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Took The Plunge - Started Spiro

Know Hope


This is going to be really long, to record what discoveries I've made in the last few months.

The TL;DR version: I'm now taking a low dose of spiro and supplementing with a dab of progesterone cream for the 2 weeks prior to my period. Also, I found a really good article that breaks down PCOS and acne and how to treat it holistically: http://ndnr.com/web-articles/dermatology/treating-pcos-acne-from-the-inside-out/


Last time I wrote I was frustrated with a breakout from supplements that left me with a strange, sebaceous hyperplasia looking lesion that lasted for almost a month. The rest of my skin was okay, but that one lesion really bothered me. Long story, short, for whatever reason, I experience abnormal wound healing whenever I get a very deep pimple which is far more distressing then any acne, because it's impossible to cover up and looks really strange, like a raised, round doughnut on the skin.

There is not a lot out there about sebaceous hyperplasia, but I did learn that scientists showed it can be induced when skin is injected with IGF. IGF is lowered when SHGB is raised - I thought about supplementing with green tea to raise my SHGB but quickly became discouraged by the evidence that green tea might raise testosterone.

Feeling depressed, I decided to try spiro since it has shown to be effective with SH, so I made the appointment with my derm.

Meanwhile, I have known that spiro can exacerbate estrogen dominance, so I thought, why not try to detox my body of the "bad" estrogen in preparation for spiro? My choices were DIM or Indole 3 Carbinol; the herbalist I go to had previously recommended I3C.

I took one pill a day for about 5 days during the week or so leading up to my period and experienced excruciating pain in my breasts, severe acid reflux and of course, a big breakout on my chin.

My theory is I flooded my body with phytoestrogen and released some of the "bad" estrogens and it was too much for me - maybe my liver needs more support - at any rate, I caused a major flare up of estrogen dominance.

I noticed something interesting, however. In the past, my main problem was noninflamed acne on my cheeks, with the occasional inflamed pimple that would resolve once the plug came out. Lately, my inflamed acne has gone way down and now my break outs are concentrated in my chin area and it always happens two weeks before my period like clock work.

The last two breakouts I had on my chin were weird - just these hard inflamed bumps that oozed clear liquid and a bit of watery puss - no real plug in them. Both have taken forever to heal. My theory is these are cysts caused by estrogen dominance.

So things have started to click for me. The two weeks leading up to my period is when I break out - before I never understood why, because everything you read says that's when your progesterone levels shoot up. But what I finally realized that is what a normal, healthy body is supposed to do, but if you have PCOS, then your ovaries get the message to create more estrogen and testosterone. I menstruate regularly, so I know I create progesterone, but I guess I'm a bit sluggish about it. Or maybe instead of just flipping one switch for progesterone, my body flips all 3 switches at once. Once my period comes and my estrogen and progesterone are at an all time low, my skin calms down and I convince myself I've beaten my acne only for it to get bad again in 2 more weeks.

I started taking 25 mg of spiro and for the last few days I'm taking 50 mg of spiro and I think this will be enough for me. I am at that 14 day mark of my period when I get my usual flare up, and sure enough two cysts popped up on my chin. They were smaller, but angry and painful.

I popped one and a tiny miniscule plug came out, but otherwise it was clear liquid, almost like a blister. Not like my usual pimples. And so strange that such a tiny plug would cause that level of pain/inflammation.

On the other one, I put a tiny amount of progesterone cream (Emerita sp?). Immediately, it became less inflamed. Today, it looks like there will be no need to extract the plug and that it will just go away.

So I am going to continue with spiro and take it along with vitex to encourage my body to produce progesterone/counteract any estrogen that is produced by the spiro. Days 14-26 I'll supplement with a small dab of progesterone cream - less than what is recommended because I want to be careful. According to articles on the internet, I may not have to take progesterone cream forever - I just need to retrain my body to make it on it's own at the correct levels. Progesterone inhibits alpha 5 reductase so maybe I won't have to take spiro forever either.

I'm going to keep taking the rest of my supplements that I know are good for me - like fish oil, chromium, etc. I'm also taking b-6, magnesium and zinc leading up to my period - this is supposed to fix the luteal phase defect, which is what I'm guessing I have (my ovaries produce more estrogen and testosterone instead of the right amount of progesterone to induce ovulation).

I'm going to keep taking milk thistle because it's good for my liver and fiber pills because it keeps me regular - all just to keep metabolizing and ridding my body of estrogen.

I'm going to keep treating my insulin resistance, for general health and well being. I've cut back on carbs and will keep eating better, for many health reasons.

I am not going to worry about blocking my body of estrogen for right now- my two experiments with that has not been good for me.

I feel like I've finally figured things out. I've known about spiro and progesterone cream for a long time, but didn't feel like I understood my body, cycle enough to take them. I am far from cured, but my gut is telling me that I finally found something that will work for me. I have read about horrible initial break outs from spiro and how progesterone can cause a flare up of estrogen dominance. But the truth is, if you're fiddling with your hormones, it's very unpredictable how your body will react. In the end, however, it's probably hormones that are causing your acne so it will take some trial and error to figure out what's going on.

So if anyone is reading this, my advice is this simple: know thyself. If you're a woman with acne, get a handle on your menstrual cycle. Experiment with one new supplement at a time to figure out how your body reacts. Consider that the two weeks leading up to your period, your skin might be more temperamental than usual and that might not be the best time to try something new.

And this article really is extremely helpful at explaining why women with PCOS deal with acne, and how to treat it, whether you're going for an all natural treatment or not: http://ndnr.com/web-articles/dermatology/treating-pcos-acne-from-the-inside-out/.

Best of luck to everyone out there!

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It's been over a year that I've written. I can't figure out how to write a new blog post , so I'll respond to my last post.

