Hello

[carcos]

I’ve been vegan for about a year have been feeling like almost always I am being misinformed on what diet is actually best for my health. I struggle with pcos and cystic acne and i am hoping to try and find a diet that will improve my overall health. Looking for some more clear answers and helpful opinions

[brimstoneSalad]

Hi carcos,

There's some evidence that dairy may promote acne, and taking a very small zinc supplement (around or below the RDA of 10mg a day) might help if you are low on zinc (or eating more zinc rich foods like pumpkin seeds).

However, effects of diet and even supplements are likely modest compared to medical intervention.
Can you improve your symptoms a little with diet? Probably. Should you do that instead of taking medicine? No way.

For cyctic acne, your best approach will be a medication like accutane (isotretinoin). A short course of treatment can be rough (dry skin, and some other annoying side effects), but it changes the structure of your pores and can provide long-term reduction of cystic acne.
So, you should see a dermatologist for that (and talk to your doctor).

Otherwise for pcos, taking the medications your doctor prescribes is the best bet. Don't be afraid of androgen blockers if you need it.

As an adjunct treatment (that is, in addition to medicine), if you're over weight then any diet that helps you lose weight will likely help with pcos symptoms. So that's mainly about restricting calories.
In the case of insulin resistance, it may also be wise to cut down on carbs which might provide some short term relief.

Have you heard about Eco-Atkins? That might be your best bet. It's basically a low-carb vegan diet.
Lots of veggies and nuts with good fats, some beans, tofu, some low-sugar fruits like blackberries, and limiting grains.

Restriction like that can be a little more tricky in terms of nutrition, though, so make sure you plan well with a nutrition tracking program like chronometer until you get the hang of it. Here's how to set it properly:
viewtopic.php?t=2054

[Jebus]

Welcome carcos,

For cyctic acne, your best approach will be a medication like accutane (isotretinoin).

Didn't they take this drug off the market due to severe side effects?

Dr. Greger has recommended barberries against acne.

[brimstoneSalad]

For cyctic acne, your best approach will be a medication like accutane (isotretinoin).

Didn't they take this drug off the market due to severe side effects?

No, just the brand "accutane" is no longer sold. This is due to the company pulling it voluntarily after a poor decision, without adequate evidence, by a jury costing the company money. But there are other generic versions available.

Regarding side effects: The belief was that it caused inflammatory bowel disease, but this is extremely unlikely to be true. There's no plausible mechanism by which accutane would cause that, and there are confounding variables. Cystic acne IS correlated with IBD... and as accutane is used to treat acne, the correlation still holds. Accutane doesn't cause it, but people who take it will often get it because they would have gotten it anyway due to their immune systems (responsible for both conditions, cystic acne and IBD).
Same with depression (cystic acne itself being correlated, or causing it, and people with cystic acne often taking accutane so it makes it look like accutane causes depression).

It's kind of like saying use of plaster casts causes broken bones, because kids who get more casts break more bones.

The only very severe side effect is birth defects, which is why regular pregnancy tests are required in some areas for women on it.
Aside from that, the most severe side effect is a worsening of the acne before it gets better.
Typical effects are dry lips and skin (need to use a lot of lotion and chap stick) and stuff like that. By no means fun, but the reduction in cystic acne is permanent for most people.