Hypothyroidism & Hair Loss
An estimated 20 million Americans have some form of thyroid disease, and as many as 60% are unaware of their condition. Hashimoto's thyroiditis, a type of autoimmune disorder, accounts for 14 million cases of thyroid disease. In Hashimoto's, immune cells mistakenly attack healthy thyroid tissue, causing inflammation of the thyroid and a decrease in hormone production. Unlike regular hypothyroidism, Hashimoto’s can cause severe inflammation and enlargement of the thyroid gland, leading to goiter in some cases.
Located in the neck just below the Adam's apple (larynx), the thyroid gland is small, but it produces two hormones that influence every cell, tissue, and organ in the body. These hormones regulate metabolism and affect critical body functions, such as energy level and heart rate. The thyroid gland produces thyroxine (T4) and lower amounts of the more active hormone, triiodothyronine (T3), which together are known as the thyroid hormones. Thyrotrophin-releasing hormone (TRH) from the hypothalamus in the brain and thyroid stimulating hormone (TSH) produced by the pituitary gland control release of the thyroid hormones.
Hypothyroidism Hair Loss
In hypothyroidism, the thyroid gland does not produce enough thyroid hormone. Symptoms can include extreme fatigue, depression, forgetfulness, weight gain, and hair loss. Hair follicles follow a natural cycle of hair growth and resting phases. Normally, hair grows about a half inch per month for about 3-6 years, followed by a resting period. At any given time, most hair is in the growing phase, while only a small portion is resting. Typically, one in 10 hairs rest at any one time, and after the 3 month-resting period, a new hair grows in place of an old one. Changes in the body alter the natural cycle, resulting in too much hair resting at the same time and not enough growing, which leads to noticeable hair loss – either thinning or balding. Hair loss is more common if hypothyroidism is severe and prolonged, which generally results from inadequate or no treatment. This hair loss is usually diffuse, involving the entire scalp rather than specific areas.
In addition, hormone-induced hair loss occurs when an enzyme starts to convert the hormone testosterone on the scalp to its less useful version, dihydrotestosterone (DHT). DHT attacks the hair follicle and shrinks it, sometimes making it disappear entirely. Hair becomes thinner, finer, and may stop growing entirely. In some people with hypothyroidism or hyperthyroidism, the DHT conversion process appears to be sped up. This process may be responsible for continued hair loss after a person is on thyroid medication and hormone levels have stabilized.
The medication levothyroxine is the gold standard treatment for an underactive thyroid. It may take a period of time to find the right dosage of thyroid hormone to normalize hormone production. Your doctor may retest your levels to assess the effectiveness of the medication. Make sure your TSH level is also tested, since it plays an important role in controlling the thyroid hormones. Ironically, levothyroxine itself can contribute to some hair loss, however, this appears to be more common within the first month of treatment and impacts children more frequently than adults. In the majority of cases, this hair loss is temporary, diminishing after you’ve been taking medication for a long enough period for thyroid hormone levels to stabilize. Hair loss can also result from being undertreated. This could mean not having adequate TSH levels or taking drugs that aren’t working optimally for you. Some people do better on medications containing both T3 and T4, not solely synthetic T4 (e.g. levothyroxine drugs like Synthroid).
Thyroid Hair Loss Tips
Wear a hair piece or wig
Get a new hairstyle to camouflage hair loss
Have ferritin levels tested (the stored form of iron), because low levels are a common cause of hair loss in women
Have iodine, zinc, vitamin D, B12, and magnesium levels tested, because deficiencies in these can also contribute to hair loss
Take a high quality multivitamin supplement with the above-mentioned vitamins
Control blood sugar – swings in levels can induce the conversion of T4 to Reverse T3, an inactive hormone that blocks T3 activity, which can lead to hair shedding
Ask your doctor about using Rogaine (minoxidil), available over the counter in 2% and 5% strengths
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