Hair loss??

[nygrl]

Hi. I'm a 40 yo woman who has been on thyroid meds for 15 years. About 6 mo ago I was on 175 mcg of sythroid and one cytomel 2x day. I remember at the time that my Dr said I was slightly over medicated but if I felt good and was able to lose some weight it was ok that I stay there for a while. Over 6 months I have managed to lose about 22lbs. At one point we adjusted my dose of synthroid to 150 and cut back to one cytomel. My last bloodwork back in Aug had my tsh at .017. I am pretty sure my free t3 was normal but I don't know the numbers. Lately I've been losing a LOT of hair to the point that I can see that it has become very thin. Some has broken off too. I have a LOT of hair normally so this seems really wrong to me. I had a blood draw this week for my appt next week but the endos office said that my dr will want to wait till my appt to discuss results. I'm panicking here!  I feel like I will have no hair left by then. I'm really hoping I'm just over medicated and that's the cause of the hair loss but I'm terrified it's not. Thoughts?  Please help.

[gimel]

It would be very helpful if we could have a look at your thyroid related test results from the time you were feeling good, and also from the time when you dosage was reduced.  You also need to know your test results from Aug.  It is a good idea to always get a copy of blood test results and write on there how you were feeling at the time, and your med and supplement dosages.  Those reports are a very useful history for future reference.  

Lacking that information, and based on your medication reduction, I can tell you that it is far more likely that your hair loss is related to being under-medicated than over-medicated.  When you review your recent lab results with the doctor, keep in mind that members over the years have gotten the best results from Free T4 at the middle of its range, at minimum, and Free T3 in the upper third of the range, or as needed to relieve symptoms.  Even though most doctors like to think that TSH is the best indicator of thyroid status, it cannot be shown to correlate well with either Free T4 or Free T3 (the biologically active thyroid hormones), much less correlate well with symptoms.  TSH is even less useful when already taking thyroid med, since it is frequently suppressed below range when taking adequate thyroid med.  Note also that a suppressed TSH does not automatically mean hyperthyroidism.  You are hyperthyroid only when having hyper symptoms due to excessive levels of Free T4 and Free T3.    

In addition, hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin.   D should be 50 minimum, B12 in the upper end of its range, and ferritin should be 70-100.  Ferritin is especially important for you to know and optimize, due to its effect on hair growth.  

A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free t3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good info from this link.  I highly recommend reading at least the first two pages, and further if you want to see the analysis that lead to the suggestions, plus the extensive, supporting scientific evidence.  If your doctor is  medicating you based on TSH, that is very wrong and you might consider giving him a copy of the paper and requesting to be treated clinically, as described.

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf