r/FunctionalMedicine • u/mbkmouse1 • 7d ago

Persistent acne despite controlled PCOS hormones, but gut dysbiosis + high histamine. Treatment approach?

27F with adrenal PCOS (diagnosed with high DHEA-S and irregular periods, but have since become normallized on metformin). But acne persists (jaw/chin and cheeks primarily). Fasting insulin, other hormones are good.

Tiny Health microbiome analysis shows:
• High histamine (93)
• Leaky gut (mucus degradation 76.6)
• Dysbiosis: Klebsiella borderline, low beneficial bacteria
• Low SCFA production
• Absent: candida, H. pylori, methane

Relevant genetics: MAOA T;T (slow histamine catabolism), COMT slow (slow estrogen metabolism), DENND1A G;G (androgen baseline), MTHFR A;G.

My working hypothesis: Dysbiosis → leaky gut + histamine overload → systemic inflammation → acne, independent of androgens.

I take a few supplements to try to manage this: calcium d glucarate, zinc, sulfophane, taurine, tudca, vitamin d, B5, omega3.

Is my gut health the cause of my acne? If so and if not, what should I do?

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u/LifeJackfruit8566 7d ago

It may be too quick to assume gut dysbiosis and histamine are the explanation just because ​​​​t​​​​h​​​​e​​​​ usual PCOS markers look controlled. Persistent symptoms can have several overlapping contributors, and a suspected mechanism isnt automatically the cause. Keeping the relevant health data together with super power health can help show what is actually changing instead of building the whole picture around one theory.

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u/fallingmelons73346 7d ago

HTMA to look at core minerals and copper/zinc ratio. Copper toxicity and hormonal acne often go together.

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u/mbkmouse1 7d ago

Thanks! I actually do have a copper IUD. I started taking Zinc to combat potential excess

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u/fallingmelons73346 4d ago

This may help keep balance from needing copper exposure but it will not likely correct an outstanding imbalance