Thyroid UK
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Female pattern baldness. Top of head hair almost gone. Elsewhere thinning

Female pattern baldness. Top of head hair almost gone. Elsewhere thinning


I am having trouble with severe hair loss. I am so thin on the top of my head now. Used to have really thick hair( couldn't see scalp at all)

Now all I see is a lot of very shiny scalp . I have got my levels to what I've been told is optimal as per STTM.

TSH 0.03(0.45-4.74)

Ft4 10.8(9-19)

Ft3 4.8(2.6-5.75)

I need help!!!

Could I be overmedicated?

I'm on combo so told the lowish Ft4 is normal when taking direct T3

Many thanks

43 Replies

Hi there

I don't think you're over-medicated as your T3 level doesn't suggest so.

I've had a T4 level much lower than this for years as on T3 only and haven't had hair loss issues and it's only now with T4 level (well under range and nearer zero) that I am suspecting an issue with T4 and hairloss.

My hair once nearly all fell out due to gluten but I had a head full of seeping blisters at the same time and I don't see any evidence of this lol.

I know the menopause can cause balding on top in women so I'm not sure if this correlates with your age? I'm having all my hormones checked out just in case but I'm not really at the right age for menopause - at least I hope lol!

I suppose maybe you could look at your diet/sugar levels and rule these out?

Not sure what else to suggest but I know how you feel as have lost all mine again lol!!

Oh and two of my friends lost quite a bit of hair with stress alopecia but they lost it quite quickly and were losing hair in other areas other than their head - did grow back in both though :-)



Thanks for your reply.

I'm 64 and well past menopause.

I started in bio identical progesterone in October hoping it would help with the hair loss and hit glusges that had strangely returned for the last three years.

The hot flushes stopped but hair loss is still bad. Although I've also lost most of my body hair (forgot to put that).

I just am at a loss!!! No stress.

I'm wondering also if it's anything to do with low dose Bisoprolol which I am on. 1.25mg daily and I'm told it's a baby dose

SNY, thank you so much for your reply


Just looked at the drug side effects and it does say alopecia can be a side effect - Very rare (less than 0.01%): Alopecia. Have no idea in relation to dose?

So very rare? It depends on whether you think it started at the same time or was already thinning before?

Apologies, I'm not sure what you mean by "hit glusges that had strangely returned for the last three years" :-)

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Lol.... I meant strangely hot flushes returned.

It's hard to say if the hair loss started after starting Bisoprolol.

My daughter said it started when my thyroid went wrong after being stable for over 28 years. Stopped converting hence combo t4/t3.

However , for all those 28 years my TSH was never less than 2 and I felt so well.

I've now got levels good according to STTM so I don't understand why I didn't feel ill when tsh was 2+

Thank you again


I would say under. But I ignore TSH , look for T4 in the Middle or slightly higher and accompanied by A T3 at least bang on the very top of the range, or if its slightly higher to get the T4 in the right area , so be it.


Have you considered vitamins and minerals? Low levels of some can contribute to hair loss. Have a look here


My folate is lowish at 6(3-33)

Everything else seems good. B12 883. Vit D 105

I really don't know what to do


Did you read the link?



Vit E


Vit A


Yes I've read the link.

My zinc is good at top of range. Ferritin is very good according to my haemotologist.

No idea about Vit A.

No idea about Vit E

No idea about biotin

Who would I need to see?

Can my Gp send me to a hair person?

Also as I mentioned body hair had almost gone!!!


Loss of body hair can be a Hypothyroid symptom. I've had no underarm hair for about 20 years, wish I could say the same about my legs!!

Research about vitamins and minerals and hair loss, there will be more than I linked to. Gather evidence, show your GP, ask for them to be tested. Your GP will be able to refer you to anyone regarding a medical problem if he wants to but sometimes we have to fight for what we need.

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So would you think by my results I may still be hypothyroid then as loss of body hair?


I suppose it's possible that not every symptom of Hypothyroidism will disappear.

I can't say whether I think you are still hypothyroid purely on hair loss, you haven't mentioned any other symptoms. Your TSH is what you'd expect it to be in a treated hypo patient, but you haven't said what dose of Levo and T3 you are on.

I am on Levo plus T3, self medicating with the T3 added to prescribed Levo, and still tweaking doses. I recently reduced my Levo from 100mcg to 75mcg which made my FT4 plummet from about 19 to 12.8 (12-22) and have had the most horrendous fatigue and brain fog return, so it's obvious that I need a good amount of T4 as well as a good amount of T3 to feel anywhere near decent. So it's not what is said in some article or on some website that matters, it's where we as individuals need our levels to be to feel well.

