Accutane induced rosacea

[shredder]

Hey guys -

Just looking for some insight and direction, as I'm not sure exactly where to begin. A year ago, I took a six month course of accutane and while on the drug I developed flushing as a side effect. When I came off accutane, the flushing never left. For what its worth, i only flush after extended periods of being outside (whether its sunny or cloudy). It will typically last for the rest of the day, until I sleep. This is about the only post-accutane side effect I still suffer from.

I'm not sure what exactly is going on, and I've tried a few of the supplement recommendations here (potassium, magnesium, betaine hcl) but none of that made a noticeable difference.

I've attached my hair analysis, which puts me at a slow-3. I'm not really sure what to take from it. If anyone has any insight or direction for me, even if thats a "read this thread" recommendation, I would be super appreciative.

Thanks a lot for all your time.

 

[HerrFisch]

Why exactely did you decide to supplement with Magnesium & Potassium?
I mean look at your Mg, Na, K, iron, Se levels. ^^

What did you supplement the last few months ?
Hows your diet. How many ~kcal a day?

 

[HerrFisch]

Are you using anything like thyroid medication or else?

toxic metals & mercury look pretty high.

 

[shredder]

Hey @HerrFisch , thanks for the reply.

I decided to supplement with them after reading about the success people had utilizing hcl and electrolytes with protein. I was under the impression that it was a good idea to take the electrolytes when you take hcl. I haven't taken them in a bit.

Previous to my hair analysis (and currently) I took small doses to T3 semi regularly along with the fat soluble vitamins.

I don't track my intake but I know I regularly eat over 3k calories per day. I eat to appetite and sometimes more just to make sure I'm compensation for my energy expenditure. I work outdoors in a manual labor occupation along with daily physical hobbies. My diet varies but top contributors would be white fish, yogurt, egg whites, whey protein, fruit, potatoes, broccoli and cucumber juice.

 

[HerrFisch]

This 3high you got from accutane looks very tricky.

Apparently ARL suggests copper in those cases. @gbolduev

Did the hair test come with suggestions / supplements to use?

 

[Orion]

What is your height and body weight? Skinny, fat or muscular? Fasting could maybe help bring some of the numbers down.

 

[shredder]

This 3high you got from accutane looks very tricky.

Apparently ARL suggests copper in those cases. @gbolduev

Did the hair test come with suggestions / supplements to use?

It did.
Do the ideas and concepts within the "nutritional balancing" approach to health align with the ideas here? The suggestions offered are from the beliefs of that health field, I think.

The supplement suggestions include a "para pack" (a general multivitamin), adrenal glandular, calcium, and vitamin e. Along with a ton of dietary suggestions, often contradicting my supplement suggestions such as "avoid calcium, calcium supplements, and vitamin d supplements." So I'm not sure what to take from this.

I'm thinking that the wonky levels are from both the accutane and perhaps the low dose T3. I'm not sure how much the thyroid would alter these levels. Perhaps its worth waiting a few months off all medications and supplements and retesting. But I'm definitely trying to take steps forward in the meantime.

 

[shredder]

What is your height and body weight? Skinny, fat or muscular? Fasting could maybe help bring some of the numbers down.

Hi @Orion , thank you for chiming in.
I'm 5' 11" and 168lbs. Quite muscular at around 10-13% body fat. I definitely don't have much to lose, and considering that my work is physically laborious I think it may be unsafe. I could get away with semi-regular short term fasts of 2-3 days, or daily intermittent fasting. But my understanding is that these aren't equivalent in efficiency.

 

[Orion]

Hi @Orion , thank you for chiming in.
I'm 5' 11" and 168lbs. Quite muscular at around 10-13% body fat. I definitely don't have much to lose, and considering that my work is physically laborious I think it may be unsafe. I could get away with semi-regular short term fasts of 2-3 days, or daily intermittent fasting. But my understanding is that these aren't equivalent in efficiency.

With that body type, almost seems you would be fast oxidizer, so yea long fasting would probably not be rec'd. Short fast could be helpful to lower some of the minerals that are high.

Donating blood might help with high iron. Yep your calcium looks low, but 43 is on the high side, so low calcium diet and no vitamin D(just sunshine).

I think just sticking to diet recommendations and short fast would be helpful to start, then re-test in 4months, see whats changed.

You can test stomach acid levels with baking soda:
3 Tests for Low Stomach Acid

 

[mattyb]

This looks like those hair tests I've seen from guys that are competition season for endurance sports. The acidity of activity causes a leeching of stored minerals from tissues, raising blood and hair levels of metals. It doesn't mean that you're necessarily toxic in heavy metals, just that whatever you had stored in you over a lifetime is finally coming out. From what I understand about Accutane, it seems to raise metabolism and leave it "stuck on".

