Hair loss due to thyroid dysfunction?

[cleo26]

I am new here and am dealing with hair loss which began three years ago when I had a hysterectomy. Prior to the surgery I had gorgeous hair. I worked out, ate moderately healthy (not Paleo, which I do now), and didn’t even have optimal levels of vitamins and minerals. I suspect I had thyroid issues at the time as I suffered digestive problems as well as depression, but I had great hair.

Now having seen numerous doctors to regain my hair after the surgery, some indicate low thyroid function (naturopaths) and thyroiditis with enlarged thyroid and nodules (endocrinologist), though I wonder at reproductive hormone imbalance. Despite having mostly optimal vitamin, minerals level, excellent diet, I have not had any success in re-growing my hair or preventing further hair loss.

Here are my latest numbers pre-thyroid medication:

TSH 1.47 uIU/mL (.45 – 4.5)

T4 free .99 ng/dL (.82 – 1.77)

rT3 19.6 ng/dL (9.2 – 24.1)

T3 free 2.4 pg/mL (2.0 – 4.4)

TPO Ab 18 IU/mL (0 – 34)

TgAb 7.9 IU/mL (0 – 0.9)

Ferritin 89 ng/mL (15 – 150)

B12 1480 (211 – 946)

Vitamin D 84 ng/mL (30 – 100)

Iodine deficient

Selenium and magnesium are optimal

Folate unknown

I would like to get opinions of those in this forum. I am able to get T4, T3, and/or NDT. I currently have been prescribed 13 mcg Tirosint (T4) and 5 mcg of compounded T3 with the possibility of increasing.

Also, a few questions:

-Could this hair loss be caused by low thyroid function even though I had no issues, and probably had deficiencies, prior to the surgery?

-By adding thyroid medication, will I suppress my own and have to completely supplement or will the additional meds complement my thyroid function?

-Will taking T3 alone result in further loss? I believe I’ve read both t4 and t3 are important for hair growth / cellular turnover.

Thanks much!

[cleo26]

Hi and thanks for your reply. The doctor wants to start low then gradually raise after labs.

I have read so much about thyroid meds causing hair loss that I'm even reluctant myself to dive in fully especially since I am almost convinced that my thyroid function was low to begin with and had no affect on my hair. Obviously I can't be sure but from past readings which were TSH and T4 only of course.

[Saggyuk]

Just in case unnoticed, the FT4 and Ft3 are using different ranges than the norm on here and are still in range although low in range but with a TSH of only 1.47 may not need huge amounts of T4/T3. Your TgAB is outside of range indicating that you have autoimmune thyroid disease.

I think it would be good to get your folate tested to ensure no deficiency there especially as it seems your B12 was low and therefore supplementing? Sorry if assuming wrong?

Do you know for sure if you are iodine deficient? Are you resolving this one as your thyroid requires iodine to work properly and iodine deficiency is actually the number one cause of thyroid failure globally. But bear in mind too much iodine is also not good for your thyroid so should be done carefully with testing. I would deal with this and see if it improves your thyroid results.

I had healthy hair while on T3 only but my hair fell out when I stopped producing T4 on my own and have therefore had to add a little T4 back in

[cleo26 in reply to Saggyuk]

Thanks for the reply. My iodine was so deficient that they tested the specimen three times. It was essentially 0.

I am treading carefully with iodine because of the antibodies. I took nascent iodine for a bit and am due to have my iodine levels retested.

How did you know your hair loss was thyroid-related and not other hormones? In my case I don't understand the thyroid correlation given my prior symptoms. Yes, I recognize there is room for improvement but my suboptimal level might have been enough for my hair.

[Saggyuk in reply to cleo26]

I think you should be okay if you make sure you get your RDA from your food intake or at least increase it from things like fish, you shouldn't get too much excess this way. You can use dietry trackers on websites like cronometer to get a rough idea of iodine intake if you're not sure maybe. Some would be better than none

Be careful with the selenium as well - maybe just eat a couple of brazil nuts each day as selenium works in balance with iodine and too much can cause hair loss too.

