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[QUOTE=chickenbutt]you know, i have no idea!!...both of them have heard about it but they say, "you think you've got it bad...i've seen women with far worse..." no kidding...as though that helps....i just don't understand how they can be so unsympathetic AND women....i feel like doctor shopping just to get the rx and be checked for potassium levels....anyone know any docs in north jersey?[/QUOTE]


Hmm...you can tell them to kiss your assets and just go to an Endocrionologist or another doctor instead. Hirsutism can be Idiopathic or Hormonal...although both are hormonal ;-)

[U]Idiopathic Hirsutism[/U] = when you have normal hormone levels but increases Follicular Sensitivity and usually increased DHT production in the hair follicles.

[U]Androgenic Hirsutism [/U] = which is due to having HIGHER than normal amounts of androgens (Testosterone, DHT, etc) in the blood stream and also increased DHT in the follicles.


A good indicator of Androgenic Hirsutism would be if you have other hormonal problems. We know that you have acne (but this could also be due to sensitivity), but what else? Irregular Cycles, Hair loss (on scalp), Dandruff, Wieght Issues, etc?

Of course, none of that truly matters because if it's not Hypertrichosis (usually it isn't), than it's caused by some form of androgenic activity. It actually took a woman doctor (I was 17) before anyone seriously looked into giving me medications for my crazy hormones. She put me on BC, did nothing for the hirsutism, but did help reduce the acne. So later I saw an Endocrinologist (2nd one) and he said tha some people can just be extra sensitive to normal hormones and if I wanted I could go on Spironolactone. Well 6 months later (new male regular doctor), I had him put me on 200mg of Sprionolactone =)

That was my medication for 3 years. I just read something the other day that Spironolactone only reduces androgen levels by 30%. I must admit that's how much it added to the effects of my BC. So instead of 50% clear skin...I would have a 60% - 80% clear skin (80% was only during the summer). This did help reduce some of the body hair, but not as much as changing my diet and spiro did (past 18 months).

Anyway, this is currently my own conundrum. I've been on Spironolactone for nearly 6 years, although I recently stopped 2 months ago. I still have hirsutism and it looks as if some hairs are growing back. This is the thing I want to get across to any of you women with hirsutism and androgenic alopecia (scalp hair loss to DHT). [B]ONCE the hair follicles have been sensitized, even when your testosterone levels naturally decline (in your 20s and so on)...those follicles will STILL be sensitive & stimulated by DHT. [/B] Meaning, you will ALWAYS need a Follicular Anti-androgen (external or internal) otherwise, the hair will come back (unless it dies). Therefore, the sooner you can get control of your Acne, Hirsutism, and other Hormonal disturbances, the less "drama" you'll have to deal with when you get older.

Now back to what I was saying, Spironolactone (Aldactone) has been around quite awhile and has been used for the treatment of hormonal disorders in women for over 20 years. So yes, you really [B]need [/B] to get a 2nd or 3rd opinion because those doctors no nothing about this! What makes this more effective than Birth Control is because it actually binds to the Androgen Recptor (it's an analogue) and becomes antagonistic. It prevents the Androgen from binding, which means it also prevents the need for 5 alpha reductase enzyme, meaning less DHT that's converted. I was on 200mg for 3 years (Sprio-BC combo), then 150mg for 1 year ([B]Avandia[/B] - Spiro) and then 150mg of Spiro and a [I]Customized[/I] Gluten-Free Diet.

Of ALL those combinations.... the GF Diet-Spiro combo was [B]the[/B] Most effective thing for my Hirsutism, Menstrual Cramps, and Acne!!! Discovering what a huge impact changing my diet had on my skin, I'm hoping to do the same with replacing the Spiro with some sort of Supplement or Herb. Mainly the only problems I have left to deal with are my Dandruff, slight androgenic alopecia, and mild hirustism (spiro only took care of some of the hirsutism) which are all symptoms of [I]some[/I] DHT exposure or sensitivity. =(

For those interested in anti-androgens, if you live outside of the U.S. [B]Cyproterone Acetate[/B] (CPA is also in Diane 35) is supposed to be supperior to Spiro. In [B]1987[/B] there was a clinical trial run where they used dosages of 50mg on women and after 6 - 8 months they noticed improvements in their hirsutism. There's also another article I found that mentioned that women can start with 100mg - 200mg of spiro for 6 - 12 months and then reduce to a maintence dose of 25mg - 50mg. I suppose that sounds about accurate because there are women on here that claimed that 25mg - 50mg of Spiro CLEARED them. Wish it did that for my acne, but it didn't. Yet I'm wondering if I might be able to handle my mild hirsutism with 50mg....hmm.

Also another combination is to combine [B]Progesterone[/B] and [B]Birth Control[/B]. This is actually what Joeh follows...sorta. He's a male and uses 100mg of Spiro and Estrogen to clear his skin. This is actually the basis of not just [B]Diane 35[/B], but [B]Yasmin[/B] and [B]Allesse[/B], but of course it really does depend on where your hormonal imbalance is coming from because they use different anti-androgens.

