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How To Pass Your Accutane Tests

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#1 Antony

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Posted 06 April 2005 - 02:19 PM

Dermatologists are concerned primarily with three major areas of analysis in your blood work both for baseline testing and routine tests (usually monthly) throughout your course: elevations in blood lipids/fats (trigylcerides), elevations in total and/or LDL (bad) cholesterol, and fluctuations in the levels of transaminases and blood proteins which indicate liver function.

Anyone would want to minimize Accutane's tendency to produce these effects not only to ensure that they can complete a full course to full effect, but also to preserve their general health both during and after treatment.

Accutane significantly risks raising triglycerides, cholesterol, and altering liver function test results, sometimes to the point that a dermatologist will, out of concern for a patient's health, reduce dosage or even suspend treatment. In order to get the most bang for your buck with Accutane, follow these steps to make these complications as unlikely as possible, both for the sake of your treatment and the greater sake of your general health.

1) To lower triglycerides: http://www.loweringc...r-triglycerides

2) To lower total and/or LDL (bad) cholesterol: http://www.loweringc...ldl-cholesterol

3) To raise HDL (good) cholesterol: http://www.loweringc...hdl-cholesterol

4) To track, both in self-observed symptoms and blood work results (a copy of which you are entitled to from your derm every time, which you should request), the levels of transaminases and blood proteins measured for liver function, and to correspondingly take steps to raise or lower them: Go here http://my.webmd.com and in "Search" type in the particular protein in question for your liver function, say "bilirubin," and read the article that comes up. Scroll down to "Low to High Values," where it discusses what factors contribute to higher or lower values outside the normal range, and then implement one such factor so long as it's not contraindicated with Accutane. So, for example, for excess bilirubin you're probably not getting enough sunlight exposure and you should increase stooling, stimulate better bile flow, drink green tea, etc.

P.S. The above sites provide measurements for cholesterol and triglycerides in US units. Cholesterol and triglycerides are expressed in different units between the US and the rest of the world (ROW); to convert them, ask your physician/derm for the conversion ratio between US and ROW units.

#2 Guest_Avian_*

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Posted 06 April 2005 - 02:24 PM

Thanks, the information there looks useful. One question: Can possible long term side effects of roaccutane be reduced by having healthy levels of these substances?

#3 peace

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Posted 06 April 2005 - 02:32 PM

nice tips, thanks,

im upset because i went and got my blood work done a few weeks ago. When i went for the consultation with my derm he said that everything was ok, except that the levels related to my liver were way too high. He asked if i had drank close to the test, which i had (two nights prior), and said that was probably the problem. What upsets me is that they told me to fast which i did, but never mentioned anything about alchohol before the test. I dont know, maybe i should have known not to drink beforehand, but i thought two days would be alright. Anyways, i have to wait ten days and then take the test again to make sure it was the booze...then wait for the test....hopefully its not liver disease...i just want to start the damn course and that definetly slowed down progress

anyways my point is: dont drink within ten days of your blood test to ensure it doesnt throw off your liver test.

#4 Antony

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Posted 06 April 2005 - 02:42 PM

QUOTE(Avian @ Apr 6 2005, 08:24 PM)
Thanks, the information there looks useful. One question: Can possible long term side effects of roaccutane be reduced by having healthy levels of these substances?

View Post



There are side-effects on Accutane that are similar to those of vitamin A poisoning, like dry skin, lips and eyes and more rarely joint inflammation among countless others (you've read the litany), and then there are the issues with cholesterol, blood fats and liver function. Taking steps to alleviate the former, such as with supplementing vitamin E 800-1200 IU/day and drinking 3+ L/day of water, won't directly help with cholesterol, trigylcerides and liver function, and vice versa. However, when a derm looks at your blood tests, the latter 3 are what they are looking at, as indicative of the INSIDE side-effects that you and they can't see (unlike dry lips, which are self-evident). Taking steps to lower your cholesterol, triglycerides, and stabilizing liver function is the best way to minimize that particular very important area of side-effects (like elevated blood fats and impaired liver) that can result in lowered dose or suspended treatment, with obvious implications for your chances at resolving your acne with a course. Also, it's important to do your best to keep your health as sound as you can while bombarding your body with the vitamin A toxicity that is Accutane, and the above links suggest the safest ways of doing that (supplementing with Pantethine, Guggul, Policosanol, Curcumin, etc.)