Well, I've been hypo since I was a kid and never had issues with my hair no matter how hypo as had mass thick curly hair. Everyone is different I suppose so can only give my experience. The only time I lost it was when my gluten intolerance worsened and blisters spread to my scalp as no hair grew through the big seeping sores lol and the other appears to be lack of T4. Once I had gone gluten free much of my health issues resolved, hair grew back and most of my deficiencies got better but something happened a couple of years ago with a completely new set of symptoms I'd never experienced before like hair loss and brain issues. I can't say for definite yet but after ages of getting no where and everything getting worse no matter what I did, I suddenly looked back over all my thyroid results and it appears these new symptoms started exactly when I stopped making T4. I also found research that suggest that T4 has a direct impact on hair growth so it seems to make sense in my case?? Haven't had enough time to really see but do have lots of annoying short new hair growth sticking up lol!!

However, you are still producing T4 and my hair was fine on under range T4 for decades. But again, we all react differently

[cleo26 in reply to Saggyuk]

I eat a lot of fish. At one point I was eating salmon everyday along with scallops and other seafood.

Agree that everyone's homeostasis, even if unbalanced, is different. This is why I am closer to believing that it's not thyroid though for all I know it was triggered when I lost reproductive hormones.

Forgot to answer on the folate. I'm sure the levels are normal if not high. I was supplementing with b complex with high b12 and folate. Again the main point is that I was deficient before with great hair.

[Saggyuk in reply to cleo26]

Yes, thinning hair is associated. Can you not replace the hormones? Sorry I'm not totally up with that side of things but my aunty had a hysterectomy also many years ago and she's been wearing a hormone patch on her bottom ever since and refuses to give it up until she retires lol! Maybe something to look into?

[Saggyuk in reply to Saggyuk]

hmm I wonder how your iodine can be so low considering the amount of fish and seafood you eat??? How long have you been on paleo diet for? Did you have stomach issues before and have they improved?

[cleo26 in reply to Saggyuk]

No idea about the iodine deficiency. Always had stomach issues. Paleo for a few months now. Gluten free for about one year.

[Justiina in reply to cleo26]

What type of iodine test you had? As they can really mislead you!

[cleo26 in reply to Justiina]

24-hour urine

[Justiina in reply to cleo26]

Loading? Did you take high dosage iodine?

Its virtually impossible youd extract 0 iodine. It just cannot happen if you are eating for example iodine rich food.

[cleo26 in reply to Justiina]

I agree with you and had questioned my ND about an iodine loading test. She doesn't believe in them and did not advise me to load. The next test I probablywill because I've read so much to the contrary.

[Justiina in reply to cleo26]

Iodine urine tests only measure the consumption of iodine during the past few days, so it can be used to determine does your normal diet contain enough iodine.

But excreting a little or a lot can be very misleading because

a) you also excrete some through your bowel, so its not all picked up from urine

b) if you have very high levels of toxins competing iodine you might excrete a lot of iodine as its not picked up

c) excreting little while iodine deficient can be a sign of deficiency as your body absorbs more, but it can mislead to think you are not taking enough so you can overdose

d) It does not tell about the iodine level in your system, just what you have consumed during past few days

Thyroglobulin seems to be better marker, but like you have thyroglobulin antibodies then it is not reliable. Having thyroglobulin antibodies could mean that poorly iodinated thyroglobulin is leaking out of your thyroid gland which leads to increase in antibodies.

Your thyroid gland is already enlarged so that would give in iodine defiency.

If you want to know does your diet contain enough iodine then 24 hour urine test is very handy tool.

[cleo26 in reply to Saggyuk]

I am working that angle as well. Just wanted to count or discount thyroid.

