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jlcampi

Member Since 30 Sep 2013
Offline Last Active Jun 29 2014 10:40 AM

#3401663 Stumped With My Hormonal Acne

Posted by jlcampi on 17 December 2013 - 05:42 PM

You should take accutane that could scar


hmmmm.... well seeing as that is a "last resort" kind of drug, has crazy side effects, and doesn't always cure acne--and seeing that I am already seeing results from diet/lifestyle change and gentle skin treatment and haven't tried many other prescription oral or topical products---that is going to be a big NOT GONNA HAPPEN. I would only take it if my acne got really giant cysts and wasn't improving. I already have scars, but that was inevitable. Accutane doesn't reduce scarring--it reduces severe acne. I'm not trying to sound rude, but I just feel really strongly about those kinds of acne treatments.

Can you post your lab results? Docs are notorious for claiming levels are normal when they aren't.
The lab reference range is just the 95% confidence interval of the lab's reference group. Every lab must form their reference range from a reference group, typically a representative sample of their patients. This is why every lab has a different reference range. Since young healthy people don't typically get their labs run, the data is skewed toward the ill, elderly and sick. To be outside of their reference range, your results must be in the low or high 2.5%. To have levels lower than those those, your results must be more than 2 standard deviations from the mean.
The bottom line is this: having results in the lab's reference range does not necessarily mean you don't have a hormonal imbalance.

I think I will go check with medical records to see the results for myself, and maybe see if someone on the forum can help. That is a really good idea. I still think it is a hormonal imbalance, but if I don't know what is dominant or excessive, then I don't want to exasperate the problem by self treatment of the wrong type--does that make sense? 

Of course, it makes complete sense.  I also agree that self treatment is not wise.

If you post your results I can give you the optimal, probably deficient and probably excessive values.

With this information you will at leAst know if the problem is hormonal and will have something to chat with your doc about.

I use the Thierry Hertoghe's reference materials. He is a 4th generation endocrinologist and likely the world's foremost expert in hormone replacement.  He had has trained more than 5,000 physicians and developed extensive references and materials to support his methodology.


#3401622 Stumped With My Hormonal Acne

Posted by jlcampi on 17 December 2013 - 01:45 PM

Can you post your lab results? Docs are notorious for claiming levels are normal when they aren't.

The lab reference range is just the 95% confidence interval of the lab's reference group. Every lab must form their reference range from a reference group, typically a representative sample of their patients. This is why every lab has a different reference  range. Since young healthy people don't typically get their labs run, the data is skewed toward the ill, elderly and sick. To be outside of their reference range, your results must be in the low or high 2.5%. To have levels lower than those those, your results must be more than 2 standard deviations from the mean.

The bottom line is this: having results in the lab's reference range does not necessarily mean you don't have a hormonal imbalance.


#3401054 Estrogen Or Progesterone Causing Oily Skin/clogged Pores?!

Posted by jlcampi on 15 December 2013 - 04:58 PM

Looking for advice from anyone who might understand which hormone is most likely to relate to overly oily skin and clogged pores! Tonight is the night I'm going to be starting the Ortho Cyclen! I'm doing some research on which hormone relates to overly oily skin and clogging- and I keep coming across Estrogen dominance. How people with too much bad estrogen will see in increase in sebum and therefore skin issues. Is it possible at all that the increase in estrogen from the Alesse(0.2) and Seasonale(0.3) is what's causing my issues? Or is this even possible because they are both considered " Low estrogen pills". I'm trying to figure out if it's that or the progestrin with high androgen levels in both those birth controls that is causing the issues? I'm also reading that progesterone with high androgenic activity increases DHT levels- which increases oily skin too.
Please share your knowledge on how hormones work and which one it's most likely to be :( So confused, and I don't want my skin getting even worse with Ortho Cyclen being (0.4) in estrogen if that's what it is! Help!!
 


Elevated Free testosterone increases sebum production and is exacerbated by insulin.

The endocrine system attempts to maintain balance among the various hormones. When a particular hormone increases or decreases it can cause an imbalance of several other hormones.

Generally
Estrogen neutralizes testosterone
Progesterone neutralizes estrogen
Cortisol neutralizes DHEA
Progesterone can amplify the effects of testosterone.

In females, the primary source of free testosterone is DHEA  

It's best to do a complete female hormone panel and include 8 am cortisol to understand the problem.
If you do, make sure you go to the lab on day 21 of your cycle.


