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What causes acne with normal testosterone and what is the remedy for constipation?

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General & Family Physician
Practicing since : 2004
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Hi There , Medical issues: Autoimmune Hashimoto's thyroiditis Post Hypothyroid , constipation, Acne , eye floaters. Medicines which I am taking. 1. Thyroxin 75 MG for Autoimmune Hashimoto's thyroiditis Post Hypothyroid. 2. VIT D3 , 2000 IU for VIT D insufficiency which affects PTH. This was prescribed by you in my in August which I am still continuing without break. 3. Constipation: Softovac Sugar Free at bed time . 4.Acne : Topical : Zinderm : Combination of Adaferin Gel + some other Anitbiotic Gel. The Tests which were advised by you last time I am uploading the reports for the same. As I understand them PTH unlike before seems to normal this time in this report but it still shows minor insufficiency in Vit D levels. Thyroid profile , Testoterene and LFT seems to be normal to me. Rest you can analyse them , I have uploaded the latest reports. Queries : 1. If Testosterone is normal then why there is Acne still at the age of 29 , I dont see anyone around with Acne in this Age . Tendency has fallen down by 80% in the last 6 months but not going completely but better by changing water, starting Vit D Supplements and using a new topical. 2. I take a very mild medication for Constipation and its not as chronic as it was years ago where i was dependent on strong purgatives. I feel the body has healed on its own and the dependency on medicines have reduced but the condition is not going. If I go to Gastroentrologists around locally , I feel worse if I am put on medication to improve the condition further. When I am ok with 1-2 fibre supplements why to take so many prescription drugs as they don't help me rather I feel worse when I try to stop them. As you said before I disagree that the Constipation is unlikely to go because I have it from 1999. Dependency on the medicines suddenly decrease and then increases . sometimes I am even fine with 1 tea spoon of Softovac for days and sometimes I need 4 spoons. Sometimes I feel I am very close to stop fibre supplements but that does not happen. 3. As I understand PTH is normal this time does it mean my Parathyroid condition is cured or it is also a life long condition which will require Vit D Supplement ? I have very less sun exposure and I agree with it. For how long do I need Vit D3 Supplement. 4. I recently heard somewhere that even if you have a damaged thyroid gland with high antibodies , still the body has the ability to heal itself and by avoiding Goitergenic foods, soy and gluten .These foods are like supplements for the Antibodies which damage the gland further. If you stop taking them the body can try to heal itself. These are those people who claim that they are cured of Hypothyroid by diet correction , Yoga. I guess every second food is Goitergenic and Gluten is also in Roti which is made up of wheat. In Indian diet you cant stop eating Roti atleast . What are your views over it , though I remember I have asked this question in a different magnitude earlier. I would like to believe them but I may not without seeing the clinical history. Do you think it's anyway possible or should I blindly ignore it ? 6. Thyroid Antibodies was high which I tested 2 years ago and you saw them in the reports uploaded previously , how often do I need to get Thyroid Antibodies repeated ? Can they increase or Decrease :-) 7. OK ,as I reported last that I am getting earthquake feelings in the night all that stopped on its own then itself in 2-3 days and never returned till date. So I did not see a local physician as I believe it was due to emotional stress due to work and family. I guess I have given you all the required info along with queries , let me know if missed anything. For your action now. Thanks, Vishwam Mob: +91-0000
Posted Mon, 6 Jan 2014 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Chakravarthy Mazumdar 1 hour later
Brief Answer: My answers were given against each question Detailed Answer: Hi Vishwam, I was specially asked to take up this query by the team as the previous doctor was not available. You seem to be well educated. Let me answer each question clearly. 1. If Testosterone is normal then why there is Acne still at the age of 29 , I dont see anyone around with Acne in this Age . Tendency has fallen down by 80% in the last 6 months but not going completely but better by changing water, starting Vit D Supplements and using a new topical. ==== Acne is rarely associated with testosterone. It was routinely tested by physicians. I have seen a number of people post 30's having acne, it is common. As you said they go on their own. Just do not pick them. If you consider it to be a social stigma or a hinderance to wedding you are under myth. You can continue with topical cream. Add 40 min exercise per day and maintain good skin tone. 2. I take a very mild medication for Constipation and its not as chronic as it was years ago where i was dependent on strong purgatives. I feel the body has healed on its own and the dependency on medicines have reduced but the condition is not going. If I go to Gastroentrologists around locally , I feel worse if I am put on medication to improve the condition further. When I am ok with 1-2 fibre supplements why to take so many prescription drugs as they don't help me rather I feel worse when I try to stop them. As you said before I disagree that the Constipation is unlikely to go because I have it from 1999. Dependency on the medicines suddenly decrease and then increases . sometimes I am even fine with 1 tea spoon of Softovac for days and sometimes I need 4 spoons. Sometimes I feel I am very close to stop fibre supplements but that does not happen. ====== Constipation is labeled if a person does not pass stool or gas for less than two times a week. Is it for you? If no you can modify your diet with the help of a dietitian and you do not need medication anymore. Increase fibre intake and water. Only if necessary you can take Softovac 1 tsp. Medication induced constipation is common. Hypothyroidism is known to cause constipation but your thyroid levels are normal. You do not need to go around gastroenterologist till the time I say. If you are able to pass stool or gas at least once in three days you are normal. 3. As I understand PTH is normal this time does it mean my Parathyroid condition is cured or it is also a life long condition which will require Vit D Supplement ? I have very less sun exposure and I agree with it. For how long do I need Vit D3 Supplement. ==== The one time rise in PTH is not considered abnormal. Serum PTH is normal now. It got corrected with Vit D3 as well. I am not sure as Serum PTH is influenced by many factors. It was good that you supplemented with Vit D3. You can stop it now. From now on spend at least 1 hour per week under the sun between 10AM to 4PM. 4. I recently heard somewhere that even if you have a damaged thyroid gland with high antibodies , still the body has the ability to heal itself and by avoiding Goitergenic foods, soy and gluten .These foods are like supplements for the Antibodies which damage the gland further. If you stop taking them the body can try to heal itself. These are those people who claim that they are cured of Hypothyroid by diet correction , Yoga. I guess every second food is Goitergenic and Gluten is also in Roti which is made up of wheat. In Indian diet you cant stop eating Roti atleast . What are your views over it , though I remember I have asked this question in a different magnitude earlier. I would like to believe them but I may not without seeing the clinical history. Do you think it's anyway possible or should I blindly ignore it ? ===== Good things first. It is better to avoid goitrogens though literature does not insist. You should ignore it. Your TSH, T3 and T4 are normal. Next time you should test for Serum TSH, Free T3 and Free T4 and not total. You can stop thyroid supplements for couple of week and test. I say this because you were doubtful about being Hypothyroid. 6. Thyroid Antibodies was high which I tested 2 years ago and you saw them in the reports uploaded previously , how often do I need to get Thyroid Antibodies repeated ? Can they increase or Decrease :-) === What is high thyroid antibodies (antiTPO)?, can you tell me the number? It does not need repetition. We do not kill the antibodies, they would not greatly reduce during treatment. They depend on genetics, traits, immune system etc. We just replace the thyroxine that does not influence the antibodies. 7. OK ,as I reported last that I am getting earthquake feelings in the night all that stopped on its own then itself in 2-3 days and never returned till date. So I did not see a local physician as I believe it was due to emotional stress due to work and family. ==== Emotional stress has a significant role in work, family and life balance. Get back to me if you have queries.
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