#5 unluckyguy

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Posted 06 April 2005 - 02:48 PM

Do not take vitamin E. It will look like it is helping with side effects, but actually it is hurting accutane. Accutane works by restricting sebum production, vitaimin E works by enhancing sebum production.
Vitamin E is already omnipresent in food, so do not take extra supplements, your oil glands will not get damaged enough if you take those and accutane will not have the desired effect of long term remission.

Also in an effort to reduce cholestrol do not cut out fat completely, it will cause less accutane to be absorbed which is not what we want.
Take liquid fats and avoid solid fats to reduce cholestrol.

#6 karen2906

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Posted 06 April 2005 - 02:53 PM

QUOTE(unluckyguy @ Apr 6 2005, 04:48 PM)
Do not take vitamin E. It will look like it is helping with side effects, but actually it is hurting accutane. Accutane works by restricting sebum production, vitaimin E works by enhancing sebum production.
Vitamin E is already omnipresent in food, so do not take extra supplements, your oil glands will not get damaged enough if you take those and accutane will not have the desired effect of long term remission.

Also in an effort to reduce cholestrol do not cut out fat completely, it will cause less accutane to be absorbed which is not what we want.
Take liquid fats and avoid solid fats to reduce cholestrol.

View Post


thanks for the info. i hear a lot about people who take vitamin e supplements to "help" with healing and dryness. i haven't bothered because the 2 Accutane pills are hard enough to swallow (pun intended. hardy har har). also, i don't want to bombard my body with other things to metabolize and I don't want anything getting in the way of Accutane!!!

#7 Antony

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Posted 06 April 2005 - 03:01 PM

QUOTE(unluckyguy @ Apr 6 2005, 08:48 PM)
Do not take vitamin E. It will look like it is helping with side effects, but actually it is hurting accutane. Accutane works by restricting sebum production, vitaimin E works by enhancing sebum production.
Vitamin E is already omnipresent in food, so do not take extra supplements, your oil glands will not get damaged enough if you take those and accutane will not have the desired effect of long term remission.

Also in an effort to reduce cholestrol do not cut out fat completely, it will cause less accutane to be absorbed which is not what we want.
Take liquid fats and avoid solid fats to reduce cholestrol.

View Post



My derm actually recommends taking vitamin E with Accutane to reduce the chances of dry eye, which can become a permanent side-effect. I doubt it significantly inhibits the action of Accutane (and I certainly wouldn't describe anything as "hurting" Accutane-- after all, it's Accutane that's hurting your body-- that's how it works!). I'm not sure of any evidence pointing to vitamin E's ability to significantly reduce Accutane's effectiveness, but it's an interesting suggestion and worth us looking into.

You're right about the need to maintain a sufficient intake of dietary fat as Accutane enhances fat metabolism to reduce overactivity of fat (oil) glands in skin, and it's absorbed almost twice as much in studies when consumed with a fatty food. That being said, a major avoidable side-effect that can jeopardize the course is dangerous elevations in blood fats and cholesterol, so suppementing with the herbs recommended in the above links are a viable way of improving health, reducing side-effects, optimizing blood work results while on the drug and all without inhibiting its effectiveness whatsoever.

#8 unluckyguy

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Posted 06 April 2005 - 03:20 PM

From what I read and what my derm said, the only known effect of accutane is to shrink the oil glands all over the body. That is how it controls acne.
Everything else is side effect resulting from that and general vitamin A overdose symptoms.

Vitamin E helps the oil glands, accutane hurts the oil glands to control acne, so vitamin E not good with accutane. As simple as that smile.gif

It is fine to deal with the side effects like dry eyes, lips by adding drops, balm but taking vitamin E is extreme for that IMO.





#9 Antony

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Posted 06 April 2005 - 04:15 PM

QUOTE(unluckyguy @ Apr 6 2005, 09:20 PM)
From what I read and what my derm said, the only known effect of accutane is to shrink the oil glands all over the body. That is how it controls acne.
Everything else is side effect resulting from that and general vitamin A overdose symptoms.

Vitamin E helps the oil glands, accutane hurts the oil glands to control acne, so vitamin E not good with accutane. As simple as that smile.gif

It is fine to deal with the side effects like dry eyes, lips by adding drops, balm but taking vitamin E is extreme for that IMO.

