Hair loss!!

[Naseebah]

Hi,

Does anybody know how I can stop the thinning and loss of hair? I am on Levothyroxine 50mcg at the moment but I always seem to get this when I take levo. Thanks for any advice x

[SlowDragon Administrator]

50mcg levothyroxine is only a starter dose

Looking at previous posts you use to be on Armour

How long have you been on 50mcg levothyroxine ?

Do you always get same brand of levothyroxine?

Bloods should be retested 6-8 weeks after each dose increase

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)

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

Low Ferritin linked to hair loss

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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)

If/when also on T3, or Armour make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

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

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Naseebah in reply to SlowDragon]

So I was on Armour a long time ago and my current GP said she could only help me with prescribing Levo and as i was so suppressed I had to start some sort of treatment so went back on it. I then came across Metavive which I have been taking along side the Levo and now they have reduced it again Saying I am high and this is where I am, I will try and get blood tests for the vitamins and see what happens....

[SlowDragon Administrator in reply to Naseebah]

Trouble is , when taking anything that has T3 in then inevitably TSH will be low ......absolutely essential to always test Ft4 and Ft3

[Lora7again in reply to Naseebah]

GP's are told to prescribe Levothyroxine and even though Michael Gove's wife Sarah Vine the journalist takes NDT we are not allowed it unless we pay.

[carolinepetrie in reply to Lora7again]

Hi there I was interested in your comment about Sarah Gove taking NDT can I ask how you know this? Thanks

[helvella Administrator in reply to carolinepetrie]

She told us!

In an article she wrote.

Would you want to know if you were getting dementia? (...and pay thousands to find out) As more of us take our health into our own hands with bespoke medical tests, SARAH VINE braves one which promises to reveal the future of your brain

Fortunately, the clinic puts together a treatment plan. I have a comprehensive set of instructions to follow, including new medication (Dr Donnai switched me from levothyroxine to armour thyroid, making me much less lethargic), a raft of supplements and detailed nutritional advice. I’ll be returning over the next few months to monitor improvements.

dailymail.co.uk/femail/arti...

[Kimkat in reply to SlowDragon]

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo.

I have just read this on your reply post to Naseebah. I’ve recently started on Levo and was told by my GP, to take it with a glass of water half an hour before any other meds and food but no mention of calcium rich foods being a problem. I’m slowly just getting used to my new morning routine but it is a nuisance waiting that half hour before I can have my morning cuppa, then I take my omeprazole, which also has to be taken half an hour before eating. My normal breakfast is either porridge made with skimmed milk, a little honey and stewed plums or one protein weetabix, also taken with skimmed milk a small banana and a sprinkling of pomegranate. Should I now change my brekkie to include less calcium?

Thanks in advance.

[SlowDragon Administrator in reply to Kimkat]

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

Guidelines on 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)

Drinks containing caffeine, like coffee, tea and some fizzy drinks, can reduce the amount of levothyroxine your body takes in. Leave at least 30 minutes after taking levothyroxine before you drink them.

Calcium-rich foods, such as milk, cheese, yoghurt and broccoli, can reduce the amount of levothyroxine your body takes in. Leave at least 4 hours between taking levothyroxine and eating calcium-rich foods.

Soya in food and supplements may stop levothyroxine working properly. If you regularly eat soya or take soya supplements your doctor might need to do extra blood tests to make sure you're getting enough levothyroxine.

Kelp (a type of seaweed) can contain high levels of iodine, which sometimes makes an underactive thyroid worse. Do not take supplements containing kelp if you're taking levothyroxine.

Why are you taking omeprazole?

Have you been taking it long ....

Omeprazole is a PPI and lowers vitamin levels

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

On levothyroxine extremely important to test vitamin D, folate, ferritin and B12

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Kimkat in reply to SlowDragon]

So it will be better for me to take at night I think. Although what to do when I’m due blood tests? As apparently it’s best to have those 24 hrs after taking Levo and as early in the morning as possible!

I take omeprazole (40mg) for acid reflux and I’ve taken it for at least 4 possibly 5 years, along with gaviscon advance, I have been reduced from time to time but every time that happens my throat gets extremely inflamed and sore, which is my only side effect of the reflux, so no indigestion or heartburn.

I also take HRT but I’ve reduced that to every three days now as I’ve been taking it a long time.

I’ve recently started using vit d spray. I also take collagen and vit b supplements.

[SlowDragon Administrator in reply to Kimkat]

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

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

endocrinenews.endocrine.org...

Also read up on importance of magnesium supplements when taking vitamin D

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Well acid reflux is frequently due to LOW stomach acid when hypothyroid

As your dose of levothyroxine gets increased and you become less hypo you should see this improving

There are thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

PPI is only every supposed to be a short term prescription

Low stomach acid and hypothyroidism

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

[Kimkat in reply to SlowDragon]

I have in the past mentioned the fact that I have been on ppi for longer than is stated to the ent consultant but all I get back is, it’s your only option.

[Kimkat in reply to SlowDragon]

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

As far as I can see, my vitamin B tabs don’t contain any biotin nor do my collagen Supps.

[SlowDragon Administrator in reply to Kimkat]

Biotin is B7

[SlowDragon Administrator in reply to Kimkat]

Previous results show you were very hypothyroid

Mar 2019 tsh 4.18 t4 15.5 t3 4.5

Dec 2019 tsh 9.78 t4 norm t3 norm

May 2020 tsh 14.9 t4 norm t3 norm

It will take time to slowly increase dose of levothyroxine

Bloods should be retested 6-8 weeks after each dose increase

When getting blood test .

