alopecia / thyroid tests / need endocrinologist?

[RCinNY]

I meant to post this here originally.

Quick background information: male, 29, developed alopecia areata in May, saw dermatologist in June, taking topical steroid cream ever since and the two bald patches I have are now stable in size for around a month (3cm, 5cm in diameter), though I have no regrowth of hair yet.

The dermatologist sent me for a blood test to check my thyroid, and these are the results:
TSH = 3.610; Free T4 = 1.43

He said that the free t4 was too high and wants me to see an endocrinologist.  After looking at my copy of the report and poking around the internet, I really don't want to doubt the doctor, but I think he only flagged the free t4 because the ranges on the lab report seem cut off on every copy.  The TSH range says 0.27-4 (I googled the range and it probably is to 4.2).  The free t4 range is 0.93-1, and after googling it, it should say 1.7.  There's also a spot for abnormal results to be flagged and that's blank.

So could this doctor have just been lazy, realized that 1.43 > 1 and stopped there, without questioning the tightness of the range?  Or are these numbers plus having alopecia enough reason to be checked out by an endocrinologist?

I'm going to call the doctor later in the week, but I have less faith now, and would appreciate any feedback here.

Thank you very much in advance.

[Mark Lupo, M.D.]

The TSH is a little high for a 29yo male, the FT4 is fine -- would repeat the TSH along with TPO/Tg antibodies as this may be hashimoto's.  The focal bald spots may be an immune system attack on the hair -- a biopsy of these areas may help and sometimes injections of steroids work better than creams.

[benny51]

Has your doctor sent a copy of your results to a endroconlogist? my doctor sent my results ot the one i was going to see and they called me immediatly for a appointment.

[benny51]

Has your doctor sent a copy of your results to a endroconlogist? my doctor sent my results ot the one i was going to see and they called me immediatly for a appointment.

[RCinNY]

Thanks.  I figured that that would be the next step, in light of what I read elsewhere re TSH after my posting.  I know the injections should work better than creams, but it's a first course that's less expensive and less invasive.  From what I understand, alopecia kind of has a mind of its own and will often get better (or sometimes get worse) on its own in a few months.  I'm scheduled to follow up in a couple of weeks, but I may do so with a different doctor.

I still have 80-90% of my hair, so my more immediate concern is getting to the bottom of what might be a more serious thyroid or auto-immune problem.  And this response gives me some direction, and I appreciate it, though I may visit my primary care physician first as I understand that it can take months to get an appointment with a good endocrinologist, and I need to follow up on a couple of things with her anyway.

[thyroidBitch]

I went thru my file while waiting in the little room for over an hour. i was bored. i found an intake form that was not mine mixed up in my patient file. Yes Doctors and other people that work in the medical Field make mistakes.

I hate dealing with doctors. got so frustrated i stop seeing them for a year. April this year i knew i need to get back into it. and waiting  and waiting now to see a specialist, insurance approved. the doc's office is busy. and they don't have Endocrinologist at the ER. mom mother is worried about me.

what to learn- How to communicate in difficult situations
Assertiveness Training can be the only good of this mess. 5 years of problems. i am considering camping out in the waiting room ready to take an empty spot if anyone should cancel or not show. i don't know if i can do that.............i may end up sobbing. sometimes sobbing works and sometime it doesn't. what is the worst that could happen. i get arrested for causing a sense at the doctors office waiting to be seen. my mood gets out of control and the police take me away. ..........well they will have to take me for medical help because of all my problems and history. maybe then i could meet an Endocrinologist?

thyroid is connected with the function of the adrenal system. so the flight or fight response, the Adrenalin all the time. ohhhhhhhhhhhhhh i will goto Adrenal shock to get help.

I am going to take a sleeping pill now.