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Ok, I'm still working on thing but this is what I've got so far:

You eat something, lets say a SANDWHICH (meat, vegetables, grain bread), and it enters your [i]digestive system [/i]where it's broken down. Now, depending on it's glycemic load, a certain amount of [b]glucose[/b] will be available for your body's energy needs. This prescence of glucose will cause your [i]pancreas[/i] to produce [b]insulin[/b] to enhance glucose utilization and sometimes it will be a HUGE amount of insulin! Now, if your body (cells, tissues) doesn't need the insulin, it will be converted into [b]glycogen[/b] and [b]fat[/b] for storage in your [i]liver, skeletal muscle, adipose tissue[/i], and [i]skin[/i].

Now, if your liver can [b]NOT[/b] store the glycogen & fat and your cells & tissues [b]will not accept [/b]the glucose then you have a problem. This is known as [b]Insulin Resistance[/b], which can later lead to [i]Type I Diabetes [/i](don't make enough or ANY insulin), [b]Type II Diabetes [/b](unable to use the insulin you do make),[b] Heart Disease [/b](due to high LDL cholesterol levels, free fatty acids), [b]Hypertension[/b], [b]Dyslipidemia [/b](lipid imbalance in blood stream), [b]Obesity [/b] etc. all prevalant in most Western societies. So anyway, [b]IR occurs because your cells are either too full of glucose or they don't RECOGNIZE the insulin you do have[/b]. As a result, you not only have all this extra insulin, but glucose, free fatty acids & amino acids floating around in your blood stream with no where to go....

Now, [b]some of us do not have the same gene defects [/b](read middle of article on CYP450 for specifics). Therefore the [b]PATHWAY[/b] to this next part, is different for all of us depending on what our defect, or in other words, [b]hormonal disorder [/b]is. Examples of hormonal disorders with acne as a POSSIBLE Symptom are [i]Hypothyroidism[/i], Hyperadrenalism, [i]Insulin Resistance[/i], Polycystic Ovarian Syndrome (PCOS)-Syndrome X, [i]Hyperandrogenism[/i], Congenital Adrenal Hyperplasia (CAH), [i]Hypercortisolism - Cushings Syndrome[/i], etc.

So depending on the pathway, this extra or free insulin is going to cause your [b]Adrenal Glands [/b]and [b]Ovaries[/b] OR [b]Testes[/b] to produce the following[b]Steriod Hormones[/b]: [b]Estrodial[/b], [b]Estrone[/b], [b]Progesterone[/b], [b]Testosterone[/b], [b]Androstenediol[/b], [b]DHT[/b] (5-alpha-dihydrotesterone) and [b]DHEA[/b] (Dihydroepiandrosterone). These hormones [b]in excess [/b]or [b]in deficiency [/b]create your...hormonal imbalance.

Obviously if it's in excess you know why you have the problem, but what about if you are deficient in a hormone (vitamin, enzyme, etc) right? What happens is that your body is looking for this hormone and if it can't find it, and is capable of making it, will produce MORE. At least it thinks it's producing more, but sometimes it's [b]unable[/b] to produce the hormone and as a result, [b]OTHER hormones get overproduced [/b]in the process.

The same thing applies to IR, if your cells don't [b]recognize[/b] the presence of insulin, then [b]your body keeps making more insulin[/b], "thinking" that you don't have enough in your system. Unfortunately, it doesn't matter how much your body produces or tries to produce of a hormone, because [b]there is a problem in the pathway that makes this mechanism work perfectly[/b]. Therefore, until the defective pathway is FIXED, the viscious [b]cycle[/b] will continue...or get worse (burnout, tumors, cancer).

A side effect to this would be [b]testosterone[/b] conversion into [b]DHT[/b] (a super androgen) in your blood stream and in your [i]sebaceous glands & hair follicles.[/i] There are several enzymes responsible for this conversion such as, [i]5-alpha reductase[/i], [i]3-alpha-hydroxysteroid dehydrogenase[/i], and 3[i]-beta-hydroxysteroid dehydrogenase[/i]. As a result of DHT conversion, there's an increase production of sebum, skin cell proliferation, inflammation, etc. all thought to contribute to the production of acne.

