The Low Thyroid/Hormonal Acne link

October 24, 2018

woman with butterfly on her throat symbolizing the thyroid

Most women know that hormones play a major role in breakouts, but what many don’t realize is that a low thyroid can cause hormonal acne. The thyroid is a small, butterfly-shaped gland 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, “…1 in 10 Canadians suffer from a thyroid condition…of those, as many as 50% are undiagnosed” (  If you want clear skin and a healthy body, it is vital to achieve optimal thyroid function.

How thyroid hormones are created

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. ( And when the thyroid makes insufficient thyroid hormone, many health problems result, including acne.

How low thyroid causes acne

When thyroid hormone levels are too low, the body can’t convert cholesterol into progesterone ( Progesterone prevents acne by keeping DHT (a potent form of testosterone that causes oily skin/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 low progesterone symptoms. And just as low thyroid hormones can cause low progesterone, low progesterone can also cause low thyroid levels.


How do you know if you have a low thyroid? A good place to start is with the major symptoms, which can include: acne (of course), low energy, PMS, weight gain/weight loss resistance, hair loss (thinning outer eyebrows) and depression. If you think you have hypothyroidism, ask your ND/MD  to run a full thyroid panel for you, then ensure that s/he interprets the results using optimal reference ranges. This is key as one of the major reasons doctors miss hypothyroidism is that standard reference ranges are too broad. Many MDs will not use optimal ranges, so 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)

Multi-faceted diagnostic approach

In comparing the optimal vs standard ranges, it’s easy to see why so many doctors miss hypothyroidism when the standard reference ranges are so broad. But lab tests are not the only way to determine if you are hypothyroid, and the more multi-faceted the 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 one of the two building blocks used to make thyroid hormones, the other is tyrosine ( Also, ensure that your ND/MD takes a detailed personal and family history that accounts for hypothyroidism risk factors such as autoimmune disease.

Dietary changes to support your thyroid

Supporting your thyroid through a healthy diet can be an effective alternative acne treatment. 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 added to smoothies or water. Dr Josh Axe suggests coconut oil, fruits and veggies plus probiotic foods like kombucha, sauerkraut and kefir, sprouted seeds like hemp, chia and flax for healthy fats and bone broth to help the gut heal, as “beef and chicken stock contain…amino acids…which can help repair the digestive lining and improve hypothyroidism.” Vitamin A is also important and is found in liver. If you hate liver, you can explore supplementation, but consult with your doctor first as high amounts of vitamin A can be toxic.

Thyroid supportive lifestyle changes

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

Thyroid Supplements

Ask your doctor if you need to take any supplements, or if you can achieve sufficient support for your thyroid through diet. In addition to iodine, selenium and ashwaganda, some other natural remedies are: vitamin B complex, probiotics, and frankincense, 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 incredible. Your thyroid could be the key to clearing up your hormonal acne forever. I did it with the help of my naturopath, and 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!

  • Reply Vic July 19, 2019 at 7:36 am

    Nice article! I definitely learned something from this. Thanks a lot for this information!

    • Reply dalesharon3 July 22, 2019 at 3:31 pm

      Thanks Vic! Glad I could help:)

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