The short answer: You bet.

The long answer: Well, yes. But what consists of diet might surprise you. And much of this is going to take some time to explain.

I’m sorry this is a long post (currently over 8000 words as I’m writing this version), and there’s probably several chapters worth of additional information I could include, but won’t because I just want to share the basics for now.

So, if you’ve got a while, sit back and get ready to get nerdy. I’ll try to work in my requisite mention of poop, here, too, since, you know, there’s bound to be some discussion of the microbiome, right?

I’ll just go ahead and start off by saying that nobody wants to talk about women’s adult acne.

We’re all surrounded by these images of women with perfect(ly photoshopped) skin and we’ve been convinced that if we’ve got acne, we’re not washing our face enough, we eat a poor quality diet and we’re unattractive.

So we’re scared to talk about it and ask questions about it. We’re embarrassed by it and get depressed.

I was tired of all that. For years, I struggled with the self-esteem problems that would come and go with skin breakouts.

I am going to take a departure from my normal love for evidence to support arguments, in favor of a story that I’ve had trouble finding significant evidence to explain the outcomes.

I’m actually just going to raise a lot of questions, that I’m hoping someone else will want to research to find those answers.

I’m going to apologize in advance to anyone reading that’s hoping I’ll back things up with some bomb-ass evidence, because it doesn’t exist.

I’m going to share what I think has happened, and then ask some questions that I haven’t been able to find the answers to, but that I theorize will back up what I’m saying.

All I can tell you is what I’ve done, what I’ve observed to be the outcome of those n=1 experiments and then add my experience to that of the hundreds of other accounts out there all saying the same thing.

My goal here is not to change anyone’s mind per se, but more to get you to think critically about indicators that might mean something is wrong.

What if things like acne, low energy and brain fog are really just early warning signs that something more insidious is developing under the surface?

What if they’re signs that we haven’t yet crossed that magic tipping point from “not sick but not well” to “sick and symptomatic”?

What follows is my story. Take it for what  you will. I will make the statement that many of our best hypotheses and theories tested through research started out as multiple people reporting the same anecdotal findings.

So, if you’re like me and willing to experiment on yourself to get your own answers, and you decide to try any of this on your acne, please let me know what you find. I’d be super interested to hear.

If you’d like to actually study this stuff clinically, I’d be super interested in hearing how that turns out, as well.

First, What Does Traditional Research Say?

Not a lot about diet, actually. A few studies were conducted a long time ago, by science standards, that looked at some potential food triggers that might be diet-related causes of acne and found either no connection or inconclusive results, despite observations made by acne patients (1, 2).

The argument for a diet-acne connection was largely dropped for several decades at that point.

With the rise of various anti-inflammatory diets such as Paleo and Mediterranean, interest in the diet-acne connection was renewed and there were some promising advances made (3, 4, 5).

The problem is, they were all done as larger trials or observational research, and because of the nature of how clinical trials and observational research are conducted, failed to account for the individual nature of the causes of acne.

And, they also did not account for some variables they had not even considered (more on that later).

As you’ll see later in this post, I have identified four (really kind of just three) different underlying causes of my own, and I have found that its not uncommon in the patients with whom I have worked, for there to be multiple underlying root causes of acne in each individual.

But, those causes will tend to vary slightly from person to person.

Because of this variable nature of triggers, both dietary and environmental, its difficult to use clinical trials as evidence of root causes. When we look at acne in general, a root cause would be something that actually sets the process of inflammatory acne in motion.

And that actually seems to vary from person to person, as much as diet, environment, skincare routines and topical product use vary.

Traditional medicine says that acne is caused by dirt, oil, dead skin cells and bacteria all becoming trapped in skin pores. If you’ve struggled with adult acne, you know for a fact based on your own experience, that this is only maybe half the story.

And then some individuals, like the Cordain camp, assert further that its the high carb and high glycemic diets we consume that contribute to acne.

But, if you read their research, you’ll notice the studies all say things like “low glycemic diets improve acne” or “prevalence of acne is reduced” [my emphasis] but none of them actually report curing acne or resolving it completely.

No matter how little sugar or chocolate you eat, how clean you keep your skin, how much you reduce oil through topical or oral medications and how much you kill the ever-loving shit out of anything that could possibly grow on your skin, you still get acne, right?

So, it can’t all be carbs, dirt, oil and bacteria.

Like me, you have become your own n=1 study in most cases.

What About Hormones?

Some people feel like our own hormones or those found in animal products we consume are the culprit behind acne (6, 7, 8). But its not everything. And, to my line of thinking, if our own hormones are causing acne, why? That’s not normal.

It is not a normal state of human biological existence for hormones to become so abnormal as to cause severe skin problems. Biology is all about maintaining homeostasis, and acne is certainly not a state of homeostasis.