Does any of the above sound familar? Well it should considering that by now we should have learned that [b]during Puberty, we ALL go through a state of INSULIN RESISTANCE![/b] The only way our tissues can grow is if they become insulin resistant (IR). Therefore, IR increases the proliferation of not just tissue cells, but skin cells, etc. Now through your DIET you will accquire or produce extra [b]IGF-1[/b] (Insulin-like Growth Factor) and [b]Insulin[/b], both of which increase our male hormones. However they do this because we have DECREASED levels of [b]IGFBP-3[/b] (Insulin-like Growth Factor Binding Protien) and [b]SHBG[/b] (Sex Hormone Binding Globulin). Both of which bind steriod hormones that are responsible for the production of acne and some other hormonal problems.

Now, this is the pathway to which Accutane (13-cis retinoic acid) works. It [b]increases your IGFBP-3 hormone which prevents IGF-1 from binding to the androgen receptors[/b]. In turn, this prevents the production of Androgen which means a decrease in the amount of DHT (dihydrotestoterone) that will be converted in the sebaceous follicles. Furthemore, it also [b]DIRECTLY prevents the conversion of DHT[/b] by inhibiting the enzyme (3alpha-hydroxysteroid dehydrogenase) neccessary for this function.

So Vitamin A, Natural Accutane (program by which you create your own 13-cis retinoic acid), and Accutane are going to attack acne by INCREASING [b]IGFBP-3[/b]. Which prevents [b]IGF-1[/b] from binding to androgen receptors, decreases androgen production, DHT conversion, skin cell proliferation, and sebum production. While various other medications, supplements (like the popular B5) and also various DIETs are going to attack acne by along other Insulin Resistance pathways.

So if we continue discussing diet, then [b]by avoiding certain problematic foods for YOU, like [i]High Glycemic Load Carbohydrates[/i], etc you can naturally INCREASE SHBG and IGFBP-3[/b]. Now, we already know what IGFBP-3 does by reading the above, and SHBG works by having a higher affinity to binding male hormones over female hormones in your system. In fact, [b]in the presence of Estrogen (birth control pills) SHBG will be further synthesiszed in the liver, but in the presence of Insulin, it won't be produced[/b] and Obesity, Acne, Hirusitism, PCOS, Hypothyroidism, ovarian tumors, and enlarged prostates can result.

Furthermore, just by lowering or balancing your insulin levels which [b]HAVE[/b] been done through dietary changes and/or medications/supplements, you will also prevent the conversion of DHT (through 5-alpha reductase and 3-beta hydroxysteriod dehydrogenase enzymes), skin cell proliferation, inflammation, and sebum production. However not everyone notes a complete decrease in sebum production despite dramatic improvements in clarity. Which indicates that sebum production isn't neccessarily NEEDED to have acne. [b]If you think about people with dry skin with acne and others with ingrown hairs, the problem isn't sebum but skin cell proliferation, poor exfoilation, and inflammation[/b].

Of course that aspect can be controlled or prevented, topically anyway, by following a regimen similar to the "Acne Cure" I've been doing the Acne Cure for years now and I didn't even know Using (gentle) acids and exfoliants on your skin is great way to help unglue the clogged pores (sebum helps here), and encourages faster skin cell turnover. Not to mention, taking certain vitamins will also enourage faster healing and skin cell shedding which is what makes an acne sufferer's skin different from someone that happens to just have "Oily" skin.

This is why there are different ways to attack acne. Different topicals, different medications, different diets, and other alternative methods (meditation, exercise, etc). Yet, [b]they all are going to work on some hormonal level[/b]. They all work along similar lines in terms of preventing the conversion of DHT, inhibiting the effects of androgens, reducing androgen levels, controlling your insulin levels, etc. So from having [b]topical anti-androgens[/b] to [b]Internal Anti-androgen[/b] medications, supplements, diets or exercise programs we have found ways to reduce, control and ELIMINATE acne (and other hormonal problems). Therefore, depending on YOUR own external and/or internal factors you may need to use [b]one[/b] or [b]all[/b] of these methods to solve your problems.

If you do not know what is wrong inside, then you should discuss your problems & "symptoms" with your doctor so that you can see a Gastroenterologist, Endocrinologist, Allergist, Naturopath, or some other Specialist that will help you find out. For most of you this is merely puberty (still suxs), but for others [b]this can continue for several decades[/b]. Please note that it's impossible to eliminate ALL DHT or ALL sugar from your diet. However, the sooner you find out the truth for you, the less [b]hormonal[/b] and [b]health[/b] problems you will have to deal with in the future.

Good luck

[This message has been edited by SweetJade1 (edited 08-03-2003).]

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