I see further up you mention bisoprolol. This might be of interest -

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If you've reduced your Levo then that in turn will reduce your Ft 3 unless you've increased T3 to compensate the t4 reduction. Did you increase?

I'm on 75mcgs Levo and now on 15mcfs t3 .

I've reduced t3 from 25mcgs to 15mcgs as I'm trying to get rid of hard heartbeat.

I've never ever had typical hyPO symptoms.

Never had fatigue(in fact opposite!!)

Never had weight gain. Always been slim 10.

My hypothyroid was only picked up on a routine blood test 30 odd years ago prior to an operation

So really I've nothing to go by symptom wise to tell if I'm still hyPO or not.


I've been tweaking doses for over 12 months. My FT3 had reached just a tad short of top of range so I didn't want to increase that at the time. I wanted to see what difference just reducing Levo would make. I ummed and ahh'd between 12.5 and 25mcg reduction in Levo and it would appear I made the wrong choice!

Without symptoms then it's hard to know how to tweak your meds. For most of us using numbers as a guide doesn't work that well.


Thanks for your reply once again.

I know it's very hard.

I did try reducing my Levo down to 50mcgs and was ok for 4 days then on day 5 I was very jittery and was for several days. Dr said to go back up as obviously sensitive to drop.

Looking back I should probablyincrease the t3 at the same time I reduced Levo.

My thoughtsafterwards ''twas that by day 4 my ft3 had probablydropped from reducing the t4.

It's weird as I seem to get jittery when lowering the dose.


Hi 130396

I am also hypothyroid, on Levothyroxine, and can empathize as the top of my scalp is very very thin and I am very conscious of it. Needless to say, GP isn't concerneds but I did see a female GP a couple of months ago and she prescribed me Regaine for Women. As yet, I haven't noticed any improvement :( She did say hair loss could be due to any one of a number of issues but, again, she wasn't that bothered either.

Have you checked out the symptoms for B12 deficiency, Folate or other vitamins? It's certainly not uncommon for B12 to be very low and you'll notice that hair loss is also one of the symptoms. Many of the symptoms are the same as hypothyroid. I think it may be worth you checking vitamin deficiency, particularly B12, and then ask your GP to check them

Good luck


Thank you so much for your reply.

My B12 is good but folate is only 6(3-33).

I also have a very sore cracked tongue which my hormone De said could be the low folate.

It's all so complicated.

Many thanks x


As your folate is so low, are you supplementing? A good B Complex will raise your folate level and will also contain Biotin (B7) which is mentioned in relation to hair loss. You can also get separate Biotin supplements.


My Gp has prescribed 5mg folic acid but I haven't started it yet as I read it can cause anxiety which I definitely don't want.

Do you think folate could be at fault?

I find that B complex makes me jittery!!!

Could I take B12 and the other B's you mentioned I.e biotin separately?


You won't know if the folic acid will cause you anxiety unless you try it. You have to do something to get your folate level up. Folic acid is the synthetic form which has to convert to folate. You could buy the more natural form which is methylfolate and already converted.

Was it Jarrow's B Complex you tried and made you jittery? Some other members didn't get on with that brand.

B12 should be taken separately anyway, it should be sublingual for best absorption. The tiny blood vessels under the tongue get it directly into the blood stream.

You can get separate B vitamins but it's a lot of supplements to take and I wouldn't like to work out what is balanced.


I did take methylfolate and it did make me jittery!!!

I used to use Solgar sublingual B12 but haven't taken it for ages.

I've just been reading about zinc and it says it's strongly related to hair loss.

I would try that but I don't want it to lower my cortisol as I've now got my cortisol levels corrected.

So would toungbknj I should try the folic acid that has been prescribed?


On STTM website it says that

"Zinc can also help lower high cortisol levels! (Note it says it will lower “high cortisol”. In the lower amounts, we’re not seeing it lower normal levels to the degree that it lowers “high” cortisol)."

So maybe it won't lower your cortisol to a level that would be a problem. I suppose it depends on how much it does lower normal levels and where your level sits at the moment.

If methylfolate made you jittery perhaps you should discuss your unease about folic acid with your GP. Other than eating lots of dark leafy greens and other folate rich foods I don't know how you can get your folate level up.


