Avatar universal

Should I see and....Endrocrinologist?

I posted back in Sept about having insanely irregular periods and the pill after several months was not able to regulate it.  Even though my ultrasound came back showing only one cyst, my doctor swore that I still had PCOS.  Since then he ended up putting me on Doxycyline to see if it would help my acne while as well as ordered blood test to check for signs of PCOS.  He finally wrote me a letter back two weeks later to say that he was puzzled because everything came back normal, but to continue the doxy to see if it helps the acne, even though it wouldn't fix the overgrowth of facial/body hair and irregular periods.  I wasn't thrilled with this "see if it helps" resolution of his because I felt like he was just trying to make the symptoms better instead of finding what was causing it, but he's been my PC doc since birth so I listened to him.  I ended up losing a bit of weight, due to the Vyvanse I'm taking for ADHD, and I know being overweight can cause problems like PCOS so I crossed my fingers that it would help, but it hasn't.  When I started having aches and pains a couple months later, I went to see him about it.  I was having neck pain and knee pain as well as toes going numb with some tingling in my skin.  Don't know if that is relevant to the whole period/acne/hair issue or not but it was concerning me.  He ordered a bunch of test to see if there was any muscle disease, as well as lupus and RA.  I mentioned to him that after two months, the doxycycline wasn't doing ANYTHING for my face.  He said that it wasn't severe enough (in his opinion obviously because to a 25 year old, this kind of acne is not much of a confidence booster) for me to use a 'dangerous drug like Accutane' which I think is another matter or opinion.  He switched me instead to Cephalexin, which after nearly 3 weeks hasn't done anything either.  He sent me another letter and of course, my test results all came back neg for the autoimmune muscle disease and metabolic disorders he tested me for.  My thyroid at the time of my physical 6 months prior was normal and it was tested again just to see if it had possibly changed, though he doubted it, and it too was normal again.  Even the xrays of my knee and neck were clean.  He said if I the pain/numbness didn't go away then he would refer me to a rhematologist.  He neglected to mention anything about my period/acne/hair issue.  I feel like he's treating me as 2 patients now.  The only thing in my mind that fits the PCOS-like symptoms is my cortisol levels possibly being out of whack.  I mean, I know GAINING weight is a cushings symptom, but bear in mind, I haven't been eating the same due to the Vyvanse which is the only reason I'm losing weight.  My weight is still carried more heavily in my face and upper trunk.  I want to be DIAGNOSED not medicated until something works.  The hair especially has me losing my mind.  It takes over an hour for me to remove all the hair every other day, and that is JUST from my face.  My chest is getting worse as well.  This can't be something normal!  My doctor never said when to come back for the acne/hair/period issue, so how long should I wait and try this antibiotic?  I feel like the Cephalexin not only isn't helping, but since I've started it, I have horrible stomach aches after eating even a small amount.  

My main questions are, how long should I wait to see my Doctor again and should I ask him about my cortisol levels or have him refer me to a endocrinologist?  I just want answers.
13 Responses
Avatar universal
Get the referral for the ENDO. and not the RHEU.

Have Cushing's ruled out.

What meds are you taking now?  (bit confused about your meds)

Medical conditions?

351246 tn?1379682132
Welcome to the MedHelp forum!
Yes, please consult an endocrinologist. Irregular and scanty periods with facial hair can be due to birth control pills. Liver metabolism disorders affecting the levels of estrogen and progesterone are also possible. This is commonly seen in people taking too much alcohol.
Cushing’s disease and disorders of adrenal gland, tumors of the ovaries and adrenals, insulin resistance and obesity are the other factors. Take care!

Avatar universal
I think you would benefit from some natural supplements. The herb Vitex (also know as Chase berry) is the treatment of choice in herbal medicine for both acne and irregular periods. Vitex will raise progestrone levels and balance estrogen. The other thing to try is beta sitosterol. It is the active agent in the herb saw palmento. It is a very good and extremely safe DHT blocker. DHT (Dihydrotestosterone) is the cause of your facial hair growth and plays a huge part in the acne.
It's likely you have a systemic yeast overgrowth as well. Yeast overgrowth will occur in your GI and vaginal tracks as a result of hormone imbalance and antibiotic use. Get a good probiotic with at least 10 billion cfu and use daily.
Natural progestrone cream is also very safe and works faster than Vitex. You would use it from day 12 of your period to day one. Adding DIM (Diindolymethane) a natural plant nutritent to balance the estrogen levels. Once you do that you will be able to lose weight!
You must totally avoid sugar. It's almost impossible to control yeast infections and clear acne when consuming moderate to large amounts of sugar. You can support and balance your blood sugar levels with the mineral Chromium picolinate. This mineral is also used for weight control, acne, diabetes and cholesterol.
Once you balance your hormones, clear the yeast infection and normalize your blood sugar you will do well.
Other things to remember are to eat well, take a good multi vitamin and make sure you are getting plenty of fiber. Thirtyfive grams a day. Fiber absorbes toxins in the intestines and quickly eliminates them from the body. One or 2 good bowel movements a day is what you want.

1. Vitex or natural progestrone cream
2. Beta sitosterol  300 to 400mgs daily
3. Probiotics 10 to 20 billion daily
4. DIM 200mg daily
5. Chromium 400mcg daily
6. 35 grams of fiber (at least try!)
7. A good multi
8. Eight bottles of good quality water per day

Good luck! Your're gonna do fine!!
Avatar universal
I'm taking Vyvanse 70mg for ADHD, 250mg Cephalexin twice daily.  He had me on Doxycycline before Cephalexin but it didn't do anything for me.  I was on birth control pills last year to see if that would help, but after several months, it didn't change one thing (well, I actually think it made my acne worse for a little while).

