The Low Thyroid/Hormonal Acne link

October 24, 2018

Most women know that hormones play a major role in breakouts, but what many don’t realize is that thyroid hormones in particular are often the root cause of hormonal acne. The thyroid is a small, butterfly-shaped gland located at the front of your neck that releases hormones essential to growth and metabolism. Hypothyroidism (low thyroid) is common and often missed by doctors. In fact, “recent studies indicate that 1 in 10 Canadians suffer from a thyroid condition…of those, as many as 50% are undiagnosed” ( When my naturopath diagnosed me with hypothyroidism, I started on a natural thyroid supplement that cleared my skin and significantly increased my energy and overall wellness. If you want clear skin and a healthy body, it is vital to achieve optimal thyroid function.

In order to create optimal thyroid hormone levels, your pituitary releases thyroid stimulating hormone (TSH) which tells the thyroid to make and release thyroxine (T4). You metabolize T4 into its more active form, T3. (Merck Manual, 2nd Home Edition, p. 861). T3 is important as it is the only hormone capable of attaching to a receptor and raising your metabolic rate, preventing brain fog, keeping you warm and regulating your other hormones. ( The problems start when the thyroid either makes insufficient thyroid hormone, hypothyroidism, or when it makes too much,  hyperthyroidism. Our focus is on hypothyroidism as that is usually what causes acne.

How does hypothyroidism cause acne? When thyroid hormone levels are too low, the body can’t convert cholesterol into progesterone ( This is important as progesterone prevents acne by keeping DHT (a potent form of testosterone that causes oily skin and breakouts) levels down by preventing the conversion of excess testosterone into DHT by blocking an enzyme called 5 Alpha Reductase. Furthermore, low thyroid hormones also cause progesterone receptors to become less sensitive (Dr. Tom Sladic), which explains why some people’s labs show normal progesterone levels even when they still have all the symptoms of low progesterone. And just as low thyroid hormone levels can cause low progesterone, low progesterone can also cause low thyroid levels, and it can be hard to tell which came first.

So how do you know if you have hypothyroidism? It can be challenging to diagnose, but a good place to start is with a list of major symptoms, which can include but are not limited to: acne (of course), low energy, PMS, weight gain/weight loss resistance, hair loss (including thinning outer eyebrows) and depression and irritability.

If you suspect you have hypothyroidism, ask your ND/MD  to run a full thyroid panel for you. Once the tests are complete, it is very important to ensure that your doctor interprets them using optimal reference ranges. This is key as one of the major reasons so many doctors miss hypothyroidism is that standard reference ranges are too broad. Many mainstream MDs will refuse to use optimal ranges. If your doctor will not work with you, I suggest finding one who will, after all, why go through life exhausted, depressed and breaking out when you could be healthy, glowing and beautiful? You may need to consult a naturopath to find out what is really going on. Here are the Optimal and Standard Reference Ranges provided by my naturopath:

      Optimal Reference                                       Standard Reference                                      

  • TSH: 0.4-2/2.5 mIU/L                                 .4 – 5.5
  • Free T4: 15-23 pmol/L                                 9-23
  • Free T3:  5-7 pmol/L                                    3-7
  • Reverse T3:  11-18 ng/dl                             11-31
  • Ft3/Ft4: >.33
  • Ft3/Rt3: 18-21
  • ThyroidAntibodies : WNL (within normal limits)

*mIU/L=milli international units/litre (IU is defined as the number of units needed for function)        pmol/L=picomoles per litre (this is a concentration and a tiny amount) ng/dl=nanograms/decilitre (a decilitre is 1/10th of a litre)

In comparing the optimal vs standard ranges, it’s easy to see why so many doctors miss hypothyroidism in their patients when the standard reference ranges are so broad. But as revealing as a full panel can be, lab tests are not the only way to determine if you are hypothyroid, and the more holistic and multi-faceted the diagnostic approach, the better. Ask your ND/MD about taking your basal body temperature for several weeks as well as your pulse rate and recording the data. Iodine deficiency also causes hypothyroidism so you should ask your doctor about doing an iodine patch test (a simple test you can do at home) or a 24 hour urine loading test (the gold standard but more complex). Iodine is important as it is one of the two building blocks used to make thyroid hormones, the other is tyrosine ( You should also ensure that your ND/MD has taken a detailed personal and family history that accounts for hypothyroidism risk factors such as a history of autoimmune disease.

If you discover that you do have hypothyroidism, there are many ways to support your thyroid that will make a phenomenal difference in the way that you look and feel. One of the healthiest long-term ways to support the thyroid is through diet. Dr. Christiane Northrup recommends adding seaweed as it “… helps restore iodine levels and is an excellent food to help the body detox from heavy metals.” She also recommends organic vanilla extract (to add to smoothies or water). Dr Josh Axe suggests adding coconut oil, fruits and veggies plus probiotic rich foods such as kombucha, sauerkraut and kefir, and sprouted seeds like hemp, chia and flax for healthy fats and bone broth to help the gut heal, as “beef and chicken stock contain the amino acids l-proline and l-glycine which can help repair the digestive lining and improve hypothyroidism.” Vitamin A is also very important and can be found in liver. If you cannot handle liver, another way to increase vitamin A is through supplementation, and always consult with your doctor on the best way to do this as vitamin A can be toxic in high amounts.

Now that we’ve discussed some foods to add to your diet for thyroid support, let’s consider foods to avoid. According to Dr. Axe, this list includes: gluten (it increases inflammation) sugar, (a hormone disruptor) large amounts of undercooked cruciferous veggies like broccoli, cauliflower, and cabbage, (they contain molecules called goitrogens that can impair proper thyroid function),conventional dairy    (it causes inflammation) organic, raw (unpasteurized) dairy is a better choice, and again, always talk to your doctor before making dietary changes. Filtering your tap and showerhead water and switching to natural fluoride free toothpaste are also smart, thyroid supportive choices as fluoride and chlorine (also in tap water) both interfere with iodine metabolism.

You can also talk to your doctor to see if you need to take any supplements, or if there’s a way to achieve sufficient support for your thyroid through your diet. In addition to iodine, selenium and ashwaganda, some other natural remedies to check out are: vitamin B complex, probiotics (50 million cfus), frankincense essential oil and lemongrass and myrrh essential oils. For more detailed information, check out Dr.Axes plan.

There are many positive diet and lifestyle choices you can make to support your thyroid, clear your skin and look and feel amazing. Your thyroid could be the key to clearing up your hormonal acne forever. I did it with the help of my naturopath, so I know that you can too.

Image Credit: Thyroid Foundation of Canada






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  • Reply April 14, 2019 at 4:33 am

    To learn more about thyroid function, metabolism and nutrition, I direct you to Dr. Peat s website (best place on the Internet!), and the large number of email exchanges with Dr. Peat that were compiled here . Have you struggled with hormonal acne? Ever considered it might be due to low thyroid function? How do you feel about boosting your thyroid with these suggestions?

    • Reply dalesharon3 April 17, 2019 at 4:52 pm

      Thanks, yes I’ve heard of Dr. Peat, and I’ll definitely check out his site, it sounds like a great resource, and to anyone else who’s interested here’s the link: and yes I did suffer from hormonal breakouts, and thanks to my naturopath, I learned that they were caused by hypothyroidism, and treating the thyroid eliminated the breakouts – my skin has never been so clear!

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