#3400882 Questions About Reducing Androgens & Spiro

Posted by jlcampi on 14 December 2013 - 01:18 PM

You could try with only 25mg. That was my starting dose, and, it cleared me up almost completely in just two weeks. I was fully expecting to have to go up to 50mg at least, because I was on 100mg per day ten years ago, and that was barely effective, but several accutane courses later, 25mg is doing a magical job!! 
 
Just a thought, if hydration, etc. is a concern.
 
Differin might help too, it's worth a try.  I have better luck with a combo of topical BP (benzoyl peroxide) and clindamycin, but you kind of have to try a bunch of things and see what works for you. 

Spiro is actually a hypertensive medication. It lowers blood pressure by antagonizing aldosterone. The anti-androgen effects are a side effect.

Aldosterone is the primary mineral corticoid and is responsible for keeping you properly hydrated. Since you will be starting intensive pt at boot camp, it really is very important to ensure that you are getting enough water, salt and other electrolytes.

Good luck in your training. We are all thankful for your patriotism and willingness to serve and defend us.

Ensuring that you get 1.2 grams of protein per pound of body weight for females will help with maintaining lean mass. Remember that meat is only about 22% protein. So if you eat 100 grams of lean meat, you are getting about 20-22 grams of protein.


#3400856 Stumped With My Hormonal Acne

Posted by jlcampi on 14 December 2013 - 09:11 AM

Hello all! 
 
Thanks for all your suggestions and insight. I have decided to stop researching for a little while, to see if the "remedies" are just exasperating my condition. I have taken all your advice in, and will continue eating a very clean diet, exercising, reducing stress, and drinking a lot of water. But as far as supplements and home remedies go, I am going to stop them all. I am going to see what my results are, talk to my doctor, and see my options. If my doctor decides to prescribe me a pill to balance my hormones or take birth control, then I will certainly take what she says into consideration. As of now, the acne has started to spread to a couple spots on my chest and shoulders, and it has been the tipping point for me. I think the stress of seeing all the possibilities of what is causing my acne is not making me live a normal life, and causing me to break out even more. I am going to try all my options, including hormonal treatment if necessary. I haven't been closed to prescriptions, I just have wanted to see if I could clear my acne by letting my body heal itself, or change my diet in order to do it. However, for my lifestyle, I don't think it is possible for me to do all the dietary changes, like omitting certain healthy foods from my diet because they might be affecting it. I don't want to feel guilty anymore for wanting a square of dark chocolate every once in a while, or for eating a couple dried figs--these are things I have eaten all my life and they have never once made me sick or given me allergic reactions. I don't want to deny myself pleasures and a social life if I can take one pill a day and get rid of my acne. For all of you who have suggested the dietary route: I am so respectful of you for finding a natural route to clear your acne, and have the self discipline to not eat caffeine or sugars, etc, or do a candida diet, but for me, I don't think that it is possible as a busy college student who is about to live in a place where having a special grain free, low salt, dairy free, sugars free, fruit free, caffeine free diet would be impossible and probably cause me to be ostracized by students who don't understand. Again, I am not looking for a quick fix--I never was. I was just looking for something that would fit my lifestyle as a poor college student who is scared to do anything drastic with her skin. 


I also think this a good plan.  When you step away from the research also leave the a anxiety and self conscious thoughts behind. The reality is that the vast majority of people don't care if you have acne. Someone as beautiful as you with such a great attitude will not have problems if you choose not to give others the power to control how you feel.

I have 2 cents that says your problem is elevated DHEA that is likely amplified by stress.  Really think about not giving others power over you by incessantly worrying about what they think or say. You really have no idea what they think or will do, so ruminating over this is a pointless stress inducing exercise.

If you can master this, it is such an empowering and liberating experience that will impact the rest of your life positively.  Good luck.


#3400394 Stumped With My Hormonal Acne

Posted by jlcampi on 11 December 2013 - 10:26 PM

Heitea,

I'm sorry if I offended you with my comment. There is nothing wrong with your face. You are very attractive. I too  am in the science business and can be very matter of fact. It comes off as arrogant and condescending at times.

The sign of hertoghe is a thinning of your outer eyebrow. If you don't know what to look for, it will won't even be noticed.

As far as the sub-orbital edema, that too is very mild.  

It's just a thought.

