Hello- I Have Had 6 Months+ Of Unusual Hair Loss.

Posted on Tue, 25 Jun 2019

Question: Hello- I have had 6 months+ of unusual hair loss. I am seeing my hair thinning and there are some areas that aren't quite patches but more noticeable than others. I had a stressful event over 6 months ago, but this is long past and it keeps happening. I also have high inflammation due to CIDP, which is treated by gammaguard IV infusions monthly. I've been tired, but this can be age, stress, and overall CIDP. I am also a vegetarian, but I take supplements and my iron and b levels and absorption have always been fine. When I was diagnosed with CIDP, I had a spinal tap and I had an EMG, etc. In diagnosing, we ruled out thryroid with several tests TSH, T4, T3. I've had that checked since. My mother has thyroid issues.

When I went to see my dermatologist on the hair thining, he ran some tests and it included the above thyroid tests plus Thyroglobulin antibodies and thyroid peroxidase (TPO). Both of those came back high at 12 and 15 iu/ml respectively. The others were in normal range (TSH, T4, T3).

He also ran a sedrate by modified westergren which came up at 45H and a C-reactive protein which came up at 9.1H which were showing as high (I typically have high protein and inflammation results with my CIDP). The other tests (ANA, testosterone, histone antibodies, and dhea sulfate) were normal range.

I can't get back into the office for another week and do have trust in my dermatologist as he was pretty comprehensive, but wanted a second opinion on this. I realize that you can't diagnose me online- just seeking feedback on anything I should seek to rule out- Is there is a next step on this?

Answered by Dr. Mirjeta Guni (1 hour later)

Brief Answer:
About hair loss;

Detailed Answer:
Hello and thank you for asking!
I have gone through your concern carefully.

The positive antibodies you described (AntiTPO, AntiTg) suggest for a chronic autoimmune disease (Hashimoto thyroiditis) that can often be associated with alopecia areata (also with autoimmune origin), but in your case, it is not alopecia areata but a tendency for a more diffuse hair loss. You may start selenium supplements to lower the thyroid antibodies.

Taking consideration of your age, I would say a decrease in estrogen level is the most probable cause.

So the next step would be to check estradiol level on the third day of the menstrual cycle and if it is low you may discuss with your physician about starting HRT.

The other causes of hair loss are ruled out.
Hope the information will help. Let me know if I can assist you further.

Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Mirjeta Guni (3 days later)

Thank you for your feedback. I will need to return to my dermatologist next week for a review of the results related to his assessment on my hair. I have been very lethargic and memory fog, but other tests have came back normal (iron, TSH, B levels) in the past and I assumed it had to do with CIDP, which some may. Do you assess the potential of early stage- Hashimoto's. Should I seek out a local Endocrinologist for this purpose or just take supplements and monitor and focus on checking hormone levels? Would an Endocrinologist be the specialty for reviewing hormone levels or Obgyn? I still have ovaries, but no menstrual cycle.

Thank you!

Answered by Dr. Mirjeta Guni (2 hours later)

Brief Answer:
about HRT:

Detailed Answer:
Hi again,
You just need to take selenium supplements and check TSH every 6 months.
Regarding to Hormonal replacement therapy, you may see an obs and gyn and he will refer to an endocrinologist if in your area is the endocrinologist who deals with them.
Regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Mirjeta Guni (57 minutes later)

Thank you- very helpful.

Answered by Dr. Mirjeta Guni (52 minutes later)

Brief Answer:
Will be a pleasure to help you further!

Detailed Answer:
Wish you good health!

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Yogesh D