# Autoimmune Thyroid, Levothyroxine and Hairloss issues :(



## DMC83 (Jun 4, 2012)

Hi there,

For as long as I can remember (adolescence and adulthood) I have become fatigued and tired very easily. Having recently decided enough was enough, I went to see my Dr who arranged me to have a blood test performed (I will list the results at the bottom of my post).

My GP diagnosed me as having hypothyroidism due to my TSH and Thyroid Peroxidase abs being above the reference ranges (My T4 is in the normal range). I was prescribed Levothyroxine, and have been taking 50 mg daily for nearly 4 months.

Within about a month I noticed that my hair had thinned a little bit around the sides of my head, and has continued to thin all over at quite a rate. Interestingly, I have not noticed anymore hair than usual falling out, though my hair is definitely much thinner than it was before I started taking Levothyroxine.

I've read that high levels of Peroxidase Antibodies will attack the enzyme which converts T4 into T3. On this basis (and the fact my T4 levels are normal), is it even worth me taking T4?

Last but not least, if I want to come off Levothyroxine, do I need to wean myself off, or is my dose so low that I can stop taking it without tapering off (Bear in mind I am 5' tall and weigh 112 lbs).

Sorry if I've rambled on a bit. I am quite worried about losing my hair 

Donna x

Results

Serum Free T4 Level 12.6 (Normal range 10.0 - 19.8)
Serum TSH Level 8.6 (Normal range 0.3-5.5)
Thyrodi Peroxidase abs 496.4 (Normal range 0.0 - 60.0)


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## webster2 (May 19, 2011)

Have you had new labs done since you have been on the Levo? You may still be hypo, and that can cause hair to fall out.


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## joplin1975 (Jul 21, 2011)

A side effect of Levo is hair loss. I had it for a time and it was nasty. But -- and this is important -- once you are regulated, it stops and gets way better. Given your labs, you might need more medication. Webster is right, you should have more recent labs done -- ideally every six to eight weeks until you are stable.

Two thoughts:
1) Your doctor should be testing your FREE T4 and T3...I'm thinking that looks like it's the total, not the FREEs.
2) Have you had an ultrasound of your thyroid done? With your TPO that high, it's really important.


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## DMC83 (Jun 4, 2012)

Thanks for the replies.

I had a further lab done about 6 weeks after starting on Levothyroxine, though was never given a copy. The Dr seemed quite happy with the results and said that I was progressing well, so kept me on this dose and told me that there was no need to have another test for two months. I've got my next test scheduled for Thursday morning.

I've not had an ultrasound on my Thyroid, the Dr seemed completely unconcerned about my raised TPO and made no mention getting an ultrasound.

I'm having a little trouble understanding the mechanism behind my hair loss. I presume I was hypo before taking Levo and had no signs of hair loss/thinning at this point, so presumably my natural thyroid hormone levels were high enough to maintain a full head of hair. Having started to take the Levo I am now experiencing hair loss. Could someone explain why increasing the dose could stop my Levothyroxine induced hair loss please?

I am so confused and worried, and what makes it feel worse is that from what I've read, my Dr doesn't fully understand the condition or how to treat it


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## joplin1975 (Jul 21, 2011)

I don't know the mechanisms, specifically, but if your labs are off, it's common to have hair loss. Request copies of all your labs -- your are entitled to them -- I would be willing to bet you aren't euthyroid yet.

While I appreciate that your hair loss is disconcerting, you really, really, really need to rule out cancer. An ultrasound is the first step.


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## webster2 (May 19, 2011)

Definitely get a copy of your labs. You could post them here. There are quite a few posters that can really decipher them. I am not one of them!

A second opinion may be in order. Your TPO is high, worth looking into. IMHO.


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## DMC83 (Jun 4, 2012)

Thanks guys,

Just to confirm what I need to ask the Dr for

Free T3 & T4
Ultrasound of the Thyroid

Are there any other tests I need to ask for to confirm presence of Hashis ?

Thanks.

