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What Is The Deal With Hormone Testing?

hormone blood test

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#21 MoonlitRiver

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Posted 14 September 2013 - 05:29 AM

First of all, the "normal" range is too broad and you might still have an imbalance if you are within the normal range. For instance, you might be on the lower end of the "normal" range for progesterone, but for your body that might still be too low.

I had blood testing done too and the only hormone that was low was my progesterone, but they told me that everything else seemed normal. Blood testing is highly unreliable because they only draw blood once during your cycle, and so it's impossible to account for all the hormonal fluctuations that happen on various stages of your cycle. Also, the typical blood testing hormonal panel for acne/PCOS/hirsutism doesn't cover ALL hormones. This means they don't check for variants like free testosterone (only regular testosterone), estrogen dominance, and comprehensive thyroid testing. I happened to get tested during a time in my cycle where my skin always calms down, so no wonder they couldn't detect anything majorly off. 

I'm getting a full hormonal panel test using saliva testing this time. Even though this isn't 100% accurate either, they have you submit a saliva sample during 3 or 4 times of your cycle so that they can give you a sense of how your hormones fluctuate throughout the course of a month. That might be an option for you if you want to figure out which hormones are causing your imbalance, so that you know exactly how to treat it. Standardized birth control/synthetic hormones don't benefit all women equally. They might fix one issue(e.g. the hormones causing the acne), but tip the scale towards other imbalances (e.g. weight gain) because they are not customized to your body's needs.

 

Thanks so much for all the info WishClean! I think I understand it all a little better now. When they did the blood test I'd already started on Dianette so I'm fairly sure that would have swayed the results. Before that there was definitely no way my hormones could be considered "normal". I don't know if I'd be able to get the saliva test done but I will look into it because it does sound like it takes a little more account of the variables. I do see what you mean about standard birth control not being tailored to an individual's hormonal imbalance but I'm not really sure what else you can do to adjust your hormone levels to something more normal. The Dianette has been helping the acne a bit I think (although I'm also on antibiotics and Epiduo so it's hard to know how much the birth control is helping on its own) but it does make me eat like a horse! It's not a bad thing at the moment because I was a bit underweight beforehand anyway but hopefully it won't become too much of a problem in the future. Thanks again for all the info and advice! :)



#22 WishClean

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Posted 14 September 2013 - 03:27 PM

There are actually some ways to manage which hormones and what quantities you get for your body. It's called bioidentical hormone therapy, but it's definitely more expensive than going the conventional route. The doctor prescribes the right amount of hormones for you, and they come in the form of a cream, pills, or lozenges. When I was on diane 35 (stronger than dianette), the doctor also prescribed androcur (which you can't get in the US, but it works like other anti-androgens) because any estrogenic/progesterone bcp can raise testosterone indirectly because it increases the ratio of testosterone: estrogen & progesterone in the body. Also, pills like dianette can cause weight gain if you are getting more estrogen than your body needs. I was eating like a horse too, and it really messed up my metabolism because I gained weight that I couldn't lose easily. I had to practically starve myself and exercise a lot to lose 1/2 a pound. I was normal weight when I started, so at first I didn't mind a bit of weight gain, but then it spiraled out of control. I was also getting very depressed and scared of other side effects, so for me it was not the way to go.   



#23 MoonlitRiver

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Posted 15 September 2013 - 05:58 AM

There are actually some ways to manage which hormones and what quantities you get for your body. It's called bioidentical hormone therapy, but it's definitely more expensive than going the conventional route. The doctor prescribes the right amount of hormones for you, and they come in the form of a cream, pills, or lozenges. When I was on diane 35 (stronger than dianette), the doctor also prescribed androcur (which you can't get in the US, but it works like other anti-androgens) because any estrogenic/progesterone bcp can raise testosterone indirectly because it increases the ratio of testosterone: estrogen & progesterone in the body. Also, pills like dianette can cause weight gain if you are getting more estrogen than your body needs. I was eating like a horse too, and it really messed up my metabolism because I gained weight that I couldn't lose easily. I had to practically starve myself and exercise a lot to lose 1/2 a pound. I was normal weight when I started, so at first I didn't mind a bit of weight gain, but then it spiraled out of control. I was also getting very depressed and scared of other side effects, so for me it was not the way to go.   


