Which is the real culprit? Hormones vs Diet

[idealist1976]

i think for some people its a combo of BOTH diet and hormones. i wrote a post recently with "my story." of course the post is a condensed version since i've been struggling with acne for about 10 years.

in short though: about 4 months ago i went on the low-carb, no dairy diet (and no processed foods too which i have been doing already for years). my skin got a little better. after about 2 months on the diet, my skin got less oily but i was still breaking out. so i went on the pill (orth tricylin). the combo of both seemed to do the trick! i've been on the pill on and off for the past five years. but never on the pill AND on the diet at the same time.

a couple weeks ago i came down with a flu and all i could stomach was bread and saltine crackers. after days of eating this i noticed my skin getting oiler and minor breakouts. then i was better and went back to "the diet" again. the pimples i had started drying up/healing very fast instead of getting worse like they used to. then, the past week i fell off the diet again because of all the holiday festivities at work, etc. i'v been eating a lot of cookies and pies. and i am paying the price for it this week with a lot of new pimples.

also, in relation. i have been diagnosed with PCOS (poly cystic ovary syndrome). symptoms include irregular, painful periods, acne, tiredness, hair loss, and overweight. i have all the symptoms except overweight. i am actually underweight. anyhow, if you research PCOS, they say low-carb diet is the one thing that helps. a co-worker of mine, who has also been diagnosed with PCOS, has a weight and fertitility prob, but not acne. anyhow, she said when she went hard-core low-carb her periods got regular. i wasn't on the low-carb diet long enough to notice the regular periods (as mentioned above i went on the pill about 2 months into the diet) but want i HAVE noticed is that my periods got heavier. before the low-carb diet, i had been on the pill on and off for the past five years (but never on the low-carb diet at the same time). these past few months i have been on both the low-carb diet and pill, and this is when i noticed my periods are heavier. before. they were so light it was almost like not having a period at all.

[idealist1976]

one more thing...more anectodal evidence that diet is involved too:

a male friend of mine who i've known for about 5 years has always had bad acne on the sides of his face. a few years ago he came down with mono and was sick for about 2 months. i saw him shortly after he was better again....his face was COMPLETELY CLEAR!

now, i'm not that close to him so i couldn't just ask about his acne. but just in conversing about his illness he mentioned during his illness he wasn't very hungry so he basically only ate fruit every day.

so then a few months later, he has a party....his acne was back. there he was at the party stuffing his face with chips, pretzels, etc.

i've heard/read other similar stories with either being sick or going into the military and having the skin clear up only for the acne to return when the "regular" diet was returned to again.

[prometheus]

yes it is definitely both. I won't encourage people to fast unless they are doing it for spiritual and health reasons. As far as I can see, though, that is the only real way to evaluate objectively diet's role in acne. Fruit fasting is a safer way to evaluate this. I mean, if you fast and your acne goes away, what else can it be? If you stay away from certain foods like I do and never have acne save for the time you eat a certain food then what else can it be? I know in my case it was diet. In my opinion it is the same for everyone. The body runs on food. There is a process of alchemy that goes on in the body when it breaks down food and transforms food into the nutrients it needs and discards the rest. I think the safest way to eat is to eat what God put on the earth. God didn't make Kellogs Rice Crispies, so I won't eat them.

[SweetJade1]

Idealist,
It's definately the diet that's taking care of your hormones! I was dx over 2 years ago as either PCOS or Insulin Resistant, even though IR is the Precursor to PCOS, among other hormonal and metabolic disorders.

I took BC and Spiro (200mg) for 3 years and that combo didn't clear me ( around 50 - 70%), didn't stop my breakout cycle (8- 9 months of my worst acne) nor did it stop my menstrual cycle pain (always had a regular cycle).

Thanks to Mino clearing me for 3 months and then I stopped, I ended up with the worst breakouts and in new places (my lower arms and legs), DESPITE still being on BC and Spiro! So after about 9 months of that I sorta cried depression (to get off of the BC) and got referred to my former Endocrinologist (3rd time the charm) and he tested me for everything! He was really great and I ended up taking Avandia (2mg) and Spiro (150mg) for almost 1 year (got 70% - 85% clear) before I switched my diet.

I would like to add that when I took the avandia I gained 5lbs (spiro will cause you to loose water weight) and it slightly improved my menstrual pains. Around the same time I switched my diet, my Endo put me on 4mg of Avandia and my skin was looking good, I gained another 5lbs (yippee was 115lbs) AND my menstrual cycles were gone!!! So, when I started experiencing IBS symptoms and we couldn't figure out what the problem (tested me for everything) was I stopped the avandia...(and lost those 10lbs)

Turns out that I don't eat enough vegetables, so all I needed was a fiber supplement (Benifiber). Not only was I having IBS symptoms, but it threw my cycle off! I started having periods 2x a month! Although, they didn't hurt =) Oh and the interesting thing though was despite that disturbance my skin just kept getting better. ;-)

I know some people think it was some sort of placebo effect, but how do you explain the elimination of terribly painful menstrual cramps??? Not to mention, I stopped the avandia during my breakout period so I was a bit concerned that I would start breaking out again....but I didn't.

