The HS “Trio”: Thyroid, Adrenals, and Androgens
Table of Contents
Introduction
Hidradenitis Suppurativa (HS) is often approached as a local skin problem—a painful nodule here, a draining lesion there. But at EliteAyurveda, we repeatedly find that long-standing or relapsing HS cannot be resolved through surface-level treatments alone. Underneath the abscesses and scars lies a systemic hormonal imbalance—particularly involving the thyroid, adrenal glands, and androgens.
These three endocrine nodes form what we call the “HS Trio”—an axis of dysfunction that drives persistent inflammation, glandular congestion, immune overreaction, and impaired skin healing.
Unless this hormonal triangle is corrected, topical creams, antibiotics, or even surgery will only offer temporary relief.
🔄 Why HS Is Not Just a Skin Condition
The skin is a mirror of systemic health, especially in areas rich in sweat and oil glands (apocrine glands). In Ayurveda, these regions are governed by Meda and Mamsa Dhatus, and are highly sensitive to Pitta-Kapha imbalances.
But these tissues don’t work in isolation—they respond to internal signals, especially hormonal ones.
In most HS cases we treat, we find:
- Sluggish thyroid metabolism
- Adrenal overdrive followed by fatigue
- Androgen excess or sensitivity (especially DHT or testosterone dominance)
This creates a hormonal inflammatory loop, making the skin behave like it’s always in crisis mode.
🧬 Breaking Down the HS Trio
1️⃣ Thyroid Dysfunction: The Metabolic Sluggishness Behind HS
Many HS patients have undiagnosed or subclinical hypothyroidism.
Thyroid hormones regulate:
- Skin regeneration and repair
- Sebum and sweat gland balance
- Immune modulation
- Metabolic clearance of inflammatory waste
A slow thyroid (low T3/T4 or poor conversion) results in:
- Delayed wound healing
- Poor detoxification
- Glandular congestion and swelling
- Sluggish immunity and recurring abscesses
🔍 In Ayurveda, this reflects Agnimandya (low digestive/metabolic fire) and Kapha–Meda Dushti (toxicity in fat and lymph tissues).
2️⃣ Adrenal Dysregulation: Stress, Cortisol, and Immune Chaos
HS often worsens with stress—and the reason is adrenal hormones.
Cortisol, when chronically elevated (due to mental or physical stress), suppresses immune accuracy. Over time, this leads to:
- Poor control over inflammatory cascades
- Weakened response to infection
- Chronic fatigue and burnout
- Worsened sugar and insulin balance
Eventually, this leads to adrenal fatigue, where even baseline cortisol drops—causing unpredictable flares, energy crashes, and immune breakdowns.
🔍 In Ayurveda, this maps to Ojakshaya (loss of vitality), Vata-Pitta aggravation, and dried-up Rasa and Majja Dhatus.
3️⃣ Androgens: The Unspoken Hormonal Driver in HS
A large number of women with HS also experience:
- Acne, oily skin
- Irregular periods or PCOS
- Hair thinning or facial hair
- Weight gain in the midsection
This reflects androgen excess or hypersensitivity, often driven by:
- Insulin resistance
- Poor liver clearance of hormones
- Stress-induced DHEA/Testosterone elevation
Androgens directly stimulate the apocrine glands, leading to:
- Plugging of hair follicles
- Increased oil and sweat production
- Hormone-sensitive inflammation
🔍 In Ayurveda, this is seen as Pitta-Kapha vitiation in Medovaha and Artavavaha Srotas, and hormonal “Ama” accumulating in the blood and skin.
⚖️ The Interplay: How the Trio Fuels Chronic HS
When these three glands misfire together, HS becomes stubborn, relapsing, and resistant to antibiotics or surgery.
Here’s the pattern we often see:
| Gland | Dysfunction | Skin Outcome |
|---|---|---|
| Thyroid | Low T3, poor metabolism | Slow wound healing, fatigue |
| Adrenals | Cortisol spikes/falls | Stress flares, immune chaos |
| Androgens | High DHT/Testosterone | Excess sweat, follicular clog |
All three contribute to lymphatic congestion, blocked sweat ducts, increased bacterial load, and deeper scarring.
🩺 Tests We Track to Diagnose the Trio
| Test | What It Reveals |
|---|---|
| TSH, Free T3/T4, Reverse T3 | Thyroid function and conversion |
| Morning Cortisol, DHEA-S | Adrenal rhythm and reserve |
| Total and Free Testosterone | Androgen levels |
| Fasting Insulin and HOMA-IR | Insulin resistance (drives androgens) |
| CRP / ESR / Ferritin | Inflammatory load and reserves |
| Ayurvedic Pulse & Dhatu Reading | Doshic and Dhatu-based imbalances |
🌿 EliteAyurveda’s Hormone-Aware HS Healing Strategy
Our HS treatment goes far beyond herbs or lepas.
We focus on restoring hormonal rhythm, rebuilding dhatu integrity, and clearing lymphatic-glandular obstructions from the root.
Ayurvedic Phases of Reversal:
- Srotoshodhana: Clearing toxic buildup from hormonal and lymph channels
- Agnideepana & Medo-Shamana: Reigniting metabolic fire and balancing fat-hormone metabolism
- Rakta & Rasa Rejuvenation: Purifying inflammatory load and rebuilding skin immunity
- Majja & Ojas Restoration: Rebuilding endocrine-nervous reserves and resilience
🌱 Herbal Strategies We Personalize
Our formulations are non-steroidal, endocrine-modulating, and adapted as you heal. Common strategies include:
- Thyroid Tonic Rasayana – Enhances T3 activity and tissue metabolism
- Adrenal Rebalancer – Restores natural cortisol rhythm and vitality
- Anti-Androgenic Gut Support – Clears DHT buildup via liver-microbiome support
- Rakta-Pitta Modulators – Cools systemic inflammation
- Skin-Gland Detox Lepa & Taila – Heals scars, prevents future nodules
These are not generic herbs—they are custom compounded for your specific trio imbalance, based on Ayurvedic diagnostic insights.
🧘 HS Lifestyle Therapies We Recommend
- Nasya + Shirodhara – Stabilizes the endocrine-nervous axis (especially for stress-related flares)
- Abhyanga with hormonal balancing oils – Improves lymph drainage and gland function
- Avoid raw/cold foods – These disturb Agni and worsen Kapha
- Sleep by 10 pm – Aligns adrenal-thyroid circadian rhythms
- Stress-minimizing breathwork – Reduces flare-inducing cortisol surges
🧠 Emotional & Mental Healing in HS
The HS–hormone loop is also deeply emotional.
- Thyroid issues = Suppressed expression, stuck identity
- Adrenal fatigue = Burnout, hypervigilance, survival mode
- Androgen imbalance = Shame, control, body image dysphoria
We integrate Satvavajaya chikitsa, emotional rasayana, and trauma-informed healing into our protocol—because skin doesn’t lie. It expresses the inner weather.
💡 Final Thoughts: Break the Hormonal Loop, Heal the Skin
If you’ve been trying antibiotics, retinoids, or even surgery for HS without lasting results, the problem may not be in your skin—it may lie in your hormonal miswiring.
At EliteAyurveda, we restore the endocrine-skin-immune axis through a personalized, doshic, and phase-wise plan.
📞 Call / WhatsApp: +91 88847 22246
🌐 Visit: www.eliteayurveda.com
👨⚕️ Consult Dr. Adil Moulanchikkal, specialist in autoimmune & endocrine skin disorders
“When the hormones harmonize, the skin heals. Real reversal begins when we treat the source, not just the surface.”