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning.

Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Kimkat in reply to SlowDragon]

Thanks for all of this info, I’m sure in time I will begin to be to able to absorb and understand this very complex problem. When I read other people’s cases on here, it makes me think that I have probably had this thyroid problem for a lot longer than I previously thought, only when my nodules started to play up, did it bring everything to the fore. I just hope that I can get some balance back into my life and stop feeling so crappy 😟

[SlowDragon Administrator in reply to Kimkat]

Only add one supplement at a time or make one change at time and wait at least fortnight to assess results before making another change

It will take many months to slowly increase Levo upwards....

Recommend keeping records of how you feel at each dose ....that way you can see that you are making progress.

ALWAYS get actual results and ranges of all blood tests

[Kimkat in reply to SlowDragon]

Hi, I’ve been taking my supplements for years now, should I stop taking them then reintroduce? Not sure what you mean

[SlowDragon Administrator in reply to Kimkat]

Ok if already taking all supplements that’s fine...what we mean is if starting any new ones only add one at a time

I notice you said recently added vitamin D

Obviously you need to look at taking levothyroxine at better time of day ,...taking at bedtime often much better

50mcg levothyroxine is only a starter dose

Bloods should be retested 6-8 weeks after each dose increase

Come back with new post once you get next Thyroid test results

[Kimkat in reply to SlowDragon]

I’ve taken vitd for five years now but I have just changed from tablet to spray. I only started Levo 3 weeks ago and I was started on 25mg, possibly a low dose because I have a pacemaker? Not sure. I’m due to have my next Endo appt next week, so I’m assuming that will be changed to a telephone appt.

[Kimkat in reply to SlowDragon]

So I’ve hit another stumbling block. I decided that I would take my Levo at night, so left it until midnight last night, as I took my morning one yesterday morning ay 6.50, only to realise that I have to take my last lot of gaviscon advance just before I go to bed! My ent consultant did say to me that, that dose is the most important as it blocks any acid burning my throat when I lay down. So I guess I’m going to have to go back to the drawing board.

[SlowDragon Administrator in reply to Kimkat]

So ...do you often/always get up for the loo in the night?

Many members take their levothyroxine then

Putting Levo in weekly pill dispenser in bathroom...makes it easier to remember

[Kimkat in reply to SlowDragon]

I did last night because if the glass of water I had with the Levo haha but no not normally. What kind of an effect would gaviscon have on it?

[SlowDragon Administrator in reply to Kimkat]

You would need to take levothyroxine minimum of 2 hours away from gaviscon

[Kimkat in reply to SlowDragon]

Thanks slow dragon, I think I need to look at what is best for me. I’m considering setting my alarm for around 3am, take it and try and get back to sleep, if that doesn’t work then I will try something else. When I was younger and taking carbimazole, I used to set my alarm for 4am as I was taking 3 tabs a day and needed to have them 8 hrs in between, that worked but I did sleep better then, for the moment it looks like trial and error for me. Hopefully if this works I’ll be able to stop omeprazole at some point as a few on here have mentioned that being hypo gave them acid reflux.

[SlowDragon Administrator in reply to Kimkat]

Yes thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

[LizzieAFib in reply to Kimkat]

You can take your levo at bedtime. I do that - then I have the required empty stomach as we eat our dinner around about 6.30/7pm and go to bed about 1130pm. Much easier than taking levo in the morning and then having to wait to eat my breakfast, which is something I'd find very difficult as I need food!

[Lora7again]

My elderly Dad is on 100mcg of Levothyroxine a day because he is classed as elderly at 78. Your dose needs to be increased until your TSH is 1 or lower and your T4 and T3 are in the upper third. Unfortunately NHS guidelines are flawed and I know this because I have suffered with thyroid disease for about 12 years now. The NHS have never helped me and this the same for a lot of other people with thyroid disease. They are brilliant at treating cancer patients etc. and the coronavirus but when it comes to thyroid disease they are sadly lacking and this is why this site exists. You can read my story on my profile page if you are interested.

[holabola]

Hi Naseebah, I have found eating some nuts and seeds regularly has helped with my hair. Particularly brazil nuts which are high in selenium. Please ensure you have no nut allergy first and it is always recommended to discuss this with your doctor.

[vocalEK]

Thyroid medications are famous for causing some temporary hair loss. Be patient and see what happens. I had already been on levothyroxine for many years when my docs said I had to stop taking estrogen/progesterone replacement meds (HRT). Taking away the female sex hormone allowed the male sex hormone to become dominant and I now have a very noticeable male-pattern balding taking place.

My primary care doc referred me to a dermatologist and I had a video session with her that flamed out immediately, turning it into a telephone session. Luckily I had already emailed her photos of my hair situation (including a picture of my new mustache) so she had no problem making the diagnosis. Our meeting was to discuss treatment options, which she had already emailed to me. It boils down to the most effective treatments being Rogaine (topical minoxidil) and Propecia (finasteride), the only drugs approved by the FDA to treat pattern baldness (hair loss resulting from hereditary causes). Rogaine is a topical solution that is applied by directly rubbing it onto the scalp where hair growth is desired. You apply it twice a day and if you ever stop, the hair you regrew goes away.

Propecia (the option I took) is a pill you take once a day. It is a diuretic, which means it makes you pass water much more often. You must make sure to drink enough liquids to prevent a buildup of potassium in your blood. The doctor says it can take 6 months to a year to see results. So I will report back in about this around Halloween.

BTW, if you ever stop taking Propecia, you will also lose the hair you regrew. So it is a "for life" treatment.