Major shedding

I am a 63 yr old female with major hair loss of 2 months.  Seen a Derm and an Endocrinolgist.  Derm says probably result of some emotional stress that began about 4 months ago. Nothing seen in blood work for Thyroid etc. Free Testosterone, estrone and estradoil are low but am taking Estratest which has testostone in it and have been on it for 2 yrs and up until now hair was quite thick and always had many compliments on it.
I am losing more than 500 hairs per day. Falls out in handfuls on a constant basis.  Sink totallu covered with hair every time I comb it and of course shampooing is even worse.  Falls out just walking around or just touching my head. Did start smoking 4 months ago. Will be quitting but wondered if there is any connection with hair loss and smoking?  Am taking lots of vitamins, eating well etc.  Scalp, face and ears itchy. Scalp feels tight and my usual low blood pressure is up.
Any ideas? Started using Rogaine but seems to be drying I guess due to the alcohol content. I am frantic.  Thank you.

[Alan Rockoff, MD]

Sudden dramatic hair loss is usually partial and temporary.  The technical term is telogen effluvium, referring to the shedding (effluvium) of hairs in the resting (telogen) stage.  Normally 10% of scalp hairs are resting, but acute shocks to the system can increase the proportion to 30-40%.  These include childbirth, high fever, sudden weight loss, etc.  Three-four months later, lots of hair falls out.  This continues for a few months, before the body's normal rhythm reasserts itself.  This no doubt is what your dermatologist was referring to.

In other words, wait a while.  Treat your hair normally and don't fret about the fall-it's likely that all or most will grow back.  You will in all likelihood, in other words, never look like me!

Best.

Dr. Rockoff