12th January 2005
Continuation of my post above....
[quote] J Clin Endocrinol Metab. 1995 Jul;80(7):2057-62. Related Articles, Links
Effects of diet and metformin administration on sex hormone-binding globulin, androgens, and insulin in hirsute and obese women.
Crave JC, Fimbel S, Lejeune H, Cugnardey N, Dechaud H, Pugeat M.
Hospices Civils de Lyon, Laboratoire de la Clinique Endocrinologique, Hopital de l'Antiquaille, France.
Evidence suggests that hyperinsulinemic insulin resistance may increase serum levels of ovarian androgens and reduce sex hormone-binding globulin (SHBG) levels in humans. The present study was conducted to assess the effect of administration of the biguanide metformin, a drug commonly used in the treatment of diabetes mellitus, on androgen and insulin levels in 24 hirsute patients. The patients selected for the study were obese, with a body mass index higher than 25 kg/m2 and high fasting insulin (> 90 pmol/L) and low SHBG levels (< 30 nmol/L). All patients were given a low calorie diet (1500 Cal/day) and randomized for either metformin administration at a dose of 850 mg or a placebo, twice daily for 4 months, in a double blind study. In the placebo group, diet resulted in a significant decrease in body mass index (30.8 +/- 1.0 vs. 32.7 +/- 1.5 kg/m2; P < 0.0001), fasting insulin (127 +/- 11 vs. 156 +/- 14 pmol/L; P < 0.01), non-SHBG-bound testosterone [Free Testosterone](0.19 +/- 0.02 vs. 0.28 +/- 0.03 nmol/L; P < 0.02), androstenedione (5.8 +/- 0.5 vs. 9.0 +/- 1.1 nmol/L; P < 0.03), and 3 alpha-diolglucuronide [3-alpha diol G](8.6 +/- 1.1 vs. 11.7 +/- 1.9; P < 0.005) plasma concentrations and a significant increase in the glucose/insulin ratio (0.047 +/- 0.005 vs. 0.035 +/- 0.003; P < 0.001) and plasma concentrations of SHBG (26.0 +/- 3.3 vs. 19.1 +/- 1.9 nmol/L; P < 0.001) and dehydroepiandrosterone sulfate [DHEA-S](8.7 +/- 1.5 vs. 8.4 +/- 1.3; P < 0.05). Beneficial effects of diet were not significantly different in the patients who were given metformin instead of placebo. These results confirm that weight loss induced by a low calorie diet is effective in improving hyperinsulinemia and hyperandrogenism in obese and hirsute women. With our study design, metformin administration had no additional benefit over the effect of diet. [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7608255]http://www.ncbi.nlm.nih.gov/entrez/query.f...st_uids=7608255[/url]
I'm a big fan of recent studies, but these were rather shocking for me to come across as they are from almost 10 years ago (they go back further). I would've been 14 - 15 years old at the time these were published and if I had KNOWN, I would have avoided wheat, saturated fats, trans fats etc back then instead of having to wait until 2.5 years ago for such information as it would have made a BIG difference in my life and how I developed. Oh, in case anyone here doesn't know, the above study mentions what I was diagnosed as 3.5 years ago. I'm actually atypical for both Polycystic Ovarian Syndrome (PCOS) & Insulin Resistance Syndrome (IR) as I don't carry any of the "classic signs" (ex: you do NOT have to be obese or overweight), yet I do still carry traits for both of these and as such there's actually a PCOS variant known as HAIR-AN Syndrome (Hyperandrogenism, Insulin Resistance, Acanthosis Nigricans) that both men & woman can have and that would explain my signs & symptoms the best.
Now, for those unaware, those words in bold are basically what you want to look for in an ANY acne treatment if your goal is to reduce/inhibit androgens. Like the first study showed, SHBG is now the new indicator (over IGF-1) for insulin resistance & hyperandrogenism. SHBG can be raised several ways, such as exercising, but more significant increases can be found by using Thyroxine, Estrogen, or Insulin Sensitizing drugs or supplements, aside from appropriately changing your diet. If your SHBG is low, you probably have Hyperinsulinemia (or Hypothyroidism) induced Hyperandrogenism as SHBG is lowered by increased Insulin and it's job is to bind Free Testosterone/Androgen. DHEA-S is a bound form of adrenal androgen DHEA (making it less potent), 3-alpha diol G is the product of DHT (Accutane inhibits this also), Androstendione, and Free Testosterone (convertes to DHT) are all androgens. The super androgen DHT can be the end result of all of these and is implicated in sebum production, acne, hirsutism, androgenic alopecia and interstingly enough certain retinoids that some of you may have used, like RetinA & Accutane, inhibit the enzymes neccessary for it's formation.