I would liken rosacea to a similar state, where the blood vessels and cells are "leaky", causing a diffusion of minerals stored in tissues to be released into the bloodstream and taken in by hair. Not necessarily a bad state to be in temporarily if you want to chelate metals in the long run. You also mentioned having a physical labor job and physical hobbies, which could be accelerating this process.

If I were you, I would put up with your symptoms for a few months more while taking a heavy metal binder like PectaSol (if you can get a doc to sign on to DMSA/DMPS treatment, then that would be better). During this process, supplementing selenium (1 brazil nut/day), vitamin E, and Vitamin C could be helpful to mitigate damage from liberated metals. Then after a course of that is finished start supplementing vitamin D, low dose K2, glycine/collagen, and maybe just eat more copper and calcium rich foods. That last part will help you keep minerals in the cells where they belong, which is what you'll want once you chelate the toxic metals from your system. I would assume the rosacea won't clear up until that last part has ran for a few months. So in total you're looking at about 6 months until things clear up if you follow this plan.

 

[shredder]

With that body type, almost seems you would be fast oxidizer, so yea long fasting would probably not be rec'd. Short fast could be helpful to lower some of the minerals that are high.

Donating blood might help with high iron. Yep your calcium looks low, but 43 is on the high side, so low calcium diet and no vitamin D(just sunshine).

I think just sticking to diet recommendations and short fast would be helpful to start, then re-test in 4months, see whats changed.

You can test stomach acid levels with baking soda:
3 Tests for Low Stomach Acid

Thanks a lot, Orion. So while my calcium is low on the scale of the hair test, you would consider it high based off of your understanding? I will definitely put forth lowering calcium and donating blood, I could see regularly donating blood being especially helpful to lower metals.
I will do the baking soda test as well. although I already believe my levels may be slightly low as I can take 850mg of hcl and not feel the "burning" that is suppose to occur if stomach acid is not low.

 

[shredder]

This looks like those hair tests I've seen from guys that are competition season for endurance sports. The acidity of activity causes a leeching of stored minerals from tissues, raising blood and hair levels of metals. It doesn't mean that you're necessarily toxic in heavy metals, just that whatever you had stored in you over a lifetime is finally coming out. From what I understand about Accutane, it seems to raise metabolism and leave it "stuck on".

I would liken rosacea to a similar state, where the blood vessels and cells are "leaky", causing a diffusion of minerals stored in tissues to be released into the bloodstream and taken in by hair. Not necessarily a bad state to be in temporarily if you want to chelate metals in the long run. You also mentioned having a physical labor job and physical hobbies, which could be accelerating this process.

If I were you, I would put up with your symptoms for a few months more while taking a heavy metal binder like PectaSol (if you can get a doc to sign on to DMSA/DMPS treatment, then that would be better). During this process, supplementing selenium (1 brazil nut/day), vitamin E, and Vitamin C could be helpful to mitigate damage from liberated metals. Then after a course of that is finished start supplementing vitamin D, low dose K2, glycine/collagen, and maybe just eat more copper and calcium rich foods. That last part will help you keep minerals in the cells where they belong, which is what you'll want once you chelate the toxic metals from your system. I would assume the rosacea won't clear up until that last part has ran for a few months. So in total you're looking at about 6 months until things clear up if you follow this plan.

@mattyb , thank you so much for your efforts to help me and breaking it down in practical way.

It seems you are able to source oral DMSA online without a prescription. Perhaps I could take low doses of this for the next few months, retest hair to see in metals have chelated, then continue with your other recommendations after successfully chelating. Does this seem like a good idea, or would it be safer to take the PectaSol if I'm not working with a doctor? Since chelation seems key for me, I am also planning to donate blood as regularly as possible for the first phase, along with juicing some cilantro.

During the process of the first phase that focuses on chelation, should I omit or reduce high calcium foods, or any other type of foods? Not sure if you saw my diet post above but my diet can be relatively high in calcium. If you have any insight on foods to focus on that would be awesome.

 

[mattyb]

@shredder

I don't think you should donate blood. If your hobbies involve physical activity and your work is physical, then donating blood will take a huge toll on your work life and hobbies. Blood donation is much better for people who are sedentary or people who can sacrifice a drop in productivity.

DMSA is pretty potent, so I think it would be safest to have someone manage things with you if you were to do it. PectaSol is a little less potent, and probably a bit safer as a result. I forgot to mention that using cilantro can work very well for chelating iron as well, may want to consider that.