Thanks for the reply again WishClean. I've never heard of bioidentical hormone therapy but it sounds ideal. I live in the UK though and I seriously doubt that it would be available on the NHS. I'm a bit confused now because I thought that Dianette and Diane 35 were the same thing. The one I'm on is under the brand name Co-Cyprindiol and contains 2mg of Cyproterone Acetate and 35 micrograms of Ethinylestradiol if that means anything to you. I've heard of androcur but I don't know if they prescribe it in the UK. I have a dermatology appointment next Friday though so I might ask them about it. I seem to be always hungry on this pill it's really annoying. I really hope it doesn't make me gain too much weight that I then can't lose! Is depression a side-effect of these kind of pills? The thing I've been most worried about is the DVT risk but I generally just try not to think about it too much! Other than eating more than usual I haven't really seen any bad side-effects from it so far *touch wood*. 



#24 WishClean

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Posted 15 September 2013 - 12:06 PM

The side effects won't be evident until you take it long term. It's not recommended for long term use. Usually doctors will prescribe diane or dianette (which I think is the lighter version that was formulated after they assessed the side effects of diane) for a few months, and then switch you to a different pill after that time period. For me, it caused mood swings, bloating, and weight gain. It screwed up my metabolism.

Androcur is a European drug, so it should still be available in the UK. I was on it over 10 years ago, but women still take it. The combination of both diane and androcur was too strong for me. The can both cause weight gain. As for the depression, if you are prone to it then anything that messes with your hormones has the potential to affect your mood. 

When I was a student in the UK, my experiences with the NHS were horrible. The doctors were clueless about hormonal acne and they would just throw pills at me to see what happens with no real concern about my health. One time, they gave me yaz and an anti-depressant, as if that would fix the problem! Needless to say, my cycle got very messed up and even on birth control my periods were never regular. I eventually turned to herbs and supplements to regulate my cycles. It's been over 5 years now since I quit taking birth control and antibiotics (although I did take antibiotics for an infection for a short period of time almost 2 years ago), and my periods are now regular. So yeah, I don't have much confidence in the NHS or doctors who prescribe hormonal treatments without doing a full hormonal panel test first. 

Also, I think you are right in avoiding accutane, especially if your acne is hormonal. Accutane will suppress the acne but will not get to the root of the problem, that's why hormonal acne returns after accutane treatments. 

You should start monitoring your cycles and acne breakouts to see if there is a pattern. My worst flare ups happen during ovulation (mid-cycle) rather than before or during my period...that's how I know there's something hormonally off. But they have been more mild since I started eating healthier and taking some supplements. 


Edited by WishClean, 15 September 2013 - 12:08 PM.


#25 MoonlitRiver

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Posted 16 September 2013 - 10:52 AM

The side effects won't be evident until you take it long term. It's not recommended for long term use. Usually doctors will prescribe diane or dianette (which I think is the lighter version that was formulated after they assessed the side effects of diane) for a few months, and then switch you to a different pill after that time period. For me, it caused mood swings, bloating, and weight gain. It screwed up my metabolism.

Androcur is a European drug, so it should still be available in the UK. I was on it over 10 years ago, but women still take it. The combination of both diane and androcur was too strong for me. The can both cause weight gain. As for the depression, if you are prone to it then anything that messes with your hormones has the potential to affect your mood. 

When I was a student in the UK, my experiences with the NHS were horrible. The doctors were clueless about hormonal acne and they would just throw pills at me to see what happens with no real concern about my health. One time, they gave me yaz and an anti-depressant, as if that would fix the problem! Needless to say, my cycle got very messed up and even on birth control my periods were never regular. I eventually turned to herbs and supplements to regulate my cycles. It's been over 5 years now since I quit taking birth control and antibiotics (although I did take antibiotics for an infection for a short period of time almost 2 years ago), and my periods are now regular. So yeah, I don't have much confidence in the NHS or doctors who prescribe hormonal treatments without doing a full hormonal panel test first. 

Also, I think you are right in avoiding accutane, especially if your acne is hormonal. Accutane will suppress the acne but will not get to the root of the problem, that's why hormonal acne returns after accutane treatments. 