That study above describes exactly what happened to me and perhaps a few others around here, when I stopped my medication. For 1 year I had been taking Avandia (metaformin made me sick) and 150mg of Spironolcatone, but was only a max of 85% clear (for 3 months of the year). Yet when I initially changed my diet, I went up to a CONSTANT 95% clear! Over time, I permanently dropped avandia (after 3 months into my diet) and even dropped the spiro for 6 months (started back on at 100mg for hirsutism treatment) to make sure that it wasn't my medication (like it actually took 6 years of Spiro before it FINALLY fully kicked in,,,LOL). Now, 2.5 years later, I'm 99%+ clear and this includes my face, back, chest, neck, ears (I can breakout in lots of...places), I've got the smallest pores since I hit puberty, have a lot less oil & dandruff, a bit less body hair (a lot less with Spiro) and I no longer suffer from horrible menstrual cramps! Trust me, I have not grown out of it, this is not some placebo-nocebo, as I can still breakout if I eat the "wrong" foods for me, but I usually don't intentionally do this as most of the time I'll end up with very stubborn cystic acne as a result =/ So of course, I do my very best NOT to =)
So I want you guys to read those studies, reread them and then reread them again (and do your own research). Science IS how you will beat this, as it's not about "healthy" foods, but about the foods that are healthy and beneficial in promoting a "hormonally balanced, anti-inflammatory, & anti-proliferative" system. In other words, those are what you want to look for in order to FIGHT acne, among a variety of other health problems! In particular for males, look for things that are geared more toward anti-inflammatory, as actual anti-androgen drugs may alter your libido in an unsatisfactory direction. So think "outside the box" and learn that what is healthy for one aspect of your developement is NOT the same for another aspect and as long as you do it safely with regards to proper nutrient balance, you should be OK. ;-)
*Some people's hormonal situations are so severe, or sensitive, that it requires both the right dietary changes AND prescription/supplements to attain 100%. Yet even normal individuals can alter their hormones by changing their diets, so this isn't exclusive to only those with health problems or hormonal disorders.
[quote] J Clin Endocrinol Metab. 1995 Jul;80(7):2057-62. Related Articles, Links
Effects of diet and metformin administration on sex hormone-binding globulin, androgens, and insulin in hirsute and obese women.
Crave JC, Fimbel S, Lejeune H, Cugnardey N, Dechaud H, Pugeat M.
Hospices Civils de Lyon, Laboratoire de la Clinique Endocrinologique, Hopital de l'Antiquaille, France.
Evidence suggests that hyperinsulinemic insulin resistance may increase serum levels of ovarian androgens and reduce sex hormone-binding globulin (SHBG) levels in humans. The present study was conducted to assess the effect of administration of the biguanide metformin, a drug commonly used in the treatment of diabetes mellitus, on androgen and insulin levels in 24 hirsute patients. The patients selected for the study were obese, with a body mass index higher than 25 kg/m2 and high fasting insulin (> 90 pmol/L) and low SHBG levels (< 30 nmol/L). All patients were given a low calorie diet (1500 Cal/day) and randomized for either metformin administration at a dose of 850 mg or a placebo, twice daily for 4 months, in a double blind study. In the placebo group, diet resulted in a significant decrease in body mass index (30.8 +/- 1.0 vs. 32.7 +/- 1.5 kg/m2; P < 0.0001), fasting insulin (127 +/- 11 vs. 156 +/- 14 pmol/L; P < 0.01), non-SHBG-bound testosterone [Free Testosterone](0.19 +/- 0.02 vs. 0.28 +/- 0.03 nmol/L; P < 0.02), androstenedione (5.8 +/- 0.5 vs. 9.0 +/- 1.1 nmol/L; P < 0.03), and 3 alpha-diolglucuronide [3-alpha diol G](8.6 +/- 1.1 vs. 11.7 +/- 1.9; P < 0.005) plasma concentrations and a significant increase in the glucose/insulin ratio (0.047 +/- 0.005 vs. 0.035 +/- 0.003; P < 0.001) and plasma concentrations of SHBG (26.0 +/- 3.3 vs. 19.1 +/- 1.9 nmol/L; P < 0.001) and dehydroepiandrosterone sulfate [DHEA-S](8.7 +/- 1.5 vs. 8.4 +/- 1.3; P < 0.05). Beneficial effects of diet were not significantly different in the patients who were given metformin instead of placebo. These results confirm that weight loss induced by a low calorie diet is effective in improving hyperinsulinemia and hyperandrogenism in obese and hirsute women. With our study design, metformin administration had no additional benefit over the effect of diet. [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7608255]http://www.ncbi.nlm.nih.gov/entrez/query.f...st_uids=7608255[/url]