I've been diagnosed with arthritis in my ankle (old car wreck injury) but that is rare that it hurts me too much since I've lost weight.  I was diagnosed last summer ADHD.  And I don't know if this counts, but I have TMJ diagnosis per my dentist.
Avatar universal
Firstly, your suggestion for the Vitex to raise progesterone and balance estrogen...Those were tested in my PCOS bloodwork.  They were perfectly NORMAL, in fact, better than normal.
Secondly, my DHT levels.  ALSO normal.
Thirdly, you suggested yeast infection when I never made any mention of anything like that, and you blamed it on the hormone in balance, which they are in perfect balance, and the antibiotic use, which I haven't been taking that long.  I'm 99% sure that the antibiotic is just agitating my stomach and not building up a yeast infection.
Fourth, you mention taking care of all this will help me to lose weight.  I think you might have skipped over parts of my story when I mentioned that I was losing a lot of weight.
Fifth, you say that I need to stabalize my blood sugar.  Coming from a family of diabetics, my doctor is VERY pleased with how low my sugar readings are.  76 at my last one and I didn't fast.  And I DON'T eat a lot of sugar so I'm kind of annoyed that you are assuming a lot of stuff here instead of just asking me, like when you tell me that I need to 'eat well'.  I have been eating well for years and I stayed heavy, but still, as I said before, with very good blood sugar readings.  Now that I'm on the Vyvanse, I'm just not eating much.  But the weight I'm losing is coming off faster in the arms and legs, not so much in the face and torso, like I said, where Cushings tends to hold weight.  Not saying that it is, just that it fits.  I'm pretty sure your theory is way off because none of your advice fits what I'm experiencing.
Avatar universal
Pretty sure you posted this back in Sept.

It's not birth control pills.  These problems started years before I began five months of BCP last year and since it didn't help (actually I think my acne got worse) my PCP pulled me off them.  Liver metabolism is unlikely because my doctor tested me for a ton of metabolic disorders, more for the pain/neuropathy, but those even came back NORMAL!  As well, my progesterone/estrogen levels, guess what, NORMAL!  I don't drink a lot.  Only socially every now and then, maybe a couple drinks in a night, and that will be it for a month or two.  I don't think its obesity.  I mean, I've always been heavy, but I've been losing weight because of the Vyvanse and certainly nothing has gotten better.  My blood sugars are perfect, so Insulin resistance is out.  I had a vaginal ultrasound to look for cysts before my PCOS blood work, and I'm betting they would've seen a tumor on there.  Possibly.  Mistakes do happen, but for the sake of argument, lets just say they didn't make one.  So, in your list of what it could be, Cushings seems to be the only thing left.  I don't take corticosteroids, so IF it is, then its more than likely a tumor.  I'm not saying this is what I want, but it fits, and I just want an answer.  Now, my question to people, when do I go back to my PCP and ask for the referral?  How long before I prove to him the antibiotic doesn't work?
Avatar universal
Get the referral for the Endo.  This situation is out of your PCP's range.  
Avatar universal
Pretty sure that's what I'm going to have to do.  I feel bad because he's been my doctor since birth.  I love the guy, but honestly, he's trying to fight the acne without looking for a cause and not really saying much about the irregular periods/facial hair except that he can try me on a different BCP.

I don't want to be on it.  Sorry.  I'm asking for the Endo.
Avatar universal
Yes, what a shame.  He may be nice, but he just can't help you in this situation.    
Avatar universal
DHT and sugar levels in the skin are not tested. Since someone thought synthetic hormones might help (i guess they didn't) I thought I'd throw out a natural approach since you had no other answers. Sorry in didn't it help you any. Hope you get get well very soon!
Avatar universal
So much of what I wrote pointed to Cushings, except for my weight loss which I attributed to the fact that I was taking Vyvanse. I was particularaly thrilled about the weight loss. I was looking great...until 3 days ago. My doctor gave me an antibiotic to treat the acne, but I am currently experiencing an intense breakout, worse than I have experienced in the last year. The hair on my face has doubled in speed of regrowth and I can't seem to keep up. And my weight...this is the most frustrating part. During my weight loss, I'd bounce between 2-4 lbs, but then lose 6-8, and it was a constant cycle, but I didn't mind. Now in the last few days I'm between 148-152, which I'm ok with, but I LOOK like I gained 15 lbs! My face, is so bloated and full along with the rest of my body. Normally you wouldn't be able to tell a few pound difference in my weight, but I wore an outfit last night that I had worn just a week and a half ago when I was 148 at the time. The difference was astounding and scary and I'm sure people think that I gained incredible amount of weight but I haven't!...I don't want to leave the house right now. I am so self conscious. It's not PMS sort of thing. I just want to know what's going on...
Avatar universal
Ok, another update.  I went to the doctor and he wants me to CONTINUE the cephalexin antibiotic and now take aldactone on top of it.  He took a blood sample at 5pm when I saw him because I mentioned cortisol.  He said he doubted it was cushings but said it was worth the try.  Of course, I get a phone call back the next day saying my results were normal.  I WANTED the 24 hr urine test, and even he said it was better, but to do blood plasma was just...easier.  Am I wrong to think that he shouldn't be going for easy, but for accurate?  I'm so stressed out its not even funny.  And he basically told me to come back in a month or two to see how it goes.  I don't want this to just get treated.  I want it cured.  This isn't fair.  I never go to the doctor for stupid little sniffles, pains, minor illnesses like so many others do.  But he's treating me like a hypochondriac now.

Sorry for the rant.
Avatar universal
Was this your regular physician?  A blood sample to check cortisol levels at 5 PM?

I thought you were going to see the ENDO.  Get to an ENDO if you haven't my dear.  

This physician doesn't know how to "pull all this together" to help you.    
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