Daughter with dark ring around neck
 

My daughter is almost 15. She has a dark ring around her neck and very dark underarms and a patch of dark skin between her breasts. She is 5ft. 4in. and weighs 150 pounds. The doctor checked her insulin level and it was low normal. Her glucose is normal so far when they have tested it. They haven't done a Glucose tolerance test or anything else. Does anyone have any ideas about why she would have this or is there any other tests she should get. She also has daily headaches, sometimes very bad or at least bad enough to take something for it. I would appreciate any suggestions as to the cause or what to do about it or anything that may be of help.

Thanks,
Mereja

Hi, Mereja. Soundslike what I have. Skin discoloration like you describe happens with a condition called acanthosis nigricans. I have this (kept scrubbing my neck cause I thought it was dirty) due to PCOS (polycystic ovary syndrome) and high insulin levels. Her headaches might be due to blood sugar levels out of wack throughout the day. Def. something to get checked out - which is sounds like you are doing. More info here:

http://en.wikipedia.org/wiki/Acanthosis_nigricans

I Think I Can Help You
 

HELLO,
YOUR DAUGHTER'S PROBLEM SOUNDS VERY FAMILIAR TO ME. I WAS BORN WITH A DISEASE CALLED PCOS. IT STANDS FOR POLY-CYSTIC OVARIAN SYNDROME. IT IS A HORMONAL IMBALANCE THAT IS CAUSED BY TINY CYSTS IN THE OVARIES. THESE CYSTS ARE NOT MALIGNENT MOST OF THE TIME SO DO NOT WORRY. YOU SHOULD GET HER TO SEE A DOCTOR PREFERABLY AN ENDOCRINOLOGIST. THEY SPECIALIZE IN HORMONAL IMBALANCES. I HAVE LIVED WITH IT AND HAD A RARE CASE. IT IS BECOMING MORE COMMON THAN IT WAS THEN WHEN I WAS YOUNGER. MY MOM SENT ME A COPY OF YOUR THREAD AND MY HEART WENT OUT TO YOU. IT JUST SO HAPPENS THAT I AM CURRENTLY WRITING A RESEARCH PAPER ON IT. I WILL COPY IT INTO THIS IN A MOMENT. THIS COULD ANSWER SOME QUESTIONS FOR YOU. I WILL WATCH THIS THREAD CONTINUALLY TO CHAT MORE WITH YOU ON THIS. HERE IS A COPY OF MY ROUGH DRAFT FOR MY RESEARCH PAPER. GOOD LUCK TO YOU AND YOUR DAUGHTER.
Poly-cystic ovarian syndrome, commonly called PCOS is a serious syndrome that many have little to no knowledge of. This serious syndrome affects many women; some of its sufferers have no idea that they have it. PCOS if left untreated can be potentially fatal. I intend on educating you on PCOS and its symptoms in this paper.
PCOS is a very complex metabolic disorder. Metabolic refers to the physical and biochemical processes required for the body to function PCOS develops when there are several small benign cysts in the ovaries. These cysts cause the ovaries to be enlarged. If the cysts cause a reproductive hormonal imbalance, several symptoms may begin to show and this is the difference between having poly-cystic ovaries and PCOS. Three key organs play the role of creating PCOS.
The pituitary gland in the brain created the hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are sent to the ovaries, once they are signaled they create estrogen and progesterone, which are the female sex hormones. Normal ovaries also create a small amount of the male hormone testosterone. The pancreas creates the hormone insulin. With PCOS, the LH and FSH are out of balance (each case is unique), the signal to the ovaries is often interrupted and ovulation or periods do not occur. Due to this the ovaries create large amounts of testosterone.
If the pancreas creates more insulin than normal, this can cause high testosterone levels also. The pancreas is imbalanced because of something called insulin resistance which is caused by PCOS. PCOS has an insulin resistance component, which means that too much insulin is required to store blood sugar When these things occur with in a woman’s body PCOS is created. The symptoms will begin to show shortly afterward.
PCOS most often comes to light during puberty due to period problems Infrequent, irregular or missing periods are common variations. Many find that the periods are heavy when they do arrive. The irregularity of periods is a sign of irregular monthly ovulation. This can be treated by an oral contraceptive. Birth control pills can regulate periods and ovulation as well as help to increase low estrogen levels in the PCOS sufferer.