And, to be quite frank, nobody should have to take medications that suppress certain hormones long term (potentially for the rest of their life), that have plenty of side effects, just in order to suppress acne. That’s a band-aid, not a cure. I’m not looking for band-aids.

In my own personal case, I found that hormones in animal products didn’t matter. If the hormones in dairy were a true problem, then the hormones in beef, which I eat many times per week, would also be.

And I failed to find any connection between elimination of red meat and acne, personally. And I’ll explain why later.

I know you’re looking for the cure, as was I. So let me get to my own story and talk about what I found through meticulous self-experimentation and record-keeping along the way.

How I Cured My Own Acne

This journey really starts in 2003, when my son was born and I moved back to the midwest from living in a small coastal town in California for a few years, but I’m going to fast-forward to 2013, as that’s where I actually started using deductive reasoning, research and observational methods to really narrow things down.

Upon returning to the midwest, my adult acne flared majorly for, what I thought, was no apparent reason.

That’s when I started questioning everything out there that had been written about acne and decided there just has to be a better answer.

In early 2013, I was going through a separation and divorce. I had just started a new job, was running a CrossFit gym, was in the middle of moving out on my own, raising a little boy and starting a new relationship. Stress had me in its grips and I had no means with which to cope with it. It was crushing.

My skin was awful. I had experienced adult acne about a year after I had given birth to my son, after moving to the midwest, and my skin flared up and erupted moderately and regularly, but eventually after a couple years, died down to the 2-3 regular acne cysts that would come and go.

I figured, ‘Well, I guess that’s better than it used to be, so I’ll just be thankful its ‘improved.”

Back to 2013, this was full blown red, painful, cystic acne on my chin, jawline and around my mouth. I cleaned with everything that said it was ‘acne control’ or ‘anti-acne’ products. I cleaned more; I cleaned less; I used natural products; I used very unnatural products (topical RetinA made me look like the crypt-keeper, for real).

My confidence plummeted and I didn’t want to go out in public on some days, even though I had to work in doctors’ offices daily talking to patients.

I had made the connection that while stress seemed to precipitate this horrible outbreak, the severity of my acne appeared to come and go with how upset my digestive tract was. And it was, a lot, because of stress. But stress wasn’t the root cause.

I’ll Say it Again: Stress Isn’t Really the Root Cause

One day in the fall of 2014, one of the docs I worked closely with said that I could try Spironolactone (aldactone), because its the most highly prescribed medication for women with adult acne.

At this point, my stress had died down and things were relatively stable for me. My skin was still terrible, though.

Spironolactone mostly works by blocking testosterone absorption at the cell level, which prevents the over-production of oil in the skin, so it reduces acne. I was desperate and went on it immediately.

Spironolactone typically takes about 60-90 days to start to make a noticeable difference. So I patiently waited, hoping every morning I woke up to see just one less blemish. Eventually, I started to see improvement. Then, eventually, I was 90% clear of acne.

But that last 10% just kept hanging on. A blemish per week maybe on my chin or around my mouth, but not 5-8 active blemishes, so I thought to myself again, “Well, its better than it was, so I won’t complain.”

One day, after talking with a client of mine who was Paleo about her digestive progress and how she was feeling so much better after cleaning up her diet, she mentioned that her acne had gone away. And specifically after fully eliminating dairy.

I had already been aware of the dairy-acne connection before, through numerous other sources, but was in denial that it was a problem for me. Many of the links earlier in this article specifically look at the dairy connection.

And, interestingly, the connection that seems to come with skim milk, or low-fat dairy (9, 10)(those researchers propose that the lower fat dairy products raise insulin more and that’s why they produce more acne, but I’m going to theorize something different later in this article).

To be clear, I had been Paleo many times before, but had always managed to cheat a little here and there with dairy, so that I was never really truly strict Paleo for very long, and therefore, never really made a cognitive connection between whether dairy and acne had a relationship for me.

However, desperate times call for desperate measures and I actually wanted to prove that, by god, dairy was not a trigger for my acne.

Well, it was. After seven days of going dairy free, that last 10% was gone. Really gone. I blogged about it here, if you want to read, but suffice to say that it was the last key.

There’s cause #1 of my acne.

Or so I thought.

Maybe It’s Just Dairy…

Fast forward to about fall of 2015, my prescription auto-refill service through my health insurance had some kind of glitch and didn’t send me a refill of the Spironolactone, so I just stopped taking it, curious to see if a dairy-free diet alone could keep the acne under control, now that I was relatively un-stressed.

It mostly did, for about six months. I remained 90% dairy-free (don’t judge. Cheese is delicious and so is cream cheese frosting. If you think otherwise, you have a sad, miserable life). I still got the occasional painful cysts on my chin maybe one per week, but again, nothing as bad as it was when it was ‘really bad.’

Fast forward again to the spring of 2016 when I went through another ridiculously crippling bout of stress. I went through a break-up, moved again, had to travel overseas with the reserves and started a new relationship again after returning to the US.

