Suggest Remedy For Severe Hair Loss Post Thyroid Removal

Posted on Wed, 22 Jul 2015

Question: I had my thyroid remived 2 1/2 years ago because of large goiters. My hair loss has been gradual but has now hut the point where it is very noticeable. ibwake up very depressed and have anxiety issues. It seems to be getting worse. I was on 137 mcg of synth round the doctor then lowered it to 125 mcg ut the caused worse symptoms. Now it us raised back to 137 mcg. How can I finally get this regulated? How can I grow back my hair? Will I ever feel better again?

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Titrate dose based on TSH level , not based on pulse.

Detailed Answer:
Good day.
Noted your concerns. It's very strange that your doctor advised to change dose of synthroid based on pulse rate. the best way to titrate the dose is by looking at TSH level. your dose should be good enough to keep your TSH between 2.5 to 3. Please meet an endocrinologist who is the best person to advice you regarding the dose change. Once you change the dose, please continue same dose for 6 weeks and check TSH level. based on that , dose may be modified if necessary. what is your weight? Dose is based on your weight as well

Once your TSH levels are good, hair fall may stop. in addition to this, many vitamin deficiencies and iron deficiencies cause hair fall. Get your vitamin B12 level checked. It's good to take a balanced diet. Take a multivitamin also.

Stress is another cause of hair fall. try to reduce it by Yoga or meditation.
regards XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 hours later)

Weight is 163 height is 5' 6". I take iron, biotin, b12 and a multi vitamin. I thought the optimum tsh level was between 1 and 2. Is that not correct? If the tsh is too low do I need a higher or lower dose? Thanks for the information.

Answered by Dr. Binu Parameswaran Pillai (16 hours later)

Brief Answer:
Optimum TSH values

Detailed Answer:
Thank you for the reply. According to your weight, your approximate Synthroid dose should be 120 mcg. However , this is just an approximate dose based on your weight. This could change based on many factors.
We aim to keep a lower dose of TSH in pregnancy. Otherwise a TSH upto 4 is okay. However in most of my patients, I try to maintain a TSH of between 2.5 to 3.

If the TSH is too low (below the normal reference range) you need to reduce the dose of levothyroxine. Please check TSH only after 6 weeks of a dose change. Once TSH is stable, recheck it only after around 6 months.

Good to know that you are already on iron and vitamin supplements.
regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (23 hours later)

Endocronologist today said between 1 and 2 is the target. I am on 137 mcg of synthroid. When I was at 125 mcg I had severe constipation, hair loss, dry skin, etc. I'm on birth control and they said that could also interact with synthroid. Should I target lower doses if synthroid? At 137 mcg, my TSH is .95.

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
NO NEED TO CHANGE DOSE

Detailed Answer:
Your TSH is in normal range . no need to reduce the dose. Each endocrinologist as well as each patient has his/her comfort level at different TSH levels. Yes , it is true that birth control pills can interfere with the thyroid function tests and hence levels may fluctuate. as long as your TSH is normal not to worry.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (6 hours later)

But you said you like to maintain at between 2.5 and 3. .95 is much lower than that. What is the difference between a TSH at .95 and a TSH at 2.5?

Answered by Dr. Binu Parameswaran Pillai (18 hours later)

Brief Answer:
IT IS with in the range

Detailed Answer:
Apologies for the delay in reply. TSH of 0.95 is in normal range. TSH is secreted in a pulsatile fashion. which means that the levels vary depending on time. you can have a TSH of 2 in the morning , 1 in the afternoon and 2.5 in the evening. Since you are taking a relatively higher dose ( based on your weight ), your TSH is slightly on the low normal side. In most laboratories a TSH of 0.3 to 4 is normal.

I said in my practice I keep between 2.5 to 3. In pregnancy a bit more lower. However, if patients continue to complain of symptoms , we increase the dose of Synthroid aiming for even lower TSH values.

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. Chakravarthy Mazumdar