Donna x


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## Andros (Aug 26, 2009)

DMC83 said:


> Hi there,
> 
> For as long as I can remember (adolescence and adulthood) I have become fatigued and tired very easily. Having recently decided enough was enough, I went to see my Dr who arranged me to have a blood test performed (I will list the results at the bottom of my post).
> 
> ...


Your doctor should have raised your dose of Levothyroixine; why has he/she not? That alone can cause hair loss. Your FT4 is in the basement, it should be above the mid-range of the range provided by your lab. Most of us feel best w/TSH @ 1.0 or less.

Also, look to low ferritin for hair loss.

Ferritin http://www.thewayup.com/newsletters/081504.htm
(should be 50 to 100; the closer to 100, the better)

And may I suggest that you take 2 to 3000 mgs. of a good quality Omega III every day to conteract your hair loss, make your hair, skin and nails healthier not to mention the benefits to the heart?

Have you had an ultra-sound of your thyroid?


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## DMC83 (Jun 4, 2012)

Hi there,

Thanks for all the helpful support and advice. I am attending the Doctors surgery for a blood test tomorrow morning. I have spent today trying to understand the Endocrine system so that I know exactly what to ask for ;

I have summarised what I have learned and have included my theories on what has happened and which tests I need. Please see below and let me know if I have misunderstood things or there is additional info I need. Donna x

Thyroid Function Overview

1. Hypothalamus (responsible for monitoring/regulating thyroid function) detects need for T3/T4 and releases Thyrotropin Release Hormone (TRH) to instruct Pituitary gland to produce Thyroid Stimulating Hormone
2. Pituitary gland releases Thyroid Stimulating Hormone (TSH) to stimulate T4 production from Thyroid
3. Thyroid Gland produces T4 (Storage Hormone) which is then converted to T3 (Active Thyroid Hormone) when required.

Explanation of Brief Improvement upon starting Levothyroxine

Symptoms improved over the first few weeks and then crashed. This is probably due to both natural T4 and Synthetic T4 from the Levothyroxine being present at the same time. Once my body got used to having the synthetic T4, it reduced production of natural T4, resulting in symptoms deteriorating again.

Suspected Issues

Possibly one of the following

1) My Hypothalamus has detected the synthetic T4 (Levothyroxine) and reduced stimulation/production of natural Thyroid hormones. My current dose of levothyroxine is too low and therefore I do not have enough T4, resulting in insufficient T3
or
2) I have adequate synthetic T4 from taking the Levothyroxine and my own natural production has reduced. My body is unable to convert the synthetic T4 into T3, resulting in inadequate levels of T3 and current symptoms eg hair loss/thinning
or
3) My Thyrotropin Release Hormone has reduced to such a level that the behaviour of my hair follicles has been altered (there is verified anecdotal evidence which links TRH to stimulate hair growth).

Tests required

Ferretin
Free T3
Free T4
Reverse T3
Thyroid Antibodies - Both anti-TPO and TgAb
Adrenal Cortisol Levels 
Ultrasound of Thyroid


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## Andros (Aug 26, 2009)

DMC83 said:


> Hi there,
> 
> Thanks for all the helpful support and advice. I am attending the Doctors surgery for a blood test tomorrow morning. I have spent today trying to understand the Endocrine system so that I know exactly what to ask for ;
> 
> ...


Your list of requested tests is good. I hope the doc is not oppositional. Please let us know.


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## DMC83 (Jun 4, 2012)

Hi there, 
I went to see my GP (as they are called in the UK) earlier today. They have taken blood and will be analysing Free T3, Free T4, TSH, and Ferretin.
I had my last set of blood tests performed on 22nd March, having been taking Levothyroxine for 6 weeks. Results below ;

Serum free T4 Level (XaERr)	15.3pmo/L (10.0-19.8)
Serum TSH Level (XaELV)	4.4 mu/L (0.3-5.5)
Serum free triiodothyronine level (XaERq) 5.0 pmo/L (3.5 - 6.7)
The last entry on this list is for T3.

