I needed to disable self sign-ups because I’ve been getting too many spam-type accounts. Thanks.
13-cis-Retinoic Acid Unmasking of Clinical Polycystic Ovary Syndrome
Case Report
13-cis-Retinoic Acid (Isotretinoin) Unmasking of Clinical Polycystic Ovary Syndrome
Objective: To describe a woman in whom polycystic ovary syndrome manifested during treatment with 13-cis-retinoic acid (isotretinoin) for severe acne.
Methods: We present serial clinical and biochemical findings for a several month period before, during, and after therapy with 13-cis-retinoic acid. Homeostasis model assessment of insulin resistance was calculated from the fasting plasma glucose and insulin concentrations.
Results: A 32-year-old woman with some past features suggestive of metabolic syndrome took 13-cis-retinoic acid for 20 weeks as treatment of nodulocystic acne. During therapy, amenorrhea and hirsutism developed, as well as biochemical evidence of hyperandrogenemia and insulin resistance, as assessed by homeostasis model assessment of insulin resistance. After discontinuation of the medication, both the clinical features and the laboratory abnormalities resolved.
Conclusion: 13-cis-Retinoic acid likely causes insulin resistance through its role as an agonist of retinoid A and X receptors. Although elevated levels of serum triglycerides are well documented with use of this drug, to the best of our knowledge this is the first report of a patient in whom polycystic ovary syndrome, a condition known to be associated with insulin resistance, manifested during isotretinoin therapy.
https://journals.aace.com/doi/abs/10.4158/EP.13.7.776?journalCode=endp
There's that "umasking" concept again. Just brilliant... what the hell is it going to take??
I expect it will never, ever happen. For them to accept the obvious will mean that they'd have to admit to poisoning millions. And, that's just not going to happen.
You're welcome.
13-cis-Retinoic acid likely causes insulin resistance through its role as an agonist of retinoid A and X receptors.
That explains or partially explains retinoic acid's effect on weight gain, diabetes and hair growth.
Do you think cells developing lower numbers of insulin receptors could be a protective response to chronically elevated amounts of retinoic acid? Or perhaps retinoic acid stimulates glucose uptake hastening the development of insulin resistance? We need to differentiate ATRA from 13-cis with this issue, they have different effects despite both being bad in elevated amounts. These might be questions for Mawson?
Hi @tim-2,
I don't know if the lower number of insulin receptors is a defensive or defective response. But, I did speculated earlier that it could be defective, and that it's probably due to the inability of the cell to produce correctly structured proteins. The reason I say that is because Accutane is associated with weird and malformed scar development (post surgery incisions or wounds, etc). I think this is evidence of RA causing malformed proteins, but showing up on the macro scale.
When Hoffmann LaRoche went to market with Accutane they claimed that their internal studies showed that ATRA was significantly less toxic than 13-cis. So, based on that claim, I think both isomers are clearly toxic. Since 13-cis is worse than ATRA, and the body can produce both molecules endogenously from diet sourced vA, I don't see much value in making the distinction. I think both isomers need to be avoided.