• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

ACCUTANE WITH PRE-EXISTING HYPOTHYROID - could this lead to diabetes or other autoimmune conditions?

L

Libbaloo

Well-Known Member
Messages
87
Hi there...would appreciate your thoughts.. my 19 year old daughter was diagnosed with Hashimotos thyroiditis at age 15 and subsequently went on to have hypothyroidism - thyroxine levels are managed with daily levothyroxine medication. However, she is suffering with acne (it may or may not be linked) and no treatments have worked so far so she is going to Dermatologist with a view to roaccutane medication.

This is a very strong drug to be taken or 6 months and we are currently reading up about it. From what I understand so far, prescribers should ascertain whether the patient has a pre-existing diagnosis of or susceptibility to autoimmune disorders (of which Hashimotos hypothyroidism is one) as the roaccutane could possibly trigger auto immune conditions and there seems to be discussion on line about developing diabetes and various other auto immune disorders (irritable bowel, Crohns, Arthritis etc) after Roaccutane treatment.

There are potentially serious side effects with this drug. My daughter has the hypothyroidism, but also a touch of mild psoriasis (itchy scalp), Raynaud's (cold hands and feet) 'clicky' feet and perhaps the acne is an inflammatory response as part of an auto immune response.

She has not been diagnosed with diabetes but my concern is that taking this strong drug for the acne will lead to other conditions being triggered sooner or later.

Important to make an informed decision.

Blood tests must be done as part of the decision for or against prescribing Roaccutane in any case - liver, pancreas, kidney, blood sugar etc.

She's off to uni soon and will need to be vigilant about noting side effects and monitoring blood tests too.

Anyone been here before?
 
It's so good that she is seeing a dermatologist, IMO that's the only way to go when acne is severe. Here is some info about acne management, including various other drugs including antibiotics and hormones. I have found this website great for accurate in depth info about skin conditions:
http://www.dermnetnz.org/acne/acne-treatment.html
 
Thank you Cat Lady. Will have a look at that site tomorrow. I always look out for your posts and you give such wise and balanced responses. Thank you.

As I research, I discover that whilst her Hashimotos hypothyroidism (- an auto immune disorder that attacked her thyroid poss triggered by a winter virus and being run down at 15 yrs), she may have been already genetically susceptible so I am concerned that such a strong drug with listed side effects could trigger others, like diabetes, IBS etc and that's not even looking at the mood issues with Roaccutane when she'll be back at a major uk uni for 8 weeks intense study..

The acne could be a complication of auto immune / inflammatory response and hormones as part of a bigger picture. I get frustrated with medical system with 10 minute appointments that cannot embrace the holistic picture of a person's health and bring it all together.

She has other complaints that come and go ( eg cold feet - Raynaud's, patches of scalp psoriasis when stressed as well as the acne) but as an aware mum, I store up these observations and wonder if there is a bigger auto immune picture going on. The 'snapshot' approach to individual concerns doesn't bring the holistic picture to the fore but I can see the wider view.

Student lifestyle and diet could be better and perhaps the skin flareups would be better controlled with improvements to these but she is desperate to take a pill to get rid of the spots. I'm so glad the derm fitted her in for an appt before she sets off back to uni. That was an extra slot in his day so its a good sign that he could be a flexible type who is prepared to listen and discuss.
 
Aw, thank you Libbaloo, that is very kind of you to say. I really care about people and I've been through a lot with my health over the years so I like making use of my learnings from that. I learn a lot from others here too! You've always struck me as a very thorough person when it comes to your health and that of your family.

I have cold feet but nothing as bad as Raynaud's fortunately. I wear socks all the time and thermal ones in winter. I've even been known to use a wheatbag to heat up my feet, lol. I suspect it is something to do with diabetes because it started around the same time as diagnosis at 38. Or maybe it's middle age and everyone gets it, lol.

I think you are on the right path with your thinking about your daughter's risk of auto-immune conditions. Has she tried antibiotics for the acne? I also seems that there are some things people can do like regular washes and topical treatments. I think the answer lies in something systemic like pills though.

The contraceptive pill can be great for acne and also menstrual problems, but it carries the risk of headaches and weight gain. Difficult tradeoff, I think.
 
Cat Lady Your care for people is clear in your responses..

The GP was against the contraceptive pill route if just for acne because she didn't think the cosmetic aspect was worth the heightened risk of DVT and pulmonary embolisms. If my daughter had needed pill for contraception, she would have been prescribed a different one and any effect on skin would have been a desirable but not guaranteed benefit . Some of my daughter's peers who are on the pill find that it does help clear skin and they tolerate other side effects like water retention and moodiness because they want the birth control..

main concerns are
the risk of Roaccutane triggering other auto immune disorders if she already has a susceptibility.
mood and concentration as she heads off to intense uni (won't say which one but it is an intense academic experience) and she will be away from home
Any adverse effect on her thyroid management with Levothyroxine

I may have to send her some socks this winter term!
Thank you for being there
 
Last edited by a moderator:
ps Forgot to say - yes she has tried oral and topical antibiotics but skin has got worse and it is starting to affect her confidence.