I'm a big fan of recent studies, but these were rather shocking for me to come across as they are from almost 10 years ago (they go back further). I would've been 14 - 15 years old at the time these were published and if I had KNOWN, I would have avoided wheat, saturated fats, trans fats etc back then instead of having to wait until 2.5 years ago for such information as it would have made a BIG difference in my life and how I developed. Oh, in case anyone here doesn't know, the above study mentions what I was diagnosed as 3.5 years ago. I'm actually atypical for both Polycystic Ovarian Syndrome (PCOS) & Insulin Resistance Syndrome (IR) as I don't carry any of the "classic signs" (ex: you do NOT have to be obese or overweight), yet I do still carry traits for both of these and as such there's actually a PCOS variant known as HAIR-AN Syndrome (Hyperandrogenism, Insulin Resistance, Acanthosis Nigricans) that both men & woman can have and that would explain my signs & symptoms the best.
Now, for those unaware, those words in bold are basically what you want to look for in an ANY acne treatment if your goal is to reduce/inhibit androgens. Like the first study showed, SHBG is now the new indicator (over IGF-1) for insulin resistance & hyperandrogenism. SHBG can be raised several ways, such as exercising, but more significant increases can be found by using Thyroxine, Estrogen, or Insulin Sensitizing drugs or supplements, aside from appropriately changing your diet. If your SHBG is low, you probably have Hyperinsulinemia (or Hypothyroidism) induced Hyperandrogenism as SHBG is lowered by increased Insulin and it's job is to bind Free Testosterone/Androgen. DHEA-S is a bound form of adrenal androgen DHEA (making it less potent), 3-alpha diol G is the product of DHT (Accutane inhibits this also), Androstendione, and Free Testosterone (convertes to DHT) are all androgens. The super androgen DHT can be the end result of all of these and is implicated in sebum production, acne, hirsutism, androgenic alopecia and interstingly enough certain retinoids that some of you may have used, like RetinA & Accutane, inhibit the enzymes neccessary for it's formation.
That study above describes exactly what happened to me and perhaps a few others around here, when I stopped my medication. For 1 year I had been taking Avandia (metaformin made me sick) and 150mg of Spironolcatone, but was only a max of 85% clear (for 3 months of the year). Yet when I initially changed my diet, I went up to a CONSTANT 95% clear! Over time, I permanently dropped avandia (after 3 months into my diet) and even dropped the spiro for 6 months (started back on at 100mg for hirsutism treatment) to make sure that it wasn't my medication (like it actually took 6 years of Spiro before it FINALLY fully kicked in,,,LOL). Now, 2.5 years later, I'm 99%+ clear and this includes my face, back, chest, neck, ears (I can breakout in lots of...places), I've got the smallest pores since I hit puberty, have a lot less oil & dandruff, a bit less body hair (a lot less with Spiro) and I no longer suffer from horrible menstrual cramps! Trust me, I have not grown out of it, this is not some placebo-nocebo, as I can still breakout if I eat the "wrong" foods for me, but I usually don't intentionally do this as most of the time I'll end up with very stubborn cystic acne as a result =/ So of course, I do my very best NOT to =)
So I want you guys to read those studies, reread them and then reread them again (and do your own research). Science IS how you will beat this, as it's not about "healthy" foods, but about the foods that are healthy and beneficial in promoting a "hormonally balanced, anti-inflammatory, & anti-proliferative" system. In other words, those are what you want to look for in order to FIGHT acne, among a variety of other health problems! In particular for males, look for things that are geared more toward anti-inflammatory, as actual anti-androgen drugs may alter your libido in an unsatisfactory direction. So think "outside the box" and learn that what is healthy for one aspect of your developement is NOT the same for another aspect and as long as you do it safely with regards to proper nutrient balance, you should be OK. ;-)
*Some people's hormonal situations are so severe, or sensitive, that it requires both the right dietary changes AND prescription/supplements to attain 100%. Yet even normal individuals can alter their hormones by changing their diets, so this isn't exclusive to only those with health problems or hormonal disorders.