Alternative Treatments thus far include: NAC (w/ 2-3x Vitamic C dose), Saw Palmetto, [B]Nettle[/B], [B]Beta Sitosterol[/B], [B]Vitex[/B] (encourages production of Progesterone),[B] NPC [/B] (natural Progesterone Cream), and a form of [B]Low Carb/Hormonal Balancing Diet[/B]. Anyway, it always seemed to me that I might have good luck if I just went out and bought a man's Prostate Formula because whatever is used to treat acne, hirsutism is usually going to also be used to treat Male Patterned baldness and Prostate Hyperplasia. Then again...sometimes it can backfire (cause increase growth) or do nothing at all.

There are people on here that RAVE about Saw Palmetto (men and women) at dosages ranging from 100mg - 350mg (or more) improving or clearing their acne. LOL, but when I was taking 1800mg for several months (3 seperate times) it did nothing. Maybe it was because I was already taking BC-Spiro (competing?) so that's something I may have to revisit. I've mainly read that [B]Saw Palmetto (at 85% - 95% sterols) [/B] decreases hair and acne, but also improves prostate function similar to Finasteride (Proscar, Propecia)! It does so by the same mechanisms as Sprionolactone, by acting as an analogue and binding to the androgen receptors, etc. It also goes under the name of Permixxon (I guess for the clinical trials) or it's natural name [I]Serona Repens [/I] and [U]reduces DHT by 50%[/U].


Now, if you want a really effect DHT blocker you want to hit it at [B]5 alpha-Reducatase Type I and Type II enzymes[/B] (why the thrill over Avodart, but it's only for men). DHT is responsible for the body hair growth and scalp hair loss due to stimulation of androgen receptors in the hair follicles. It also stimulates the oil glands (sebacious glands) and induces inflammation, etc that creates a symptom we like to call Acne. Below are the types of 5-alpha reducase enzymes:

[U]Type I[/U] (33% of DHT) - skin, sebacious glands, sweat glands, & scalp follicles Ex: Spironolactone, Flutamide

[U]Type II[/U] (66% of DHT)- sebacious glands, hair follicles & prostate Ex: Finasteride


Hmm...just like Spiro is actually a duretic but acts like an anti-androgen too, there's a drug used for control of stomach acids and ulcers that also acts as an anti-androgen...[B]Tagamet[/B] (Cimetidine). Apparently it has worked to treat hirsutism (facial hair) and the results are promissing for the treatment of alopecia. However, like I was mentioned earlier anything you find that works for you will usually be a Long Term Treatment, so you want something with the least to no side effects. Drugs have their own side effects, but to help jump start your progress you could try one of the above. Now, for those wanting to go the natural route, probably finding supplements that bind to the androgen receptor and [B]blocks [/B] androgen interaction is probably a best bet in terms of this whole mess.

HTH and Good luck (finding a better doctor) =)
Coloradogirl,
I'm going to be very honest with you and say, not that I know of. It is pretty rare for anyone to go into remission of acne unless it was purely due to a temporary hormonal imbalance (Puberty, Pregnancy, Adult Acne).

I seriously doubt my acne has gone away. I know this because I'm only 99% clear, not 100%. That 1% fluctuates depending on what I eat, but I still don't quite know what it is ;-) I've still got some "no nos" in my diet that I'm working on eliminating as I find neccessary. Through this process I've learned to induce acne on myself by simply eating GF cereal w/Organic Milk, peanuts, chocolate candy, etc (on my bad food list). I've tested them several times over (after my skin improved) and they usually show up in the same areas and produce specific types of acne. That's enough proof for me.

I have not eaten anything with wheat in it and have no intentions of ever doing so (reactionary breakouts are a BAD thing). Yet if anyone needs more proof, the fact that this diet eliminated my menstrual cramps (never improved with time) should suffice. If that does not, the only other example I have is that during this past summer when my skin is usually at it's clearest, I started breaking out in cysts all of sudden! I finally narrowed it down to the Cherries that I had been eating for over a month ...or the Whey Protein Isolate shake I had been drinking. I stopped them both at the same time, and when I did...the cysts stopped too. I eat cherries all the time and that's never happened (some foods can mask effects of others), but Whey Protein is something I've never taken before. So this Summer, when cherries are back in season, I will retest this one. I'm avoiding dairy at the moment to see how my skin reacts (when I add some back in) and I'm willing to test out Cherries again. Not just because they are my favorites, but mainly because I want to give you guys the most accurate and reliable of information.

Indeed, over time all those hormones that we are blaming for our problems will decline. However you must remember that we are extra sensitive and/or produce too much hormones. Therefore a natural decline for some of us could essentially mean and do nothing for our skin =( I've come across members that are 30, 40, and 60 years of age and they (male and female) STILL have acne. Most of them at this point have conceded to trying diet and it has worked for them. Some cleared and others preferred to have a bit more freedom and chose supplements (digestive enzymes, fish oils, r-ALA) to compliment this and get improved/clear skin.

