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*ShiningStar*

Some questions/guidance regarding PCOS, Spiro and Retin A

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I'm now convinced that my acne is hormonal. I was diagnosed with PCOS 10 years ago, diagnosed via ultrasound and elevated levels of testosterone. I was seeing a reproductive endocrinoligist at the time (to help me get and stay pregnant), and was prescribed Metformin. I did not have typical symptoms. I did not have acne, I am thin, no excessive faical hair and I was not insulin resistant. The only true signs I had were the elevated testosterone and "string of pearls" around my ovaries.

I stopped taking the Metformin after I birthed my second child and felt my family was complete. I stopped seeing the reproductive endo at that time. I also did not continue to have my testosterone levels monitored. Still, I had NO acne or other symptoms, which is why I never gave PCOS a second thought.

After the birth of my last child, though, I started having thyroid problems. I developed a multinodular goiter. The only thing my endo checked was my thyroid levels, which were low, but not low enough to treat. Even with the thyroid problem I was not experiencing acne.

It's now been 4 years since the birth of my last child and goiter diagnosis. Within the last 12 weeks I've had an acne explosion (keep in mind that 6 of those weeks were on Retin A, and therefore the IB may be partly to blame). To be honest, I never even considered the PCOS connection until last week.

When the acne erupted I sought help from my dermatologist, never even considering the possible hormone connection. But now that I'm in to my 6th week of Retin A treatment, I'm just not so sure that this alone is going to help. I know it's still somewhat early and I'm in the midst of my IB, but the placement of my acne (along the jawline and lower cheeks ONLY) combined with my history, just SCREAMS - HORMONES!

I contacted my endocrinologist and he ordered:

Regular thyroid panel, TSH, T4 (free), Free T3

Testosterone (Free)

DHEA Sulfate

FSH

LH

(so that oughta cover it, if there's a problem, right?)

I don't have the results yet, but I imagine the testosterone is out of control, and I'm hoping he'll put me on Spiro, if that is the case.

So, after all that information, I was wondering if I will experience another IB from the Spiro, even though I'm going through the tail end of it now from the Retin A?

If you have any other Retin A/Spiro info please share. I'd love to hear fomr other PCOSer's that have tried this combo, or share with me the systems that worked or didn't work for them.

Oh, and could someone/anyone respond. I think I've written 3 posts that never received any responses. I could really use the opinions before I go to appt.

Thanks!!!!

Edited by *ShiningStar*

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I'm now convinced that my acne is hormonal. I was diagnosed with PCOS 10 years ago, diagnosed via ultrasound and elevated levels of testosterone. I was seeing a reproductive endocrinoligist at the time (to help me get and stay pregnant), and was prescribed Metformin. I did not have typical symptoms. I did not have acne, I am thin, no excessive faical hair and I was not insulin resistant. The only true signs I had were the elevated testosterone and "string of pearls" around my ovaries.

I stopped taking the Metformin after I birthed my second child and felt my family was complete. I stopped seeing the reproductive endo at that time. I also did not continue to have my testosterone levels monitored. Still, I had NO acne or other symptoms, which is why I never gave PCOS a second thought.

After the birth of my last child, though, I started having thyroid problems. I developed a multinodular goiter. The only thing my endo checked was my thyroid levels, which were low, but not low enough to treat. Even with the thyroid problem I was not experiencing acne.

It's now been 4 years since the birth of my last child and goiter diagnosis. Within the last 12 weeks I've had an acne explosion (keep in mind that 6 of those weeks were on Retin A, and therefore the IB may be partly to blame). To be honest, I never even considered the PCOS connection until last week.

When the acne erupted I sought help from my dermatologist, never even considering the possible hormone connection. But now that I'm in to my 6th week of Retin A treatment, I'm just not so sure that this alone is going to help. I know it's still somewhat early and I'm in the midst of my IB, but the placement of my acne (along the jawline and lower cheeks ONLY) combined with my history, just SCREAMS - HORMONES!

I contacted my endocrinologist and he ordered:

Regular thyroid panel, TSH, T4 (free), Free T3

Testosterone (Free)

DHEA Sulfate

FSH

LH

(so that oughta cover it, if there's a problem, right?)

I don't have the results yet, but I imagine the testosterone is out of control, and I'm hoping he'll put me on Spiro, if that is the case.

So, after all that information, I was wondering if I will experience another IB from the Spiro, even though I'm going through the tail end of it now from the Retin A?

If you have any other Retin A/Spiro info please share. I'd love to hear fomr other PCOSer's that have tried this combo, or share with me the systems that worked or didn't work for them.