Hair growth in uncommon places for women is also a symptom of PCOS. High levels of androgens (hormones such as testosterone) can cause this embarrassing problem. The high testosterone levels can also cause acne and male pattern baldness. The treatment for these symptoms is also an oral contraceptive at a low dose including a drug called Spironolactone Depending on the severity the treatment can range from twenty five milligrams to one hundred milligrams of Spironolactone daily. Spironolactone can stop unwanted hair growth and induce normal hair growth on the scalp. A low dose contraceptive allows for regular periods (Spironolactone makes them erratic) and will raise the estrogen levels to stop hair growth and acne.
Another symptom that can pop up are called acanthosis nigrans, which are dark patches of skin in the groin area, back of the neck, on the knees and elbows. These dark areas are simply how your body shows it is imbalanced chemically. There is no option for treatment with this symptom. If you were to try skin bleaching, an expensive alternative, the dark spots would simply reappear. The chemicals of a PCOS sufferer will continuw to be imbalanced and cause the darkening all over again.
All women worry about weight. PCOS sufferers will be forced to worry even more. Because of insulin resistance obesity is common in PCOS sufferers. Obesity is a double edged sword for a woman with PCOS. Obesity itself can initiate the symptoms in some women who would not have other wise suffered them if they had remained at a normal weight. Obesity will also worsen the symptoms of PCOS. Thos who suffer from PCOS are urged to see a nutritionist to get on a strict calorie and carbohydrate diet along with a daily exercise program. Insulin inducing agents can also be prescribed like Metformin or Glucophage. This regulates insulin in the levels thus allowing the body to dispose of unneeded sugars.
If all of these symptoms are left untreated they can have some serious long term affects on you. They are related to the high insulin and androgen levels. The high levels of insulin are directly related to and increased risk of developing type II diabetes. The constant hormone changes described increase the chance of developing high blood pressure and cholesterol levels, both of which can lead to a greater risk of heart disease (www.womens-health.com). The irregular or infrequent periods can lead to an increased risk of cancer in the uterus lining. On top of infertility issues, a woman with PCOS can have pregnancy related complications such as preeclampsia which is a toxic condition in late pregnancy. It is characterized by a sudden rise in blood pressure, excessive weight gain, severe headaches, and visual disturbances.
The cause of PCOS can not be pinpointed. It has however, been associated with: genetic predisposition, insulin resistance, obesity, organ/hormonal disorders, environmental pollution (hormonal disruptors), and chronic inflammation PCOS is not a simple disease with one cause; this is why it can only be treated and not cured. This fact also causes the disease to be misdiagnosed or simply over looked. It is reported that four to ten percent of all women have PCOS but because many do not realize they have it, the actual number probably exceeds ten percent
I decided to write this paper because I have PCOS. My case was discovered at a mere age of five. I was basically developing and going through puberty at age five. I would have stopped growth at a small four foot. I have all of the symptoms of PCOS. I deal with them on a daily basis. I was diagnosed at Vanderbilt University Medical Center in Nashville, TN by Dr. Jennifer Najjar. Due to her excellent treatment of close monitoring I am twenty years old, 5’4, and working towards losing weight. Dr. Najjar monitored my ovaries by ultrasounds and my hormones by close monitoring of lab work. I currently am on a low dose oral contraceptive, one hundred milligrams of Spironolactone, and two and a half milligrams of Glyburide (another insulin resistance medication).
If the information in this paper sounds like you or someone you know, ask your obstetrician to take some lab work. If hormonal imbalances appear, seek help from an endocrinologist, who specializes in hormonal treatment. It is possible to have PCOS and appear completely normal. Many may believe they are normal but when educated on this find that they are a little more complex than they thought. Seek help if there are any symptoms familiar to you. While some may have only three out of nine of the symptoms; another may have nine out of nine, they are more than likely PCOS sufferers because each case is unique.

