acne

Nuts for Nuts

I recently came across a meta-analysis regarding nut consumption and health outcomes.  Meta-analyses are generally far better regarded than several studies alone, as they look for general trends across many studies.  This includes looking for inconsistencies in data, conflicts of interest, or how well the study’s authors controlled for variables.

Daily nut consumption was shown to be associated with a 22% reduced risk of all-cause mortality, 30% reduced likelihood of coronary heart disease (when arteries become hardened and narrowed), and a 40% reduced risk of DYING from diabetes.

So what were the key points, and how might it relate to acne?  First of all, 20 grams of nuts per day maximizes benefit.  Anything above that provides no further benefit.  This amounts to a handful, or a little less (I have big hands, just like Donald Trump).  I personally got out my gram-scale and weighed nuts, just to get a general idea as to how much 20 grams is.  Brazil nuts weighed about 3 ounces, so it would take 7 per day to achieve 20 grams.  Walnuts were heavier than I had assumed, as it was about half a handful of walnuts to reach 20 grams.

According to the analysis, nuts are helpful because they are “high in fibre, magnesium, and polyunsaturated fats”.  The study’s author also notes that “Some nuts, particularly walnuts and pecan nuts are also high in antioxidants, which can fight oxidative stress and possibly reduce cancer risk. Even though nuts are quite high in fat, they are also high in fibre and protein, and there is some evidence that suggests nuts might actually reduce your risk of obesity over time.”

Looking at biomarkers for acne patients, they tend to be deficient in certain polyunsaturated fats and various antioxidants.  It seems prudent to include a handful of nuts in your daily diet.  I personally eat only 2 meals per day and then have a handful of nuts mid-afternoon.  This has worked out well for me, as I save time and money.  I also feel fine doing it.

 

Reversing the damage of Antibiotics on your Gut Microbiota

People with acne are intimately familiar with gut microbiota.  Having severe or moderate acne probably means you have cycled through tetracycline, minocycline, Azythromycin, and doxcycline, among others (these are the ones I have used)…

Unfortunately for us, research in the past decade is indicating that these bacteria are pretty damn important for our systemic health.  I have gone down the rabbit hole of gut testing–I have already used Ubiome (many times), American Gut (once), and the more comprehensive Genova Stool Test (results already posted).  I am not going to fool you into thinking that these are diagnostic or incredibly actionable at this point.  Most of it has been interesting, but it is still somewhat preliminary.  Have I been able to ‘target’ and change these things?  Not really.  I have been messing around with DIY fecal transplants, which I will do a blog post about soon (yes, fecal transplants are a thing but the FDA only allows it to be performed clinically for a very small number of conditions, unfortunately).

As a general rule of thumb, I always participate in research.  I recently participated in Ubiome’s mental health study.  I was very impressed and look forward to seeing the results.  I also received a free gut kit from it.

Another company that I have been really impressed with, and testing with of recently, is The Biocollective.  Martha Carlin, the CEO is awesome.  Her TED talk about the gut microbiota of Parkinson’s patients is here: http://tedxtalks.ted.com/video/Do-Gut-Microbes-Predict-or-Caus

Martha is  dead set on figuring out how the gut microbiome interacts with human health.  To get your gut sequenced, check out the website.  You can get the basic bird’s eye view of your gut bacteria done for free.  To get fungi, viruses, parasites, and bacteria checked, you can use the code word CAND50 for 50% off–this brings the standard kit’s price to $275– a good deal in this world.  And I am sure the price will drop in coming years as the price of sequencing continues to drop.  So if you take a shit–get tested.  It isn’t tough, the data benefits us all as we learn about us–the super-organisms that we are.

Acne and Inflammatory Markers

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I just wanted to get this out there.  Acne does not seem to be related to inflammatory markers, at leas the ones presented here.  A suspicion I have is that acne is related to interleukin 1beta, although that is not measured on this test.

From my findings acne seems to be related much more to insulin resistance instead of markers for heart disease. 