If you really want to know about the cortisol comment I will reply. What sucks for us, is that there is a huge amount of information on the endocrine system that our docs have chosen to ignore.


#3400238 Hormonal

Posted by jlcampi on 11 December 2013 - 10:11 AM


Why are you taking DIM and not something that lowers your testosterone instead? 
I don't think they should affect your fertility if they help raise free testosterone in your body. 

im not sure , i just read that DIM supplement helps control hormones and then i started taking it then i havent gotten any acne since then
 
so im confused why dim cleared my hormonal acne if it raises testosterone ?? also what are good hormonal supplements that actually work for getting rid of excess testosterone or andogens ? and is hormonal acne in male causes by excess estogen or androgens ?? kinda lost
Acne is primarily caused by elevated free testosterone and secondarily by elevated insulin.

DIM is a metabolite of indole-3-carbinol (i3c).  High quality i3c is unstable and must be constantly refrigerated to maintain potency. Most people use DIM as it's more cost effective and easier to manage.

Both of the supplements I just mentioned are found in cruciferous vegetables and are thought to reduce the incidence of prostate and breast cancer. Estradiol (E2) is a potent form of estrogen that metabolizes to several species. DIM and I3C positively change these ratios by metabolizing toward the more protective estrogen metabolites. Without this you may have a tendency to metabolize estrogen toward the inflammatory species of estrogen.

As far as i know the mechanism for reducing acne is not well understood.


#3399788 Sudden Adult Acne On Right Side Of Face

Posted by jlcampi on 09 December 2013 - 11:12 AM

Thank you all for responding!  I am very happy that I joined this site.
 


Environmentally you could be reacting to foods...sometimes even foods you have always eaten.  Although a one-sided reaction usually does not happen because of that.  More likely is a reaction to a new detergent or make-up or lotion.

 
I have been trying to see if anything is different in my environment, since I did recently move and started a new job.  It's the 2nd time I've moved in 2 years and to be honest, this move was a relief!! Before I was terribly stressed because I had to move back into my childhood home after grad school.  I've been using the same detergent, makeup, and products.  My apartment has carpet (that I shampooed 4 times) and no visible mold.  I've even had the water tested! No notable changes there.  
 
I am a vegetarian and I work out regularly.  I've been racking my brain trying to find something around me that would cause this change in my skin but I can't seem to find anything.  I am hoping it is stress related, but I would be surprised if it was.  The biggest source of my stress lately has been my skin :-/
 
Hopefully you are right and it will clear up on its own.
 
>

>
You need a female hormone panel, testosterone, cortisol 8 am, and DHEA sulfate to determine what's going on.
 
If you do blood testing make sure it's on day 21 of cycle with bleeding starting on day 1.  Day 21 is when progesterone peaks...
 
If you think you have PCOS make sure you get both Estradiol and Estrone.

>
 
I think you are right.  I will ask to have my hormones checked out at my next appointment.  Even though I am focusing only on my acne right now, it's best to know what is going on with my body.    
I feel you! You case sounds so similar to mine except that I am 26.. and had no insurance to see a doctor.. I got painful acne on my right side too which happened right a particularly stressful event in my life! I was wondering what I did wrong especially because I ate clean and exercised regularly. It was mostly through trial and error that I found out what worked for me - a cocktail of vit A, vit E, chelated zinc, borage seed oil capsules and DIM. I know it sounds like a lot, but within 3 weeks of diligently taking this my breakout stopped and the acne healed quickly too. Also I stopped drinking regular milk now and switched to almond milk. I do continue eating yoghurt on and off that hasnt caused a problem! I use Cetaphil cleanser every day and a salicylic acid peel every 2 weeks to help with the scars. If I do see an occasional breakout during the time of my period I use colloidal sulphur and it has really helped! I hope this helps you out! Good luck and keep your chin up :) 

Dairy can significantly contribute to acne. The Milk Industry made a huge impact on the American diet when they convinced us than an UNHEALTHY product "does a body good".

Milk is only acceptable when non-pasteurized and whole from heifers that are grass fed, free range and organic.  We generally won't find that palatable.  It's also difficult to find a source like this.

From an overall health and in particular an acne based perspective, it's best to avoid all dairy.


#3398395 Testosterone Levels In Women!