Also The Headaches Are Common In Cases Of Pcos. The Hormones Being Imbalanced At Her Age Can Create Head Aches. I Used To Have To Take Something For Migrains, It Is Common In Pcos Sufferers.

My daughter is adopted. But I have PCOS (self-diagnosed) after years of infertility, ectopic pregnancies, weight problems, skin tags and finally blood test that showed my insulin level very high. Now I am having problems with blood sugar.

What I don't understand is that when they tested my daughter's fasting insulin level it was low-normal. Shouldn't it have been high. She had been eating a high number of carbs for 2-3 days before the test. When she had a bad headache on evening I checked her blood sugar and it was 110. At the doctors it was 98. Should she have a gtt or what tests?

So far she is not really over weight and her periods are regular and she doesn't have much cramps or heavy bleeding.

Thanks for all the information Colegchic, I appreciate it. Hopefully our pediatrician will send her for some tests. We are already working on the low carb eating. When you PCOS or insulin resistance can you have low insulin sometimes when checked?

Children and adolescents often have low insulin levels due to their younger, less damaged pancreases. Youngsters' insulin is very powerful and less is required to clear sugar from the bloodstream than with an adult.

pcos answer 2
 

Yes, insulin levels in all individuals fluctuate, even diabetics, hypoglycemics. If your dr. does not refer her to an endocrinologist, you should get a second opinion, and if you don't have to have a referral for a specialist (for insurance purposes), you should go ahead and let and endo. look at her asap, the earlier it is treated, the better the future is for her. My heart is with you two and please keep me updated.

Get rid of pigmented areas painlessly forever!
 

http://www.clinicalaserdepiel.com.c...pigmentadas.htm (it is in English) There may be these laser clinics elsewhere in other countries. Check into it. I know it is in the UK for sure and should be in the States.

I have PCOS and was told the acanthosis nigricans is caused by insulin-resistance related to the disease. Sounds to me like she might need some hormone testing. Best of luck!

I have PCOS, never had the cysts on my ovaries, never had the dark ring, never got poor results on the blood sugar tests.

I couldn't lose weight though, had high blood pressure, and got the PCOS hirsutism and migraines. You don't have to have the laundry list checked off to have the disease. Get her on low carb. Fast.

I'm confused. How can you be diagnosed with polycystic ovarian syndrome without having polycystic ovaries?

ETA: Never mind. I found the answer myself while researching the topic in preparation for an appointment scheduled for the week after next. I take it, then, you were diagnosed with excessive androgen production and determined to have an irregular ovulation pattern?

although i'm not sure why it matters... no, I was not determined to have an irregular ovulation pattern.

The ONLY problems that presented were as mentioned. the hirsuitism, is a classic symptom.

Sigh.

my point was, that, like many diseases, the tests are not always conclusive and one does not need to have EVERY one of them before approaching the doctor or low carb as a solution.

98 fasting? That's highish, certainly for a 15 year old. 100 to 125 is pre-diabetic.

Just thought I'd put my two cent in here (yes, even though no one asked lol) being diagnosed with PCOS can vary greatly from doctor to doctor. There is no *one* test they can do to say conclusively you have it or you don't. *Most* doctors (atleast here in the states) require that you have irregular menstrual cycles and atleast two other of the long list of symtpoms that can be tell tale signs of PCOS. Penn is right, you don't have to have the whole list. I myself do not suffer from the cystic ovaries either but have/had the menstrual issues, hirsuitism, high androgen levels, etc... and of course,most if not all of the classic symptoms of PCOS can be caused by something entirely different which is why it makes diagnosing so difficult. I wasn't officially diagnosed with PCOS until last year although I have suffered through the symptoms for years.

The dark ring is usually caused by insulin-resistance which *can* be part of PCOS but can also be totally unrelated! Perhaps the doc will put her on some metformin and go from there, it has worked wonders for my IR.

Best of Luck :)