Hi suffering severe hair shedding/ loss since August last year. Visited GP in November who said because of my age 49 was menopausal, tested for coeliac which came back negative, thyroid was borderline and ferritin levels 42. I saw a tricologist in January who diagnosed telegenic effluvium. Had bloods done again in March ferritin 45 and thyroid borderline. I started levothyroxine 50mcg at the end of March and ferrous fumarate. After 6 weeks on levothyroxine my hair is shedding was shedding worse than ever so decided to stop as no blood test being done at the moment. I’m taking lots of supplements evening primrose, multivitamins and am at my wits end. My once thick hair is now thin, 200+ hairs come out when it’s washed and also when brushed.
Excess hair shedding : Hi suffering severe hair... - Thyroid UK
Excess hair shedding
Hi there,
One of the symptoms of being hypothyroid is hair loss, it also may get worse once starting on levothyroxine but should settle down once your levels return to normal. Blood tests should be done every 6-8 weeks once you start the levothyroxine to check your levels and see if you need to increase. Do you wash your hair regularly or have you changed the amount? If you go more days between washing it can seem that more is coming out xx
For some the thyroid hormones only need to be a little out for symptoms to be apparent. Hairloss is a symptom of thyroid problems.
Often when levo is started the struggling thyroid goes 'phew' and has a rest. This means that it reduces its production of hormones. Now a starter dose of 50ncg may not replace those missing phew hormones so things may initially get worse before they improve.
That ferritin looks very low. That will most definitely make you lose your hair. And, that coupled with thyroid problems… But, it should all sort itself out once you optimise your levels. 
So taking the levothyroxine shouldn’t make it worse. I was worried about carrying on taking them without a blood test. I will speak to my GP and think about restarting Levo. Initially went to GP because concerned about hair loss didn’t really think I had a thyroid problem. Thank you for your advice x
I have two lots of extreme hair loss and my last one lasted over 2 years because my GP wouldn't treat me and my hair was so thin I had hair extensions to hide my balding head. I then decided to self medicate because I felt very ill. Unfortunately this can be one of the symptoms of thyroid disease and my nails also lifted off their nail beds amd some dropped off. You must keep taking levothyroxine until your TSH is 1 or lower and your T4 and T3 is in the upper third of the range to resolve this. Also your ferritin needs to be above 80 in the range (I was told this on a hair loss site). Until your thyroid levels are right for you and when your levels are moving your hair will continue to shed I'm afraid. Mine stopped falling out about a year ago and it is not as thick as it used to be because hair takes a long time to grow back. Also 50mcg is a starter dose and you need to increase by 25mcg after 6 weeks not stop it. I do realise how distressing this can be but your hair will grow back once you are on the right dose of thyroxine.
Thank you, sorry this is all new to me, what should my T4 and T3 readings be I have no idea what my blood test came back at. I will ask GP. Will levothyroxine put all these in range with the right dose. Thank you
Ask for a copy of your results which must include ranges and then come back here and post them. I usually log into my GP services to read my results and records but not all GPs have this service. It might be better if you start a new thread because they might be missed on this one.
50mcg levothyroxine is only a Starter dose
Bloods should be retested 6-8 weeks after each dose increase (Or brand change in levothyroxine)
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
nhs.uk/medicines/levothyrox...
Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Low ferritin linked to hair loss
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Do you have Hashimoto’s?
Ask GP to test vitamin levels
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Bloods should be retested 6-8 weeks after restarting back on levothyroxine
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus ultra vitamin
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Hair links
thyroidpharmacist.com/artic...
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone 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.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Thank you for all your help, I will contact GP and post results on here when I have them
The doctor who said you were menopausal was probably correct, but the end of that sentence should NOT be "so just learn to live with any symptoms you might have." If you have any bothersome symptoms, treatment should be offered.
Hair loss can be triggered by a dip in estrogen and progesterone.
womens-health-concern.org/h...
These days doctors are reluctant to provide the best treatment -- hormone replacement therapy, I was very happy for decades on HRT, but now they won't let me take it any more because I had one Atypical Ductal Hyperplasia, which they claim increases my risk for breast cancer.
My hair started falling out with a vengeance after I stopped HRT and now my hairline looks like my sons' did in their early 20s. My obgyn referred me to a Dermatologist. I sent photos of my hair, front and back, as well as of the cute little mustache and chin hairs I am growing now. (God! I miss my HRT!)
After reviewing the treatment options via a video/telephone appointment, I opted for Spironolactone. It can cause drowsiness, so I take it at night. It increases output of urine, so I must stay well-hydrated. As a result, I use the bathroom a bit more often. I'm told it will take 6 months to a year to see results, so we shall see.
Are you positive you have telegenic effluvium? They might have decided this simply because you are the right age to be menopausal.
"Most cases of telogen effluvium can be diagnosed based on medical history and an examination of the scalp and hair. If the hair loss has been occurring for several months, there may be visible thinning patches, but often the hair loss is not dramatic enough for a doctor to notice. If you have large bald patches, you probably don't have telogen effluvium. If the doctor gently tugs on some hairs on your scalp and four or more hairs come out, you probably have telogen effluvium. Also, the hairs will look like hairs in the telogen phase — they will have a white bulb at the end that was in the scalp, and will not have a gel-like covering around that end of the hair."
The good news: "The outlook for telogen effluvium is very good. Most cases run their course within six to nine months, and the hair usually grows back. In some cases, the disorder may last longer. In other cases, not all hairs grow back."
Thank you for your reply. Spoke to GP this week and I’ve started back on levothyoxine 50mcg and going to have a blood test in 4 weeks to see if I need to be on medication.
A tricologist diagnosed telegen effluvium but not sure how much faith I have in her. Hair fall has not got any better, most hair has white bulb on the end or white tip. Hair thinning all over but more on sides and parting.
I’m taking ferrous fumarate 210mg three times a day as well as vitamins and evening primrose.
I think maybe seeing a dermatologist my be the next best option
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