Roaccutane/ Doctors VS Paleo/ Primal

Commented on January 25, 2015
Created January 15, 2014 at 1:22 PM

I have just been prescribed Roaccutane/ Accutane treatment for my hormone related acne. The doctor recommends I lower my intake of high cholesterol foods whilst on the drug. She gave me a leaflet titled 'Cholesterol Lowering Advice' which completely contradicts the paleo diet;

It advises that I avoid/ reduce my intake of eggs, red meat, offal, and all fats *especially saturated animal type fat. It recommends you eat polyunsaturated spreads (sunflower oil, soya oil, etc.) and high fibre foods *particularly oats, beans and lentils.

I literally can't bring myself to follow these guidelines as it goes against everything I have been doing to follow the primal lifestyle. However, I am worried about my heart and the risk of heart attack! After-all, I can't help but feel "the doctor knows best".

I am a healthy 21 year old 5'2 female, weighing in at 8st and 22% body fat. I am consciously trying to reduce my weight and body fat through an extremely healthy paleo/whole 30 diet and regular dynamic exercise. My acne was just an unfortunate turn of events, spurred on a mere month ago by PCO. Nothing I did to cause it and nothing I can do to fix it naturally. Roaccutane was my last resort and I am happy to be trying it as I'm not enjoying this new pizza face.

I am not looking for advise/ negative opinions in regards to roaccutane, I am already scared enough as it is.

But please could someone assure me that I can just continue eating as I am, or advise me on how to adapt these medical food guidelines to suit the paleo diet and keep my cholesterol low?

Many thanks & warm regards x

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3 Answers


on January 21, 2015
at 07:25 PM

Same for me. I'll be starting Accutane (brand: Absorica) tonight, and I eat a very low cab/ high fat diet. I'm concerned about what it will do.

I had lipids checked before getting the approval to start:

Name Test result Range Flag
Cholesterol, Total 193 mg/dL 100-199 N
Triglycerides 96 mg/dL 0-149 N
HDL Cholesterol 63 mg/dL >39 N
VLDL Cholesterol Cal 19 mg/dL 5-40 N
LDL Cholesterol Calc 111 mg/dL 0-99 H

I have to get my cholesterol rechecked at 2-week intervals, and my dermatologist will only start me on a daily dose of 20mg. I should add that I have type 1 diabetes, which is why the concern is greater than a non-diabetic.




on January 25, 2015
at 01:21 AM

Hi there,


Don't worry about a thinh - I can't vouch for the diabetes side of things as I am not experienced in this area. But as for the roaccutane and paleo lifestyle they worked perfectly together for me. 

In fact, Roaccutane was one of the best decisions I ever made in my life. My acne was making me so unhappy and within a matter of months the drug completly cleared my skin.

Yes, there was a lot of emotional strain and my mood swings were quite extreme, but for the end result it was so so worth it. 

I did lay off the extremely fatty foods but that didn't mean I had to completely change my paleo diet plan. 

Best of luck with it all!

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on January 15, 2014
at 08:39 PM

Conventional medical advice is being given by your doctor. As Paleo followers we generally don't believe 99% of what they say. I'd stick with Paleo if it was me.

I do find a lot of contradictions in your post but since you don't want to hear about it I pass.


on January 15, 2014
at 06:56 PM

The reason your doctor wants you to lower cholesterol is because there was a study that showed Accutane can raise total cholesterol and triglycerides [1].

For starters, they only measured total cholesterol and did not differentiate between HDL (good cholesterol) and LDL ("bad" cholesterol).

I'm not sure if you got your cholesterol checked, so I'm going to assume it's fine and your doctor is just being precautionary.

According to Wikipedia, triglycerides can be brought down by a low carb diet [2]. Sounds like Paleo to me.

Studies have also shown high fat/low carb diets (such as Paleo) can raise your HDL. This might raise your "total" cholesterol, but HDL is protective and doctors should at least differentiate between the two.

Lastly, even if your LDL goes up eating Paleo, this might not even be a bad thing. I'll refer you to this blog post for more info: http://www.marksdailyapple.com/cholesterol/

So personally, I don't think eating Paleo while on Accutane is going to be a problem.

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