I don't know what's more "amazing". The fact that so far changing my diet has lessened my mild hirsutism even more, lessened my oil production, shrank my pores, got me so far 99% clear, or that it ELIMINATED my menstrual pain. Tylenol wasn't good enough, nor advil. I would pop 1800 - 2400mg of Motrin (Ibuprofen) a day and usually on an empty stomach to get rid of the pain. 3 years ago I discovered Gingo Biloba did the trick and so I switched to taking this 800mg - 1600mg a day, until I changed my diet and no longer needed anything! I was suffering with that for almost as many years as I've been dealing with acne. Even if my Customized Gluten Free Diet hadn't given my skin those kind of results, I would stay on it just for the FREEDOM and control of knowing that I don't have to depend on some pill to relieve that kind of pain anymore.

So, we all have options. Its inevitable that we must eat, so why not improve things in that department? Yet, I think most of us don't have to rely on all these medications to get by. However, if anyone else is reading this that was dx PCOS these are the available treatments (more extensive listing in the Archives) that work Directly OR Indirectly to control/balance our Androgen Levels, etc:

Birth Control - various forms, Estrodial (primary estrogen) will work as the anti-androgen to increase our Sex Hormone Binding Globulin (SHBG) that has a higher affinity for the male steriod hormones. (follows along the pathway below)

Spironolactone or Flutamide,etc - Defined as Anti-androgens. Work differently depending on the drug, but will reduce your androgen production, thus reducing your enzymes needed for converting testosterone into DHT and therefore reduces our DHT (the most potent of androgens).

Insulin Sensitizers - Avandia, Metaformin, etc. Work different ways, but reduces your Insulin Resistance, by increasing Glucose uptake or Reducing Insuln Produced.

Glucocorticoids - Prednisone, Dexamethasone work to provide your body a form of cortisol, which balances out hormone production, etc. PCOS and NCCAH/LOCCAH (Late Onset Congenital Adrenal Hyperplasia) can be misdiagnosed as one or the other and some people have both.

Progesterone - Balances Insulin Levels and reduces estrogen dominance, etc. Has ability to convert into either estrogen or testosterone (some people have broken out from this), but if you are deficient, can work wonders. Will balance hormones, eliminate acne, and give you a regular cycle so that you'll be able to concieve if you chose, in the future. Choose Natural Progesterone over synthetics (cause problems).


Of course, the alternatives to these would be:

Low Carbohydrate Diet - so many to chose from but find the right one and you can lose wieght, fix menstrual problems, conceive, have clear skin, etc. Based on what I've read, it works just like you were taking a combination of Accutane, Birth Control and other Anti-Androgens...seems to hit it from all angles.

Natural Anti-Androgens - Nettles, Saw Palmetto, Beta Sitosterol, Omega 3s, EFAs, Zinc - B6, etc etc

Natural Insulin Sensitizers - (work along different mechanisms) EFAs, ALA, Chromium (GTF or Polynicotinate), NAC, d-Chiro-Inositol, CLA, Selenium, Magnesium, Niacin, Vanadium, B5 (and B1, B6...just take a B Complex), and not to mention, several herbs (fenugreek, gymna sylvestre, Bitter Melon).

Natural Progesterone - Using Vitex/Chasteberry or Natural Progesterone Cream.

That's all my brain can come up with for now. I'm so glad you've found a combination that works for you. =)

[prometheus]

It is the food we put into our bodies that causes the reaction. It is the body that determines what will happen when we eat x,y, and z. So it is both. What it all comes down to, is what is easier to fix. The bacteria that causes acne is part of your body. It is not a foreign invader. The hormones that cause your acne are part of your body too. The oil that causes acne is part of the body. These things are all good for the body in a state of health. I don't think any of them need to be attacked, either with food or medicine. I think we just need to eat what we are meant to eat, and everything will fall into place. Because God didn't invent disease. Man did, with the help of someone else. If God didn't make it don't eat it. So that leaves us with fresh fruits, fresh vegetables, raw nuts, raw seeds, and fresh meat. When grains started to be consumed many new diseases sprung up and I'm not simply saying that because I think grains cause these diseases. Medical science recognizes these diseases too as being caused by grains. In the bible there is a bread recipe. I think minimally processed unrefined grains are the only grains people should eat and people should not eat wheat or the gluten containing variety unless and until they objectively determine that they are ok.