Seeking Guidance on Hormonal and Weight Issues
Greetings healthcare professionals, I've been grappling with what I suspect to be hormone-related problems for several years now. My primary challenges include persistent acne, significant weight gain, and constant bloating. I would like to share my experience and would greatly appreciate your insights or suggestions regarding my condition — I am genuinely in need of help. When I hit the age of 20, I began experiencing severe cystic acne that persisted for about two years. I consulted with a naturopath who conducted a Dutch test, revealing notably high levels of antibodies related to my thyroid as well as elevated androgen levels. Subsequently, I visited my general practitioner who tested my thyroid and found the levels to be normal, so I didn't pursue that further. I was then prescribed spironolactone, which remarkably cleared my acne — a relief! However, I noticed an increase in my anxiety levels, which I was willing to overlook due to the absence of acne. Fast forward about a year, and I began to experience panic attacks (depersonalization/derealization), which severely affected my life. My doctor prescribed Pristiq, and while it offered some relief, I gained around ten pounds (from a starting weight of 118 lbs to approximately 128 lbs) alongside worsening bloating. It’s worth mentioning that my weight had remained stable for years, regardless of my food intake. Feeling uncomfortable with the weight gain, I decided to taper off Pristiq after about six months, but the bloating and extra weight persisted. Additionally, my anxiety returned, now more intense than before. I then tried Luvox, which was a blessing for my anxiety and panic issues. Initially, my weight remained relatively unchanged, but as I gradually increased the dosage to 100 mg, my weight rose to 140 pounds, with most of the increase concentrated around my midsection, which made me feel disproportionate. Attempts to discontinue spironolactone led to the inevitable return of my acne. However, about three months ago, I successfully stopped taking it after tapering down from 24 mg, and there was a brief respite from my acne. Intriguingly, my bloating subsided shortly after stopping, but alas, it returned subsequently. Recently, I've developed a theory that my issues are linked to hormonal imbalances. As a self-experiment, I’ve begun reducing my dose of Luvox slightly, and my bloating seemed to improve initially, resulting in a weight reduction of about two to three pounds (though this fluctuates). However, after a few weeks on the lowered dosage, the bloating flared up again, albeit not as severely as it was before. Unfortunately, I also noticed an increase in breakouts after this adjustment in my SSRI dosage. What should I do next? There's a possibility that halting my SSRI could trigger the return of both acne and anxiety, yet it might alleviate my bloating and weight concerns. This presents a troubling dilemma for me. Could I be experiencing low estrogen or even low progesterone, as spironolactone typically reduces those? Or is the issue stemming from my thyroid instead? I am contemplating asking for a comprehensive panel to evaluate my thyroid this time around. I would be grateful for any suggestions or insights you might have. Below is a detailed list of my symptoms, as some were not previously included. Any guidance would be tremendously appreciated! Symptoms include: - Continuous bloating - An increase of 20 pounds over 18 months - Constipation and sluggish digestion - Swollen nipples (breast size has increased from A to C cup) - Acne when not taking my SSRI or spironolactone Thank you for your attention, and feel free to inquire if you need more information!
Answers (1)
3/23/2025, 6:31:30 PM
OpenHealth AI
Thank you for sharing your experience and concerns in such detail. It's clear that you're navigating complex hormonal and mental health challenges that are deeply affecting your well-being. Let’s address your primary concerns regarding hormonal imbalances, weight gain, bloating, and the use of medications.
Main Points:
- Hormonal Imbalances: You suspect hormonal issues given your symptoms, including acne and bloating.
- Medication Impacts: Your experience with SSRIs and spironolactone indicates the potential need for a balanced approach to treat both your mental health and hormonal issues.
- Next Steps for Evaluation and Management: You are considering further evaluation of thyroid function and could explore other hormonal factors.
Explanation:
Hormonal imbalances can manifest in various ways such as acne, weight changes, and bloating. The situation you've described suggests possible interactions between your medications and your hormonal status. For example:
- Spironolactone can affect hormonal levels, specifically androgens, which can impact acne but also potentially influence mood and anxiety.
- Weight gain associated with SSRIs is a common concern and could vary based on individual responses.
- Bloating, constipation, and weight gain could relate to several factors, including hormonal influences on digestion and metabolism or side effects of your current medications.
Actionable Next Steps:
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Comprehensive Hormonal Panel: Request a full hormonal evaluation, including estradiol, progesterone, testosterone, and thyroid hormones. This could help clarify whether your symptoms stem from hormonal imbalances. Make sure to mention all your symptoms and past medication history to your healthcare provider.
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Review Medications with Your Doctor: Discuss your experience with Luvox and spironolactone in-depth with your doctor. Highlight your concerns about anxiety, weight, and bloating. This conversation might reveal alternatives that manage your anxiety without exacerbating weight or hormonal issues.
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Diet and Lifestyle Considerations:
- Track Your Diet: Keep a food diary for a couple of weeks to identify potential triggers for bloating or weight gain. Focus on whole, unprocessed foods, and watch for foods that may trigger bloating (like dairy, beans, or certain vegetables).
- Hydration & Fiber: Ensure you’re drinking enough water and consuming adequate fiber, which can help with constipation and digestion.
- Gentle Exercise: Incorporate moderate physical activities, such as walking, yoga, or swimming, which might ease bloating and support mood improvement.
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Monitor Symptoms: Keep a detailed log of your symptoms and any changes in your emotional and physical health, especially as you make adjustments to medications or lifestyle changes. This will help in discussions with your healthcare provider.
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Consider Stress Management Techniques: Incorporate relaxation techniques, such as meditation, deep breathing exercises, or journaling, to address anxiety without solely relying on medication.
Final Reassurance:
It's understandable to feel overwhelmed given the complexity of your situation. Taking systematic steps to evaluate your hormonal health and medication effects can empower you in managing your symptoms. Remember that you are not alone in this journey; many individuals face similar challenges, and supportive health professionals can assist you in finding the right balance for your health. Please feel free to reach out if you have more questions or need further guidance!
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