Now since my knowledge of medical stuff is very limited I could easily
be wrong, but from what I've read:

Vitamin A is also called retinol, were accutane is retinol acid.  Also
my dermatologist tells me that accutane has an addition to the molecule
that makes it less toxic then vitamin A.

Retinol acid has some different effects that retinol doesn't have.  In
Discover magazine July 1991 in the article "Reversing Leukemia" it says
"Retinoic acid is well known to have striking effects on cell
differentiation".  "Thus encouraging the replacement of inflamed cells
with healthy ones".  "...in his test tubes.  "We can clearly see the
diseased cells mature,""  "Once that happens, they die and the cells
are replaced by normal cells."

It said it cured promyelocytic leukemia in 3 months.  It took 11 months
to cure my problem.

They called the drug in the Discover article "all-trans" and
"retinoic acid".  I read else were(newer source) that they now use
accutane, which I think is less toxic.

This all gives me 4 questions:

1)Inflammation was the cause of my pain, and many of my other problems
so is it possible that the "encouraging the replacement" effect is what
fixed it?  And is it probable?

2)Some weird disease were my cells were not maturing normally?

3)Differentiation(whats that?) problem?

4)Some other effect?

Also if yes to question #1, then will my cells again slowly become
inflamed and require accutane to fix it?  What worries me is were it
says "cells seem to develop a resistance to retinoic acid."

It says fatigue occurs in 5% of patients.  It did cause me fatigue, but
it cured a lot more of the fatigue then it caused so initially I gained
a feeling of increased energy, but by the time I was 99% cured the drug
was causing most of my fatigue.  At that point when I stopped taking the
drug, after a few days I felt a lot less tired(big improvement).

The same with inflammation of the eye lid, and irritation of the eyes,
the drug caused that effect on me and it improved when I stopped taking
it, but the disease caused it worse and the accutane improved it from
the diseased state.

It lists "flushing" as a side effect(listed as infrequent).  If it can
increase {*filter*} flow to the face might it not also increase {*filter*} flow
throughout the body?  And there by fix the Raynaud's phenomenon?  3 days
after starting the accutane(10mg/day) my feet turned near normal in
color for the first time in 10 years!

Question:

With restricted {*filter*} flow to the feet and skin the cells located there
would be less healthy, eh?  Also less {*filter*} = less immune system white
{*filter*} cells to the area?  So could a virus hid there easier then else
were in my body?  So with Raynaud's fixed by accutane my body could kill
off the virus easier, eh?

I read that the liver makes use of zinc in removing vitamin A from
its stores in the liver.  The drug book says "A rise in serum levels of
liver enzymes may occur".  Presumably from too much accutane being
stored in the liver.  My liver enzyme counts were higher before I went
on the accutane, but still higher then normal on the accutane.  During
the 9th month of taking accutane I started taking 100mg/day SR zinc and
the enzyme level improved.

The accutane caused increased pressure in my skull(that's what "Benign
Intracranial Hypertension" means, eh?).  Not nearly as bad as the
250,000 IU/day of vitamin A did, but I could feel it.  So I thought if
I am effectively increasing my vitamin A may be I should increase my
other vitamins and minerals to match(although not by the same huge
amount).  Anyway I did that and the feeling of pressure went away!
After several months I let my vitamin supply run out(except the
vitamin C) and the pressure came back, so of course I started popping
the vitamins again.  I did continue to take tetracycline while taking
the accutane(which increases the chance of increased pressure in the
skull).

If you find out any other relevant information on accutane I'd be
most interested in it.
--
Canada Remote Systems  - Toronto, Ontario
World's Largest PCBOARD System - 416-629-7000/629-7044

Hmm.  Doubtful.  It turns out that there isn't really any inflammation in
fibromyalgia to speak of, it just feels that way.  You were able to stop
the accutane after several months and your symptoms didn't come back?

The muscles use most of the {*filter*} going to the extremities.  If there were
a decrease in {*filter*} flow enough to affect skin health, there would be
significant ischemic muscle pain which doesn't seem to be much of a problem
in fibromyalgia.

Good.  I'll have to remember this too!

I have heard back now from two patients I've tried on Accutane since your
initial post.  In one it is working marvelously.  She has cut way down on
her amitriptyline dose without problems and feels more alert.  Interestingly,
she had a couple of nights of poor sleep after dropping the dose, but didn't
suffer any increased pain the next day, which is most unusual for her.  This
leads me to believe that Accutane may work on the second step of the process
(however increased deep sleep reduces the symptoms) rather than on deep sleep
itself as with most of the other useful therapies (amitriptyline, exercise).

The other patient said, no, it didn't help at all, she didn't want to try a
higher dose, and would I please fill out her disability papers now.  I'm not
sure it's fair to count that as a failure, though.  It really is sad that she
would put her desire to be on disability over a chance to get well (if this
is in fact what she is doing.

Finally, I would like to publicly thank Chris for coming forward with this
observation.  If this turns out to be a major advance in the treatment of
fibromyalgia, he will deserve the credit.  Maybe this will get more docs
to read this newsgroup, too!

David Nye