View Post



Thanks for the tip about vitamin E. The exact mechanism of isotretinoin has never been fully disclosed by Roche, even in 23 years since it patented the drug as Accutane and in the 3 years since the patent expired to free it up for generics, but it seems to desensitize the receptors on oil glands to stimulation by androgens in addition to regulating how fats are metabolized in terms of their effect on the fat/oil glands, and it seemingly does this by altering DNA transcription (not changing one's genetic makeup but changing how genetic instructions are followed by certain cells, in this case oil gland cells). The resulting effect of all this is the atrophying of oil glands. So it basically destroys your oil glands (thus the dryness).

Are there any other vitamins besides vitamin E (and vitamin A, obviously) that you think should not be taken while on Accutane, and any vitamins or other supplements that you think should be taken?

#10 unluckyguy

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Posted 06 April 2005 - 04:28 PM

I take the following

vitamin B and C : nothing to do with accutane per se, just to help me get more energy for my workouts and it is rumoured to help with red marks from old acne
fish oil supplements: to reduce muscle pain during my workouts
zinc/copper : hoping that it helps with wound healing

I wanted to take vitamin E, it helped my dryness, but soon I actually started feeling my skin oily, which is ridiculous to happen while on tane, so that is when I concluded it is stupid to take Vitamin E while on tane, becuase you are helping your oil glands which you should not.

I am open to trying out other supllements except some "liver cleansing supllements" which was popular in this board some time ago. My concern is accutane is stored in liver, so if the supplements cause liver to throw it out then I dont want it...



#11 Antony

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Posted 06 April 2005 - 06:50 PM

QUOTE(unluckyguy @ Apr 6 2005, 10:28 PM)
I am open to trying out other supllements except some "liver cleansing supllements" which was popular in this board some time ago. My concern is accutane is stored in liver, so if the supplements cause liver to throw it out then I dont want it...

View Post



No, this isn't accurate. Accutane fully exits your system within 29 hours at most, with an average elimination time of 21 hours. Its effect upon the oil glands persists not because any amount of Accutane remains in the liver, but because during the course it has broken the acne cycle by altering how the oil glands respond to hormonal instructions from androgens telling them to produce oil (in acne sufferers the oil gland receptors are oversensitive and/or the androgen levels are imbalanced)-- it has in a sense destroyed the oil glands.

On the contrary, after a course of Accutane you SHOULD be especially good to your liver as it is undoubtedly weakened after Accutane (that's the point of the Liver Function Tests, to make sure that even though your liver is being impaired to varying degrees, at least you're not getting liver disease). Even if you don't want to do a full-on liver flush, you should consider supplementing with liver cleansing herbs, and then liver building herbs, cycling back and forth between them for 2 weeks each. This has absolutely no effect on whether your Accutane will continue working or not: IN FACT, many people break out again after Accutane precisely BECAUSE their liver has been weakened by Accutane and is now even LESS capable of dealing with the same remaining internal hormonal imbalances. The liver is even MORE compromised in its ability to cope with the burden of hormonal imbalance (it is the liver's job to deactivate and eliminate excess and used hormones) because it has been weakend by Accutane. So liver cleansing and building herbs will actually ENHANCE the remission of acne achieved by a course of Accutane, in addition to helping the liver to recover from the hepatoxic nature of the drug.

#12 yoohoo422

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Posted 22 November 2005 - 02:21 PM

Wow! Lots of great info here! So the Vit. E seems controversial. Not so stir things up again, but anyone have any more thoughts about taking Vit. E, or any websites that could help with this question..

#13 monopoly

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Posted 03 May 2011 - 12:12 AM

Hey,

I'm just curious with your update. Did you end up getting another blood test done without drinking prior to it? How were your results the second time around and how are you finding Accutane?

QUOTE (peace @ Apr 6 2005, 03:32 PM) <{POST_SNAPBACK}>
nice tips, thanks,

im upset because i went and got my blood work done a few weeks ago. When i went for the consultation with my derm he said that everything was ok, except that the levels related to my liver were way too high. He asked if i had drank close to the test, which i had (two nights prior), and said that was probably the problem. What upsets me is that they told me to fast which i did, but never mentioned anything about alchohol before the test. I dont know, maybe i should have known not to drink beforehand, but i thought two days would be alright. Anyways, i have to wait ten days and then take the test again to make sure it was the booze...then wait for the test....hopefully its not liver disease...i just want to start the damn course and that definetly slowed down progress

anyways my point is: dont drink within ten days of your blood test to ensure it doesnt throw off your liver test.



#14 Grind

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Posted 04 May 2011 - 02:16 PM

thanks for the links for mitigating the tain side effects

i'll probably be on 10mg per day of tain for the rest of my life, so this stuff should give me an extension on that