My skin erupted, but this time, in addition to the cystic acne around my chin, nose and mouth, I started breaking out on my cheeks, where I had never had a blemish before. The breakouts were both my upper and lower cheeks, and near my ears. Seriously, I had never had a blemish there in my life.

I was consuming zero dairy at this point, too.

Maybe It’s Not Just Dairy?

I thought that location of my acne to be odd and googled things about the location of acne and its significance and came up with all kinds of stuff about Chinese skin mapping.

The skeptic in me found this implausible, but the slightly crunchy hippie in me thought ‘Hmmm, file that away under, Who knows, maybe there’s something to it.‘ According to various skin mapping articles, the upper cheeks are related to digestion.

Oh, my digestive problems are linked to even more things? Welcome to my life. Thanks for the really obtuse statement, Internet.

I was reluctant to go back on Spironolactone, because when I had previously taken it, it had actually depleted a good deal of my minerals (it is a potassium-sparing diuretic, as well, but that means it doesn’t spare sodium, obviously, and there are some anecdotal case studies of it depleting other minerals like magnesium).

That left me feeling like a fatigued, zombie-like person with sapped energy and no zest for life, the last few months I had taken it.

As soon as I had stopped taking it, within a couple weeks, that all lifted and I returned back to a normal state of feeling pretty energetic throughout the day. So, I just kind of resisted going back on that medication.

Back to Spironolactone

In June 2016, I was miserable about my skin again, and once I got back in the U.S. from my annual tour in Japan, I contacted my doc again and went back on it. The doctor said that because I lift weights a lot, I am probably just going to have to accept that I’ll have more testosterone because of that, and my acne will continue to occur.

I really didn’t like that answer, because it seemed so defeatist. I didn’t want to be on this medication at all, but I didn’t feel like I had another choice at that point. I wasn’t going to stop lifting weights. THAT’S CRAZY TALK.

This time, I added copious amounts of Celtic sea salt to all my food and added a multi-vitamin/mineral boost to my protein powder from True Nutrition.

I was drinking the equivalent of 3-4 scoops of protein powder a day at that point because the stress had caused me to lose a lot of weight (13 lbs in one month!), which, in the nutritional world, is a bad thing and a sign of something very wrong.

All my food was kind of running right through me (I know, gross, but consider that my poop reference for this post), so I figured it wouldn’t hurt to increase my protein, and in so doing, was also increasing the multivitamin and mineral intake from the booster in my protein.

The rapid and unintentional weight loss stopped by mid-June and by mid-July, the Spironolactone was starting to have mild effects on my acne.

By end of August 2016, it was starting to look about 50% better. By end of September, it was about 80% better, but I still had the occasional chin blemish, and the stuff on my upper and lower cheeks wouldn’t go away. No matter what.

At that point, I had also started having really irregular periods due to the Spironolactone, which is a known side effect. My doc ran some labs and determined that I was not ovulating, which caused a short cycle, and a period every 2-3 weeks.

Its bad enough that we have to have them once a month, but any more frequently than that can really put a cramp (pun intended) in your life.

So, I went on progesterone bioidentical hormones to offset the Spironolactone. I had hoped that this might also cause my skin to reach full clearness again, but no luck.

    

Picture taken around early October 2016

It did regulate my periods, for which I was grateful (and my boyfriend probably was too, as I was kind of falling apart emotionally at this point dealing with awful skin and what seemed like a period with a mind of its own).

By the beginning of November of 2016, I was still at just that 80% clear, very little acne on my chin, jawline or around my mouth, but still would get an occasional blemish on the line of my lip (weird placement, right?) and the blemishes on my cheeks were ever-present.

I can’t even remember what I was reading, but was browsing through some research studies related to some microbiome stuff for the gut tests we do at the lab at work and I stumbled across something about yeast/bacteria imbalances on the skin.

All I remember was that this one comment jumped out at me regarding the itchiness of yeast over-growths on the skin. ‘Weird, the blemishes on my lower cheeks and near my ears itch a lot,’ I thought.

On a hunch, I stopped by Sprouts on the way home one day and grabbed some grapefruit seed oil. I applied it generously that night before bed and not surprisingly, the blemishes on my lower cheeks and part of my chin were markedly reduced the next morning.

I continued to apply the anti-fungal grapefruit seed extract for a couple days after that and continued to see those blemishes disappear, never to return again.

Why did this work?

This most recent skin manifestation had shown up right after a course of antibiotics for a UTI. I’m used to this happening in my gut, but had not considered that my skin could also be affected.

Makes sense. Yeast overgrow opportunistically in many parts of the body, including the skin, when commensal bacterial populations are suppressed after antibiotic treatment.