That's what worries me about taking zinc.... the lowering or cortisol levels???

I've worked on high cortisol at two points for about a year.

I'd been doing periodic DATS to gage how my adrenals were throughout treating the highs.

I stopped holy basil in January and my DATS remain stable so I've been told my adrenals are happy and stable still


An you recommend a good B complex?


I've used Thorne Basic B in the past, it got my folate level up from bottom of range to top of range in two and a half months, it contains 400mcg methylfolate.

I currently use Metabolics B Complex, it has a different balance and I'm quite happy with it.


Thank you for that. Ooohhh methylfolate!!! I only took one tablet of that before of 400mcgs and made me jittery!!:(

Maybe it's that which made me jittery when I took the B complex


Have you had your ferritin levels checked? Low ferritin can cause hair loss..(happened to me)..have you had your reverse T3 checked to make sure you are converting (also can cause hair loss)? Also, somewhere above there was mention about something your on having a very rare side effect of hair loss. I would believe you are the rare case..quite often those "rare side effects" on medications..etc are hardly rare. So you may have a combination of things going on..Also it's likely your trace minerals are way out of balance- esp. selenium, zinc, copper. They are all co-factors so if you take one you will throw the others off..but it's well known that thyroid needs selenium-which means you need the others. Take a separate biotin supplement as well..also you may not be absorbing digestive enzymes may help and get on a good pro-biotic. Lastly-our hair and skin react to what's going on internally..I would also cut out anything inflammatory (gluten, sugar and dairy)..give your system a rest..anyone with thyroid issues should do that anyway.


Thank you for your reply.

Yes my ferritin is good. It's 110 and Haemo says I have good iron .

My folate is very low but in range.

I had rt3 checked and it's in range and ratio is good.

I am on combo as was discovered 18 months ago that after being good and very well on Levo alone, that I had developed difficulty in converting after so many years on Levo only.

I think you are referring to Bisoprolol as having a rare side effect. But I'm on a baby dose and told this isn't the causr


Yes-the blood pressure drug..even if it's a baby dose-I would find an alternative and see if it helps. With having an autoimmune condition it often amplifies other things..I lost my hair taking ALA supplement..which is VERY rare, but my system is super sensitive..and yours may be as well. I only have done well on the oldest beta blocker on the market..but the new formulations cause loads of problems that Pharmas fail to acknowledge. Also, acupuncture helps immensely for high BP as well as thyroid.


I don't have high BP. Also I don't have auto immune thyroid condition. It's just thyroid.

What beta blocker do you take and is it long acting? Does it cause hair loss?


Why are you on bisoporol then if you don't mind me asking? It's a beta blocker..most used for high BP..I was on one when first diagnosed with Graves..for elevated heart rate. I tried several of the newer formulations and had horrific (very rare) side effects..(and drs figured out I had an issue with newer fomulations and put me on the oldest one on market and I did much better)..but again with hair loss being a side effect of this particular beta blocker you are on..then I would get off of it and see if it by the dosage amount it doesn't seem like you need it esp if you don't have high BP.


I don't have high BP

I was put on it when they stopped making my original beta blocker which was Half Indetal LA. I was put in this several years ago for migraines.

When they stopped making it I was put on varies slow release propranolol tablets but they made me feel ill as the didn't release a steady amount through the day.

I'm frightened to stop Bisoprolol even though a small dose as I had horrendous withdrawals from the inderal LA which really suited me


Do you have any amalgam fillings, not sure if it's relevant in your case but my hair is thinning and with all my other problems fibrosis, arthritis, silent reflux, depression, sinus pain the list goes on, I am now waiting for a mercury test as this can cause a lot of these problems, worth checking out good luck xx


Yes I have 2 fillings.

Had th since I was about 8. Always had very thick hair.

I'm 64. 17 years post menopause. The only result I have as low in range is folate


What do your numbers look like for reproductive hormones? Estradiol, estrone, progesterone, testosterone and free testosterone, prolactin, shgb. What are your insulin and glucose levels? Are you taking any other drugs or supplements besides thyroid meds and the one aforementioned one? If so, what are they? Have you been tested for food allergies? When did the thinning start? What happened three to six months prior to the hair loss? We need a clear picture.

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These are my female hormone results as of August 2016

Estrodial <56

Progesterone <1

Testosterone 1.0

DHEA-s <2.3

My morning fasting glucose is 4.6

I can't pinpoint when hair started thinning. Probably 8-9 years ago and steadily got worse.