You should start monitoring your cycles and acne breakouts to see if there is a pattern. My worst flare ups happen during ovulation (mid-cycle) rather than before or during my period...that's how I know there's something hormonally off. But they have been more mild since I started eating healthier and taking some supplements. 

 

Yeh my doctor's only prescribed me 6 months of it but I haven't been able to discuss what will happen after that yet. The only bad thing it's done to me so far is make me eat way too much! I might look into the Androcur if it's a European drug. I haven't noticed any particularly bad mood effects, if anything I feel better in myself than I did before taking it (probably because the acne's improved and I'm no longer on my period almost constantly), but I am on anti-depressants anyway so that could be a factor. 

 

I'm sorry to hear you had such a rubbish experience with the NHS when you were a student. I think they're really good on some things and not so good on others and they do often seem to treat the symptoms rather than the cause. I'm on antibiotics for the acne as well now. It's a bit frustrating that nobody bothered to explain the results of my hormones tests to me though because I'm fairly convinced my acne is hormonal, though I can't really explain why it got so much worse this summer in particular.

 

Thanks, I am very keen to avoid Accutane because a) I think the side-effects are very downplayed by doctors and I don't want to do something that has the potential to affect my overall health for the rest of my life unless I'm utterly desperate and b) I don't trust it not to play havoc with the depression that I already have anyway. I have heard that hormonal acne comes back after Accutane treatments as well so in all likelihood it might be completely ineffective for me anyway.

Can you monitor acne breakouts in relation to your cycle even if you're on the pill and antibiotics? I literally have no idea how my acne relates to my cycle because before taking the pill I effectively didn't even have a cycle and was just getting breakouts all the time. It has improved a lot now but I do still break out unfortunately. 



#26 WishClean

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Posted 16 September 2013 - 12:21 PM

Yeah, usually they'll prescribe it short term, then either take you off bcp or switch you to another pill like yasmin. Wow, you are on a lot of things right now. Be careful  because all those pills you are taking can cause digestive issues and liver problems. At least take some probiotics to make sure the antibiotics don't kill all the good bacteria in your gut. If the antibiotics and bcp are working, then you might not be able to track your breakouts because your hormones are changing already. I still had some breakouts around my period while on bcp, so I don't think they cleared me 100%. I was too depressed about my weight and had crazy mood swings to even care about the state of my face, so I don't remember how well each pill cleared me. The one I do remember because I wasn't as depressed was kariva - it comes in other names too, but that made my blood sugar drop abruptly and my legs were getting numb a lot so I stopped it after about 2 years I think. 

I was prescribed antidepressants a few times, but again I was getting numbness and the doctor took me off lexapro after 2 days, so that was my only experience with antidepressants. What has helped me tremendously is a high dose of vitamin D, which my new doctor prescribed because I was deficient. Within 1 week, my mood changed and I have been feeling much better since supplementing with vitamin D. So if you ever consider getting off the anti-depressants, check your vitamin D levels to see if it would benefit you to supplement with it. 



#27 MoonlitRiver

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Posted 16 September 2013 - 12:38 PM

Yeah, usually they'll prescribe it short term, then either take you off bcp or switch you to another pill like yasmin. Wow, you are on a lot of things right now. Be careful  because all those pills you are taking can cause digestive issues and liver problems. At least take some probiotics to make sure the antibiotics don't kill all the good bacteria in your gut. If the antibiotics and bcp are working, then you might not be able to track your breakouts because your hormones are changing already. I still had some breakouts around my period while on bcp, so I don't think they cleared me 100%. I was too depressed about my weight and had crazy mood swings to even care about the state of my face, so I don't remember how well each pill cleared me. The one I do remember because I wasn't as depressed was kariva - it comes in other names too, but that made my blood sugar drop abruptly and my legs were getting numb a lot so I stopped it after about 2 years I think. 

I was prescribed antidepressants a few times, but again I was getting numbness and the doctor took me off lexapro after 2 days, so that was my only experience with antidepressants. What has helped me tremendously is a high dose of vitamin D, which my new doctor prescribed because I was deficient. Within 1 week, my mood changed and I have been feeling much better since supplementing with vitamin D. So if you ever consider getting off the anti-depressants, check your vitamin D levels to see if it would benefit you to supplement with it. 


