Hi,
Welcome to the board! First of all, your build is very similar to mine. I've always been underwieght and am currently 105lbs (average wieght since the age of 12 and I'm 23 now). Of course, I would have loved to have reached 120 (which is actually the avg. wieght for 5'4), but my metabolism just wouldn't allow it. =/
OK, so you've heard how carbohydrates are capable of making people gain wieight, right? You've also heard that carbohydrates can cause of host of diseases and hormonal disorders, right? One of the symptoms to these problems would of course be acne, as you've partially discovered. Based on what I've learned over the years, especially this past year, now that I think about it, it makes sense that I turned out to be at least on the thin side and with acne.

You see, carbohydrates can be good for us, but there are some that are also bad for us. Or MAYBE it's just because they aren't as "good and healthy" as they used to be, i.e. McDonalds, TV Dinners, Hydrogenated Oils, Refined Grains, etc. Either way you choose to debate this, if you get ENOUGH of an Insulin Rush in your system, it's going to cause problems.

I'm sure some people must be sick of hearing that, infact, I know people that are beyond annoyed and angry when they hear this, but I can't help it if it's the truth. =) There are acne sufferers that are overwieght and there are those that are underweight and probably of normal wieght as well. In fact there are acne sufferers with a combination of problems or no other (outwardly visible at least) problems. That's because Insulin Resistance can get your body any way YOUR body sees fit!

That's right, it does come down to genetics and your genetics will decide the type of problems your body will have as a result of all of this Insulin (or IGF-1). As such, it also usually comes down to having a healthy liver. It's rather interesting to see how many enzymes, proteins, vitamins, and hormones that rely on a healthy liver. If your liver is burdened in some way...too much glucose to produce, too much toxins, or a genetic/enzyme defect, you will eventually have problems. The problem or combination of problems that result from Insulin Resistance include:

High Cholesterol,
Dyslipidemia,
High Blood Pressure,
Heart Disease,
Obesity,
Type II Diabetes (90% of cases, sometimes Type I can result),
HyperAndrogenism (another name for Acne, Hirsuitism, etc),
Hyperovarianism,
PCOS (Polycystic Ovarian Syndrome),
Hyperthyroidism (possibly Hypothyroidism)
Hyperadrenalism
Hyperaldosteronism
Certain Cancers

Notice how some of these begin with Hyper? That's due to the IGF-1 and its role in the body to increase cell growth (cell proliferation). Cell growth is a Good thing, but too much due to overstimulation (enlarged sebum glands or tumors) and it's a VERY bad or even Deadly thing. Therefore, the list can actually go on. I could add to the fact that it increases skin cell proliferation, hyperkeritinzation, and increased sebum production, which of course we know ADD to our acne delimas. In fact, if you can just get those in control, why you use topical DHT inhibitors such as RetinA, Azelex, etc, or follow The Regimen or "The Acne Cure" (these work on the inflammation and proper skin cell shedding aspect), you will more than likely get clear skin, IF your problem, isn't that deeply rooted. However, for those of us that have one of the above problems (if you haven't visited an Endocrinologist you should), topical solutions just aren't good enough of a solution.

That's why liver cleanses work for some, as do certain supplements such as B5 (hits the cholesterol aspect of hormone production) and Saw Palmetto (natural anti-androgen). For others, they find that they need Birth Control (estrodial acts as an anti-androgen by increasing our SHBG which likes to bind to Male steriod Hormones) and/or another anti-androgen such as Spironolactone (accidently binds to androgen receptors). Of course, theres those of us that the above methods STILL didn't cut it and so we moved on to other drugs such as Insulin Sensitizers (Avandia, Metaformin) or Glucocorticoids (Dexamethosone) to help our body's hormones stabilize. Glucocorticoids, help to reduce inflammation and rebalance your adrenal glands (another source for steriod hormone production). Whereas, Insulin Sensitizers, help your body's cells take in MORE Glucose...although it's been debated that FORCING your body take in more glucose when it's already full (form of Insulin resistance) can actually cause more problems down the road (Type II diabetes or Type I Diabetes due to pancreas burn out).

Notice I said NOTHING about Antibiotics. The only reason these work is by preventing inflammation. In fact some of these, such as Minocycline and Tetracycline, actually Increase your DHT production! I guess that would explain why some acne sufferers, including myself, brokeout worse the ever before after stopping them. =( Out of all the treatments and supposed cures out there, I think that Antiboitics is the worst of them. It gives us all false hope into thinking that we have attained clear skin, when in fact upon stopping we realize that we haven't.