Not that I'm losing more Judy I've lost soooo much that it's now very obvious.

My other medication is:

Hydroxycarbamide ( lowest dose)

20mg nortriptyline

75mcgs Levo

15mcgs t3

Calcium and Vit D lozenges


I can sympathize with not knowing the cause and how you feel your hair influences your appearance.

Sounds as if you've been losing hair for a while and it's really hard to pinpoint a specific cause. First, you need to journal what occurred 3 to 6 months prior to the loss / thinning -- meds, supplements, lab levels, changes in meds, diet.

Second, I don't know the ranges of your labs. That would be helpful as well as the units. At a glance, your estradiol seems low as well as your progesterone. All of these hormones work in a complex web.

I cant asses the dhea s or glucose particularly without the ranges.

I am not familiar with the two drugs. Please do some research as to (1) there are contradictions for these drugs and (2) if hair loss is a side affect.

Finally, how do you feel overall? Normal except for the hair loss? Are you getting enough sleep? Losing or gaining weight?


I can't remember back 8-9 years.

I was only on Levo ( for over 28 years) until I went on combo in Sept 2015.

I'd been on Inderal LA for many years until June 2015.

The female hormones do not have ranges but expected to be low as 17 years post menopause.

I started bio identical progesterone October 2016 after my hormone Dr saw these results.

She said it's not how low estrogen and progesterone are BUT the ratio of P to E. She said my P was low to the E.

I've no idea what the ranges are for fasting glucose but mine was ok in the range for a morning fasting glucose.

I've already put ranges for the thyroid results.

I think the thinning probably started after the menopause but I had sick thick hair I didn't notice it much.

My hair has got finer in texture as well.

I'm getting enough sleep since addressing high cortisol. My weight is stable.

I get 3-4 days of waking up to anxiety feelings every month.

I have a constant HARD heartbeat and I get breathless if I walk to fast or except myself.

I'm 64.


It sounds as if you're working through the thyroid issues, though perhaps this new combination (sorry if I don't recall if you said you switched to NDT) may have an activating a T3 component. Again, still a bit hard to say since our bodies don't remain static and it could very well not be that at all.

It's hard to distinguish thyroid vs. menopause, obviously since they are both linked.

What I can say is please have your doc check your shgb and prolactin levels, insulin and hemoglobin A1C.

My first thoughts go back to reproductive hormonal imbalance. Yes, balance is foremost; however, in my experience your estradiol seems too low. (I don't get these docs who try to maintain estrogen at low levels then years later try to treat women who have developed osteoporosis likely from insufficient estrogen (and testosterone)). Again, you do have to balance estrogen with progesterone.

Oh, and it goes without saying that I am not a doctor and am only reviewing and offering what I see based on my experience. Yours may be different. I am still working through my issues, but know I have an estrogen / progesterone imbalance with thyroiditis, and they have contributed to issues similar to yours. I have had some relief by upping my estrogen.

I have found Dr. Westin Childs' blogs and Youtube channel very enlightening as to helping to result my issues. Here is one:

I have also found information on a Trichologist site very useful:

I'm sorry if I couldn't give you direct answers to your situation. Just some hypotheses.

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Thank you so much for your detailed replies.

Unfortunately I've missed the window of opportunity for having estrogen as I am 4 years past 60 which is basically the cut off age for starting estrogen.

Plus I've had breast cancer so it's a no no for me.

I believe my sgh but was a bit high? But not sure. Never had prolactin checked and I doubt my Gp would agree to do it😩.

He might send me to a hair person?

What age are you?

I did trial NDT in 2014 but it wasn't good, I had terrible muscle pain on it so have gone the t4/t3 route


Sorry to hear about your breast cancer.

SHGB is optimal between 70 and 80 for women, indicating the body's use of estrogen and testosterone. SHGB can be skewed when on birth control, etc.

Excessive prolactin can be an indicator of other other issues (other than pregnancy) in the high ranges. High levels can affect hair.

You can contact Anthony Pearce on your own for an assessment if you want to discuss with a trichologist. He does virtual consults and perhaps can give you advice so you can be your own advocate with your GP.

I'm 45.

I tried NDT as well and it didn't agree with me.


Thank you once again for that information. I'm sure my shgb was a bit harsh gh??

Can't find where I put the results now!!!

ThNk you . You are very knowledgeable x


You're welcome. Hope you find resolution or at least peace.

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