You may find it surprising that your thyroid function may be the underlying trigger of your acne or rosacea.
Your thyroid, a small gland that sits in the neck, is crucial for a range of functions and is like our master regulator, telling your metabolism to speed up or slow down and influencing the functioning of just about everything within your body, from your hormones, gut function, skin cell turnover, heart rate, temperature regulation, mitochondria & more.
When your thyroid isn’t functioning well and you’re lacking in thyroid hormones, this can cause sluggish bowels (constipation), dry skin, brain fog and low energy. Everything slows down, including a slower rate of cellular skin turnover, which can result in clogged pores and poor healing capacity. On the other hand, if your thyroid is overactive (hyperthyroidism), it speeds everything up. Think increased sebum production, causing oily skin and acne breakouts.
Let’s break this down a little more...
Hormone-Thyroid-Acne Connection
An underactive thyroid can disrupt reproductive hormone levels in a number of ways. Firstly, it can increase testosterone and worsen insulin resistance. Both of which are common contributors to acne and oily skin. Often in this case, the face can feel oily but other areas of the body, such as your legs and arms can appear dry and flaky.
High prolactin levels, a hormone important for breast milk production, is often higher in those with hypothyroidism. High prolactin levels (hyperprolactinemia) triggers hirsutism (excess hair growth) and acne by increasing androgens via the adrenals and reducing sex hormone binding globulin (SHBG), resulting in higher free testosterone levels (1).
Your thyroid can also impact oestrogen to progesterone ratio as your body relies on good levels of thyroid hormones for ovulation and thus, progesterone production. Without ovulation, you don’t get a good production of progesterone, and this can cause a number of premenstrual symptoms. Acne occurring in your luteal phase is often associated with excess oestrogen to progesterone. What this means is that progesterone is either lacking or oestrogen is higher than it should be, triggering acne. Progesterone is needed to prevent breakouts. It’s our calming hormone and is supposed to work synergistically with oestrogen when balanced.
Acne, Thyroid and Gut triggers
A sluggish thyroid causes sluggish bowel motions and when you aren’t going daily, this means more toxins and metabolic by-products (including excess hormones) can be reabsorbed and recirculated, further triggering hormone imbalances, inflammation, overburdened detox pathways and ultimately, skin issues. Your skin is a major excretory organ after all so any issues with your detoxification pathways via your gut, liver or kidneys, can result in acne & other skin concerns.
To further complicate things, an underactive thyroid is linked to small intestinal bacterial overgrowth (SIBO) and this is a huge contributor to acne, and especially rosacea. A study found that out of 113 patients with rosacea, 52 tested positive for SIBO and after treatment, 20 out of 28 had a complete clearing of their rosacea with an additional 6/28 experiencing great improvements (2). In the placebo group, rosacea remained unchanged and even worsened. SIBO releases inflammatory endotoxins that can disrupt the intestinal lining, triggering increased intestinal permeability (leaky gut). This can trigger systemic inflammation and inflammation of the skin via the gut-skin connection (3).
A sluggish thyroid can also impact stomach acid production, often a huge contributing factor causing SIBO along with leading to multiple nutrient deficiencies that are essential for healthy and glowing skin.
How do you know if you have a thyroid issue?
To determine if your thyroid is causing or contributing to your acne and skin issues, we need to take a more comprehensive look at your thyroid function. This should be your number 1 focus before starting on any further expensive skin treatments, medications, or supplements because if you don’t know what’s causing your acne, you could easily be making it worse.
Often, doctors will only test TSH which simply tells us the communication between your brain and thyroid gland, not your thyroid hormones. TSH is often ‘within range’ because roughly 90% of the thyroid gland becomes dysfunctional before TSH is considered abnormal. We won’t want to wait for 90%, we want to take action earlier to reverse and optimise your thyroid. This is why we need the entire picture to understand how your thyroid is functioning by testing the following:
- TSH
- T4
- T3
- rT3
- Thyroid antibodies: TPO Ab & TgAb
- Urinary iodine
Once you have your results, it’s essential that they are evaluated based on optimal ranges. Lab reference ranges for TSH is an average of the population who were tested at that lab, which includes those who have a thyroid disease. This means each labs reference ranges can be different, and they are not based on what’s optimal. This is why so many individuals with a thyroid issue are MISSED and DISMISSED.
Test first, don’t guess.
Acne is a multifaceted skin condition with a variety of underlying triggers. Identifying these by working with a practitioner who knows and understands what to test and look for is essential for effective treatment and healing your skin once and for all. Once you know what is causing your skin concerns, the correct treatment plan & prescription follows seamlessly.
Download a copy of my free guide – ‘Insights for a Healthier Thyroid’ to learn more about your thyroid, common symptoms, underlying causes impacting your thyroid and more.
If you need support with healing your acne, thyroid, gut or hormone imbalance, you have come to the right place. Book a free call to discuss how I can support you.
References:
1. Mehta-Ambalal S. Clinical, Biochemical, and Hormonal Associations in Female Patients with Acne: A Study and Literature Review. J Clin Aesthet Dermatol. 2017 Oct;10(10):18–24.
2. Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, et al. Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication. Clinical Gastroenterology and Hepatology. 2008 Jul;6(7):759–64.
3. Wang FY, Chi CC. Rosacea, Germs, and Bowels: A Review on Gastrointestinal Comorbidities and Gut–Skin Axis of Rosacea. Adv Ther. 2021 Mar;38(3):1415–24.
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