I know it's very frustrating to deal with this over a long period and feel like you are better now than when you started.
Thanks for the reply. I live in a small town on the coast of BC, and do not have access to any kind of specialist to preform tests. The only reason my family doctor put me on spiro was because a year of antibiotics (that he prescribed) didn't work and my mom and I came to him to beg for the 'script. Therefore, I've had to do my own research/diagnosis.
If you link to any of my other posts, you'll read that spiro worked for me for three years and then I started getting breakouts again. I was also taking glucosmart (after weaning off metformin). Around July this year, the spiro or glucosmart or both stopped controlling my acne.
Now I'm just in the trial and error stage (because I do not have access to a specialist). I was taking NPC every day because hearts (who got clear on it) is. I talked to her lots before starting the NPC treatment.
Now though, I haven't seen much improvement and am questioning the whole thing.
Also, I do breakout at other times of the month, but the nodules always come during my period.
Any other advice would be appreciated!Hi Brenmc,
Thanks . I have been taking NPC everyday. My worst breakouts are during my period. I know it takes awhile but I haven't seen much indication to show me it's working. I'm mostly stressed due to the painful acne and confusion over the right treatment path for me. I am going to add something to better regulate my insulin, like the powder.
With the exception of the first few weeks on NPC, my skin has not improved and it has been months. I'm going to lower my dose. I'm still taking spiro because I have issues like stray facial hairs (not lots but still). Also, I fear my acne would be worse without it. I'm thinking the glucosmart stopped working. And my estrogen (weight gain, long periods) has increased. I do not have the opportunity to get hormonal testing at this time.
Sorry to hear that But it hasn't been that long on NPC...it took hearts some months to see improvement. NPC doesn't work fast at first. Are you using it every day , or only during the times progesterone is supposed to be low? There are times of the month where progesterone peaks, and those days you might not even need it. The goal is to make sure there aren't many hormonal fluctuations that are too abrupt, like too many highs and lows.
I would say try pure inositol powder if you are looking something comparable to glucosmart. It's easier on the liver because you don't have to ingest a capsule.
Is there anything else in your daily life that could be contributing to hormonal imbalances, like stress or lack of sleep?
It's very unusual for a premenopausal woman to take progesterone daily. Typically it's taken only during the luteal phase (14-28) and most women unless they have a severe problem use it about 9 days.
Just to give you an idea of how dosing relates to severity of deficiency:
Mild progesterone deficiency:
50 mg miconized progesterone on days 16-26
Moderate to moderately severe:
50 mg miconized progesterone on days 5-15
100 mg miconized progesterone on days 16-26
It's very important to restore the natural cycle for optimum health and reduce the risk of cancer.
Unless something unusual is occurring, you should only be using bio-identical hormones. Transdermal progesterone doesn't work well. It's far better to use miconized oral progesterone. You take progesterone only in the evening, just before bed.
It's risky to modify hormones unless you are under the care of an informed doc.
One quick note:
You mentioned that your worst breakouts occur during your period. You should have a 28 day cycle with bleeding occurring from about days 1-5.
Testosterone is level with the exception of a peak at days 13-15.
Estradiol peaks and drops just before day 14, then follows a progesterone but at a lower level
Progesterone starts increasing at day 14, peaks at day 21 and is at baseline when bleeding starts.
Hormonal Acne is caused by elevated free testosterone
Progesterone opposes Estrogen
Estrogen opposes testosterone
Testosterone potentiates the effects of progesterone and vice versa.
The idea is to balance ALL hormones. Making small changes to several hormones can have a significant overall effect. In my experience (I'm not a doctor) most women require at least one hormone by age 40 to correct deficiencies only related to age (not a specific disease). All women should have a thorough exam prior to initiating treatment, including comprehensive serum (blood) testing. This is even more important when younger.
Based on what you said above, it appears that unopposed free testosterone that occurs just before your period is exacerbating the acne problem. I'm also slightly surprised you don't experience a breakout in the middle of your cycle. It could be that estrogen is unusually high at this point or some other issue with testosterone not peaking at ovulation.
To really know where to go from here your doc should be carefully looking at your lab data.
The blood work and exam are critical. I also understand there are access issues.
My take is that elevated free testosterone causes acne. Couple that with poor diet and it can be exacerbated.
When I posted initially here I made some comments regarding diet that resulted in negative feedback. I'm not here annoy and argue so I have been primarily focused on the hormonal side. I have an interest in hormones and this is where most of the heavy lifting occurs anyway.
Because you don't have access to the hormonal side, perhaps you would be willing to look at the nutritional side.
Modifying diet is extremely difficult in my view. I also have a very strong interest in health/fitness and understand nutrition and training fairly well.
Are you interested in logging your diet? Since this isn't a fitness issue, you could omit the quantities if that's a problem for you. The only way it will work is if you list everything you eat/drink. You could start with just a few days. Ideally we would have 30 days, however it may not be necessary if there are obvious problems.
Just to repeat, you must include everything, regardless of how trivial you think it might be. This also includes everything you drink. Start at 2 days. Also, you can't improve your diet for the logging period. You will want a baseline for comparison purposes.
Also look at endocrine disruptors/phalates and toxins that you may be exposed to.
If we look at the sex hormones of men today versus 30 years ago, there is a startling and statistically significant decrease that has occurred. There are men in the NHL that have the androgen levels of an 80 year old of 40 years ago.
We think this is related to xenoestrogens. These are estrogen like chemicals that exist in the environment that we are exposed to everyday that have unknown effects on the endocrine system. I will find a link and post that.
One quick example is household fragrances that are emitted daily from a dispenser. Some of these are known xenoestrogens, bind to the estrogen receptor and can result in potent estrogenic side effects. It's speculated that they may contribute to decreased hormone levels and some of the genital/reproductive cancers.
Also try and avoid other toxins in the environment. A few quick example is microwaving food in plastic containers, eating foods that have been overdone on the bbq or the bph on cash register receipts.
Edited by jlcampi, 27 November 2013 - 09:49 AM.