Oh, and could someone/anyone respond. I think I've written 3 posts that never received any responses. I could really use the opinions before I go to appt.

Thanks!!!!

I've never used Retin A.....but I have taken Spiro. I don't remember getting an IB with it, but I was only taking 25mg and I only took it for 2 months. I believe its still possible to have an IB with Spiro even though your using Retin A, it just might not be as bad as it could be. I really don't have any advice not what combo you should use, but I thought I'd still respond. Goodluck and I hope your don't get any more IB and that you can get your hormones under control. =] I have to go soon to see if I have PCOS myself. So maybe if I do have it eventually I'll find a way to control the acne because of it....

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retin-a can cause REALLY bad IBs. not sure if you're open to it, but a short-term (maybe a couple months) of an oral antibiotic (like minocycline) probably couldn't hurt. Do you NEED the retin-a? is it something you could stop to see if that's what's making things worse?

were you on metformin for the antiandrogen properties? have you stopped taking it, and if so, when?

those tests that the endo ordered should help, but there are a ton more they could check if you wanted. In my case though, all my labs were completely normal (other than my thyroid, due to hypothyrodism, and btw, i also have a thyroid nodule). maybe a repeat pelvic ultrasound to check out your ovaries? or an ultrasound to look at your thyroid again to make sure the nodules aren't growing?

Not sure if you are hypo or hyper thyroid, but my doc wants my TSH to be between 0.1 and 1.0 to suppress nodule growth. If your endo is not treating you in a similar way, I would press the issue or switch doctors. There is a pretty large "normal range" for TSH, but i've read that it should be less than 3 (not 5 or 5.5 that is usually "normal"). Also, have they done an aspirate of the nodules to rule out any cancer (not that this is related to the acne issue, but something that I, personally, would want done and have had done myself).

I've been on Spiro and Levothroid for about 4 years now and my skin is looking great. I still get a few zits, but not nearly as bad or as painful as before. Hang in there.... let me know if there's any other questions I can help with!

sorry if there's typos or grammar errors.....probably shouldn't be up at 2:30 AM on the acne boards!!! lol

Edited by peachy_D225

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Thank you so much for the replies.

I'll try to go in order with the questions:

I don't know if I'll benefit from the Retin A. At this point, after taking it for 6 weeks, I'm not seeing any new ones creeping up, but the ones that are there are taking forever to go away, plus I'm left with the hideous red marks. I'm going to give the Retin A the full 12 weeks before I throw in the towel. If my acne is hormonal, Retin A probably won't work without supplementing it with Spiro, and/or antibiotic.

I'm having a repeat u/s for both my PCOS and thyroid in two weeks. I even scheduled them on the same day. My lad results will be reviewed at that time, as well.

I have at least 6 nodules on each side, but they are very small and my endo won't biopsy until they are 1cm.

All of my labs fall within the normal range, but they are on at the bottom of the range every time.

I'm supposed to have an u/s and lab work every six months to monitor growth, but it's been a year since my last set.

Since I'm starting to become symptomatic, I am demanding intervention. I don't care what the labs say - the effects are obvious.

Thanks so much for your help.

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Oh, I forgot to ask:

What other tests could I have run?

When I was first seen by my endo, she ordered the following tests:

Testosterone, total

Testosterone, free and total

LH

FSH

DHEA-S

Prolactin

17-OH-Progesterone

Cortisol

TSH

Thyroperoxidase antibody

Free T4

Tri-Iodothyronine, total

Comparing this list to the list your doc ordered, it looks like most are the same, with the exception of a few (prolactin, cortisol, 17-oh-progesterone, and maybe a couple thyroid labs). I'm sure your doc will cover things though.... if your results come out "normal", advocate for yourself until they order more tests or prescribe meds that you think will work for you! good luck.

Edited by peachy_D225

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Hi.

I just started my spironolactone. I really like it because my acne explodes during that special time of the month. I am finally starting to clear up, but I will know for sure next month if it works.

This message is actually about your IB. I was told when I started to have food alergies (gas/ bloating/pain) that I could have IB. I had a friend tell me about DIGESTIVE ENZYMES. They occur naturally in your body to help digest your food. Over time your body loses the ability to produce them. I went to my natural food store and purchased some and within a month my food alergies went away, and I feel great. They seem to work, but are harder to find in the USA than in Canada. They are inexpensive, and are worth the try.

Ask your doctor about Digestive Enzymes because they will never suggest them to you.

Good luck, and I hope you are all better soon.

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if your acne is hormonal, stop eating meat. particularly red meat. it's full of hormones. the more you eat it, even if it's home cooked and healthy, the worse you'll get acne.

period.

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