My acne has dramatically improved better since going on spiro plus taking a few key supplements and changing my diet.

What I'm taking right now:

-50 mg spiro per day - I started by taking two 25 mg per day because it made me feel dizzy at first. Now, it's no problem to take the full dose at once. I did get an initial breakout, which sucked, but it was mostly on my lower back and went away fairly quickly.

-Vitex - to help regulate progesterone to keep my estrogen levels in check (since spiro promotes estrogen)

-Calcium/Magnesium and Zinc combo pill - this gives my body the materials it needs to create progesterone. Also, these minerals are good for lots of other reasons.

I was able to get passably clear just on that combo above, but noticed whenever I ate a carb heavy meal I felt oilier and more prone to break out. I read the book Sugar Nation and it convinced me to try a low carb diet, because while acne sucks, the prospect of diabetes, heart disease and alzheimers is much scarier. I already knew that I had PCOS and that insulin resistance is interrelated, but when I read the book I recognized myself and my family and it convinced me to change my diet - something I'd never done.

-Diet - low carb, similar to atkins or south beach. I eat as much dairy (cheese and cream, no milk) as I like and I try to limit the carbs I get from grains to no more than 30 grams per day. I went through the carb flu for a couple of days but when I got through it, I felt better with more energy and my skin looked amazing.

Eating low carb is hard to do 100% of the time - it takes lots of planning and will power. So what I do now is I strive to eat healthy 80% of the time. The rest of the time, I eat what I want. I just make sure to take supplements to reduce the impact carbs have on my body. Those supplements include:

-Chromium - I should take this all the time honestly

-Cinnamon - I'll take before a high carb/sugar meal

-White Kidney Bean extract - this is a carb blocker that I'll take before a high carb meal. It does not work on sugar.

Last, but not least:

-Gluccomannan - this is a fiber that helps regulate blood sugar and cleans you out really, really well. For me, this was the missing puzzle piece. Since taking this, I've experienced NO pre or post menstrual symptoms. Before gluccomannan, I still had sore breasts before my period - it wasn't bad, but it was still there and I attributed that to the spiro producing extra estrogen in my body. RIght before my period I would feel deeply sad and would cry over every little thing. And then after I started my period, I would get a severe migraine. I would have one day a month that I felt like utter crap and couldn't get anything done. Now, I feel great pretty much all month long which is a minor miracle for me. I attribute all of this to my estrogen levels sky rocketing and then crashing once my period started. What I think happened is the gluccomannan cleaned out the excess estrogen that was in my body. As most of know, estrogen dominance is a real problem for men and women.

Tips for going low carb

- Find a good low carb tortilla. I like one made by Santa Fe Tortilla company that I found at walmart. They taste really good if you pan fry them with a bit of olive oil. I make chicken quesadillas and pizza pockets with them and it satisfies that craving for something bread-like.

- Atkins makes good frozen meals for breakfast and dinner. Good to have when you're first trying out low carb or don't feel like cooking.

-Atkins also makes good deserts/treats like a peanut butter cup or m&ms. I know a lot of people advise you to cut out sweets completely, but for me, I just need a little taste of something sweet here and there.

-Cauliflower - I love this vegetable! I slice it up and roast it and eat it with ketchup. A fantastic potato replacement!

-whipped cream - when I'm craving something sweet, a squirt of whipped cream does the trick too. It's gotta be the real stuff, from heavy cream though.


-for a while I wasn't using anything, but I decided to get back on Finacea and AHA. This combo works really well on hyperpigmentation which I'm prone to, even with a small breakout. Studies have shown this combo to be as effective as 4% hydroquinone. In small amounts it doesn't dry me out and I can wear it under make up.

Things I need to do:

-I'm not good at eating small meals/snacks every 2 hours and when you are on a low carb diet, you really need to eat more often. I'm pretty sure I have something that's called reactive hypoglycemia so I need to get better about packing snacks and planning out my meals better.

-I'm still not exercising. I have a lot more energy though - after a meal, I feel energized, not lethargic, which I love. So for me, it's a matter of finding the time. The good news is that with just diet alone, I've lost about 10 pounds and I'm wearing jeans from when I was in my early 20's. If I exercise, I'll allow myself to cheat on my diet a bit more.

Things that did not work for me/I choose not to continue:

-Indole 3 Carbinol - this gave me the worst break out of my life. It's supposed to remove the "bad" estrogen. For me, I think it added a crap ton of estrogen to my body. My recommendation is to incorporate more fiber into your diet and take a fiber supplement like gluccomannan.

-B6 - the only reason this did not work for me is because it counteracted with spiro and gave me a rash. I know this because Dr. Weil has a post about b6 counteracting with estrogenic drugs. Otherwise, ladies should be taking b-6 in combination with their Calcium, magnesium and zinc the two weeks before their period because this will help your body produce progesterone.

-progesterone cream - nothing bad happened with this, but I think you should focus on getting your body to produce its own progesterone rather than supplementing with a cream.

-tazorac/retin a - everyone raves about retinoids and since I'm getting older, I thought I'd try to use it for anti-aging, but it just does not work for me. It makes my skin oily with dry patches.

If you're on the fence about spiro or you're a guy who is rightfully worried about taking an anti-androgen, I would try everything else that I did, including the supplements and dietary changes. Read up on insulin resistance and metabolic disorder. The amount of sugar and carbs is to blame for SO many health problems. Acne is just the tip of the iceberg. But the good news is there is a lot you can do to reduce insulin resistance.

I hope this helps someone out there! I had chronic, difficult to treat, hormonal acne for my entire adult life. I've also dealt with depression and a lack of energy for decades. All of that stuff is GONE! It's amazing and so worth it to take control of your health. Best of luck to you guys. You deserve all the health and happiness in the world :)

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