Then again, the same can be said for Accutane (temp. solution that works as an anti-androgen by decreasing IGF-1 levels) and practically any other solution, EXCEPT unlike certain antibiotics, they don't secretly increase our male hormones. If you are beyond puberty and find something that clears your skin, I can almost guarantee you will have to stay on this treatment or regimen for the rest of your life. Therefore, it's best to find the safest, healthiest, and most cost effective solutions out there, and that's where a change in diet comes in to play ;-)

Granted you can take supplements, or Birth controls, any prescription really, just as long as it works and you won't experience any negative side effects. If these things will cause you problems or you've discovered they don't work very well, that's actually when dietary changes became so popular. This was actually the last thing I did for myself, although for 10 years I avoided Chocolate and Soda with no results. I wasn't desperate, but I was EDUCATED and aware of my own hormonal condition and along with the testimonies of former sufferers, I took the plunge.

Heck by changing your diet once can reduce inflammation, reduce sebum, reduce/balance steriod hormones (especially those androgens), reduce IGF-1, and Increases SHBG (anti-androgenic) and IGFBP-3 (binds to IGF-1) and Prostaglandins among others so why not???

to continue...

So like I mentioned before, I'm not surprised that I ended up being skinny and having acne. I tried to gain weight for years eating more carbohydrates (and protein) because I had heard how that would make you gain wieght. Except, right now it's not in my genetic makeup to gain weight (so I don't care as much). It turns out my mother had acne as bad as mine, body acne like me too and was skinny when she was younger and now she doesn't have acne, but she's a bit overwieght. She still eats the same foods, perhaps more so along the lines of unhealthy foods and she's definately a sugar addict. In fact, the majority of the women in her family are either overwieght or obese! Whereas, on my father's side of the family we've got a few (borderline) Diabetes Type II to deal with. So no wonder I turned out the way that I did ;-)


I've been dealing with acne for 16 years and I finally got a diagnosis over 2 years ago! After going through doctors, one nice dermatologist, and 2 other endocrinologists, I FINALLY hit the jackpot! I'm forever grateful to all of them, but this (3rd) Endocrinologist is the one that really helped me understand why the suggestion of low carbing, really should be much more emphasized. Granted he wanted me to stay on the Avandia (I didn't), but he freely admitted that my skin was doing really well after I had switched my diet =)

He dx me as being either PCOS or Insulin Resistant (same treatments) and since IR is the Precursor to PCOS and I don't really have those symptoms I just tell people I'm Insulin Resistant. There's actually 2 forms of Insulin Resistance, but I usually only stress the aftermath of these forms and never really explained the difference between the two. Did you know that within minutes of consuming too much glucose, your cells become insulin resistant??? That's right, you can become Insulin Resistant (IR) due to your diet being too HIGH in Glucose (why people low carbohydrate diet). When your cells become FULL of Glucose, they stop responding to the Insulin that's required for the entrance of More glucose. Furthermore, since your liver (and muscles) will also become insulin resistant, it starts to produce MORE Glucose as well. Thus further increasing your Blood Sugar levels, which, INCREASES your Insulin Levels. Therefore, lower your (high) glucose levels, and the cells will respond normally again, and Insulin resistance disappears. This is why it may not be wise for some people to take Insulin Sensitizing Drugs, because they may not be genetically prone to IR, but due to their lifestyle they have become so. Taking drugs that FORCE your cells to uptake more Glucose, theoretically can eventually make you a diabetic.

So, just to give things a bit more perspective, have you ever added up the amount of carbohydrates you eat in a day? Well if you were to follow the food pyramids suggestions and included a nice amount of junk food, those on the "Western Diet" would be consuming 200g - 800g of Carbohydrates a day! As a result of switching my diet, I currently consume 200g - 300g of carbohydrates a day, which is around the average (200g). So there's definately room for some form of low carbing for most people ;-) Unfortunately there are people that freak out over that because (the wrong) low carbohydrate dieting made them sick, but it's NOT about eating 30g (a box of raisens) - 50g of Carbs a day! It's SIMPLY about Lowering your EXCESSIVE amounts of carbohydrates and possibly the other foods that can also increase your Insulin Resistance or IGF-1 levels.


