Can levothyroxine cause acne?: I was diagnosed... - Thyroid UK

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Can levothyroxine cause acne?

sarahjrobertson profile image

I was diagnosed with subclinical hypothyroidism in December and have been on 25mcg of levothyroxine since January.

My results are:

Dec - TSH 4, T4 18.3

Feb - TSH 1.3, T4 17

Apr - TSH 2.5, T4 14

I’m under the care of a fertility clinic following recurrent pregnancy loss and they want my TSH to be between 1-2. The rise to 2.5 is of course a bit of a blow but fertility issues aside I’m also disappointed as I was hoping to lower frequency of dosage from daily to every two days due to skin problems, which started days after being on the meds. GP has suggested no change for now and retest in another 6 weeks. She doesn’t seem to believe the acne is related to the levo but it’s the only change I made at the time. It gets particularly bad around ovulation. My skin has been tchy and painful and my GPs response was “well what are you going to do?” which I think can be translated as “if you want a baby you have to accept it.”

I’ve been looking into switching to a non-synthetic product such as Armour. But I don’t know if it would help as something hormonal is going on. Possibly need to retest testosterone, oestrogen and progesterone but otherwise I’m a bit stuck so thought I’d reach out here.

Free T3 was normal in December - private test as GP wouldn’t carry out. Also negative for thyroid antibodies.

Hopefully, someone can help. Or help me ask the right questions.

Many thanks in advance.

25 Replies

Experts will be able to advise you better than me, but, one things I have learnt from being on here and research is 25mcg is a very low dosage to be started on.

My GP tried to put me on 25mcg of Levothyroxine, but, I pointed out that was for elderly people, so started on 50 mcg and now after 4 weeks I’m on 75 mcg with another blood test booked in 6 weeks.

You are suppose to have increases every 4- 6 weeks and blood tests every 6 weeks. Google NHS Levothyroxine (I took the print out to show my GP)

Lots of people say that such a low dosage (25mcg) can make you feel worse.

Best Wishes


Thank you for commenting so soon.

I had thyroid tests as part of a recurrent miscarriage panel, not due to symptoms, so I don’t feel better or worse as such. The only benefit I’ve seen on the levo is my TSH lowering, which is what the fertility specialists want, but that’s recently gone up. And the side effect is what I have an issue with. Wouldn’t an increase dose exacerbate the skin problems?

The problem with 25mcg is that it can suppress the function your thyroid had - meaning that overall, there’s now even less thyroid hormone in your system. I have a feeling you might find that an increase in dose sorts out your acne problems (it would make it much more likely you’ll conceive, too).

25mcg is not a dose you’re supposed to stay on. You can’t supplement thyroid hormones - it doesn’t work like that.

Thanks for responding. Do you know of others who have experienced acne (having never had it before) when starting levo? I had my first breakout a few days after starting and it’s just been one breakout after another since.

I’d be happy to trial an increase to 50mcg for 6 weeks and see if that helps. I really don’t know very much about it and the more I read the more lost I feel. It’s a lot to take in on top of my other health problems. So I’ll chat to GP tomorrow!

Hey as you're trying to get pregnant you should have all hormones tested not only thyroid. Once tested see results for yourself.

In my experience thyroid hormones disturb all other hormones which in effect will cause acne.

I've had persistent acne on Levo but all my hormones were out of whack (of which I didn't know) due to Hashi and thyroid. So although thyroid levels were (somewhat) corrected thanks to Levo I don't think levothyroxine on it's own caused my break outs.

Correcting thyroid meds didn't help to correct my other hormones and it had to be tackled on it's own.

You need to pay attention to estrogen and shbg and in effect testosterone - those are the main culprits of acne.

You need to find good hormonal specialist to get it sorted or get well educated. Former is preferred as it will involve prescriptions and often monitoring.

I'm sorry I can't be more helpful, I had to tackle and discover it on my own and it took me years to get to the root of it.

Hi trelemorele, thanks for commenting. I’ve been having my hormone levels tested for the past 18 months and besides being diagnosed with immune and clotting disorders no issues besides slightly raised TSH have been detected. Oestrogen and testosterone has always been fine and it’s assumed progesterone is okay because of my history but that’s being tested next cycle along with my other hormone bloods. So maybe that’ll give me more info. Thanks again

Have you seen those results for yourself or were you told "it's all ok"?

I was told my hormones are ok too but on closer look and analysed together - weren't ok. I.e my shbg was too high + few other things...

I reviewed them with the fertility clinic and have all the numbers. Then I hired a fertility coach to help me assess things in detail and order new and repeat tests.

GP has suggested increasing dose by 50% so to 37.5mcg but only since I quizzed them. Original advice was to come back in three months as everything was “normal”, but of course when I look at the bigger picture it’s not. I could reorder most of the hormone bloods again over the coming weeks to take a closer look at everything again.


sarahjrobertson It's very possible that he fillers in the Levo your dosing with does not agree with you . Even the coloring can be upsetting for some . Ask your Dr to switch you to another brand Levo .

jgelliss what are your thoughts on Armour? I wondered if I should try an alternative to the synthetic version?


