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I have been reading numerous posts about your personal experiences with acne and being insulin resistant etc...and have been very impressed with your knowledge! No wonder why everyone on these forums keep raving about you smile.gif I was wondering if you could offer me some advice as I have several of the same problems?

Quick Bio: I have had acne for years and always told myself that I would grow out of it. Well, I am 29 now and I think that the acne is worse than ever. I was also diagnosed as having PCOS and Pre-Type II Diabetes a few months ago by my family doctor (who thank goodness recognized my symptoms to be more than just a minor hormonal imbalance and had me tested). Through her advice, I have an appointment with an Endocrinologist in 2 weeks and would like to be fully prepared on my options BEFORE I go to see her.

I started taking Spiro about 4 months by a recommendation by my derm who suspected that I may have an issue with hormones, but couldn't confirm it (nor was I tested). She thought that hormones would almost have to be an issue since I tried every typical form of treatment for acne with zero success. Anyway, I took the Spiro for a couple of months so I don't think that I gave it ample time to judge if it was really helpful or not. The only thing that I did know was that I was having CRAZY irregular periods...my first one after I started the Spiro was 6 weeks long! Well, upon talking with my family doc, we decided Metformin would be worth a try as a replacement to Spiro just for the simple fact that Met is a pregnancy category B versus Spiro's category D. And, since OC (of ALL kinds) gives me migraines...I have to be extra careful with a med that may cause birth defects. So I tried the Met to help with my insulin levels (which hopefully would then reduce the acne), but after 2 months, I started having migraines back to back. I had to either stop the Met or get fired from my job for all the missed time from headaches...so away the Met went!

I have recently been reading your posts regarding the med Avandia and wanted to know if it is still working for you? Is it similar to Metformin...or in other words...do you think that it would give me migraines as well? Also, do you know of any medications that are similar to Spiro that A. can be taken by women and B. do not cause the severe birth defects?

I am looking for your help because I so want to find something that will help me. I'm starting to feel as if my issues and problems are getting to be where they are overwhelming me. OC might help acne, but gives me migraines. Met might help with my insulin resistance, but gives me migraines. Spiro might help with acne, but I'm worried about defects. It just doesn't seem to stop!

Sorry for rambling, but I wanted to let you know (if you read this) about me and my personal experiences. I hope that you have the time to respond... Thanks in advance biggrin.gif


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LOL, you really do have quite a few concerns, don't you. First off the quesiton is, is your goals to get pregnant right now? Do you normally have regular periods or are they infrequent/irregular? If you aren't planning on having kids, then taking Spiro is OK. However, depending on the dosage Spiro could cause you polyammenorrhea. So how much were you taking..50mg, 100mg or 200mg? Also, do you have signs of hirstuism or androgenic alopecia? If you do, there's a few supplements you could mess with that would theoretically have similar anti-androgen, specifically androgen receptor blocking, effects. http://www.acne.org/messageboard/index.php?showtopic=30721 If not you can probably skip the spiro and use other things for your acne.

Did your doctor mention whether you were deficient in progesterone? If you were though, one of the signs would be irregular to no periods. Does that sound like you? If so, the treatments that PCOS women use for this are either micronized progesterone, natural progesterone cream, or vitex (chaste tree berry).

Since you have something called Pre-Diabetes, that means you are possibly beyond just being Insulin Resitant, either way it's always the same drugs for treatment. I started out on Metaformin for 2 months and it made me sick. I don't remember if I had headaches, but I didn't feel good stomach wise nor a bit mentally. This is common for some women and so that's why Avandia could be a better choice for you. I never felt sick on Avandia and I took 2mg for a little over a year. Most doses range from 2mg - 8mg. This I believe is safe enough to use while pregnant as it's what can help get PCOS women pregnant in the first place, but you can check these websites for their insite on this:

http://www.soulcysters.org (fav. pcos site)

http://www.obgyn.net/pcos/pcos.asp (forum & various info)

http://oak.cats.ohiou.edu/%7Ecp391990/ (resource)



http://www.infertilityphysician.com/androgen/intro.html (there's several variants of PCOS and sometimes it can even be mistaken for an adrenal disorder)

http://www.labtestsonline.org/understandin...tions/pcos.html (types of tests an Endocrinologist run)


http://marykateroget.home.comcast.net/ (this is a site that one of the soulcysters did that summarizes the best treatment methods)