*****IMPORTANT: In no way am I saying that you shouldn’t take antibiotics. Antibiotics save lives, so please take them when you need them, but just know that you need to be aware of what else might thrive in the absence of bacteria. A good protocol to replace and rebuild your microbiome can offset the damages done by antibiotics.

If you’re counting still, that’s now two separate causes of my acne.

A Miracle Topical Solution?

Back to the acne story. I was on Facebook one day and an ad for NERD Skincare came up on my feed with a cute, witty video about how they had developed a topical solution that feeds the beneficial skin bacteria in order to control your harmful acne-causing bacteria, to treat acne.

At $85 a bottle, the price seemed steep, but I was willing to try anything.

I started that on Dec 5th, 2016 and it took about 4-5 weeks to see a really noticeable decrease in acne. They advertise that it works within days, but obviously they’re assuming that your acne is just caused by too much acne-causing bacteria. That may have been one of the factors for me, but wasn’t the only one, as you’ll see shortly.

 

This is first week of December 2016, the night before beginning the NERD Skincare product

In February of 2017, I had a random conversation with one of the sales reps for the laboratory I work for when she was discussing her teenage son’s nutrition and hormonal acne.

I lamented that I knew how that felt and she suggested taking pantothenic acid. Yep, regular old Vitamin B5. I thought, surely it can’t be that simple?

A Vitamin Too? Is It That Simple?

I googled Vitamin B5 and acne and all I came up with were a bunch of acne forum posts and a paper written by a doctor that claimed that a lack of B5 affects acetyl-CoA production in the skin, which up-regulates inflammation and causes acne.

The paper was never published in a peer-reviewed journal and was generally regarded by scientists and dermatology researchers as bullshit.

So, naturally, because there seemed to be no support for it by research, I decided to try B5.

I started taking 1500mg of B5 in three divided doses. Literally overnight I saw a reduction in the acne on my upper cheeks.

What else also happened around this time was that I had run out of protein powder and there was a back log of orders through True Nutrition, so I was without my normal protein powder for about 10 days.

During that time, the blemishes on my upper cheeks all disappeared. COMPLETELY. As soon as I got my protein powder back in, they started to come back a little. Not as aggressively as before, but definitely a few small blemishes were appearing weekly.

I was still taking the B5 and still applying the NERD Skincare solution, so the upper cheek blemishes were sort of suppressed, but I could tell they were just being controlled.

Under the skin, I could still feel some inflamed pores starting to brew. Some came to the surface, others just sort of sat there for a few days and then disappeared.

After doing some cursory digging into this B5 connection and just why it might be a treatment for acne, I found that B5 and B7 (biotin) use the same receptor for absorption in the gut.

Biotin has been attributed to acne in a few small studies, interestingly. And I eat a diet high in biotin (eggs, red meat, bananas, mushrooms).

Now, there are also some that say that high doses of biotin can clear up acne. This was not the case for me, obviously, but just consider that.

It’s highly likely that my high intake coupled with really efficient biotin-converting microbes had me kind of ‘over-dosing’ the vitamin just enough to cause the acne flare up on my cheeks.

When you eat a lot of biotin, and when you have an abundance of the gut microbes that produce biotin (yep, your gut and the quality of your diet absolutely affect what vitamins you can produce and absorb), you’re going to absorb more of it, but then possibly absorb less B5, because the receptors that absorb both vitamins are being commandeered by an abundance of one vitamin, B7, which causes a sort of limited sub-clinical deficiency of the other vitamin, B5.

This turned my attention to supplements. I started adding up all the things I was taking that had biotin in them.

In addition to a basic multi-vitamin, I was also consuming a minimum of 2 scoops of the protein powder with the vitamin boost (and up to 3 scoops on some days). I hope you’re drawing the same connection I am here…

When I wasn’t taking the protein powder supplement but started taking the B5, the acne on my cheeks disappeared rapidly. When I started taking the protein supplement again, and still took the B5 supplement, the acne started to come back, but to a much lesser degree.

My guess is that my regular intake of biotin-containing foods was not enough to cause this kind of skin breakout, but all the additional biotin from supplements increased that intake by around 5 fold.

I immediately re-ordered my protein powder without the vitamin/mineral boost and it took about seven days to get to me. Those were the longest most anticipatorily frought days of my adult acne-having life. Could this really be it? The answer to it all?

Protein powder arrived, acne on cheeks gone within 72 hours.

 

End of January 2017, note the disappearance of active blemishes on the cheeks from elimination of biotin sources, less cystic spots on the chin from about 6 weeks of the NERD product (scarring still visible, however)

THREE! I COUNT THREE CAUSES OF ACNE! MWAHAHAHAHA…

Okay, sorry. No more Jim Henson puppetry references.

But None of This is Still the Root Cause, Is It?

At this point, if you’re an astute individual, like I’d like you think you are, you’re probably thinking “But, Sarah. Your acne was controlled, but you’re still taking a prescription, a high dose vitamin and avoiding an entire food group in order to make that happen.”

