There is no doubt about it, your hair is very important to you. And when you start to see it falling out like crazy, it can really be cause for alarm.
I have had patients actually bring in a baggie of the hair they have lost (I think in case I didn’t believe them), and another who was actually counting her recovered hairs daily and recording them. (Normal is up to 100/day).
Diffuse hair loss and breaking of the hair shafts can indeed be a symptom of low thyroid hormone (hypothyroidism). But if that is your only symptom, one should really be thinking about other causes. If you are chronically tired, feeling cold all the time, brain fogged, having unexpected weight gain, constipated, depressed, and your nails are breaking, thyroid hormone deficiency really could be the cause of your hair loss.
Now if you are already taking thyroid hormone, that is usually the first thing that gets blamed (too low or too high), even though there are several other possible reasons for it. And some of them are more common than a thyroid issue.Over the years, I’ve come to believe that hair follicles are sort of like people in that they don’t like change.
Change in your life circumstances, your body’s hormones, or change in your age. I think that the absolute static level of thyroid hormone is not usually the deciding factor about thyroid-related hair loss unless it is clearly too low. I think it usually has more to do with changes in the levels. And keep in mind that the hair follicle goes through a regular cycle of regeneration/growth/loss and at any given time, and at any given time 6-8% of your hairs are in the telogen phase when hair can fall out.
When there is a major event in your life like having a baby, severe injury, or loss of a loved one, it can cause a lot more of your hairs to go into that phase (called telogen effluvium) and hair falls out a lot more. And that typically occurs around three months later.
Hair loss, or alopecia as it’s formally named, comes in various forms and is from various causes. First off, after menopause, it is normal for a woman to lose more hair and for the scalp to thin in a diffuse pattern. It’s a matter of simple aging. Second, there is something called female pattern baldness, which is the female version of male pattern baldness. This is regional, not diffuse. Its distribution is not exactly the same as men, as it most commonly occurs in the center of your scalp from front to crown. It can be somewhat severe.
So, as you can see, just because you have a thyroid disease does not mean that your hair loss is necessarily due to an incorrect thyroid dose. But when it is, a slight increase in the replacement dose may be helpful. Or adding a small amount of the more active thyroid hormone called liothyronine (T3) may help.
The other causes and treatment of hair loss are beyond the scope of this week’s blog, but stay tuned as that could be a topic in the future.