Now, the other way to become Insulin Resistant is due to your genetics or some form of nutrient difficiency or alteration. I'm still looking this part up, but I apparently there are genes that code for Altered Insulin, thus the body's cells don't recognize it Infact, this can be due to the consumption of Hydrogenated/Partially Hydrogenated Oils and Trans Fats. [url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8001841&dopt=Abstract[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7910281&dopt=Abstract[/url]

Also, Insulin Resistance is a natural part of puberty. Infact, Puberty is actually defined as "a state of Insulin Resistance". Therefore, anyone going through Puberty MUST enter "a state of Insulin Resistance" in order for the body to grow (sounds odd I know).
[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10626552&dopt=Abstract[/url] (another accutane connection)
[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12364479&dopt=Abstract[/url] [url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12112937&dopt=Abstract[/url]

So, my theory on this (based on collected facts) is that since Insulin (glucose isn't really the problem) is a KEY player in Steriod Hormone Synthesis (Estrogens, Androgens, and Progesterone) maybe the body signals the Insulin Receptor cells to deactivate in order to INCREASE these hormones so that we can have our Growth spurts and develop further as males and females (of course this can also screw up our development) during Puberty. To further expand on this, since Cholesterol (we need the fats, but bad fats?) is what Steriod Hormones are made from (think Testosterone) that could be why some of us Get acne (more cholesterol to produce testosterone, etc from) while others end up having High Cholesterol Levels or Being Overweight....because Insulin Resistance Increases all of these factors and your body decides which problem it would "prefer".

So let me say that again only a bit differenlty. Since Insulin Levels have also been connected to Leptin levels, Leptin is a proten that tells our brains to eat more so that we can have MORE fat cells, this would explain why 60% of the population in the U.S. are now considered Overwieght or Obese. OK, so that means that when we eat whatever we want, we are increasing the fats in our bodies, correct??? Except, some of us aren't overwieght, right? Perhaps that's because:

Our body says "hey, I don't want to be overwieght/obese, so I'm going to take these extra fats and turn them into cholesterol and just produce more steriod (male) hormones. Hence the BIRTH of a nice variety of Hormonal Disorders that have acne as a symptom...

Where as, other teenagers and adults bodies are saying, "hey, I don't want to be overwieght either so I'm just going to not do anything and I'll let these fats compete with sugar in the blood stream (why B5 works) and clog our arteries."

With that knowledge and more, I'm sure you can come up with other scenarios that explain why "you have acne, and 'Jane' doesn't" or why "you are underwieght and 'joe' is overweight". Regardless, finding the right Insulin Controlling-Hormonal Balancing diet that's also healthy for your nutritionally can work wonders. As you've noted, your skin is now dryer and that's probably due to the fact that you don't get enough EFA's in your system (is the rest of your skin dry?). I would suggest fish oils, but since your a vegetarian I'm not certain you'd want that. You can try consuming Flax Seed, Evening promrose oil and others to give you a Vegan EFA supply. That should take care of the dryness (did you know hydrogenated oils, Insulin, & certain food enzymes can cause EFA imbalance?) and may just improve your acne even more ;-)

Indeed, EFAs are in charge of producing prostaglandins, body's hormone balancers, and are also involved in helping balance our insulin levels as well as increasing the good prostaglandins involved in reducing inflammation (why I no longer suffer from menstrual cramps and all I did was stop eating most grains) . So taking 1 - 3 g max of this (especially Omega 3s) if you don't consume seafood, meats, is your best bet.

So tell me more about the diet you were on. I had no trouble following my diet (gluten free/low grain, and avoidance of peanuts, cashews, bananas, cherries, and soda), but of course, I'm not a vegetarian. So the ONLY foods you ate for two months were Vegetables, Nuts, Seeds??? No Diary? No Fruits? Fast Foods? Hmm, How clear did this get you? Were you consumng any of the other Intolerant Reaction/Inflammatory reducing foods (find a list in Perricone's acne prescription) such as Peanuts and Bananas??? You wouldn't believe what a difference eliminating additional (if they are a) PROBLEM foods will do for you. Some people don't have to and others like myself and several others around here had to do so in order to keep that cystic acne away.

Well anyway, that's all I've got for you. I hope I covered most of your questions and if you want food suggestions, medication suggestions and tests to ask your doctor about (if I can find that post) I can post those for you as well. Again, glad to see you here. There's so many knowledgeable people on here that I'm sure we'll help you figure things out. =)

Idealist and KillerBoots,
This was something that was originally for Idealist under the Hormones vs. Diet thread, but I'm sure it fits in just as well here:

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. =)

[url]http://www.healthboards.com/boards/showthread.php?p=782332#post782332[/url]

Take care

P.S. Somewhere in the archives is a list of hormonal tests and the kinds/brands of medications to take. If I can find them again, I'll repost it if you'd like.