[Justiina in reply to Saggyuk]

I agree, no matter how underweight or whatever deficiencies I have including iodine and now low thyroid it has no affect on my hair. I guess it's partially genetic.

Both side of my family have had strong hair.

[Saggyuk]

Also, iodine deficiency often results in swelling of your thyroid (goitre) which you've mentioned but I would suggest that now you are showing thyroid antibodies, it's not likely you will reverse it now and will need meds at some point soon regardless. Going Gluten free can help lower anitbodies but I believe you're already doing this with paleo so I keep my fingers crossed that you manage to work it all out soon and start to see some improvements

[katey]

I have a similar story to you...Long term hair loss... Tried​ everything over many years. Started on bio identical eostrogen (sandreena gel , easy prescription from gp). Hair loss stopped in 2 weeks and now hair normal again.

[cleo26 in reply to katey]

I am going to probably write a separate post on reproductive hormones. Thank you.

[jacrjacr in reply to katey]

was your bio identical estrogen, the 80/20, 50/50, or all estradiol? just wondering bec I am low in estrogens and dr keeps bouncing around difference ratios and I have hair loss.....

[cleo26 in reply to jacrjacr]

I have a 50/50 but have done and prefer 80/20 as E2/E3, i.e. with the smallest percentage as E3. I don't believe in the estriol protective dogma. I just think it's weak and then therefore requires higher dosing to get the same effect of a lower dose of E2.

[jacrjacr in reply to cleo26]

thanks for your reply...I am on 80/20 now but maybe a little too low on dose...think I need to be on 50/50....THANKS ...I TOTALLY AGREE WITH WHAT YOU THINK AS WELL....

[cleo26 in reply to jacrjacr]

Most docs prescribe 50/50 or 80/20 with estriol (E3) as the highest. I have never found the latter formulation effective.

[SlowDragon Administrator]

As you are supplementing B12 are you also taking a good vitamin B complex. Often recommended on here to keep all the B's in balance. B complex usually contains biotin (good for hair & nails)

But if taking B complex we must stop taking 4-5 days prior to any thyroid blood tests as biotin can falsely affect TSH results

endocrinenews.endocrine.org...

Do you supplement vitamin D ?

[cleo26 in reply to SlowDragon]

I supplement with B complex and Vitamin D.

[SlowDragon Administrator in reply to cleo26]

Did you stop B complex 4-5 days before any thyroid tests

[cleo26 in reply to SlowDragon]

Yes

[cleo26]

Had mercury levels checked. No problems. Thank you.

[cleo26]

Trying to avoid the thyroid gland which in addition includes T1, T2 due my antibodies. I understand there is debate over NDT or not with antibodies. I have taken Nature Throid and WP Thyroid in the past but seem to get stomach aches especially with Nature Throid

I have just started the Tirosint (T4) and compounded T3.

[jacrjacr]

adrenal fatigue can cause hair loss...if you do a 4 times a day saliva test it can show if you have high or low cortisol.....which cause hair loss....making sure you get 8 hours sleep a night very important ...., high vitamin A or selenium can cause hair loss, Dht can cause hair loss from change in hormones, out of balance hormones can cause hair loss like progesterone and estrogen and testosterone....

[cleo26 in reply to jacrjacr]

I think I could write a book on this topic. Have done cortisol / adrenal saliva test and taken adaptogens. I could certainly use more sleep.

My selenium levels are mid range (i.e. good). Can't vouch for Vitamin A but I suspect it is normal as I am not supplementing with it.

DHT is low.

Seriously thinking it's the reproductive hormones out of balance. I was in worse nutritional standing pre-surgery but had great hair.

[jacrjacr in reply to cleo26]

I THINK low estrogen can cause it from my own personal experience, I was surprised when I tested high in vit a and then again even after 6mths off supplements.....and I tested high on selenium, ......I assume your dr put you on bio identical hormones after surgery..if not, the hyster itself caused It most likely and you don't have enough hormones, for me it was menopause...and a sudden drop in progesterone and estrogen which threw off thyroid and everything else as well but the low estrogen I am finding is the culprit....

