Hair loss

[Enanna]

i have recently had my prescription review with the pharmacist at my local medical centre and she lowered my dose of levothyroxine from 125 to 100, since then my hair seems to be thinning drastically. I have recently started taking biotin but have now read that it's not advisable for a thyroid condition. Does anyone take these or have any advice please?

[MissGrace]

Sorry but - you had a prescription review with a pharmacist? Not a doctor? On what basis did they decide to lower your medication for what is a disabling chronic condition? Does your doctor know? I don’t know about biotin so I can’t comment on that. I’m sure someone else will help, but I’m concerned that your Levo has been lowered rather randomly when it could make you very unwell. Were you doing okay on 125mcg? 🤷‍♀️

[shaws Administrator]

Was your TSH result 1 or lower. If not she had no right reducing your dose at all. Adjustments made (especially reductions) when not connected to clinical symptoms, usually find the patient gets more symptoms.

Do you get your blood tests at the very earliest? Fasting? (you can drink water) and do you allow a 24 hour gap between your last dose and the test. If you do not, ask for another blood test as results are skewed.

Always get a print-out of your results with the ranges. Ranges are important and enables members to comment upon them.

If you get a copy of your latest ones, post them for comments. Put them on a new post.

[Judithdalston]

Though I have had annual reviews with my pharmacist for years, he has never attempted to alter my dosage.... I would think that is a doctor's job. Why did she lower it...have you any recent blood test results you could post? You say the reduction by 25 mcg was recent- I very much doubt that that in itself could be the cause of hair loss. Half my hair fell out earlier this year, all over scalp, at the time when it was noticeable with small handfuls coming out daily, I was also trying to increase my FT3 with T3 added to levothyroxin ie was undermedicated, but also took folate, ferritin, B12, D3 supplements, plus zinc, magnesium, selenium, Vit B Complex( with biotin) and 3/4 months later it is better. So not sure what improved hair loss...might have been combo of improved thyroid results and supplements.

[Enanna in reply to Judithdalston]

My T4 was too high. At our surgery all prescription reviews are dealt with my a resident pharmacist.

[Judithdalston in reply to Enanna]

My doctor's' pharmacists are very restricted as what they can do, annual prescription reviews are done by doctors via health assistants, who take the blood tests in the first place. But I use an independent pharmacist near my house, he knows so much more about thyroid problems than the GPS, and it was he who suggested I should consider trying T3 too....but are your doctors' pharmacists prepared to be so independent in thought and action?

[SeasideSusie Remembering]

Enanna

What were the results of the tests that the decision to reduce your dose of Levo was based on? If you don't have them then please ask for a print out at your surgery's reception desk, we are legally entitled to them here in the UK.

As for Biotin, this needs to be left off for about 5 days prior to any blood tests. If Biotin is used in the testing procedure (which some labs do) then the result will be skewed.

Reducing your dose may have brought on hypothyroidism symptoms due to undermedication now, and this may have caused your hair loss. Other information about hair loss here:

hubpages.com/health/16-Vita...

[StitchFairy]

I am so shocked. How can it be allowed for a pharmacist to reduce thyroid medication.

[Enanna in reply to StitchFairy]

My T4 was too high, at our surgery a resident pharmacist works with the doctors.

[helvella Administrator Thyroid UK in reply to Enanna]

It sounds like the pharmacist was making decisions outside her competency. Did she actually discuss the issue with a doctor?

[Enanna in reply to helvella]

Yes they work together

[Enanna in reply to StitchFairy]

In our surgery the resident pharmacist works with the doctor.

[SlowDragon Administrator]

A pharmacist is not a doctor

First thing is, do you have the actual blood test results? if not will need to get hold of copies. You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need enhanced access to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up. They can no longer charge for printing out, rules changed after May 25th 2018

Just dosing according to TSH or TSH plus FT4 is completely inadequate, especially with Hashimoto's

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with Hashimoto's

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

There's nothing wrong with taking biotin, but if you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Enanna in reply to SlowDragon]

Thank you.

[Enanna]

Apart from the hair loss I feel much better, I wasn’t sleeping properly before but sleep pattern has improved. I will keep taking the biotin and see what happens.

[SlowDragon Administrator in reply to Enanna]

You will need to get full Thyroid including FT3 and vitamin testing after minimum of 8 weeks on lower dose