On my next post I will document potential integrative pharmaceuticals for acne (life is short and while foods are the basis for health, not all problems can be overcome in a timely fashion with kale and coconut oil).  I will also upload another test, but the internet is so damn slow right now…

Also HDL Labs has a great basic panel and if anyone is looking for blood testing they should consider their basic panel.

Acne and Intestinal Dysbiosis (Urinary Organic Acid Test)

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Above is the urinary organic acid test.  Urinary organic acids are measures of metabolites of intestinal bacteria that are released into the bloodstream.  There are several other urinary markers as well, including urinary neurotransmitter metabolites.

Relevant to acne, there is a vitamin C deficiency (vitamin C excretion = 0).  Vitamin C is important for collagen formation and skin structure.  Collagen/gelatin supplementation is an interesting avenue for healing acne scars.  Elevated cortisol (the stress hormone) causes a breakdown of collagen into amino acids, thus leading to a loss of skin structure.

There are markers for bacterial dysbiosis.  Arabinose is elevated, which is a marker for yeast overgrowth.  Acne patients tend to have dysbiosis.  This may be due to the traditional route of using antibiotics for acne (very short-sighted approach!), or it may have something to do with lack of essential fatty acids allowing for intestinal permeability (which wouldn’t inherently cause bacterial overgrowth AFAIK).  Either way antibiotics should not be prescribed anymore for acne.  If you want to go the antibacterial route, use coconut oil for caprylic acid and lauric acid, or ideally get your fatty acid profile done and get them into optimal zones, and the problem may resolve itself.

I used to look forward to not having acne due to this: http://www.popsci.com/science/article/2010-04/nano-bombs-deliver-bacteria-killing-therapy-acne, but now I realize how silly that is when you could simply take coconut oil and over time reap the benefits of the systemic effects as well.  A lot of these researchers are more interested in making $$ by formulating patentable compounds, so keep that in mind when going through research articles and constantly try to figure out the integrative approach.

Also, as far as neurotransmitters go, I had high levels of dopamine compared to norepinephrine.  Norepinephrine is the downstream metabolite of dopamine (by the enzyme dopamine decarboxylase).  Copper is needed for this conversion.  I had low plasma copper levels, due to long-term zinc supplementation.  Zinc in high doses is recommended by many acne sites and practitioners, but be vigilant to not overdo it in either direction.  Keep a 15 mg to 1 mg Zinc to copper ratio through supplements AND diet.  Ideally, TEST TEST TEST.  That is the best way to know what your levels are and avoid problems downstream.

Acne, Fatty Acids, AND Amino Acids

Test Date: February 2014

# of Lesions: 10

Diet/Supplements/Drugs: Lower Carb, Paleo-ish diet, with milk/Spirulina 50 mg/day for past 6 months (around 30-60 mg GLA per day), vitamin D, Aged Garlic Extract, Magnesium citrate, b12 1 mg)

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Even after 6 months of supplementation of GLA the GLA, and more importantly DGLA, were on the very low side. DGLA is the precursor to anti-inflammatory prostaglandin E1, and can also be converted into arachidonic acid. There are many checks and balances when it comes to fatty acid metabolism.

The interesting thing to me on this test was the taurine deficiency. All of my fatty acids trended low, and lo and behold taurine is a necessary constituent of bile, which is necessary to break down fats and fat-soluble vitamins (vitamins A, D, E, and K). 1 gram 3x per day is standard dosing, preferably before meals to increase fat absorption.

Taurine is found in seafood and meat, and to synthesize it naturally the body needs the amino acids cysteine and methionine, plus the activated form of vitamin B6, p5p.
Taurine regulates blood sugar as well, and decreases inflammation in obese people. It is an interesting amino acid.

The high Linoleic acid: dihomo-gamma-linolenic acid ratio, even after long term low-dose supplementation of GLA seems to indicate that Delta-6-desaturase enzyme is not converting Linoleic acid to Gamma Linolenic Acid effectively. For this enzyme to function properly the vitamins and minerals zinc, b6, C, and magnesium need to be present. There could also be genetic aspects for the dysfunction.

Gamma Tocopherol was also on the low side. Long term supplementation of Alpha-tocopherol can deplete gamma tocopherol, so supplementing mixed tocopherols or ensuring vitamin E from natural sources is wise.