Posted by jlcampi on 02 December 2013 - 06:54 PM

 

 

 

So I got the results of my blood tests back, and I'm very confused. I have oily skin, HEAVILY congested cheeks (they look puffed up they're so lumpy), inflammatory acne here and there and dark upper lip hair (and lower lip hair) that I have to remove. I'm also quite prone to fast growing, dark leg hair and arm hair. I recently started spironolactone, but I started it AFTER my blood test. My results were this on the 21st day of my cycle:

 

Sex hormone binding globulin - 44 nmol/L.

Serum TSH level - 2.66 mU/L. This is my thyroid, I've been hypo for about a decade. It's a little higher than usual so I increased my dose a bit.

Testosterone level - 1.4 nmol/L.

Progesterone level - 17.6 nmol/L.

 

EDIT: I actually found another chart that says my levels are normal, so I'm just gonna throw my hands up and trust my Doctor on this one. Now if only I could get them to do the proper set of thyroid tests instead of just TSH, I'd be pretty content. smile.png The one other thing I noticed is that while 17.6 nmol/L for progesterone indicates successful ovulation, it's supposedly not ideal according to charts. My periods were very regular at that point, but they've been thrown out of whack by Spiro. Two periods this month. sad.png

 

There seems to be a lot of opinion/variation thrown around on optimum hormone levels, which is kind of annoying. Also, the nmol/l vs ng/ML differences are a pain.

 

Always test female hormones on day 21 of cycle.  Day  1 is first day of bleeding.

 

Unfortunately your doc ordered an incomplete female hormone panel.  What we need are the following:

 

Total Testosterone 

Free Testosterone (not as important as total as free fluctuates)

SHBG

DHEA Sulfate

FSH

Estradiol

Progesterone

LH

Cortisol 8 am

 

I can comment on what we have but it isn't complete.  Without Estradiol we can't go very far as this is the hormone that neutralizes the side effects of elevated testosterone.

 

The following are optimal levels:

Progesterone: 41-73 nmol/L; YOU ARE DEFICIENT at 17.6

Free Testosterone: 1.2 nmol/L: YOU ARE ABOUT OPTIMAL AT 1.4 

Serum TSH; 1; YOU ARE PROBABLY DEFICIENT AT LEVES OVER 2.5.  YOU NEED FREE T4 AND FREE T3 PLUS THYROID ANTIBODIES TO KNOW MORE. most patients do the best on Armour Thyroid.  It's desicated porcine thyroid that consists of approximately 35% T3 and 65% T4.  Your doc will give you a million reasons why it doesn't work.  He/she are mistaken.

SHBG. 65 pmol/L; Your levels are reported in nmol/L.  Converting it makes the number too large.  What is the reference range reported on your lab report?

 

YOU REALLY NEED:

 

DHEA SULFATE

LH

FSH

ESTRADIOL

CORTISOL 8 AM

Please test on day 21 of cycle

 

Yes, progesterone is low, but we don't want to supplement until we know what is going on with estradiol.  If it's also low, then progesterone can amplify the effects of androgens.

 

The LH/FSH ratio will tell us if the source of our androgens is adrenal or ovarian.  If adrenal, and your cortisol is low, then you can supplement with Medrol.  This will inhibit DHEA production and also act as a anti-androgen.  It also will block the action of DHT and help with any facial hair.  

 

If the source of the androgens is ovarian, then estradiol is used to neutralize the side effects of testosterone.

 

Also work to reduce insulin by not eating grains, sugar, dairy.  Try and eat meat, vegetables and fruit 5 days per week.  

 

Fruit increases the conversion of T4 to T3 and may help with your thyroid problem.  

 

I had such a long post typed up and then actually backed out of the window. Here we go again. I found the other test information - it was halfway down the page because the receptionist printed the results twice onto the same piece of paper and it's all overlapping. Heh. I think I have everything but cortisol and DHEA sulfate. I've put the reference ranges in, too. I think the only thing that I'm missing is cortisol, which is unfortunate. The tests were originally ordered to check for PCOS, and were done on the 21st day as you said.

 

For some reason there doesn't seem to be any reference ranges for SHBG, which is weird. I thought I found a conversion tool that said my SHBG was actually on the low side of normal, but I could be wrong.

 

EDIT: Found the chart, it says my SHBG is normal? On the low side of normal, but still normal. I read  that low SHBG is related to hypothyroidism, so that's not surprising, I guess.

 

FI7j3lx.png


Progesterone level: 17.6 nmol/L.

 

Follicular: <5.4 nmol/L.