I personally dose with T4 and some NDT for my T3 . It works well for me and many others . You would need to try out and see how well it works or you . I had TT and since I have no thyroids I supplement what my thyroids would have made . But I must forewarn you that supplementing with any T3/NDT can unmask any adrenal insufficiency and make it difficult to dose with T3 /NDT . I would suggest that you have all the nutrients that help support your adrenals in place first . Vitamin "C" Pantothenic (B-5) B-Complex . Nutrients that are very helpful for our thyroid meds to work better for us Vitamin "D" , B-12/folate , Iron if your low , Magnesium .

*SeasideSusie's * Has Excellent post on vitamins . It really helped me very much and many others on this forum .

*SlowDragon* has Great Posts on Gluten Free . Very Valuable .

Best Wishes on you next Steps .

What’s the simplest way of finding these posts? Sorry, I’m a newbie and can find all the posts they’ve been involved with but can’t see these particular ones!


Sure . Put into the search box on the upper right side and Type in SeasideSusie posts on vitamins and the same for Slowdragon on gluten .

Happy reading ! It's very worth it .

Super, thank you for your support!

Thanks for the suggestion by the way. My hope is that it's something in the levo itself as otherwise, I'll be opening up a whole new can of worms!

One question. Are you taking Vitamin D? I get acne every time I take it but rarely otherwise. Hope you find your answers. all best

No my levels were top end of normal so never supplemented with it. A small amount is in my prenatal but I’ve been taking that for two years. There’s definitely something getting knocked out by the levo or as others have said it could just be highlighting another issue. It gets worse when my oestrogen levels are rising.

From what I’ve learnt on this forum, 25mcg is much too low a dose to start with and can exacerbate the problem. From my own experience I had bad acne for 30 years when I was hypothyroid and undiagnosed. I could speculate that taking only 25mcg of T4 has made your hypothyroidism worse and acne is one of the symptoms of hypothyroidism.

Both the GP and fertility clinic were hesitant to start me on more than 50mcg but I might take the updated advice of the GP and go for 37.5mcg and see if it eases these symptoms.

Is your GP up to speed on hypothyroidism? In my opinion I’d trust this forum over any of my GPs.

I’ve only just joined the forum so it might take a little time for me to build up the confidence to take the advice of someone here over that of my GP...but I do appreciate that my GP isn’t extremely experienced in this area and that’s why I posted. Keeping an open mind for now and trying out some of the recommendations such as dietary changes. And I’ll ask for a few extra hormone and vitamin bloods.

I meant to add...and my opinion is only that; I’m not a medic.

Thank you jgelliss for pointing me in the direction of SeasideSusie.

Susie, thanks for replying to my message. You asked about nutrient tests and I had the following between December - February:

Vit D - 88 nmol in December around the time TSH was 4

B12 - 806ng (range 180-2000) in December

Folate - 19.98 (range 2.8-20) in February

Ferritin - 47.4 (range 13-150) in February

This is what I'm supplementing with:

Thorne prenatal – 3 capsules daily

Health thru nutrition ubiquinol – 1 x 300mg capsule daily

Opti3 vegetology Omega-3 EPA & DHA - 2 capsules daily

Serrapeptase - 600,000iu daily

To break down scar tissue in my womb. Started last week. Stopping in 7 weeks.

I haven't had tests for vitamin C, B5, Iron or Magnesium. But could potentially include them when I next have nutrient tests. I'm hoping to do this over the summer before trying to conceive again.

Thanks for your help.

SeasideSusie profile image
SeasideSusieAdministrator in reply to sarahjrobertson


Unfortunately your Thorne pre-natal supplement contains iron and that will affect absorption of the other ingredients. It also contains calcium which decreases iron absorption. I'm always surprised that quality brands do this.

If needed then iron should be taken at least 2 hours away from other supplements, and both iron and calcium should be tested before supplementing. Both need to be taken 4 hours away from thyroid meds.

Ubiquinol contains omega 3 so I don't know if you need both of those supplements.

I have no knowledge of serrapeptase.

Vit C probably doesn't need testing, it's a good supplement to take when hypo as it supports adrenals.

Magnesium testing tends to be unreliable and generally shows low.

Vit D - 88 nmol in December - the Vit D Council recommends a level of 100-150nmol so you should nudge yours up with some D3, maybe 3000iu daily and retest in 3 months. Vit K2-mk7 and magnesium are important cofactors needed when taking D3.

Like Vit D, magnesium should be taken 4 hours away from thyroid meds.

B12 and Folate are good.

Ferritin - 47.4 (range 13-150) in February - Ferritin needs to be at least 70 for thyroid hormone to work. I usually recommend eating liver to raise Ferritin, but this won't be possible if you get pregnant.

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