Acne and Your Thyroid

Hypothyroidism and acne are two very common conditions I treat, and sometimes they are unrelated.

Common symptoms of hypothyroidism include fatigue, constipation, hair loss, dry skin, heavy periods, and cold extremities.

Common causes of acne include hormone imbalance, a backed up liver, elevated androgens (hormones in the testosterone family) sometimes due to PCOS, too-high sugar and insulin resistance, and occasionally low essential fatty acids.

But sometimes, acne can be a symptom of hypothyroidism.

The Thyroid/Progesterone Connection to Acne

One common correlate to hypothyroidism is elevated cholesterol. This is because when thyroid levels are low, the liver isn’t filtering the cholesterol out of the bloodstream as quickly as it should — which means it won’t be available to the body tissues that need cholesterol to form all the stuff cholesterol makes. The most important of these in this case is progesterone.

Why this is important? Progesterone facilitates the release of thyroid hormone from the thyroid gland, while estrogen blocks it (which is why estrogen dominance and hypothyroidism tend to coexist).

Adequate Vitamin A is also necessary for the formation of progesterone… but there’s another reason why Vitamin A is important.

The Thyroid/Vitamin A Connection to Acne

The best known treatment for acne involves retinoid drugs, which are derivatives of Vitamin A. Vitamin A works by encouraging the regeneration of keratin in the skin (which is why it’s also in most anti-aging formulas).

Vitamin A is a fat-soluble vitamin, found in liver, meat, eggs, and dairy. Its water-soluble precursor, carotenoids, are found in red, yellow, and orange veggies.

However, if your thyroid is sluggish, you won’t be able to effectively convert carotenoids to Vitamin A, no matter how many carrots you eat. (And there’s a feedback loop between the two: if you’re low on Vitamin A, you won’t be able to effectively convert T4 into the more active T3.)

Conclusions (and Disclaimers):

You might have noticed that it’s all interconnected: low thyroid function can cause acne. But so can a low-fat diet, since you’ll be low in Vitamin A, and so can estrogen dominance (and low progesterone). But then low progesterone and low Vitamin A can also exacerbate hypothyroidisim, too. The best approach to keep all these factors in balance?

And here comes the disclaimer: Vitamin A in high doses does treat acne, but it’s not a good idea to take high doses of it without supervision, as it is a fat-soluble vitamin and therefore possible to overdose. Vitamin A in high doses is also unsafe in pregnancy and should be avoided. (Balanced thyroid and progesterone hormones and sufficient dietary fat, on the other hand, are all very good ideas in pregnancy!)