Unfortunately, some thyroid patients suffer from hair loss. This is obviously very distressing for those with this problem and often it can be extremely difficult to discover what is causing it. It might be connected with their hypothyroidism, or it might not be.
Over the years I have been asked the question of what could be causing hair loss. I have usually answered that hair loss is not a symptom that I focus on very much. This is not because I do not care, it is just because it is not a symptom that I know a great deal about.
Sometimes the thyroid patient associates some change in their thyroid medication to a worsening of the condition. However, I believe that this is often because a change in thyroid medication has further exposed some other underlying issue.
Whilst, I am no expert in hair loss causes, I have managed to accumulate some suggestions of issues that can contribute to hair loss.
Here are just some of the possible causes of hair loss:
- Low iron (testing for serum iron, ferritin, TIBC and transferrin saturation % is a good idea).
- Heavy metals in excess.
- Hypothyroidism (esp. low T3).
- High testosterone, DHEA or DHT.
- Polycystic ovary syndrome (PCOS).
- Insulin resistance.
- Low blood sugar or low blood pressure – both can limit the nutrients getting to the scalp.
- Cortisol imbalances – high cortisol and low cortisol can both cause hair loss.
- Hormonal changes in menopause. Esp. low oestrogen or progesterone.
- Micronutrient deficiencies (vitamin B12, biotin, iron, zinc, silica, and essential fatty acids especially).
- Immune system dysfunction (e.g. alopecia and lichen planopilaris).
- Environmental (skin mites).
- Drug side effect (such as those used for cancer, arthritis, depression, heart problems, gout and high blood pressure).
- A stressful event or shock.
- Some hair treatments.
Note: a few thyroid patients who are on T3-Only have told me that sometimes adding a little T4 medication can help to avoid the hair loss. Even as little as 10 to 25 mcg has helped some to overcome this issue. But clearly this is not going to help everyone. However, the vast majority of patients on T3-Only do not have any hair loss at all.
As I said earlier, I am definitely no expert in this area. However, the above may help some of you to begin your own investigations into the cause and solution for this distressing problem.
Best wishes,
Paul
Due to hrt and raised testosterone dosage by my doctor my testosterone went from really low 0.83 to really high 4.84 nmol/L and subsequently my hair is shedding excessively, my shbg is 82.69 nmol/L and my free androgen index is 5.85, how do I deal with now lowering this to normal levels!?
Annette,
The most obvious answer is to lower the testosterone. Too much testosterone for the person will cause hair loss. The only thing that is stopping it being worse is likely the raised SHBG. If you lowered SHBG then the free testosterone would be higher and this would cause worse shedding.
Best wishes, Paul