Unexplained hair shedding

I have visited a dermatologist but before jumping onto his "hair regimine", I wanted another opinion. I am in my early 30s, very health, eat well, no kids. I always had thick long hair all my life. My family all has thick hair (including all grandparents with exception of my grandpa). I experienced increase hair shedding especially in the shower for 1.7 years. I comb my hair in shower and def end up with 150+ in my hands when Im done, as well as the hairs on my coats clothes etc. Now my temples and front hairline are receding, my crown is thinning, my part is definitely widening and my overall hair is not as thick as it used to be. I sometimes get a itch/burn/tingling scalp that comes and goes in these frontal areas (where my hair thinned most) and sometimes in back and sides. I took iron, thyroid and hormone tests. My iron HCT was 36.2% (normal was 37-47%) thryoid is normal, hormone tests are pending. I mentioned that I was on loestrin birth control from April 2008-2009. I never ever had a hair loss issue before that, can't remember if I had one during the pill, but have experienced hairloss after I stopped the pill. My dermatologist dismissed this topic altogether, and said I had TE, it wouldnt hurt to take 325mg iron and biotin and also prescribed fluocinonice topical solution to use as needed for the itch/burn/tingling sensation. I felt like he didnt pinpoint the cause to be treated.

1. Can this slight iron deficiency of less than 1% cause hair loss? I don't know if I really should be on iron supplements and that amount. Is 50mg iron 1-2x day enough (assuming I need any)? Is this only for a few months or will I have to take it forever? I dont want to create a dependency. I felt like he was guessing when prescribing meds. My primary dr. has known about my iron level for 2 yrs and said its normal and bever prescribed medication.
2. Can the stopping of birth control still have hair loss effectes almost 2 years after stopping the pill? My gyno said its not likely-my body would go back to its normal hormone balance which in my case neevr caused hairloss before. Unless my hormones have changed since I turned 30? What type of hormone imbalance are there and does imbalance always show up on tests?
3. Is fluocinonice topical solution safe? Can it make TE worse or cause more hair to fall out?
4. Any other tests or doctors specializing in hair loss?
5. I had an allergic reaction which caused hives and rednessback in Sept 2010. Allergist had no explanation. I have no known allergies. Could that be indicative of something thats going on? I know alot of hair cycles has to do with blood flow.

[Angebelle]

To answer your questions:

1. Iron levels are good, therefore iron deficiency is not a reason for your hair loss.
2. While the birth control pills are not the culprit, they did help to regulate your hormones.  You mentioned your hormone tests are pending, which will help to determine if you have an endocrine disorder.  If you have an endocrine disorder, treating the condition often treats the shedding.
3. Topical solutions are generally safe, but only work as long as you use it.  It's not a long term solution.
4. You can visit the website of the International Society of Hair Restoration Surgery (ishrs dot org) for referrals to dermatologists with expertise in hair disorders.  In fact, Dr. Neil Sadick is in your area.
5. Have you done a patch/skin test or a blood test to find out specific allergies?  
Hope you find relief soon!

[Bhupinder Kaur, MD]

Hello,
To me it looks like telogen effluvium. You need to pay attention to your diet. Your hair needs vitamins and minerals to grow that it can only get from the bloodstream. So if you want to speed up your hair growth and thickness you should limit the intake of fat and salts. Selenium, zinc and magnesium are some of the minerals that your hair needs and also amino acids and vitamin E will help in growing hairs. You can regularly massage scalp with oil, use protein conditioner to avoid loss and help growing, prevent exposure in hot sun etc.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.