I have Hashimotos and I’ve just got my results from having a variety of things tested re. alopecia (balding patches appeared on the top sides of my head several months ago). I would really appreciate help understanding them. I will try and attach photos.
I have a self-booked appt in about a week with a doctor at my surgery to discuss my results. Nobody has looked at them and requested me to make an appt so I suspect they are considered ‘normal’.
I had an appt with an endocrinologist 2 weeks ago who looked at my thyroid blood test results from June and upped my Levothyroxine from 25mg to 50mg (mainly based on my weight). She said to still have the vitamin, iron, etc. tests booked by my doctor; have another full blood test for everything in 6 weeks; and to come back to her for another appt when results are in. She said if all my results were ‘normal’, then I would need to see a dermatologist about alopecia.
Obviously, I am keen to stop my hair loss so, if my recent tests show a deficiency in some area, I will ask the doctor at my surgery to prescribe supplements when I speak to them.
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None of the results you've posted are from thyroid function tests i.e. no TSH, Free T4 or Free T3, doesn't include thyroid antibodies and none of them are vitamins or minerals.
Your Levo dose is very low. When did you get diagnosed with an underactive thyroid, and how long have you been on Levo at 25mcg and 50mcg?
It might not be your vitamins/minerals/thyroid which are responsible for your hair loss. It could be that you have developed another autoimmune disease that is affecting your hair. But there isn't really enough information for us to go on. Once someone has one autoimmune disease e.g. autoimmune hypothyroidism, they are more at risk of developing another than someone who hasn't got any autoimmune disease.
If it is low vitamins and/or minerals and/or thyroid hormones that is causing your hair loss it could take a long time to recover, but it ought to start regrowing eventually if low levels of nutrients and thyroid hormones are improved.
My thyroid blood tests were done back in June so these tests were supposed to be for vitamins, iron, etc. I thought my doctor had requested the tests that might show up a deficiency.
Thanks for the link. I will certainly read that but I am so unsure where to go next for my hair loss. I was hoping that these tests would show an obvious lack of something that I could get as a supplement.
Thank you for being so kind to reply so quickly! 🙂 With regards to my levo dose - I've only been on 50mg for a couple of weeks so maybe this might help my hair growth.
I agree with SeasideSusie - your potassium is rather low.
Sodium and potassium work together - they are both very important electrolytes.
Your sodium is approx 56% through range which is approx mid-range, which is good.
Your potassium is only about 19% through range, and it would be better being roughly mid-range too. Find lists of potassium-rich foods on the web and start incorporating some of them into your diet.
Pages 1 and 2 results appear OK except for potassium is close to bottom of range. You might want to consider potassium rich foods, bananas is one.
Iron panel
Did you fast for 12 hours before the iron test and not eat iron rich foods for a couple of days beforehand nor take any iron tablets for a few days before the test?
I can't see a ferritin result and this important - see
According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.
Serum iron: 55 to 70% of the range, higher end for men - yours is 28.57% through range so is on the low side
Saturation: optimal is 35 to 45%, higher end for men - yours is 22% so is low
Total Iron Binding Capacity (TIBC): Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 72% through range so higher than mid-range but not at the very top end
Bananas - great, I can start eating those more often - thank you.
Iron - I'm not currently taking anything and yes, I fasted before the test.
Ferritin - I did think the doctor was requesting that. I had talked to her about what this forum had recommended and I thought she had said she would test Ferritin but obviously not.
I have a form from my endocrinologist for my next blood test (should be in about a month's time) and she has listed the following investigations to be done: Vitamin B12, Calcium, Electrolytes & Creatinine, Ferritin, Serum Folate, Free T4, Iron status, Liver Function Test, Thyroid Function test, Vitamin D.
So it looks like I will have to wait for my Ferratin to be tested unless I push my doctor to test before those tests.
Looking at what I have been tested, is there anything else apart from bananas I could supplement or ask the doctor to prescribe?
Ferritin should be done along with the rest of the iron panel, not on it's own. So where it says "iron status" please make sure that includes
Ferritin
Serum iron
Saturation %
TIBC
You'll need to do a Google search for potassium rich foods, bananas is the only one I know off the top of my head.
The only other thing I can see is that your Vit D is low at 69nmol/L but you wont get your GP to prescribe, they will only prescribe until it reaches "sufficiency" which they generally tend to say is 50nmol/L. Even if GP did agree to prescribe it would probably be 800iu daily which is too low.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.
Your current level of 69nmol/L = 27.6ng/ml
On the Vit D Council's website you would scroll down to the 3rd table
My level is between 20-30 ng/ml
So now you look at how much is needed to reach 50ng/ml (125nmol/L) and you'll see that they suggest 3,700iu per day. So you could supplement 3,000iu or 4,000iu which are the nearest.