At the point I had this test performed, I'd already seen some thinning of my hair, but thought it was just a temporary thing related to starting the drug. Prior to taking the drug I had no hair loss or thinning.

I read this afternoon, that Levothyroxine can increase the amount of 5-alpha reductase in the body, which in turn binds with testosterone and produces dihydrotestosterone, responsible for male pattern baldness. Is it likely that this is the culprit, and if so, after only three months, will my thinning be permanent?

Donna x


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## Andros (Aug 26, 2009)

DMC83 said:


> Hi there,
> I went to see my GP (as they are called in the UK) earlier today. They have taken blood and will be analysing Free T3, Free T4, TSH, and Ferretin.
> I had my last set of blood tests performed on 22nd March, having been taking Levothyroxine for 6 weeks. Results below ;
> 
> ...


Let's wait and see what the ferritin results are like.


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## DMC83 (Jun 4, 2012)

I shall post my new results as soon as I collect them on Thursday.

Out of interest, do you think it would be worth me getting my DHT levels tested ASAP? If these are out and causing my hair loss, I would like to limit the damage ASAP

Donna x


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## Andros (Aug 26, 2009)

DMC83 said:


> I shall post my new results as soon as I collect them on Thursday.
> 
> Out of interest, do you think it would be worth me getting my DHT levels tested ASAP? If these are out and causing my hair loss, I would like to limit the damage ASAP
> 
> Donna x


I am not good w/acronyms. DHT is?????


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## DMC83 (Jun 4, 2012)

Andros said:


> I am not good w/acronyms. DHT is?????


dihydrotestosterone - please see http://www.hairlossexpert.co.uk/hair-loss-thyroid-problems.html

Donna x


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## Andros (Aug 26, 2009)

DMC83 said:


> dihydrotestosterone - please see http://www.hairlossexpert.co.uk/hair-loss-thyroid-problems.html
> 
> Donna x


Donna, taking this would really whack out your estrogen and other hormones. Every hormone must be in concert.

But, if you decide to do this, please let us know for I could be wrong. I sincerly hope that you can find something to help you.


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## DMC83 (Jun 4, 2012)

Hi everyone, sorry for not posting an update to this thread for so long. It has been a terrible month and we have had a death in the family 

Anyway, I had a further test run at the start of June, and requested that Ferritin was included. Results were ; Free T4 17.2(normal range 10.0-19.8) 
Serum TSH level 4.2 (normal range 0.3-5.5),T3 4.9 (normal 3.5-6.7) 
Ferritin 20 (normal 12-300)

Apart from a short lived improvement which occurred when I first started taking Levothyroxine, I've felt just as fatigued as normal. Panicking over my hair and seeing no benefit to taking the Levothyroxine, I stopped taking it for a week after my blood test in June, but was talked back into taking it by my boyfriend.

I have been supplementing with Ferritin, Vit C and Lysine for a few weeks. I had a routine blood test taken at the beginning of last week, and a Drs appointment a few days later. When I had my appointment my results hadn't come through for some reason, however based on my continuing fatigue and the results from the beginning of June (see above), my Dr has doubled my dose to 100 mg with the aim of getting my TSH to bottom of range, and T3/T4 to top of range.

A few days after my appointment, my blood test results were posted to me. These came as ; TSH 2.6 (0.3-5.5), T4 15.9 (10-19.8), T3 5.0 (3.5-6.7), Ferritin 37.

Despite my T4 decreasing (presumably due to me not medicating for a week), T3 has increased slightly and my TSH has gone down. Could this be down to the increase in Ferritin enabling Thyroid hormones to function and convert more effectively?

Could it be that I'm not actually Hypothyroid after all and that it was just low Ferritin levels causing my problems, or could the reduced TSH just be down to me having had the test performed at a different time of day?

I am also a little worried that my Dr doubled my dose without being able to see my latest results. Taking into account my previous results and the fact that taking 50 mg of Levothyroxine for four months increased my T4 from 12.6 to 17.9. Is the extra 50 mg likely to make me Hyperthyroid, or even worse suffer from a Thyroid storm?

Thanks

Donna x


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