She can cover it up with Bare Minerals make up which has good coverage and is supposed to help with zinc content and is non comedogenic. but underneath is still looks inflamed and bumpy with lots of small sebaceous glands and mini blackheads although thankfully no huge lumpy cysts.

The underlying cause must be a hormonal one. GP also mentioned sub clinical PCOS (she doesn't seem to have any clear symptoms apart from acne) This is not worth exploring at this stage as it involves internal ultrasound which is undesirable if not yet sexually active or needing fertility investigations. However PCOS often linked with hypothyroidism.

Daughter has enough to think about with studies looming again... plus wants to look her best for the parties and balls coming up.

oh to be 19 again!
 
My daughter had bad acne and it was upsetting for me as well as her as no skin care options seemed to work, and it got worse. Luckily for her, a topical zinc treatment worked. I can't remember the name of it but it was in a roller and mixed up fresh by the chemist. She also had a high strength peroxide cream. Those both improved her skin, and then the acne just seemed to go of its own accord. I wonder whether there was a hormonal cause.

You mention PCOS. If it was my daughter, that'd be something I'd look into. There are various diets that are said to improve PCOS so that might help, mainly low carb I think, and those are worth a try.

A friend found antibiotic tablets worked, but if these haven't helped your daughter then i can understand why the Roaccutane was suggested. I can equally understand why you're hesitant about it.
 
azure said:
i can understand why the Roaccutane was suggested
Click to expand...

I will be blunt. This stuff (IMO) is dangerous. It cost me a marriage. My wife's really BAD acne was cured (so what, I still loved her no matter what) but the mood swings and depression that accompanied it frightened the heck out of me
 
Mike D said:
I will be blunt. This stuff (IMO) is dangerous. It cost me a marriage. My wife's really BAD acne was cured (so what, I still loved her no matter what) but the mood swings and depression that accompanied it frightened the heck out of me
Click to expand...
Yes, it can have severe side effects for some people, but for others it is a helpful medication that treats a significant problem, and luckily for them without severe side effects.
 
I think the GP is taking the wrong approach. This is not just "cosmetic", this is about psychological health and the risk of permanent scarring. The DVT/PE risk for young women with no other risk factors is minimal. It's usually women over 35 who also smoke or have a family history who are at risk of these complications. If your daughter wants to try contraceptive therapy for her acne she might want to see a different doctor. Severe acne is a very unpleasant condition and I am sure there are other doctors who would take a different view than this GP. Sorry but things like this rouse my internal Mad Mama Bear tendencies, lol.
 
Thank you for your comments and insights so far. My daughter has tried various topical treatments including the mix up solution which I think was zineryt. The only thing that seemed to sort it was 'Dalacin T' (Is that adapalene?) but that was earlier on and she seemed to become more immune to it after using it for a while.

Sorry. I've lost count but know that various topical antibiotics and retinoids and the oral Oxytetracycline haven't really helped so far.. Most meds say be patient and wait for 8-10 weeks for things to show effect but my daughter is becoming increasingly fed up with the trying out of various things and some seem to add to the inflammatory response. All this with trying to cover up occasionally (most of the time she bares it out) and trying to cleanse and moisturise without creating extra problems.

Diet may be key but she is a student and knows her own mind and doesn't really want to talk about her skin with me. Of course, there must be a strong link with diet, nutrition, vitamins, digestion etc and our general health and specific conditions and metabolism.

I am glad we have the derm appt coming up. She has no more Oxytetracycline tablets to take and interestingly, this morning, I thought her skin had calmed down a bit but she isn't convinced. Close up, there is lots of current pore inflammation and the red marks of older healing lesions too. It is in a constant cycle. As Cat Lady says, it is a very upsetting condition, especially at an age when an attractive girl wants to look her best and can't cope with disguising it when having to focus on studies and life in college res..when she feels she is the only one having to cope with acne. Of course she is not, but that doesn't make it any easier and although I think it is moderate rather than severe, she says she thinks about it constantly as people look at it instead of her.

I hope we will have some confidence when we see the derm.
 
Hi i'm diabetic and have hypothyroidism and like your daughter developed acne in my mid 20s (i was like why i am developing this....something that affects teenagers!!!!). Like your daughter i tried all sorts but it didnt work. so i ended up going on the Roaccutane, luckily i only needed a low dose and i dont know if this contributed to me not having many side effects. There will be many things to consider and you need to be quite self disciplined (only 3 units of alcohol a week and staying out of the sun - i have lupus so this wasnt an issue for me). For me, it was worthwhile doing and i am glad i did it, but i can understand it isnt for everyone, good luck with seeing the dermatologist and in whatever you and your daughter decide
 
Hi there - just doing some research and came across your message - my daughter's story is almost identical - did you end up going down the roaccutane route and if so was it all ok? Many thanks!
 
Catswhiskers53 said:
Hi there - just doing some research and came across your message - my daughter's story is almost identical - did you end up going down the roaccutane route and if so was it all ok? Many thanks!
Click to expand...

Has she been tested for PCOS? Often a source of bad acne. Other treatments could then be considered.
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…