A bit of calcium isn't bad at all, I would aim for around 500mg/day in your case during the first phase. You could take in higher amounts up to 800mg/day in the second phase. In general though, I think 400-600mg/day is good for most people.

Just saw that you took accutane AND low dose T3. That, on top of an active lifestyle, would cause metabolism to spike and the body to pull metals from the tissue - explains the high hair levels in my mind.

 

[Orion]

Thanks a lot, Orion. So while my calcium is low on the scale of the hair test, you would consider it high based off of your understanding? I will definitely put forth lowering calcium and donating blood, I could see regularly donating blood being especially helpful to lower metals.
I will do the baking soda test as well. although I already believe my levels may be slightly low as I can take 850mg of hcl and not feel the "burning" that is suppose to occur if stomach acid is not low.

Calcium definitely not sky high, just a few points over the midline. Mattyb gave some good points, sounds like a good diet and chelation will be helpful.

Taking HCl if you are low, needs to be balanced with potassium even when its high on the hairtest. I believe HCl depletes K quickly.

 

[HerrFisch]

Dont donate blood. Iron is not really your problem. Its just TEI scale it looks highish. On ARL scale you would even be below middle.
Body just is trying to get rid of things that speed you up.
I dont think you should focus on lowering Iron, chromium, molybdenum.
Rather focus on Mg,K,Na.
And dont keep Calcium too low. I think it is doing you good.

 

[aybolit]

Hi @shredder fellow accutane -> rosacea victim. For me it's been more than 10 years, gradually worsening since.
Interesting about your high mercury, do you have dental fillings? My rosacea started not directly after accutane, it was more or less the time when I got several fillings.

 

[shredder]

Dont donate blood. Iron is not really your problem. Its just TEI scale it looks highish. On ARL scale you would even be below middle.
Body just is trying to get rid of things that speed you up.
I dont think you should focus on lowering Iron, chromium, molybdenum.
Rather focus on Mg,K,Na.
And dont keep Calcium too low. I think it is doing you good.

When you say focus of MG, K, and Na- are you saying I should focus on consuming more of the electrolytes? The reason I ask for clarification is because you questioned my choice to supplement them earlier in the thread, because of the high levels. Just wanted to make sure I'm following.

 

[shredder]

Hi @shredder fellow accutane -> rosacea victim. For me it's been more than 10 years, gradually worsening since.
Interesting about your high mercury, do you have dental fillings? My rosacea started not directly after accutane, it was more or less the time when I got several fillings.

Hey man, sorry to hear that. 10 years is a long time but I hope you're making progress now.
I never had dental fillings. Im not sure where the mercury has come from. But my rosacea started about 3 weeks into accutane and remained since, but has reduced gradually in frequency of flare ups since stopping.

 

[shredder]

Just wanted to update this by saying I've committed to the advice of @mattyb .

I'm a few weeks into dosing PectaSol to bind heavy metals, along with supplementing vitamin C, E, glycine, and selenium containing foods to protect from liberated metals. I'm also juicing cilantro and consuming daily to lower my iron.

I've dropped my thyroid medication.


Thinking about adding digestive enzymes. After recently reintroducing HCL, I noticed the burning with a single capsule so I think my body's HCL production is okay.

I'll move onto the second phase of treatment (vit d, k2, copper, calcium) after I finish the container of PectaSol (~2 more months).

Diet at the moment is seafood, chicken, egg whites, whey protein, some milk and cheese, apples, corn flakes, OJ, broccoli and other veggies, cucumbers (juice), butter, coconut oil, coconut water.
Some rice/potatoes but I do better digesting fruit so I lean toward them more when I want carbs.

No notable change in flushing symptoms, definitely not worse.

 

[mattyb]

Lately I've been doing a significant amount of reading on infectious diseases. I did some reading on Isotretinoin and infection as well.

Seems it can increase the likelihood of staph infection, which can be a driving factor behind rosacea in some cases. Have you gone on the standard rosacea treatment of tetra/doxycycline and/or metronidazole before? I'm thinking an oral antibiotic + oral probiotic might be another form of treatment you could consider, and it might have more immediate effects than a long-term balancing approach (also comes with a bit more risk though).

If the cause is bacterial, raising copper may be a good idea. There are plenty of high copper foods you can add into your diet to raise these levels - sesame seeds, cashews, dates, wheat germ, maybe even liver, and many more.

If you have access to any blood tests, a CBC, hs-CRP, and iron + ferritin panel could be useful for indicating if there is an overt persistent infection, but by itself these tests won't be extremely sensitive. There are also antibody tests for a variety of staph that could be worth getting as well, but I don't know how easy it will be to get them. Some physicans may even do a swab of the face to detect bacterial strains.