Any success with Spiro ?

[U4IA]

Originally posted by 21withacne:
U4IA
I was wondering if you could please tell me about your hypotyyroid. I was just detected to have it, with a possibility of Hashimoto. Can you please tell me what your dr said about its correlation with acne? And also why you are on sprio?

Thanks,
21

My doctor never said anything about the correlation between my acne and hypothyroidism. After I had my second child I complained of severe fatigue. She tested me and found my thyroid levels to be low. I believe I might have had a thyroid disorder all along but none of the many, many derms I went to for acne ever bothered to refer me for any endocrine testing. As a matter of fact they made a point of telling my mom that I probably did not have a hormonal disorder. They were basing this on research they read that measured total testosterone levels in patients with acne. Unfortunately this measure of total testosterone does not give an accuate picture of what is really going on.

I have since found out on my own via internet research that hypothyroidism is associated with a low level of SHBG (sex hormone binding globulin). If you have a low level of SHBG then your level of free circulating testosterone will be high because there is not enough of the SHBG for the testosterone to bind with. Your total testosterne level may however, be perfectly normal. This unbound testosterone is converted to dihydrotestosterone in the hair folicle resulting in increased sebum production and acne.

What I have found in the articles I have been reading is that there appear to be 3 main disorders that cause androgen disturbances in women:

1. Polycystic Ovarian Syndrome which results in increased testosterone production by the Ovaries.

2. Congenital Adrenal Hyperplasia (the mild form not the classical form) which results in excess androgen production by the adrenal gland

3. Hypothyroidism that results in decreased levels of sex hormone binding globulin.

Because derms only treat the symptom (acne) many of us never know we have these other disorders unless we ask the right questions of our PCP's and get the right tests done.

The following tests need to be done to determine if you have any of these 3 conditions:

To rule out PCOS:
Total Testosterone
Free Testosterone
Androstenedione
17 hydroxy Progesterone
DHEAS (not DHEA)
Dihydrotestosterone
SHBG
To Rule out CAH:
Rapid ACTH stimulation test
To Rule out Thyroid Disease:
T3 and T4

If you want to read more look up "Androgen Disorders in Men and Women". The articles at this site are more informative than anything else I have ever read.



[This message has been edited by U4IA (edited 02-09-2003).]

[21withacne]

U4IA-
I can not thank you enough. They have done the thyroid tests on me and it came out that I have HYPO. What meds are you on now and are you clear? You have helped me so much and I thank you.

[U4IA]

21withacne, I take levoxyl 50mcg for hypothyroidism and 50 mg Spiro. I asked my PCP to let me try Spiro because I had read about its use and it was about the only drug I had not tried for acne. She would not prescribe it for me but referred me to yet another dermatologist. He tried to discourage me by stating that he hadn't read of much success with the drug but was willing to prescribe it after I showed him my list of all the drugs I had tried.

I have always believed (and still do) that I have some sort of enzyme deficiency that is causing my acne but never found the research or a doctor to support my belief. When I first started having acne at the age of 11, I did not have access to all the information that we have now. At the time I asked to be put on Spiro I only knew of PCOS as a possible hormonal cause of acne but I did not fit the profile of PCOS.

I now know about the relationship of hypothyroidism and CAH as other possible causes of acne and have since gotten a referral to an Endocrinologist. I hope I'm not wasting my time, the doctors time and alot of money on tests that show nothing. I just feel that I have to know why I have suffered with this disease for so long. I want to know the underlying cause mostly for the sake of my children as they are beginning to show signs of acne. I don't want them to go through what I have gone through. This is going to be my last try.

You asked if my skin is clear. I would say it's clear for the most part. I still get ocassional breakouts mostly around the nose area. My acne is nothing like it was in high school and college but it is disturbing that after 36 years I still have acne.

[21withacne]

Thanks U4IA. After I am done with accutane- which is helping but by no mean a miracle drug- I am going to make a case to my derm for spiro. Are you on any BCPs? I was also thinking about trying Yasmin. What do you think?