Skin breakouts - what do you think ?

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Skin breakouts - what do you think ?

Postby ApVish » Tue May 29, 2012 10:09 am

Hi All,

My DH has MS and has been taking vitamin supplements etc. after blood tests to determine his level of Zinc, D3, B12, Mg etc. He has been doing good (touch wood), except for the skin problem, after starting copaxone + vitamins and moving on to dairy free + gluten free diet, he has been having acne problem (more so in his forehead). It is not severe, but one or two keeps popping up every week.

We are not worried if this is just a side effect to anything we are taking, what we ARE worried is if toxins are building up and causing the breakouts.

We have not stopped copaxone and obviously shared solutions is swearing up and down that it is not a side effect of copaxone, but we have reduced the vitamins but didn't see any improvement.

Do you think it is a side effect of any vitamin supplement ?

He takes the following supplements

1) One a day multivitamin
2) Zine + Mg
3) Alpha lipoic acide + Acetyl L Carnitne
4) Curcumin
5) Vit D3
6) Fish Oil
7) Flax seeds
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Re: Skin breakouts - what do you think ?

Postby jimmylegs » Wed May 30, 2012 6:06 am

hi there, i can't say that i've noticed acne problems on my nutrition regimen, but i'm not a comparable case because i am not on an exclusion diet of any kind, except that i exclude most processed food and don't eat much restaurant food.

may i ask what the bloodwork results were, and what are the daily forms and amounts of all these supplements? also the timing for taking each? for the specific details, i'm particularly interested in the forms amounts and timing of zinc, magnesium (is that a combo pill?), vit d3, and fish oil.

i had one pimple on my chin recently, around the time we had a going away party for a co-worker and the staff fridge was full of delicious desserts for days. it was pretty self explanatory :)

found this abstract - wow that's a high daily dose! just for four weeks though. if i had full text access i'd go in and see if they measured serum levels. i wonder if the 15% still with acne at the end, had levels in the lower part of the normal range, vs the upper end.

Effects of Oral Zinc and Vitamin A in Acne (1977!)
http://archderm.jamanetwork.com/article ... =1&page=31
The effects of oral zinc sulfate (corresponding to 135 mg of zinc daily) alone and in combination with vitamin A (300,000 international units) daily on acne lesions have been compared with those of vitamin A alone and of a placebo. The number of comedones, papules, pustules, and infiltrates were counted at each visit. After four weeks, there was a significant decrease in the number of papules, pustules, and infiltrates in the zinc-treated groups. The effect of zinc plus vitamin A was not better than zinc alone. After 12 weeks of treatment, the mean acne score had decreased from 100% to 15%. The mechanism for the effect of zinc therapy in acne, to our knowledge, is not presently known.
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Re: Skin breakouts - what do you think ?

Postby ApVish » Wed May 30, 2012 7:07 am

Thanks for the reply, JimmyLegs.

Here are the test values from 4 months back

D3 - 67 ng/mL
B12 - 1923 pg/mL -> High, so we stopped the B12 vitamin 4 months back.
Zinc - 0.90 ug/mL
Mg - 1.9 mg/dL
Calcium - 9.8 mg/dL
Potassium - 4.2 mmol/L
Sodium - 139 mmol/L

and these are the strengths of the vitamins and the schedule he is following to take the same.

Curcumin - 450mg - one a day in the morning after food
One a day for men - daily after food
Vitamin D3 - 5000 iu - 4 times a week in the evening
Ca (1000 mg) + mg (400 mg) + zinc (15 mg) - 3 times a week in the evening
Acetyl Carnitine (400mg) + Alpha lipoic Acid (200 mg) - 3 times a week in the evening
Fish Oil (EPA 800 mg, DHA 500 mg, other Omega 3 300 mg) - 1 teaspoon , 3-4 times a week
Flax seeds - one tablespoon in the morning with breakfast

He also takes Atenolol (25 mg) twice a day to control his heart rate ( he has a slightly enlarged aortic root - birth defect, but has been in control for 30+ yrs)

Also, we cook our food from scratch everyday and probably eat restaurant food once a month, so minimal processed food.

Thanks again for your reply!
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Re: Skin breakouts - what do you think ?