[cleo26 in reply to jacrjacr]

I think you are right. Just out of curiosity I'm going to get my vitamin a levels tested.

How much and what kind of progesterone do you use?

[jacrjacr in reply to cleo26]

bio identical progesterone cream , 40mg twice a day ..creams bypass the liver so I always use them...you can get it online as long as it says USP on the ingredients label..but I get mine thru a dr. prescription

[sdp10112]

I also am suffering from extreme hair loss. Have been to every dr. imaginable. Endobrinologists (3 different ones) say I am on too much thyroid meds according to my labs. Gynocologist (2 different ones) say to get off of Thyroid at once. Internists says to raise thyroid meds. Have just been to a menopause clinic that put me on the Vivelle Dot Estrogen patch. My estrogen was <5 on the lab. Did not register. I am hoping after 9 months that hormones are the culprit for the hair loss. It just does not stop. No regrowth in sight. I am just curious because I have read many women are also on progesterone but my Dr. does not want to add it since I am in menopause. This is so confusing as no Dr.'s have the same advice. I am not sure who to believe or what protocol to follow. I am currently on 65 mg. WP Thyroid. Internist wants to double it, gyno's say get off of it, endocrinologist wants to switch meds to tirosint and t3. I will keep you posted on the hormone side of it and let you know if it helps at all with the hair loss. i am also on sprionolactone for hair loss but it doesn't seem to be helping. Have been on it over a year but endo. just upped the dosage to 200 so we will see if that helps. Soooo confusing.

[cleo26]

It is all very confusing. What do your lab numbers read for thyroid levels? Complete panel. Also, estrogen of < 5 on what range? If it didn't register then it must be low. Definitely lack of estrogen causes hair loss. Feel free to message me privately if you like.

[sdp10112 in reply to cleo26]

Not sure how to private message.

These were my numbers that Dr's. were going off of. I was on 95 mg of WP Thyroid at the time this blood work was done. Several Dr.'s suggested lowering or getting off thyroid meds. One suggested to increase to 125.

Serum Ferritin 342 (15-150 ng/ml)

Free T3 2.3(2.0-4.4)

Reverse T3 17.3 (9.2-24.1)

B12 (697 (211-946)

Vit D 61.2(30-100)

TSH 0.312 (0.45-4.500)

T4 1.14 (0.82-1.77)

Estrogen <5 No ranges given.

Put on Vivelle Dot .05 for estrogen and reduced WP to 65 for 6 weeks. New blood work:

Estrogen 24

TSH: 1.680 (0.450-4.500)

Testosterone 5 (3-41)

DHT 250 (Range 21-402)

B12 537 (211-946)

Ferritin 227 (12-150)

T3 2.6 (2.0-4.4)

Cortisol was also a high. 22

Today the endocrinologist suggested adding 5mg, of Cytomel, increasing Estrogen patch to .1 and increasing spiro to 300mg. per day. Afraid to take cytomel in case of additional hair loss. Also worried about the high dose of Spiro.

Any suggestions would be greatly appreciated!!!

Thanks so much!!

[cleo26 in reply to sdp10112]

Sorry to have missed this reply. I am still working through my issues. Have you noticed that your ferritin is very high? Outside of the range? I have never heard of prescribing spiro higher than 200 mg. Seems a lot.

What is your free testosterone (rather than total)?

Though like mine your ft3 is low, get it about adding Cytomel.

I wouldn’t concern yourself about the Vivelle Dot increase. Your estrogen is really low.

I will send you a private message. I am probably going to start a new thread to discuss hormones and hair and see if we can collectively draw some conclusions.

[jacrjacr]

I have been told over and over that cortisol is a big thing with hair loss....must get 8-10 hours asleep at night, and stay calm and take supplements in the b family and vit c to help out....and avoid all sugar.