Periovulatory: 1.2 - 18.7 nmol/L.

Mid Luteal: 19.1 - 76.2 nmol/L.

Luteal: 3.3 - 71.2 nmol/L.

 

Oestradiol level: 617 pmol/L.

 

Follicular: 90 - 716. pmol/L.

Luteal: 147 - 958 pmol/L.

Pre ovu: 243 - 1509 pmol/L.

Post menopausal: 37 - 145 pmol/L.

 

LH level: 12.7 IU/L.

 

Follicular: 3 - 12 IU/L.

Mid cycle: 2- 80 IU/L.

Luteal: 3 - 16 IU/L.

Post meno: >30 IU/L.

 

FSH level: 3.3 IU/L.

 

Follicular: 0.5 - 5 IU/L.

Mid cycle: 8 - 15 IU/L.

Luteal: <8 IU/L.

Post meno: >30 IU/L.

 

I thought my LH was high originally because people claim a 1:1 ratio is best for LH/FSH, but I was on the 21st day of my cycle which is apparently when LH levels soar, so that looks fine.

 

Regarding my thyroid tests.. I would LOVE it if I could get the full tests for my thyroid. I'm diagnosed hypo already and I'm getting treatment, but I'm on a very standard dose and they like to keep me at a level of 2.5ish, for some reason. I caught a glimpse of my history and they'd actually marked 1.9 as 'low'. The NHS refuse to order the full panel of tests, saying that TSH is enough. Hypothyroidism runs in my family. My brother is hypo to the point where they don't think his thyroid is functioning at all. My aunt was hypo up until she hit 50ish, then she kept swinging between hypo and hyper so rapidly that they just killed her thyroid with radiation to make medication easier. Neither of them suffer with acne or skin problems, outside of the occasional teenage spot my brother gets (he's 18). His skin texture is sublime. EDIT: They do have keratosis pilaris on their arms, which I've somehow dodged. My arms and legs are very smooth, so I don't think it's KP on my face.

 

I mostly just dose by my symptoms these days. I've noticed that if my dose is too low, I'm cold/tired and the outer third of my eyebrows falls out. My elbows also crust over. When I increase my dose a little, my eyebrows grow in, my elbows smooth out and I'm not as tired and cold.

 

Thank you very much for your posts and help!

 

Another edit: I'm a normal weight (107 @ 4'11"). I'm also 22. I was recently tested for diabetes as well and I'm all good there.

 

Thanks for the follow up.

Optimal Estradiol: 550 pmol/L;  You are slightly over at 617, however with the progesterone deficiency I would expect you are experiencing bloating, anxiety, breast tenderness, swollen breasts and excessive menstruation.

 

LH: 2-4 mIU/mL; you are 12.7.  Elevated LH is likely due to progesterone deficit. (LH is highest at ovulation or day 14)

PCOS is probable when LH>FSH and Estrone greater than Estradiol on day 21 of cycle

 

So, it looks like you are experiencing estrogen dominance.  This is resolved with bio-identical progesterone before bed.  Generally micronized progesterone taken during the luteal phase.  

 

Still need DHEA Sulfate and 8 am cortisol.

Most women with acne have elevated DHEA.

Thanks for your post. I might not be able to get DHEA Sulfate and Cortisol for a while as my Doctor referred me to a derm and doesn't seem interested in going the hormonal route anymore. If I do, I'll make sure to post it up.

 

Thanks a lot for all your advice, though. I did some reading on estrogen dominance and symptoms of hypothyroidism like tiredness, lethargy and cold hands and feet are all estrogen dominance related. My hands and feet are sometimes so cold that when I touch people, they'll yell at me or shriek because my fingers are ice. It's worth reading into a little more, I suppose!

 

Very good.

 

Cold hands and feet are unquestionably signs of hypothyroidism.  Your thyroid controls metabolism and temperature.  Your doc probably doesn't know this but when you are dosed correctly there is between a 5 and 20% difference between your winter and summer thyroid dosage (lower in the summer).

 

Hypothyroidism will affect your other hormone levels as well.  Correct the thyroid problem and some of the other issues may resolve or decrease in severity.

 

Also tell them not to treat the lab form but to treat you.  You reach optimal hormone levels when your symptoms disappear, not when you reach some predetermined number like 2.5.

