Hi All
Started on 25mcg Levothyroxine in December 2023. I have booked for my 3 month blood test but just wondering if anyone has experienced hairloss. I know myself its thinner and my hairdresser pointed out a missing patch of my hair this weekend at the side of my head.
Just wondering if any one has had this and did it get better with a higher dose of Levo ?
TIA
There is quite a bit of discussion about this amongst people with thyroid problems. Although there are products out there which might help, it’s probably best to see doc first.
Short answer is - yes.
Sub optimal thyroid hormones, as well as a very common related situation of low ferritin/iron, both cause hair loss.
Optimizing both will help.
Obviously doing that is not quick or easy, there is no pill or surefire supplement/shampoo/etc that will fix it immediately.
So while you titrate from your starter dose of Levo, and if you have ferritin/iron numbers please share them, as the action plan to address those will also help your hair.
Lastly, if you search this forum for “hair loss” you will find countless similar posts and many of those posts have dozens of replies with others’ personal experience with similar.
For my personal experience, my thinning hair is just starting to turn around now after 18 months of thyroid hormone replacement - but more importantly, a few months or so of a very dedicated action plan to fix my iron levels.
There are probably other reasons for hair loss of course, but the above is my experience.
How old are you
Standard starter dose of levothyroxine is 50mcg
You should have blood retested 6-8 weeks after each dose change or brand change in Levo
Levothyroxine doesn’t “top up” failing thyroid, it replaces it
So it’s essential to get on correct dosage as fast as possible
Typically dose is increased in 25mcg steps upwards until on approximately 1.6mcg per kilo of your body weight per day
Being left on grossly inadequate dose levothyroxine will result in low stomach acid and poor nutrient absorption…..with low vitamin levels as direct result
Especially low iron/ferritin
low iron or ferritin frequently linked to hairloss and/or breathlessness
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/testing/thyro...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/signs-and-sym...
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
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