Hi everyone

I would be really grateful for any advice anyone can give me please. Im 39 and have had cystic acne for 25 yrs im currently on accutane for the 2nd time in 2 yrs day 16 at the moment. In the past my dermatologists have said that all acne is hormonal my spots tend to be in the chin area . ( alhough at the moment im breaking at everywhere ) . The cysts are very painful at times can keep me awake at night.

A mth ago at my wits end i went to the dr to ask for blood tests to find out if my hormones were out of synch i was tested for testosterone , tsh which is to do with thyroid all results have come back normal. I have since been tested for oestrogen and progesterone, lh and fsh again all normal and the testosterone has been done again . All in all i have have adrenal , ovarian , pituitary , thyroid all tested and all normal .

Is there anything i have missed out which i can request ?

I cant imagine i would have PCOS as i only have acne as a symptom and all bloods normal and periods normal but im at my wits end with it

any suggestions on anything else to be tested most welcome

thanks

Emma

x

Even if your hormones fall within the normal range, the ratio could be off. For instance, your testosterone: progesterone ratio might be unbalanced. I

Also, if you got blood tested, that won't reveal much because hormones change all the time. You should do a comprehensive saliva test that includes cortisol and all the thyroid panels. An ultrasound to check for polycystic ovaries might also be useful in confirming whether or not you have PCOS.

If it's your second time on accutane and your acne has returned, then it means that accutane is not targeting the issue, which could be hormonal.

I'm thinking what tests to take at the moment as well. Birth control no longer works for me, so I need to either find a medication or go on a different pill. I'm thinking definitely testosterone, estradiol, progesterone, TSH, FSH.

Thank you just logged into here first time in a week . I have had an ultrasound scan and PCOS has been ruled out. I have had thyroid tests and T3 i think and everything is normal i have had multiple TSH tests and they are fine. The testosterone has been tested twice and is normal i have had progesterone day 3 and day 21 taken both normal. I did ask about DHEA-S test but GP ( im in UK ) said no point as testosterone is normal. Im on accutane now but am ovulating thats how in tune with my body i am and i have just got a cyst on the jaw line no doubt more will follow this next day or so. Im waiting for the appt with the Dermatologist see what she says im going to ask about spironolactone thats the only one i havent tried . I need to find the cause no point going round in circles thanks for the advice and reply xx

 

Hi everyone

I would be really grateful for any advice anyone can give me please. Im 39 and have had cystic acne for 25 yrs im currently on accutane for the 2nd time in 2 yrs day 16 at the moment. In the past my dermatologists have said that all acne is hormonal my spots tend to be in the chin area . ( alhough at the moment im breaking at everywhere ) . The cysts are very painful at times can keep me awake at night.

A mth ago at my wits end i went to the dr to ask for blood tests to find out if my hormones were out of synch i was tested for testosterone , tsh which is to do with thyroid all results have come back normal. I have since been tested for oestrogen and progesterone, lh and fsh again all normal and the testosterone has been done again . All in all i have have adrenal , ovarian , pituitary , thyroid all tested and all normal .

Is there anything i have missed out which i can request ?

I cant imagine i would have PCOS as i only have acne as a symptom and all bloods normal and periods normal but im at my wits end with it

any suggestions on anything else to be tested most welcome

thanks

Emma

x

Even if your hormones fall within the normal range, the ratio could be off. For instance, your testosterone: progesterone ratio might be unbalanced. I

Also, if you got blood tested, that won't reveal much because hormones change all the time. You should do a comprehensive saliva test that includes cortisol and all the thyroid panels. An ultrasound to check for polycystic ovaries might also be useful in confirming whether or not you have PCOS.

If it's your second time on accutane and your acne has returned, then it means that accutane is not targeting the issue, which could be hormonal.

Most physicians are astoundingly ignorant in the area of endocrinology.

Post your lab data. Serum (blood) testing best. Can be combined with urine. Salivary tests are not useful as the reference range is too wide for most physicians to interpret and free levels fluctuate over a wide range daily.

1. The patient should be treated, not the lab form. Lab data is used to catch gross excesses or deficiencies and confirm a clinical diagnosis;

2. Your doc should have told you to test on day 21 of your cycle (I know- they didn't);

3. In pre-menopausal women on day 21 of cycle (bleeding starts on day 1):

Estradiol is optimal around 150 pg/ml

Progesterone is optimal between 13-23 ng/ml

SHBG optimal around 6.1 mg/L

Testosterone should be optimally around 8 pg/ml (free) and 350 pg/ml (total) - free has low diagnostic value

Thyroid (TSH) optimal around 1, T4 1.3-1.8 ng/dl (free), T3 2.5-3.4 ng/L (free)

DHEA Sulfate optimal around 2800 ng/ml;

4. Hormonal lab range data is nothing more than the 95% confidence interval for that lab's patient reference group. In English that means it cover 95% of those that get tested. Since elderly and sick or those suspected of illness get tested, the results are skewed toward the ill and old. Your doc won't know or recognize this either.

If your lab data is normal, then the problem is diet. Switch to a Paleolithic Diet and post everything you eat and drink after 1 week of implementation. Most people don't really follow the diet but claim it doesn't work.

Good luck. There is a solution. I speak from experience.