The copper is low, which in all likelihood is from excessive zinc supplementation. Both are relevant to the acne discussion, and I would recommend that you personally check your plasma levels of both, or do a hair mineral analysis to get personalized recommendations. Rule of thumb is 15 mg zinc per 1 mg of copper.

Acne: Copper or Zinc?

Test Date: January 20th, 2014

# of lesions: 10

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Unfortunately I have taken zinc and copper supplement or eaten beef liver intermittently for a long time, so the zinc and copper levels are not organic data.  I think acne patients would be wise to test zinc and copper.  On a hair metals analysis my copper levels far exceeded zinc, which would make sense as previously I consumed a regular multivitamin (2mg copper per day) plus weekly beef liver (12 mg copper per slice) would lead towards copper excess.  I will post that test soon.

Keep in mind that the recommended balance is 15mg zinc per 1 mg copper, as both antagonize each other.  Balance is crucial.

Vitamin D is at a good level. I have not found a correlation between vitamin D and acne, although theoretically it could give a small benefit.

Magnesium should be on the higher end of the reference range, as in upper half.  I have often been magnesium deficient.  Shoot for RBC levels above 5.

Magnesium has insulin sensitizing effects (anti-diabetic), so it will help acne some.  Every 5 or 10% decrease helps.  It also reduces anxiety and is involved in 300 enzymatic reactions in the body, so don’t go without.  The best forms are gylcinate or citrate, and magnesium oxide (the most common form) is very poorly absorbed.

Acne and… Gamma Linolenic Acid? or Vaccenic Acid?

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Gamma-Linolenic Acid is on the low side.

This comes after 3 months of taking 3 grams of spirulina daily, which has 30 mg of Gamma-Linolenic Acid.  On an anecdotal basis, GLA has changed skin texture for the better over the course of 2 months.  Skin seems to retain moisture better, as ridiculous as it sounds.

Vaccenic acid was low.  Data show that acne comes from high-carb diets that tend to lack various fatty acids: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/

Here is a new study on GLA/Fish oil and acne

Leave it to the Koreans to finally conduct much-needed studies.

Fatty Acids– My biggest find so far!

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While there are many factors to acne, fatty acids have been the biggest boon.

EPA (the omega 3 found in fish/fish oil) and Arachidonic acid were abnormally low.   EPA is low due to poor antioxidant status (probably), and the arachidonic acid is low, perhaps due to the rapid conversion to prostaglandins and other Arachidonic acid metabolites.

Oct.-Dec. 2014: Gluten-Free Diet, Multi with Zinc and Copper, Broad-Based Probiotic, Aged Garlic Extract

There seems to be good evidence that acne correlates or is caused by a fatty acid imbalance.

Micronutrient Test #2: Antioxidants and Acne Revisited

*We are working on a better format for this website.  In short it is a collection of lab tests aimed at identifying the root cause of acne.

Spectracell 2 online

Date: 7/10/13

Lesions: 15

Medications/Diet/Supplements: NAC 1600 mg, Standard Multivitamin, Typical American Diet, Beef Liver 1x per week, Vit. D 5000 IU

There is definitely a correlation with acne, although low antioxidants can also lower Testosterone and DHT, so it could even out.  But in general, acne and low antioxidants tend to correlate in my experience.

It does seem as if this is not the root cause, because simply taking NAC or vitamin E did not do much by way of eliminating acne.

Basic Blood Workup: Correlations We Can Draw

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Date: April 18,2013

Number of Lesions: 7

Medications/Diet/Supplements: Zyrtec 10 mg, Vit D, Animal Pak Multivitamin, NAC 1200 mg, Typical Diet with Beef Liver 1x per week

Correlations:  HDL cholesterol and fasting blood glucose correspond to acne. (Lower HDL = more acne) (Higher fasting blood sugar= more acne)

C-reactive Protein did not correlate with acne, as levels were great.  C-reactive Protein is an inflammatory marker.

Acne doesn’t necessarily correspond to testosterone levels necessarily, but it does seem to have some relation to estrogen (estradiol), for whatever reason.