Postby jimmylegs » Wed May 30, 2012 7:58 am

ok that's great. the d3 results are solid. he may be getting a bit high if you've continued at 5000IU per day over the last 4 months. it could be depressing magnesium and zinc levels if there aren't enough dietary and supplemental intakes to get a good balance.

b12, also solid. shouldn't be a problem.

zinc, yeah that one was definitely a problem area. that works out 13.8 umol/L, and you know to aim for more like 18 i take it?

as for the magnesium, that works out to 0.78 mmol and you want him to be at least 0.9, so that's a great one to supplement too.

that cal mag zinc thing. is he alternating cal mag zinc one evening, and d3 the next? or does he sometimes take them together? also what is the copper and zinc and magnesium content in the multi?

can you tell me the forms of magnesium and zinc in that combo pill and the multi? does the package say whether those numbers are 'elemental' mineral amounts?

basically i think it would be wise to up the zinc, and ensure the magnesium form is a soluble, organic, absorbable form. you might end up needing to buy separate calcium magnesium and zinc products. i haven't been able to find a decent blend, myself.

next, are there plans for any follow-up bloodwork to assess the efficacy of his regimen?

and just for comparison's sake, i personally take double that amount of EPA DHA etc in fish oil softgels, daily. i don't have any lab measurement info for that unfortunately.

i think this acne situtation might be as simple as high d3 intake with not enough zinc to balance it out. low zinc and acne are strongly correlated as shown in that study above.
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Re: Skin breakouts - what do you think ?

Postby ApVish » Wed May 30, 2012 8:42 am

Hi JimmyLegs,

Yes, he alternates between D3 and cal,mg and zinc tablets on weekdays.

We are up for his 1 yr Neuro appt this friday and we are sure his neuro will order all the blood work to get the numbers again (if she doesn't , then we are insisting). So hopefully by next monday/tuesday we should have the new numbers to adjust his dosages.

His ca/mg/zn tablet says cacium carbonate, mg oxide and zinc sulfate. We will see if we can get seperate tablets inside of the combination one.

His multi vitamin has

Copper - 2 mg
Zinc - 15 mg
Mg - 120 mg

in them.

So hopefully when we get good D3 numbers in the next blood test we might want to reduce the D3 by just once a week and probably up the zinc and mg to everyday of the week to balance out.

Does that sound better ?

Anyways, once we get the blood work results, I will come back to pick your brain a little bit.

Thank you for all the help.
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Re: Skin breakouts - what do you think ?

Postby jimmylegs » Wed May 30, 2012 12:31 pm

hi there,

awesome re imminent bloodwork. you're my fave kind of person to help, lots of great info at your fingertips :D

yea that mag oxide is a inorganic insoluble form, poorly absorbed - most of what goes in goes out the other end. if you can find magnesium glycinate that's the most absorbable one i've found to date. i also use magnesium citrate for part of my daily intake.

all right so for zinc, he's getting 30mg one day from the cal/mag/zn and multi, then 15mg the next from the one-a-day alone. that is likely a bit low when high dose d3 is going in. good to see that 2mg copper in the mix - will provide needed balance when you increase the zinc intake.

i think your plan to up the mag and zinc, and back off on the d3 a bit sounds good - depending of course on what the next set of bloodwork shows.

for now he can just start taking the cal/mag/zn every day, and as you say, in future you can look for separate magnesium and zinc. for myself i can't supplement calcium or my muscles go spastic.

likely a better option from the info perspective, would be to wait until after the bloodwork is done to make any changes. in order to get a clean read once the neuro gets you your lab requisition on friday, i would suggest stopping it all to get at least a small 'washout' period, until after the blood is taken.

talk to you soon :)
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Re: Skin breakouts - what do you think ?

Postby NHE » Wed May 30, 2012 10:36 pm

ApVish wrote:Curcumin - 450mg - one a day in the morning after food
One a day for men - daily after food
Vitamin D3 - 5000 iu - 4 times a week in the evening
Ca (1000 mg) + mg (400 mg) + zinc (15 mg) - 3 times a week in the evening
Acetyl Carnitine (400mg) + Alpha lipoic Acid (200 mg) - 3 times a week in the evening
Fish Oil (EPA 800 mg, DHA 500 mg, other Omega 3 300 mg) - 1 teaspoon , 3-4 times a week
Flax seeds - one tablespoon in the morning with breakfast


It's good that you separate the timing of curcumin and lipoic acid. Curcumin, as an Nrf2 activator, reacts with thiol groups and would thus react with lipoic acid potentially neutralizing the benefits of both molecules.


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Re: Skin breakouts - what do you think ?

Postby ApVish » Thu May 31, 2012 10:50 am

Thanks Jimmylegs, Off I go to get that magnesium glycinate. And like I said earlier I will be back with the new results next week.

Thank you NHE, for that valuable information on curcumin and ALA, I will make sure DH takes them atleast 8 hrs apart.
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Re: Skin breakouts - what do you think ?

Postby NHE » Thu May 31, 2012 1:08 pm

ApVish wrote:Thank you NHE, for that valuable information on curcumin and ALA, I will make sure DH takes them atleast 8 hrs apart.


The actual timing would be dependent on the half-lives of the compounds in circulation. That is information that I do not have at this time.

By the way, with respect to lipoic acid, you may want to look into r-lipoic acid supplements as they've been reported to be about 6-12 times more effective than alpha lipoic acid.

Lipoic Acid: R vs. S
natural-approach-f27/topic4347.html
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