 

If you find at some point that you have elevated DHEA Sulfate, you can ask your doc about trying dexamethasone.  It will inhibit your adrenals and reduce both cortisol and DHEA output.  It will also tend to act as an anti-androgen.

 

Good luck! 




#3397192 Vitex (Agnus Castus) And Saw Palmetto

Posted by jlcampi on 26 November 2013 - 09:48 AM

Hi Wishclean.
No I'm not a doctor. I am familiar with endocrinology, in part, because the subject area interests me.
There is zero chance hirsutism is caused by elevated estrogen. It's only caused by unopposed DHT. As I mentioned you need to understand the testosterone source to come up with the best treatment plan. It could be adrenal (but may not be) based on your last comment. You mentioned melasma in your last post. That could be caused by a cortisol deficiency.
Cortisol is the most important hormone in the human body. If levels drop low enough it becomes a medical emergency and without intervention death can occur. This hormone is responsible for regulating blood pressure, regulating the immune system, fighting inflammation, increasing dynamism and regulating glucose. It's incredibly important to have this hormone regulated if you are correcting thyroid hormone, IGF-1. growth hormone or melatonin.
A few common signs of cortisol deficiency are - fatigue, excessive negativism, feeling like you are a victim, low stress tolerance and periods of yelling and screaming. The latter is caused by an increase in ACTH attempting to stimulate cortisol production by the adrenals. Since this isn't occurring, adrenaline is produced instead.
8 am cortisol should be around 20.
Hormone testing:
The female hormone cycle is well known. Depending on what the complaint looks like we may want to test on a day other than day 21, however testing on a day when progesterone and estradiol just dropped to relatively low concentrations isn't going to provide AS MUCH information. It isn't useless.
Generally, the best lab testing is to combine serum (blood) with urine. It depends what you are looking for though. Saliva testing has some benefit, however it's diagnostic value is low. So why don't we like it? You end up with a free hormone value (free hormones fluctuate substantially throughout the day) and a reference range for the analyte that is large. This makes interpretation more difficult.
You can test for testosterone just about any day of the month (slight increase at ovulation). Best tests to order for testosterone are:
Total testosterone
SHBG
Androstanediol Glucoronide (fist metabolite of DHT)
Of course we need the adrenal androgens, female sex hormones, fsh, lh, etc, etc.
Histamine:
I suggest you order the Array 1 panel from Cyrex labs. This is a saliva sample.
Www.cyrexlabs.com
This test will look for a gluten intolerance. If it comes back positive, then try Array 4 next. This will test for cross gluten sensitivity based on specific foods.

I would think that based on chronic stress and some mid-section weight gain, my cortisol is high, not low. Again, symptoms of high and low cortisol overlap, which makes it confusing. I'm not even sure they are testing my cortisol. The doctor's office didn't like the fact that I was asking too many questions about the blood test (bc I didn't think it would be that useful) so I didn't get a chance to see which hormones they are checking. I'm pretty sure though they are not checking for all testosterone, which is frustrating. 
Right now I'm betting on high androgens (or androgen sensitivity) and high estrogen, with low progesterone. I'm treating high testosterone with inositol, which has reduced my hirsutism, but I still get some breakouts around ovulation and my period. Not sure if I need to up my inositol dosage or not, because when I first started taking it, it minimized all those breakouts, even the ovulation ones. 

Hi Wishclean:

I'm not familiar with overlapping symptoms of cortisol deficiency/excess. They symptoms look very different. If you have chronic stress it may be that your adrenals are fatigued, leading to cortisol deficiency.

Extreme cortisol deficiency results in a vey thin sillouette.
Extreme cortisol excess results in muscle wasting (thin legs and arms), a large square-like torso, purple stretch marks on the upper body and a "moon face". Your face will look nearly round and very large.

At ovulation estrogen drops and testosterone increases. Since estrogen neutralizes the side effects of testosterone you get not only increased testosterone, but it's unopposed since estrogen declines.

Testosterone doesn't change at the end of the month but estrogen drops off. So, you seem to get acne when estrogen declines.

Would you be interested in posting your lab work?  

Lef.org is a great place to purchase lab work without having to nag the doc. You can order what you want and it's discounted if you are a member. They also have an annual sale that drops the pricing further.

Note that DIM is NOT an aromatase inhibitor, i.e. it does not inhibit the CYP19 enzyme.
 