Otherwise, I believe for women with Insulin Resistance or Type II Diabetes the big supplements are:

Chromium GTF



D-chiro Inositol

Now, all of them help with insulin or blood sugar, but only NAC and D-chiro inositol have been clinically tested to see if they lower testosterone levels and they do! This week I will be testing out NAC at 1 g (1g - 3g clinical dose) and I've started to eat Buckwheat grits as this has the highest amount of natural d-chiro inositol. However, Buckwheat Farinetta is the only product that contains the clinical doses though and so I just got through ordering that from www.minndak.com. You can do a search from the above or catch some references here http://www.acne.org/messageboard/index.php...pic=30135&st=60 (page 4 & onward).

Of course, if you alter your diet you may find that you have more success than from using drugs and that you may not even need various supplements or at the very least not at such high doses.



So, do you think that's enough of an arsenal for ya? It's always a good thing to go in there having some knowledge about your condition or possible others so that your doctor may treat you with a bit more respect and actually listen to your concerns. It sounds like your regular doctor is rather wonderful and I'm really glad to see that someone other than a specialist is willing to help you out, let alone actually knows something about all this. Hopefully your endocrinologist is just as wonderful and even more knowledgeable ;-)

Best of luck

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Thanks so much responding and sorry it took me so long to read it! I'm in the middle of changing jobs and as always...is never any fun. Anyway, let me answer some of your questions. I am definitely NOT trying to get pregnant now and I have never had regular periods. I can go 2 months without a single period and then the next time I might have my period for 4 weeks straight. This past month and a half I've been spotting on and off constantly. Every couple of days I'll have nothing...spot for a day or too...then nothing again for maybe a day...then flow heavily for a day or so...repeat.

The amount of Spiro that I was taking started at 25mg/day for 1 month...50mg/day for 1 month...then finally ended at 75mg/day. I do have signs of alopecia and have always thought of myself as "strange" because of it, but my mother didn't exactly have the thickest hair either so I just figured it was hereditary. Now, the level of progesterone didn't really seem to be the problem...it was my definite high levels of testosterone instead. And again it's so hard to judge because like I said earlier...sometimes it seems that my problem is not having a period and then later on I'm having too many, but over the last few years I definitely have had a problem with my periods becoming much more frequent.

I have adjusted my diet somewhat to cut back on carbs and sweets and am *trying* to exercise more per instructions by my family doctor. She has been a tremendous help! She is also great because she doesn't immediately prescribe 15 kinds of medications...isn't exactly holistic...but definitely thinks more to that approach and I completely agree with her. I would prefer to keep the medications down to 1 or 2 in addition to the one that I already take daily as a preventative against my migraines. She labelled me as Pre-Type Diabetes as I am kind of on the verge of Type II (i tested after fasting at a little over 130) but wants me to adopt a diabetic diet to avoid the possibility of things getting worse.

But I'm starting to run out of options for dealing with my acne. It's the worst that it has ever been and I'm sure a part of it is stress (which is the reason for the change in jobs), but I am just so desperate to find SOMETHING that will help me not feel so embarrassed. I hate being in a professional field with break-outs all over my face which is why I am VERY tempted to have another go with the Spiro. After trying everything, but Accutane, it seems like my last hope. I start my new position in a little over 2 weeks and I have GOT to somehow make my face look better so I won't look like the new "freak". I still have some left from my last prescription and am very tempted to start taking it again, but don't know if the Spiro will mess up any of my blood test results from when I see the Endocrinologist. Do you happen to know?

I very much appreciate the time that you spent reading and replying to my post and will definitely read over all of the links that you provided to read more about Avandia and women who deal with PCOS and other hormonal issues. I hope all goes well with your "trials"! You are truly a blessing wub.gif


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