And I've thought that pre-menstrual acne is caused by decreasing levels of progesterone before menstruation, but I'm not sure.
You may have vitamin B12 or pholate deficiency that could've contributed to the macrocytic anemia, so it may be a good idea to include foods high in those vitamins (e.g. liver), or perhaps take supplements. But some other issues like blood loss or liver dysfunction can cause it as well. Vitamin deficiencies are the most common cause though. They will probably want to do more tests to define what's caused it for you. And also since thalassemia is a genetic issue apparently, according to Wikipedia, I don't know if that may have contributed to the macrocytic anemia.
I hope things will resolve for you now that you know what the issue is! Good luck!
Yeah, I researched low progesterone symptoms and acne is one of them. No idea why the doctor said it's not the main cause of my acne and that I should look at other possibilities. Then again, this was the same doctor who was convinced I should go on spironolactone because my androgens were high....So glad I got my hormones checked and refused to go on spiro or birthcontrol. Those are not for everyone, especially in complex situations. Even the doctor told me that spiro would have made things worse in my case, because it would have thrown my other hormones off balance too.
As for the anemia, my family insists it can't be thalassemia because they would have found out earlier - in mediterranean countires, they check at birth to see if babies have the thalassemia gene, which is not the same as full-blown thalassemia (which can require blood transfusion). So, once again, I will need to take more tests to verify...my trust in these particular doctors is ultra low right now! I have started taking B vitamins with folic acid to hopefully address some of the deficiencies.
Good luck to you too! Keep me updated on your progress! I haven't yet tested for insulin resistance but it's on my to-do list.