Acne and Intestinal Dysbiosis (Urinary Organic Acid Test)

Organic Acid Nameless

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)










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

2014-04-04 17.21.34

2014-04-04 17.22.06


2014-04-04 17.22.58


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.