You know, the tricky part about all of this, and what most people on here miss, is that [B]the differences among us have to do with the differences in our genes AND environment[/B]. To rephrase that, what will determine what symptoms or problems you have in life are based on your body's [B]Gene-Environment Interactions.[/B] Now our Genes play a big role, but our environment clearly has a large part too, afterall, this is where our food comes from. Since Food provides the Building Blocks (fat, protein, sugar, etc) for the body, if you give those genes the wrong nutrients, mimickers, inflammatory proteins, etc ...they will respond accordingly. Acne is but [I]one [/I] possible symptom of an underlying hormonal or health disorder. Just as with time, some have noticed their acne has traveled or worse...spread, the same goes for this disease. Insulin Resistance, now known as a [B]Metabolic Disorder[/B], can change from acne after so many years into being Overwieght, High Blood Pressure, Diabetes (type II), Obesity, and even Cancer.

(Example) Your friend may not have acne from eating the same foods, but is she overweight? is she Diabetic? Does she have allergies, etc?

I am a product of my parents and depending on what they eat (chocolate candy or citrus) they get a breakout too. In fact, even my brother still has some breakouts. Anyway, my father side has (borderline) Diabetes Type II his side. My Mother has Overweight, Obesity, and Fibroids on hers. She and my uncle (out of 8 kids) had the worst acne and just like me, she even had body acne, was skinny, and had very bad menstrual cramps. In her early 20s her acne cleared (before she got married at 25), but that's when her hormonal problems really began. She actually had trouble carrying all of us to full term. After her 2nd child her fibroids (had in her breast and uterus) started to cause her serious menstrual problems. Severe pain and bleeding, but she held out on getting hysterectomy until after she had a Girl (me). Several years later and 30 pounds heavier, she finally gave up (had she only known about Natural Progesterone Cream) and had the hysterectomy. My Grandmother also had a hysterectomy (also has skin boils), along with most of my mother's sisters. All are overwieght (my mom is the smallest) and unfortunately 2 (1 is her niece) are obese. You know what they eat???? Well I can mainly only speak for my mother, she's a basic "healthy eater" but an actual Sugar Addict (and also has arthritis). I had her and my father take this Insulin Resistance test and Dad and I were in the same catogory (possibly IR) and my mother came up as definately IR!

Say, what are you doing for your acne now? Sometimes I forget, but are you the one that has a Derm and a Doctor in the family? What have they done for your hormonal imbalance? What have you found to be the most effective treatment for you thus far?

As for me, Diet and Spiro were the [B]most[/B] effective treatment combo against my acne, hirsutism, and menstrual cramps. Last night I finally realized more so [I]why[/I] Diet is so effective and, depending on your goal, more effective than any drug they give us. That's because when you alter your diet by simply [U]Low Carbing [/U] or [B]Low Carbing through the elimination of certain foods [/B] (Gluten Free, Evil Lection Free, Paleo Diet, etc) you are [B]reducing[/B] your [B]overall hormone production[/B]. Therefore, the LESS hormones you have, the less IGF-1 you'll have, the less Testosterone there is to be converted into DHT, and the less acne (or other) medication you will need (if any)!!!

A good example would be... lowering your cholesterol levels. You are given medication that lowers this, but you are also advised to not gorge on high cholesterol producing foods, why? Because [U]your eating habits are antagonistic [/U] to what the medication is [I]trying [/I] to do. Therefore, when the doctor suggests for you to alter your diet, it is really in your best interest and will [B]SPEED[/B] up your results if you do so. =) Not to mention, by altering your lifestyle in this healthy way, you can usually reduce or eliminate your medications altogether.

Thus, that explains why I saw a greater improvement in decreasing my hirsutism when I changed my diet. ;-) Before I was merely using something to Block the androgen receptors (spiro), but [U]combining [/U] that with reducing my [B]overall [/B] steriod hormone production (through diet), meant even LESS androgens to block! I've still got some extra body hair, but the acne is practically gone so I know most people probably don't need medication/supplements to eliminate their acne.

I know this because people of all ages have cleared (or vastly improved) their long term acne by altering their diets to something much more nutritionally healthy and hormonally balanced. Heck I had to give up pistachios because I was suspecting they were breaking me out (neck acne). They are related to cashews, which I am avoiding (Evil Lectin thing), so I brought them to work. My co-worker loves pistachios but frowned when I brought them in. I asked him why and he says that he breaks out whenever he eats them. WOW...his skin is flawless, but even he can detect when something causes a problem for him (thinks it's the oils). Of course someone at work has been eating the pistachios, so I may have to pay his skin a bit more attention. ;-) Anyway, I really think that we are all products of an increasing hormonally deteriorating generations. My mother was worse than her mom and I am worse than my mother. I don't want to pass this on to my kids, therefore I need to learn to eat right now. Furthermore, I don't want to deal with becoming a Diabetic etc. I mean, [B]why would anyone WAIT for something to happen before fixing it,[/B] particularly when an increasing number of people and evidence is telling you that your lifestyle will take you down the path of at least, one of several Health Problems???

........





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