Oh, yes, my friend. You are soooooo right. Believe me, I’m very aware of that.

Which leads me to the above statement that almost none of these things were the root cause, were they?

The biotin/patothenic acid connection aside, the rest of the interventions I was doing were merely control mechanisms that were suppressing the acne.

In February of 2017, I followed up with my doc and shared with him my findings about the B5/B7 imbalance and he was impressed with my deductive and googling skills. If there is a degree is googling, I should have one at this point.

I told him that I really wanted to get off the Spironolactone, so that I could get off the progesterone. When I take the progesterone, I feel really bloated in my abdomen, as if I retain 5 lbs of water that just sits like a rock there.

So he said I could try to decrease my dose of Spironolactone, then eliminate it when I felt ready and see what happened.

I was really nervous to try this, because what if this really was just all a hormone thing and I really was going to need to take a prescription my whole life in order to have clear skin?

I reduced my 100mg/day dose to half that (50mg/day) in the beginning of March 2017. Four weeks later, no signs of cystic acne, except one blemish that appeared on my chin. Then one on the line of my lip. Then another on my lip.

That little annoying voice in the back of my head said ‘Hey remember when you read that super weird stuff about skin mapping? Maybe there’s something to the placement of the ones on your lip, at least?’

So, after googling (sorry to my evidence-based friends, but so far it had seemed to pay off with all kinds of things that shouldn’t have worked, but did), I found that there actually is indeed some tenuous connection between lip pimples and….fluoride.

What?

Yeah.

The stuff that’s literally in everything. *exasperated sigh and eye roll*

But, most notably, most people who had written about their own acne experiences had noted that when they switched to fluoride-free toothpaste, their lip acne went away.

Weirdly enough, about a week before that first lip pimple appeared, I had been using fluoride-free toothpaste for over a year, but we ran out and my boyfriend bought some from Sprouts that wasn’t fluoride-free and I didn’t even notice.

He probably didn’t notice either, and I wouldn’t have attributed the acne to that had I not stumbled across those anecdotes.

I immediately dropped the fluoride toothpaste again and within 48 hours those lip pimples were totally gone.

What also happened over those 48 hours? I was in Phoenix for drill weekend. (So many seemingly unrelated tangents here, right?)

While on drill weekend, I drink almost exclusively bottled filtered purified water that is fluoride-free because the drinking water on base and in the public water supply doesn’t taste very good. So I consume basically no tap water over that weekend.

In looking back over the last 4 months that I’ve been drilling in Phoenix, my skin tends to clear up by the end of the day Sunday, but then had been breaking out mildly upon returning home by Monday morning. Didn’t make the connection until now.

Which leads me to the last breakthrough of this journey.

Take a deep breath, because you’ve lasted this long, through a marathon rambling account of the details of my adult acne and if I could give you a hug for just being that dedicated, I would.

Water.

Oh man. At this point, I’m willing to do anything. I want to get off that Spironolactone so bad, so I can stop taking that progesterone and maybe I want to eat cheesecake again one day??

Please, please, please. I’ll do whatever you say, random anecdotal accounts on the Internet.

I started reading more and more about the connection between fluoride and acne. What I read was both terrifying and distinctively hopeful at the same time. It started, as many of my searches for information do, with forum posts.

Forum posts are a treasure trove of absurdity, but also have some nuggets of truth if you know how to tease it out. I usually find something interesting, then try to follow the research trail to figure out if there’s a connection.

In regards to fluoride and acne, mostly just stuff about fluoroderma came up (11, 12).

But, honestly, after reading the limited amount of information about fluorderma, my acne just really didn’t sound that intense. I didn’t know if I was on the right track after all.

So, once again, because there really wasn’t any evidence to support it personally, and all the info I found was largely anecdotal, I went ahead and did it anyway.

I won’t go into super great detail, because this is already long enough.

But, long story short, fluoroderma is a real thing and sure enough, when I eliminated all sources of fluoride from my diet (meaning everything I was consuming internally), my acne went away. And I mean, almost overnight.

That was cause #4. But get ready to get rid of one of the causes in a minute.

If you want to read a little more about fluoride, and why its such a problem, and why its actually not that necessary to be added to our water (13), why its either under investigation as or considered to be a neurotoxin (14, 15, 16), a suggested mutagen and/or carcinogen (17) and why you should try to avoid it if you’ve got acne, check out The End of Acne, by Melissa Gardner. Its a quick read and I’m not going to re-hash what she has written there. This is already long enough.

Also check out Fluoride Action Network. This is an organization committed to the ban of the use of fluoride in drinking water and other sources of water due to its harmful side effects in human populations.

A lot of the things I cite here are links to FAN’s website because they’ve actually compiled multiple sources all in one place and I’m lazy and don’t want to link to hundreds of different studies here.