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
90-100mcg K2-MK7 is enough for up to 10,000iu D3.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form
Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
I can't diagnose iron deficiency nor can I advise you to take iron supplements, this should be down to your doctor and if prescribed you need regular iron panels to keep an eye on your levels. All I can tell you is that you can help raise your ferritin level (once this has been tested and you know what your level is) by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
I just wanted to thank you for all the information. I've read all the links and am going to try to make sure I include lots of iron rich foods in my diet and have ordered the 'combined D3/K2 supplement' you spoke about.
I'm a bit puzzled about magnesium as to which type would suit me.
I had a telephone appointment with a doctor from my surgery yesterday to discuss my results from 20th July and found out that there were more results that I hadn't been given, including B12, ferratin and folate (see attached - hopefully you can read them), along with a letter from my endocrinologist to the doctor. I found out there is a 'plan'!! ("...I have suggested increasing the dose of Levothyroxine to 50mcg, aiming for a free T4 in the upper quartile...")
I am due to have everything re-tested at the end of August to see if my T4 has increased. I am feeling a bit more reassured that if my levels don't improve much that I could ask for my levo to be increased again. I know that this needs to be done in stages and I have coped well with my current increase.
I wondered whether you might have a moment to look at the rest of my results and give your opinion. The doctor said I could consider taking a multivitamin with iron but I know that this is not recommended on this forum.
STRONGLY Recommend getting TSH, Ft4 and Ft3 tested privately
Private testing
Always test thyroid levels early Monday or Tuesday morning and last dose levothyroxine 24 hours before test. Just drink water between waking and doing test
Come back with new post once you get results
How much levothyroxine are you currently taking
Which brand of levothyroxine are you currently taking
Approx how much do you weigh in kilo
Have you had coeliac blood test done yet
If not get tested before considering trial on strictly gluten free diet
Only 5% Hashimoto’s patients are diagnosed as coeliac, but further 80% find strictly gluten free diet helps or is essential
Thank you for replying. My thyroid results were in my previous post back in June. My recent tests were supposed to be to test vitamins, minerals and iron levels. I thought I was having ferritin checked as well but it seems not.
If I have private tests done, will my doctor or endocrinologist be happy to use them? I can’t afford to manage this condition privately.
Always test TSH, Ft4 and Ft3 6-8 weeks after any dose change or brand change in levothyroxine
Or, for example, 6-8 weeks after starting HRT
HRT frequently results in needing dose increase in levothyroxine
Most important results are always Ft3, followed by Ft4.
When adequately treated on levothyroxine most people will have Ft3 at least 60% through range, Ft4 often will need to be higher at 70-80% through range or higher
Do you always get same brand levothyroxine at each prescription
If yes…..Which brand
Test vitamin D, folate, ferritin and B12 at least once a year minimum
You can self manage vitamin supplements
Always test thyroid levels early morning, ideally shortly before 9am and last dose levothyroxine 24 hours before test
List of private testing options and money off codes
That’s interesting what you say about HRT. I started HRT in January and noticed my hair loss a few months later. I did ask but neither the doctor nor the endocrinologist have thought there might be an issue with taking HRT and Levothyroxine together. My doctor did say I could try stopping the HRT for a while to see if it made a difference but I’m not keen to stop as I don’t want to go back to constant night sweats!
Brand of Levothyroxine - when I was on 25mg, I was always given Teva. My 50mg (started 2 weeks ago) are Accord.
Weight - currently 11st 8lb
I have not been tested for coeliac but am considering going gluten free following reading here and other sites that it might help. I do suffer from bloating and stomach issues occasionally.
I’ve only recently (2 weeks) been increased from 25mg to 50mg. I did feel a bit jittery and hyper at the beginning of taking 50mg but that’s settled down now.
I'm not lactose intolerant to my knowledge and didn’t seem to have any problem with taking 25mg Teva. That’s just the brand I’ve always been sent (I use Pharmacy2U for my prescriptions which has been so much easier than going to a pharmacy).
I’m not sure why I was only started and kept on 25mg for 2 years. I wonder whether it was linked to my family history of heart problems? My mum has hypertrophic cardiomyopathy (thickened heart wall) and it can be hereditary so my sisters and I were tested. None of us had it when we were tested about 10 years ago.
I agree, my doctor was unsure how to treat my hair loss so I was pleased to be referred to an endocrinologist. I do however see that I need to be more knowledgeable about my condition and advocate for myself during my appointments.
After my Hashimotos diagnosis 4 years ago, I was recommended by the consultant to have 6 monthly blood tests. (I think he was ENT as I was referred when I had a lump in my throat which then was found to be a goitre). For 2 years my TSH was normal, then when it showed an abnormal level, it was a doctor who prescribed 25mg and I’ve been on that since 2 weeks ago because my TSH has always been in normal range.
