Hair Loss and Hypothyroidism

Losing your hair can be very upsetting. It’s not just vanity, but it also contributes to your identity. 

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I’ve experienced drastic hair loss, where I lost about 80% of my head-hair after a hospital stay in intensive care with pneumonia. I had a type of hair-loss they called telium effluvium, which basically occurred because the severe illness I was going through at the time caused a drastic shock to the growing follicles, so much so that they went into a resting state, resulting in an increase in hair shedding and thinning of hair on the scalp. As WebMD backs up my own thoughts, this type of hair loss often develops suddenly, although typically a month or two after the initial shock. In my case, it was a month after I left hospital. Because the trigger was short lived, the hair follicles returned to their usual growing state after about three months of shedding (by which point I had incredibly thin hair) and started producing new hair fibres fairly quickly. After six months or so of the new hair starting to grow and come through, my hair was looking much healthier and thicker, although the new hair that came through was like baby hair!  Since then, my hair has been the thickest it has ever been. imag3746

But I wouldn’t wish going through the trauma of hair loss on anyone.

I’ve also experienced thinning of eyebrow hair, which I haven’t found so bad, as makeup allows us to ‘fix’ this easier than head-hair. However, this can also knock your confidence and be another frustrating physical demonstration of how unwell you feel.

However, hair loss can occur for a myriad of other reasons, especially when you also have a hormonal imbalance such as hypothyroidism, so I’m going to explore these below. If you are experiencing hair loss, please ensure you explore as many of these as possible.

Less than optimal thyroid levels

It’s a term I and so many other sources of thyroid information, use a lot; optimal thyroid levels. Optimal thyroid levels are different to just being ‘normal’ or ‘in range’, which I’m sure are phrases you’ve heard your doctor say before. Optimal results are the places most thyroid patients say they feel best WITHIN the range. These are: a TSH below 2, a midrange Free T4 and a Free T3 in the top quarter of the range. But what if my doctor doesn’t test all those? Well then, that’s not good! These are the basic tests you should always be having done; Free T4 is the storage thyroid hormone and Free T3 is the active hormone. They need testing always. TSH alone is not accurate.

If you’ve checked that these three levels are optimal and they are, then look in to Reverse T3 and calculate your RT3 ratio, which is known to cause issues like hair loss, anxiety and lingering hypothyroid symptoms if not optimal. Reverse T3 counteracts the Free T3.

Full list of tests you should have done a hypothyroid patient.

Low/Deficient Vitamin Levels

Probably the most common with its links to hair loss, is iron, but it’s ferritin you want to pay particular attention to. Ferritin is the stored form of iron and is usually the first thing doctors check when you go in to their room explaining that you’re experiencing hair loss. This is especially important when you  suffer from an underactive thyroid, because having low ferritin levels is fairly common with hypothyroidism. I myself was given iron tablets for my low ferritin levels at the same time as a diagnosis of hypothyroidism. However, you also want to ensure that your ferritin levels are optimal, before ticking this off your list as not the culprit for your hair loss. Optimal ferritin levels are commonly cited to be 70+ and I vouch for this as I felt much better in terms of fatigue and achniess once my ferritin went above 70. However, your personal optimal level may be higher or lower than this, so you ought to work with your doctor to figure this out. I wouldn’t recommend supplementing iron unless you know for sure that you’re low in it, as taking it when you don’t need it can be harmful.

As well as ferritin, it’s also worth checking other vitamin levels such as vitamin D, Zinc, Magnesium, B12 and folate.

Apparently, the vitamin D receptor is expressed in numerous cells and tissues of the body, including the skin. Studies of mice and humans lacking these functional receptors have demonstrated that absence of the VDR leads to the development of alopecia, another word for hair loss. (More on alopecia below)

Zinc plays a role in cell reproduction as well as hormonal balance, and these functions can affect your hair growth. Zinc even manages the glands that attach to your hair follicles, which is very interesting to know. When you’re zinc levels are low, these follicles can become weak, causing strands to break off or fall out.

Magnesium facilitates the release of energy from foods. It helps the body absorb nutrients, including those needed for hair health and hair growth.  Therefore, low levels of magnesium in the body could be affecting your hair, too.B12 and folate can also affect your hair. Healthy hair growth is dependent on synthesis of DNA and adequate B12 levels, so a potential sign of vitamin B12 deficiency is hair loss.
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Alopecia
You’ve probably heard the name of this form of hair loss. Alopecia Areata tends to cause bald spots on the scalp as oppose to overall thinning and is an autoimmune disease, as the immune system attacks the hair follicles. This is particularly interesting, as those of us with Hashimoto’s Thyroiditis, the autoimmune cause of hypothyroidism (about 90% of us with an underactive thyroid have this), are by default at a high risk of developing other autoimmune diseases, such as Alopecia Areata.
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Adrenal Dysfunction
Adrenal fatigue is a phrase thrown around a lot on thyroid sites and in books lately, and it’s a condition you ought to familiarise yourself with if you haven’t already.

Adrenal fatigue seems extremely common among thyroid patients, with myself included. I have high cortisol adrenal fatigue which causes me fatigue (as the name suggests!) and anxiety and palpitations.

Other symptoms include: insomnia, headaches, depression, weight gain (especially around the stomach), joint inflammation, gastrointestinal issues (e.g. diarrhoea), low libido, fibromyalgia, irritability, over emotional tendencies, anger, blood pressure problems, low blood sugar moments, light-headedness and dizziness. But a full list can be seen here.