Once again, I’m really only interested in telling my story at this point.

Eliminating Fluoride, Step by Step

I started by purchasing a special water pitcher that filters out fluoride. Almost all the store bought ones like Brita and Pur do not remove fluoride. I live in a condo in a high rise building, so I can’t put a reverse osmosis filter on my entire water source, so I had to go with just filtering the water I was consuming for now.

That includes the water that makes my coffee and the water I drink all day. I even have to fill my huge 48 oz water bottle up with filtered water before heading to the gym so I don’t drink the water there that is fluoridated.

I then removed all sources of beverages that were made with water that I could not verify was fluoride-free: soda, water when eating out at restaurants, cartons of coconut milk, juice, wine from specific regions of California and tea; then removed any other dietary sources that contain higher than normal pesticide residues with cryolite, a pesticide that is essentially just concentrated fluoride (18).

Like I said, the results were virtually overnight. Within 36-48 hours, totally clear skin. My old acne red spots from previous blemishes are still slightly visible about 2-3 weeks later, but fading fast.

 

April 25, 2017, about 2 weeks into fluoride-free: I still don’t consider this perfect or normal, just due to waiting for the scarring to fade completely, BUT this is an enormous improvement. No active blemishes (pardon the splotchiness, as I had a touch of sunburn from a couple days earlier and was getting ready to peel :/ )

I have since tested this hypothesis with specific beverages to see what happens: water from both home and the gym water fountain made me breakout, low-fat milk that has had water added during processing made me breakout, coffee from Starbucks made with tap water made me breakout.

For me, it does not appear that the water I shower in has much effect, probably because its not being internally consumed. Whatever small amount is absorbed through my skin during a shower contains such a small amount of fluoride that it doesn’t seem to matter for my case.

Some people on the Internet, however, (anecdotally) report that they also need to shower in fluoride-free water. So, who knows.

I’m going to insert some more anecdotes into my anecdote.

I had no idea about the high levels of concentrated fluoride pesticide used primarily only on grapes in California until I read Gardner’s book, but about 6 months before reading her book, I drank a few sips of Apothic Dark and had a severe reaction to it within 30 minutes that I couldn’t figure out why red wine would cause that, as I’ve never reacted to red wine before (acne on my face, a painful and itchy red rash across the backs of my hands and a stabbing pain in my back, around the thoracic area).

Come to find out, guess where Apothic’s vineyards are? San Joaquin valley…not joking. Coincidence? Probably not, at this point.

In case you didn’t click on the links to read about wine made in the San Joaquin valley, its the only known region where winemakers in the U.S. are allowed to use cryolite on their grapes due to specific pests. The massive amount of cryolite (again, just a highly concentrated fluoride) leaves significant enough residues that people who are sensitive to fluoride will react strongly.

The last anecdote that leads me to stop questioning the fluoride connection in myself is about 2 years ago when I broke out in what I thought was a heat rash that started on my back and shoulders, crept up my neck, onto my face and then down my torso.

A dermatologist thought it was just body acne from working out and sweating and waiting a maximum of 30 minutes to shower (I know, right?), so she wanted to put me on antibiotics.

I refused the antibiotics and tolerated this for a couple months and it went away when I stopped drinking tea. I had started drinking tea from a coffee shop near the gym I was working out at because I was trying to limit my coffee intake at the time.

Well, guess what tea has a lot of???

Fluoride (19). Some varieties of tea leaves have up to 300x the ‘safe’ allowable limit determined by the EPA. Plus when its brewed with tap water, as it almost always is, even more fluoride.

So the extreme skin breakout showed up after I started drinking tea, then went away when I stopped drinking tea.

The only thing common to all the foods/drinks I was consuming is fluoride.

***************

A short digression: if you noticed at the beginning of my story, I stated that after living in a small coastal town in California for a few years, and returning to the Midwest, that’s when my acne flared up.

That small coastal town, Pacific Grove, does not fluoridate their water (and didn’t at the time). There are very minute trace amounts of dissolved fluoride found on average in the water supply there, but not anywhere near the scale that would be found in a fluoridated municipal supply. Again, purely anecdotal, but relevant in my opinion.

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Now, I promised to explain the dairy connection so we can eliminate that as one of my triggers. Before, I made reference to some studies that seemed to show that the dairy/acne connection was most prevalent in skim milk products or low fat dairy.

I’m theorizing, as well as some other people, that the lower fat dairy is a trigger because it has additional fluoridated water added to it during processing, as well as possibly being a more concentrated source of fluoride.

The steps that milk goes through after being acquired from the cow take it on a journey where fat solids are removed and water is added, to reduce the fat content.

In almost every dairy processing plant, the water being added is just from a municipal water supply, unless that plant happens to be located somewhere that doesn’t fluoridate the municipal water.