My mum’s health is managed by a multiple of different medications (for thyroid, heart, blood pressure, cholesterol) and she is also being watched for diabetes. I don’t want to go down the same route as her if I can avoid it.
I’m 55. She was in her 40s when she had her thyroid removed.
For 2 years my TSH was normal, then when it showed an abnormal level, it was a doctor who prescribed 25mg and I’ve been on that since 2 weeks ago because my TSH has always been in normal range.
But just testing TSH is completely inadequate
At very least they should be testing TSH and Ft4
If Ft4 was below 60% through range that would indicate needing dose increase in levothyroxine
ALWAYS get TSH, Ft4 and Ft3 tested together
For thousands of U.K. patients that means testing privately
Cheapest option is Monitor My Health, NHS private testing service at £26.10 if go on thyroid uk for code
Hello.I have had alopecia arreata for over 25 years and probably undiagnosed sub clinical autoimmune thyroid disease. I’m apparently still ‘subclinical’ but now with a rapidly growing goitre…
I followed the advice on here about vitamins and it has helped enormously with both my symptoms and my hair loss.
I self treat with vitamin D with K2, folic acid and a B complex- led by private blood test results of where I am deficient. My levels are now in the upper parts of the range and I feel so much better.
What, unexpectedly, seems to be the ‘final piece of the jigsaw’ to my hair loss is to take an antihistamine daily (Levothyroxine). A consultant recommended it for my allergic rhinitis. I noticed it after about 6 weeks. When I stop taking it my hair starts falling out in 48 hours.
I started researching and there are some scientific papers on it online, if you want to find out more.
What, unexpectedly, seems to be the ‘final piece of the jigsaw’ to my hair loss is to take an antihistamine daily (Levothyroxine)
Levothyroxine isn’t an antihistamine, it’s replacement thyroid hormone
Rhinitis is frequently linked to lactose or dairy intolerance……extremely common with autoimmune thyroid disease (hashimoto’s)
Standard starter dose of levothyroxine is 50mcg….not 25mcg
Levothyroxine doesn’t top up failing thyroid, it replaces it, so it’s essential dose is increased slowly upwards in 25mcg steps until TSH is always below 2
Most people when adequately treated will have TSH around or below 1. Most important results are always Ft3 followed by Ft4. Ft3 at least 50-60% through range
Aah! Thank you for picking this up! I mean the antihistamine Loratadine. One a day hay-fever tablets. I’m not yet taking Levothyroxine as the consultant & Doctor consider me subclinical.
Thank you for all your advice Slow Dragon and the time you take to reply. I’ve been following this group for a while, reading and learning. I’m building my knowledge for my next blood test and review in the autumn!
That’s good to hear you have found what helps you. I am going to work out what vitamins I need. I’ve received a lot of info and links to this post so need to digest it all.
Like Slow Dragon, I am a bit puzzled when you say ‘antihistamine (Levothyroxine)’
Aah! Sorry I mean the antihistamine Loratadine! One a day hay-fever tablets. I still can’t quite believe taking them has stopped my hair falling out…but there seems to be a direct link for me. I’m not taking Levothyroxine yet…The Dr & consultant won’t prescribe it for me.
You need to see a dermatologist for an assessment of your hair loss. If it is really patchy alopecia (alopecia areata), the usual treatment is steroid lotions or steroid injections. But there are different types of hair loss. Alopecia areata is an autoimmune disease and is not caused by nutritional deficiencies.
Thank you - although I’m hoping not to get diagnosed with alopecia, it’s reassuring to hear that there is treatment if I end up having to see a dermatologist.
I hope you haven't developed Alpecia Areata - another autoimmune disease.
Once we have one autoimmune diagnosed, we can develop others.
I was first diagnosed as being hypothyroid. Since then I have developed Alopecia Areata (have bought a couple of wigs) as I have been - at times - without hair on my scalp.
The first time I lost hair my husband couldn't bear watching me having injections on scalp and told me not to do so again. The injections by a doctor did help hair to grow then - after a few months- began to drop out again. The most recent diagnosis I have had for several months at present and it hasn't grown back at all.
I now have three autoimmune conditions and have been diagnosed as having a Polyglandular Autoimmune Disease as I have hypothyroidism, pernicious anaemia, alopecia areata. I have since developed vitiligo too.
I found a benefit from two products I bought from Amazon:-
The first was Luv Me Care Biotin Hair Growth Oil Hair Growth Serum for Thicker Longer Fuller Healthier Hair, Prevent Hair Loss & Thinning, All Natural Vitamin Rich Treatment, Women & Men, All Hair Types 1.7 oz
and
At present I am using another - also from Amazon which also seems to have stimulated hair growth again - too early yet to decide whether it works.
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