Heavy hair loss

[Nikilll]

Im 30s, 6 years continuously taking birth control pill for endo. This month I took mri scan and report was normal. Last january hair loss started. Any advices and if you do any blood test for hair loss please suggest me Thankyou

[gardentink]

Hi! So sorry to hear you're experiencing hair loss, I know how bad it can make you feel. I've had bad hair loss for a few years now, and I never been able to find evidence of why it is. I started on the progesterone only pill back in 2010, but didn't notice hair loss until around 2015, so I don't know if it's related. I went to a private trichologist (there aren't NHS ones) who suggested various blood tests to check vitamin levels etc, but nothing came back as an obvious reason why I have hair thinning and patches. I don't know what type of pill you're on, but when googling before I've only managed to find a few anecdotal mentions of hair loss with POP.

[Tetrao in reply to gardentink]

Hi! I'm sorry about your unsuccessful experience with a trichologist. Mine was just as useless. "Your labs are fine."If you have copies of your bloodwork from that visit, get Kate Knowler's books from the Blood Labs series. The book on fatigue might be the most useful one for you as it has optimal values for anaemia and thyroid panels.

Please read my other reply in this thread. Perhaps it may be of help too. x

[Tetrao]

Hi! Another hair loss sufferer here. I've been researching hair loss causes for a couple of years now. Doctors have been useless. A trip to a trichologist was a joke and an utter waste of time and money. According to her, my labs were fine, and all I needed was proper scalp massages. Eventually, I had to educate myself how to read blood labs and surprise, surprise; they were far from fine. Here's what I found out on my own so far, and frankly speaking, investigating hair loss causes in women is one hell of a rabbit hole. I suspect I haven't learnt everything on the subject yet. In my experience, there's no single root cause of hair loss but rather a bouquet of contributing cofactors.

1) hair loss causes:

- Iron deficiency or anaemia.

Note that there are two types of iron anaemia: iron deficiency and anaemia of chronic disease. Iron supplementation can treat the first one; for the second, it is useless and can even be harmful (my experience was terrible; don't be like me).

- Other deficiencies: vitamin D, zinc, biotin (B7). Biotin is linked to iron absorption.

Note. Zinc is related to copper. Google info on zinc and copper ratio.

Excess selenium supplementation can cause hair loss, too!

Therefore before supplementing, always test your levels!

- Hormonal medication such as birth control pills.

- Other hormonal imbalances.

- Perimenopause (it can start as early as 30 years old).

- Stress (childbirth isn't the only cause of stress, think of other factors that add stress to your adrenals, for example, a surgery or covid-19).

- Hypothyroidism

- dihydrotestosterone (DHT)

DHT is a by-product of testosterone, and when there's too much DHT, hair follicle is affected. When estrogen levels fall (during peri/menopause), DHT can rise. Natural scalp sebum contains DHT. Therefore, it might be a good idea to wash your hair as soon as the scalp gets greasy. Saw palmetto and pumpkin seeds applied topically are said to inhibit DHT. I haven't researched this topic in depth, so can't say more.

- insufficient protein intake / low protein diet

- inflammation

If your ESR and CRP blood tests are within range, look at your ferritin levels. If the value is above 100, it's a sign of an inflammatory process. Ferritin is a more sensitive marker than ESR and CRP. Look up inflammation on the Stop the Thyroid Madness website.

2) blood tests:

- iron and ferritin - these are two different blood tests.

Optimal value for iron should be 23-ish umol/L.

Ferritin is the amount of iron your body stores. The optimal value for women should be 70-90 ng/ml.

How to read your blood labs:

ferritin under 40 = hair loss

ferritin 40 = hair loss stops

ferritin 80 and higher = hair starts growing back

Check out Kate Knowler's book series "Blood Labs." Iron, ferritin, B12, and thyroid labs are included in the book on fatigue. In fact, the whole series can be very helpful for those willing to take their health issues into their own hands.

- Thyroid panel: TSH, free T3, free T4, TPO antibodies, TG antibodies. If you can get Reverse T3, do it.

Important: Testing TSH alone is a bad idea. TSH goes out of range when there's already significant damage to the thyroid; at earlier stages, TSH stays within a healthy range. Why test for antibodies? Elevated antibodies mean Hashimoto's disease. It's an autoimmune condition. When it progresses, it becomes a full-blown hypothyroidism. Hair loss is a textbook symptom of hypothyroidism.

Optimal values for TSH should be 0.5 - 2.0 miu/L.

For more information on thyroid health, check out the Stop the Thyroid Madness website. The page on how to interpret lab values is under the Lab Work tab.

3) Patchy hair loss is called alopecia areata, and it's an autoimmune disease. Autoimmune diseases like to have company; i.e., if you have one autoimmune condition, sooner or later, another one might appear. Since endometriosis has several autoimmune features, no wonder endo warriors can experience other autoimmune conditions.

To sum up. Here's a list of blood tests that can help in finding what causes your hair loss:

iron

ferritin

vitamin D

vitamin B12 (it's another type of anaemia caused by low B12). The standard reference range for B12 is very low, so look up the optimal values in Kate Knowler's book I've mentioned earlier.

folate (vitamin B9, related to B12)

zinc and copper (not sure if you can get them through NHS)

thyroid panel: TSH, free T3, free T4, TPO antibodies, TG antibodies, reverse T3. (If you had no thyroid issues before, NHS would, most likely, check your TSH only. If it's elevated, they'll check your T4. No point arguing with them, it's a standard endocrinology protocol.)

total protein (google what it's for)

inflammatory markers: ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein)

Hope this helps. Good luck with your investigations. x

[gardentink in reply to Tetrao]

Thank you so much for sharing this x

[Nikilll in reply to Tetrao]

Really very useful, your valuable information THANKYOU SO MUCH