DIM upregulates CYP1A1, CYP1A2 and CYP1B1 enzymes. This increases the speed at which you clear active estrogen from the body, or in other words converts estrone and estradiol (two types of estrogen) into estrogen metabolites. DIM generally gives you more "good" estrogen metabolites (2OH and 4OH) than "bad" estrogen metabolites.
 
However these metabolites that DIM promotes are still estrogenic. What is the benefit? Well, the metabolites are not as estrogenic as estradiol. So the hope is that you reduced your overall estrogenic activity a little bit. Here is where the effects of DIM will vary from person to person.
 
No reduction in estrogen from DIM can occur because:
 
1. In some, the increase in estrogenic activity from the increased estrogen metabolites is roughly equal to the reduction of precursors estradiol and estrogen. So DIM didn't do much for this person.
2. DIM requires certain cofactors in the body to work. We don't really know what all these cofactors are. DIM's results can vary from person to person without a clear answer why. 
 
Increase in free testosterone:
 
Increased estrogen metabolites from DIM can increase free testosterone by knocking them off binding proteins. Generally in someone with more bad metabolites than good, adding DIM will increase good metabolites but will also increase free testosterone. However...
 
Decrease in free testosterone:
 
Some people already have high levels of "good" estrogen metabolites, or 2OH and 4OH. Raising these levels further with DIM creates negative feedback on testosterone that outweighs the estrogenic effects of the estradiol and estrone you had before DIM. 
 
Umm...what?
 
Now, as interesting as this all is, it's not an easy thing for the average person to determine if DIM will have the desired effect. 
 
In my opinion, DIM does not work very well if you are trying to decrease androgenic and estrogenic activity at the same time. If you don't care about a possible rise in androgenic activity (e.g. if you think you mostly have a progesterone/estrogen balance problem, not an androgenic problem), then go for it.
 
But for those of us who clear primarily on anti-androgens, DIM is a poor choice. Personally, it made me break out while still on 100mg of spiro after a very long time being clear. 
 
We can go on for pages and pages about all the possibilities here, but in the end, you can either spend a lot of time finding a practitioner who gives a shit, and has actually looked at research since they graduated from medical school, and then paying them an arm and a leg to take some tests. And hopefully between the two of you, those results will give you something that can be translated into take this drug -> clear your skin. 
 
Or you can take the cheap way and just try something, and record how you feel and how your skin fares. It's not terribly scientific, but it doesn't cost an arm and a leg, either. 
So what...
 
So if you just want to inhibit estrogenic activity, honestly I would go for an actual aromatase inhibitor, not DIM.
 
There are over-the-counter compounds that are supposedly aromatase inhibitors, if that's a route you're interested in going.
 
If you have estrogen dominance, though, it's worth noting that spironolactone is not the way to go either. Estrogen dominance is not going to be solved by taking an anti-androgen with some estrogenic properties. For estrogen dominance you're better off with progesterone supplementation.
 
Study on "natural" products as aromatase inhibitors
I also want to note that DHT itself inhibits aromatase. But I haven't seen conclusive evidence showing that inhibiting aromatase through other means (drugs, supplements) does the reverse and increases DHT.


Yep. I know of no well informed, competent doc that treats estrogen dominance with aromatase inhibitor or dim as first line treatments.

Progrsterone is always used to treat excessive estrogen in women. If testosterone is contributing to this through excessive aromatase activity and everything else has been tried, then possibly an aromatase inhibitor can be used caution.

This will sound arrogant and condecending, however after a decade or more of studying this material, I truley believe that the vast majority of physicians were not trained in endocrinology, are uninformed on the subject and  don't believe it has much relevance in the clinical picture.

Even more frustrating is this phenomena is not limited to the physician. It also extends into the research community.  Because of their ignorance they tend to design studies that are baseless (don't consider the full breadth of our understanding) and then end up with an erroneus conclusion.  A perfect example of this is a recent study indicating that Omega 3 fatty acids cause prostate cancer. Complete BS.


#3394646 How Much Fat Required To Survive

Posted by jlcampi on 13 November 2013 - 11:07 PM

Acne is caused by elevated free testosterone and poor diet.

Dairy with yogurt being the biggest violator, chocolate sweets etc.

A make-shift paleo diet won't cut it. Get Loren Cordain's book on the subject, follow it precisely and make sure you eat 100% grass fed, organic meats.

Dropping fat will result in a potential hormone balance and could increase inflammation and glycation.

10 is very young. Did you experience precocious puberty?