Another element to this, and I haven’t had much time to dig on this either, is that fluoride has been shown to accumulate to a certain degree in human breast milk (20), so does this also happen in cow milk?

When cows are watered via municipal water supply that’s fluoridated or they consume feed with high levels of fluoride like chickens do, how much fluoride carries over into milk? Good thing we don’t milk chickens, right? (just kidding, seriously. They don’t have nipples…please, someone get the movie reference. I’m trying to keep this lively).

And then when that milk that has a low or moderate level of fluoride that may or may not be problematic, is then altered wherein more fluoridated water is added, the fluoride content goes even higher?

Another question to answer.

So the theory is that low-fat or skim milk dairy products are more strongly related to acne because their fluoride concentrations are higher.

I tested this as best as I could and found it to be a plausible hypothesis.

I ate ice cream from Shatto, which is just pure whole cream, unprocessed milk product (but incidentally, high glycemic): no acne. Have been eating butter from Kerrygold daily: no acne. Low-fat yogurt: acne. Whole milk yogurt: no acne. Ongoing testing for other dairy products currently (I really can’t be more excited about this, for real).

And, here is where I’d like to point out that if it were the hormones in milk, you’d expect that all milk products would cause acne, but as you can see from the observations above, not the case.

I’d be interested if anyone else wants to test this too.

Does fluoride cause everyone’s acne? No.

Could it be the cause of what you think is hormonal acne, especially around the nose, lips, mouth, chin and jawline? Maybe. The only way to know is to go totally fluoride free and see what happens.

Can you have truly hormonal acne? Sure. Anything’s possible.

Other Nutrients

In addition to eliminating the fluoride I was consuming, I also added more iodine to help flush it from my body faster.

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Now, before I go on, do not mess around with iodine if you don’t know what you’re doing. It can have rather unpleasant and even dangerous side effects if you take too much too fast, especially if you have autoimmune thyroid disorders, like Hashimoto’s or Graves.

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There are many great studies on iodine and thyroid function, as well as supplementing high doses safely, and some are even done in patients with Hashimoto’s, but they are under the care of iodine-literate doctors that know what they are doing.

I have messed around with iodine before on myself and know my own body very well, so I feel confident in what I’m doing for myself, but I’m not going to discuss dosing or what I would do for patients in this blog post, just so you don’t get any crazy ideas.

Here’s the weird thing that happened after I started adding the iodine:

For about 5 days, my neck ached a lot (very similar to how I feel when I’m fighting off an infection or a virus), then the neck ache went away, my brain fog lifted and my memory and focus were all of a sudden razor sharp.

I stopped wanting to fall asleep at 2pm every day. My skin started glowing and my mood lifted. I stopped retaining water in my abdomen and felt generally more energetic than I have in years.

Some cellulite has also started to disappear from my thighs and this could either be the increase in iodine OR improved lymphatic flow from removing fluoride OR going off of spironolactone, a medication that also commonly causes adipose deposition in the thighs of women who take it.

My weight has not changed, nor has the circumference of my thigh, so I’m not thinking this is actual cellulite or fat loss per se, just the reduced appearance, therefore I’m leaning toward lymphatic flow improvement, but who knows at this point.

My morning cortisol also went from a measurement of 6 ug/dL in November (the lowest it can be and be considered “normal” by the lab reference range on which it was run) to 12 ug/dL in April, 2 weeks into adding iodine and avoiding fluoride.

This explains why I wake up feeling so much more refreshed and in a much better mood most days, as well as far more focused and alert. My cortisol could still be higher in the morning upon waking, but for now, that’s pretty amazing after just a couple weeks of supplementation.

Again, all observational and anecdotal, but this falls completely in line with what you would expect to see when you add iodine and remove fluoride.

Here’s why:

Halogens

The halogens are a class of elements on the periodic table that are not quite noble gases like helium or neon, because they lack an electron in their outer shell. This makes them highly reactive because they’ll bind to anything and everything that will allow them to gain that extra electron. For the human body, this is generally a bad thing, unless we’re talking about iodine.

The halogens include, from order of lowest molecular weight to highest molecular weight: fluorine, chlorine, bromine, iodine, astatine and tennesine. The last two are not found in nature, or anything we naturally consume, so we’ll leave them out of this discussion for the sake of brevity (which, lol, I obviously have made no attempts at brevity here, have I?).

Fluorine, given its identical outer shell configuration to iodine and the rest of the halogens, will bind to thyroxine, among other things, the thyroid hormone we make, aka T3, triiodothyronine (“tri” for three, “iodo” for iodine, and “thyronine” as the amino acid base; make a note that’s “3 iodines bound to thyronine” if we’re translating this). And it will bind in place of iodine binding there, if we don’t have enough iodine (21).