Ah ok, well I really hope they transfer me onto another pill when I have to come off this one then because I do think it is significantly helping both the cycle and the acne problems. I am still breaking out sometimes but mostly with whiteheads now whereas it used to be great massive cysts all the time. I'm definitely not clear yet but have noticed a big improvement in the last couple of months so that's a positive. 

I know, I hate being on so many things at once. :( I'm on Dianette, Lymecycline and Sertraline every day as well as Epiduo topically. I really hope I'm not doing my digestive system or my liver too much damage! It is something that's been worrying me. I was having one of those little Actimel drinks every day but I recently ran out of them so haven't done so for a while. Is there a brand of probiotic you would recommend? I looked into them when I first started the antibiotics but I wasn't sure which would be best to get so I tried the Actimel instead in the end. However, as I've been trying to avoid dairy as well the Actimel isn't really ideal.

What you mention about vitamin D is really interesting because I am actually extremely worried about coming off the anti-depressants when the time comes in case I revert back to how I was before. I honestly don't think I'd cope with that a second time round so I will definitely look into vitamin D supplements if they might help in any way.

Thanks for all the advice! :)



#28 WishClean

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Posted 16 September 2013 - 01:51 PM

Some anti-depressants can worse acne btw. I have a friend who is always on anti-depressants and is not acne prone, and when her doctor switched her to a new one she was breaking out a lot. So you may want to google your anti-depressant's side effects and see if there are people complaining about acne.

Digestive enzymes and a dairy-free probiotic can help your body cope better with the medication, and even absorb those pills more efficiently. I take PB-8 vegetarian formula probiotic, but I'm not sure if you can get it in the UK. I'm sure Boots has many options too, just make sure it doesn't have dairy, gluten, corn, gelatin, sugar, etc. The first time I took probiotics I tried Solgar's Acidophilus and they were pretty good. Solgar is one of the best supplement companies in Europe, and they don't put too much crap in their capsules. You could start with just acidophilus and see how your body reacts to it. I read that some strands of probiotics can exacerbate acne, so acidophilus would be your best bet. I took acidophilus after coming off birth control and it helped me regulate my metabolism and lose the bloating from bcp. 



#29 MoonlitRiver

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Posted 17 September 2013 - 10:38 AM

Some anti-depressants can worse acne btw. I have a friend who is always on anti-depressants and is not acne prone, and when her doctor switched her to a new one she was breaking out a lot. So you may want to google your anti-depressant's side effects and see if there are people complaining about acne.

Digestive enzymes and a dairy-free probiotic can help your body cope better with the medication, and even absorb those pills more efficiently. I take PB-8 vegetarian formula probiotic, but I'm not sure if you can get it in the UK. I'm sure Boots has many options too, just make sure it doesn't have dairy, gluten, corn, gelatin, sugar, etc. The first time I took probiotics I tried Solgar's Acidophilus and they were pretty good. Solgar is one of the best supplement companies in Europe, and they don't put too much crap in their capsules. You could start with just acidophilus and see how your body reacts to it. I read that some strands of probiotics can exacerbate acne, so acidophilus would be your best bet. I took acidophilus after coming off birth control and it helped me regulate my metabolism and lose the bloating from bcp. 


Oh dear. Well acne isn't listed at all as a side effect in the leaflet but when I Googled "Sertraline and acne" it came up with loads of people saying they'd had outbreaks of cystic acne whilst taking it. Now I don't really know what to do. Are there any anti-depressants that don't cause acne? If I've caused my own cystic acne this summer by choosing to ingest an anti-depressant then I am going to be absolutely livid at myself! 

Thanks for all the advice on probiotics. There are so many different ones that it's really difficult to know where to start with them but I'll definitely look up the ones you mentioned and see if I can get hold of any of them. :)



#30 WishClean

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Posted 18 September 2013 - 12:20 PM

So the antidepressants could explain why your acne suddenly got worse. I noticed some of my friends getting acne when starting anti depressants, and they previously had clear skin. The only natural anti depressant that doesn't cause acne is vitamin D grinwink.gif






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