So what are the adrenal glands and what do they do?

The adrenal glands sit on top of each kidney and their main function is to manage stress. This includes mental, physical and emotional stress. Have you been through chronic emotional, mental or biological stress of any kind? If yes, then you could have adrenal fatigue. Having hypothyroidism alone, counts as a physical stress on the body.

Adrenal fatigue can cause a knock-on effect and affect many other functions of your body, including that of the thyroid and sex hormones. However, adrenal fatigue isn’t a condition commonly recognised by mainstream medicine yet, which means that many doctors haven’t heard of it, don’t test for it and so don’t treat it. But it is very real. Many people living with adrenal fatigue report many symptoms and issues due to their low or high cortisol, and once this is brought back to normal, their symptoms go.

Order or ask for a 24 hour saliva test, testing your cortisol levels at four key points of the day, to find out if you have adrenal fatigue. Most doctors will only test it with a one time urine or blood sample, which is not as accurate. Four samples taken over a 24 hour day show how your rhythm of cortisol production is working. It should be highest in the morning, tailing off throughout the day. Only four saliva samples taken in one day will tell you this accurately.

Dr. James Wilson wrote a book I have reviewed called Adrenal Fatigue: The 21st Century Stress Syndrome where he covers treatment and symptoms of adrenal fatigue. It’s a must read.

Adrenal fatigue is the umbrella name given to issues and symptoms that derive from too little cortisol, too much cortiol or a combined mix of both as your levels fluctuate throughout the day. None are normal.

With the adrenals so delicately linked to other aspects of our bodily function and handling stress, perhaps this helps you understand why stress can cause so many issues such as hair loss?

Sex Hormone Imbalances

‘Sex hormone imbalance’ is pretty much my buzz phrase at the minute, as I’m currently trying to correct my oestrogen dominance (see my other blog posts for more information). I’m starting to realise that an imbalance with the sex hormones oestrogen, progesterone and testosterone, is increasingly more common with thyroid patients.

You want to test your levels of: oestrogen preferably on days 1-5 of your cycle, progesterone around day 21 (although this may be tricky to predict if you have irregular periods – a sign of a hormonal imbalance!) and testosterone any day of the month, but also consider the menopause and perimenopause as hormonal culprits. As well as oestrogen dominance causing hair loss, or too little oestrogen even, too much/too little testosterone can cause it, too. Testosterone is one of the first things my doctor checked when I was experiencing hair loss.

Blood Sugar Imbalances

Low blood sugar is something I’ve covered before, here, and it’s something that places extra stress on our adrenals. When your blood sugar levels drop below normal, your adrenal glands respond by secreting cortisol. This cortisol then tells the liver to produce more glucose, which brings blood sugar levels back to normal. Doing this repeatedly can cause abnormal cortisol output, and, as I’ve already covered above, abnormal cortisol levels can be detrimental to your hair.

Thyroid Pharmacist, Dr. Izabella Wentz also wrote:

Blood sugar swings brought on by eating too many carbohydrates and not enough quality proteins and fats can wreak havoc on your health and hair! Blood sugar swings encourage the conversion of T4 to reverse T3. Reverse T3 is a inactive hormone that blocks the body’s utilization of T3, resulting in increased hair shedding.

Diet 

I’ve also heard before from thyroid patients that they found sensitives to food such as gluten, dairy, eggs etc. caused them some hair loss, and eliminating it from their diet helped it to regrow but also become stronger and better in quality.

Low stomach acid
I’ve covered low stomach acid and issues such as acid reflux, indigestion and heartburn on another post, so I won’t go in to too much detail here to avoid repeating myself, but low stomach acid links back to your ferritin levels. Dr. Jonathan Wright explains that if stomach acid is low, which can cause issues such as reflux and heartburn, then protein isn’t efficiently digested from food. Hair is made up of protein, so it makes sense that if we aren’t taking in enough protein, then our hair can suffer. Our bodies will prioritise heart muscle for example, which crucially needs protein, and sacrifice our hair in the process, thus leading to hair loss.
Most common for those on T4-only medication like Levothyroxine or Synthroid, an inadequately treated underactive thyroid and/or Hashimoto’s can cause low stomach acid, so it’s worth exploring.Ensure your thyroid levels are optimal and look into apple cider vinegar to correct low stomach acid.Other medicationsThere are some medications that can cause hair loss, including thyroid medications when too much is taken (causing hyperthyroidism).Others that you may be taking include: hormonal contraceptives, antibiotics, antidepressants, anti-convulsants, beta-blockers, NSAIDs, steroids and many more.Make sure you check the listed side effects of any medications you are using and consult your doctor if you believe any could be causing you hair loss.

If you found this article informative, useful, helpful or in other words are grateful you stumbled across it, please consider helping me keep The Invisible Hypothyroidism running, so that we can carry on building a strong community, spreading awareness and helping each other. Running the site comes at the expense of my personal time and money from my own pocket. You can make a one-off or monthly donation to support me keeping this website going, by clicking the button below.

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I run a Facebook group, called Thyroid Family: Hypothyroidism Advice & Support Group. This group is for underactive thyroid/hypothyroidism patients only, and not medical professionals or anyone else. If you have any questions on living with hypothyroidism, or want some support, help or advice, please join us. 

I also run a group for the spouses, partners and other halves of hypothyroid patients, called Hypothyroid Patients Other Halves – Support & Advice Group. This is for the other halves only and not patients. 

-Rachel

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