What if you’re already kind of iodine deficient, or sub-clinically deficient, such as you don’t really have a critical lack of iodine in your diet enough to produce goiters, but you also could definitely use more shellfish, seaweed and kelp because you live in the midwest, for instance?

Then you’ve got a situation where you may not have enough iodine from just iodized salt to prevent the binding of all the sources of fluoride you’re consuming.

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Keep in mind that micronutrients like iodine have recommendations that are based on what governement data has shown to generally be the minimum level required to prevent disease.

In the case of iodine, many of the recommendations were established before heavy fluoridation of water systems, fluoride dental treatments and fluoride toothpaste were a mainstay, therefore did not account for the potential of one halogen to replace the other in potentially harmful ways.

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In addition to binding thyroxine, fluoride will also bind to places in the brain (22, 23, 24, 25, 26) which has been linked to cognitive impairments, psychological disorders and behavioral disorders, and the skeleton (27, 28, 29, 30).

It accumulates there and remains, unless you eat enough iodine (usually quite a lot of iodine by American-diet standards) to dislodge it and let something else bind in its place that should actually be there (hint: its iodine).

Anyway, let’s say fluoride has bound up some or all of your T3 in place of one of the iodine molecules. This T3 will appear normal on your lab work, because all the laboratory is doing is measuring a thyroxine molecule that has 3 other molecules bound to it at 3 separate sites. It’s not measuring what is specifically bound at those sites.

So you’ve got this T3 that looks like T3, but because its not really T3 in the strictest sense, can it really act like T3 in the body in all the ways that T3 should be able to?

So, these people kind of feel tired, they’ve got some concentration problems, they gain a little weight or struggle to lose weight, they have trouble sleeping, maybe some constipation, etc etc. Some of those generic symptoms that are often attributed to low thyroid, but could admittedly also be other things too.

Is this why some people with sluggish thyroid or hypothyroid symptoms, appear to have mostly normal T3 and T4, maybe even TSH on lab work, in the absence of detectable anti-TPO or anti-TG?

I can’t find much out there on this, but I’d be really interested if someone would dissect the T3 molecules of some of these people and take a look for me 😉

My question is, could some of these people have this kind of sub-clinical fluoride toxicity? They don’t quite have skeletal fluorosis and they don’t quite have obvious overt symptoms of total fluoride neurotoxicity, but there’s just enough to kind of screw with their skin, nervous system and/or thyroid?

The National Research Council of the National Academies Press published this great little (not little) read on fluoride, mostly from drinking water, but does consider aggregate fluoride consumption overall.

It’s pretty comprehensive looking at all the data so far that says fluoride does or does not do certain things biologically, and even the data that say we don’t know if it does these things, but we’re starting to recognize some patterns.

My next question is why doesn’t this (acne) happen to everyone that drinks fluoridated water?

I’m not sure, and I can’t find anything specific, but it probably has to do with what I mentioned above, being the aggregate fluoride exposure and intake over a lifetime.

Things that contribute to a higher than normal fluoride intake and that seem to (anecdotally) be connected to adult acne are:

  • fluoride dental treatments in childhood (21)
  • use of high fluoride mouthwash or toothpaste (like the kinds they gave me when I had braces in middle school?) OR
  • living in an area where there is naturally high fluoride found in the groundwater sources, as well as
  • drinking fluoridated tap water, all the beverages made from fluoridated tap water and then there’s
  • all the other exposures we have to fluoride, such as medications like Prozac AND,
  • there are likely many other factors, such as genetic influences on natural detoxification pathways in the body (such as MTHFR – methyltetrahydrofolate reductase, of which I have two mutations that I know of)…

Another ‘risk factor,’ if you will, that I’m wondering about is the (anecdotally) high number of females that are physically active with ‘hormonal’ acne and, could it be, that we have more acne because we tend to drink more fluids (which are going to statistically come from more fluoridated sources because over 70% of the US population drinks fluoridated public water)?

Again, I can’t really find any evidence anywhere, but I’m wondering about that one most.

Keep in mind, this is my theory, and probably the theory of others, too, and I’d be interested if someone wanted to study the prevalence of these connections and rule them in or out, or at least shed some light on things that nobody is looking at.

In the meantime, I’m now totally fluoride free, acne medication free, off of panthothenic acid supplements, use acne topical treatments like NERD pretty much never and life’s great.

My mood has never been better and I am totally okay with avoiding fluoride for the rest of my life if I have to, in order to never get acne again.

Draw from this story whatever conclusions you will. I welcome your thoughtful questions, your own anecdotes and observations and anything else you want to contribute that’s constructive for the conversation.

My goal is not to scare everyone from turning on their tap water either, lest you think I’ve gone Food Babe over here. I think there are many, many questions that need to be answered still, surrounding this entire topic.

My results speak for themselves.

Before (on Spironolactone)

After (4 months later)

 

 

 

 

 

 

Before (on Spironolactone)

After (4 months later)

 

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