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When does hair loss stop after TSH was elevated
Hello, I was diagnosed with Grave's disease in October of 2010 and have been on methimazole since. I responded very well to the meds...too well in fact. I was put on 30 mg a day to start with and had my blood drawn 6 weeks later. My blood tests after the meds showed I was within normal range with everything. The doc did not adjust my dosage at all and set me up for another blood test 6 weeks later. I ended up going 8 weeks later. My TSH was at 17 in January for that next blood test. I suspect it was much higher for a few weeks before that because I was having severe hypothyroid symptoms. I took it upon myself to cut my pills in half. Anyways, I went back to the doctor and he told me my levels were at 17 and he wanted to cut the meds in half. I informed him I had already done so weeks before. A side note...I did try to tell him but his office did not return multiple messages I had left. He then decided to put me on 10 mg a day after I told him I was already down to15 mg and my TSH was at 17. I could tell within a couple of weeks I still wasn't quite right and after trying in vain to reach his office again I cut the dose in half a second time, and switched doctors. By the time I saw my new doctor, it was March 3 and my TSH was at 4.87 and I had only been taking 5 mg of methimazole a day at that point. Long story short, I estimate my TSH was really too high for about 12 weeks. I started losing massive amounts of hair starting February 13th. A full month after my TSH was so high. So...why did it happen after it was peaked, and when will it stop falling out now that my levels are relatively normal. My new doctor has me on 2.5 mg a day and I feel for the first time in months that I am myself again. I should get my latest results within the next few days.
I will indeed present all of this to my doctor. My next appointment is on June 3rd, and it was actually her next available appointment so I won't get in any sooner. She has limited office hours due to the fact that she is a teaching physician in a teaching hospital, which is something I like about her. I think she will be open to anything I present to her. If I don't see any kind of changes within the next couple of weeks (as my levels have only been "normal" for 4 weeks now) I will put a call out to her and not wait until June. She does seem to be wonderful with answering my calls, and I do think she's open to suggestion. Also, I will mail a copy of the literature before I go and ask her to either call me with her thoughts or tell her I wish to discuss the free t3 on my visit. Once again, I thank you. I will keep you posted.
Those "normal" ranges aren't really normal for you unless they result in you having no symptoms. I know that your current dosage is very low and tweaking it adequately might be difficult; however based on your low TT3 levels, I expect that your FT3 is very low in the range as well. FT3 is the thyroid hormone that largely regulates metabolism and many other body functions. Frequently It needs to be midrange or higher to relieve symptoms.
I wonder if your doctor might be more amenable to doing something to increase your T3 levels, if you get FT3 tested and confirm what I suspect, and also if you give him a copy of this link. The link is an abstract of a scientific study that shows conclusively that FT3 correlated best with a composite rating of major hypo symptoms, as subjectively rated by the patients, while FT4 and TSH did not correlate well at all.
http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002
Please understand that I've never delved into anything like this, but I wonder if tweaking your antithyroid med is not advisable, would it make any sense to add a small amount of T3 tp your meds. This would have little effect on any test result other than the FT3 and TT3. Something for you to discuss with the doctor. Also, first chance you get make sure to test for FT3.
I wonder if your doctor might be more amenable to doing something to increase your T3 levels, if you get FT3 tested and confirm what I suspect, and also if you give him a copy of this link. The link is an abstract of a scientific study that shows conclusively that FT3 correlated best with a composite rating of major hypo symptoms, as subjectively rated by the patients, while FT4 and TSH did not correlate well at all.
http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002
Please understand that I've never delved into anything like this, but I wonder if tweaking your antithyroid med is not advisable, would it make any sense to add a small amount of T3 tp your meds. This would have little effect on any test result other than the FT3 and TT3. Something for you to discuss with the doctor. Also, first chance you get make sure to test for FT3.
Hello Gimel,
I have my latest results. My TSH came in at 2.640, Free T4 at 1.03, and T3 at 89. Since they are all within normal range I have a suspicion my doc will not change my dosage. There's a high chance of slipping back into the Grave's disease if the meds are cut too much. I am going to ask, however, about getting those T3 and T4 levels a little higher, as per your advice. I will also ask about the free t3. Today I noticed that there was slightly less hair loss than usual. However, there was still way more than anyone should have to deal with. I will keep monitoring and keep hoping it will stop.
I have my latest results. My TSH came in at 2.640, Free T4 at 1.03, and T3 at 89. Since they are all within normal range I have a suspicion my doc will not change my dosage. There's a high chance of slipping back into the Grave's disease if the meds are cut too much. I am going to ask, however, about getting those T3 and T4 levels a little higher, as per your advice. I will also ask about the free t3. Today I noticed that there was slightly less hair loss than usual. However, there was still way more than anyone should have to deal with. I will keep monitoring and keep hoping it will stop.
No problem at all. I will get all the info on Monday and post then. Thank you, once again. In the meantime my doc has sent me a lab slip to get testosterone and vitamin levels checked. We are doing a complete CBC and iron levels, etc.
If not too much trouble for you, how about getting the T3 and T4 results, and reference ranges, and posting here.
Hello Stella, I looked into prim rose oil and am wondering what you know about it. It comes in capsules and in liquid form and can't really get a clear idea if anybody uses it topically. I keep finding things about Pantene Pro-V shampoo, and also about saw palmetto. Have you heard about these or tried any of them?
I got a call from the endocrinologist yesterday about my new test results and all was within normal range. She said all was normal and my TSH was 2.6. By the time we finished our conversation I hung up and realized we got side tracked from getting the t3 and t4 levels. The results are on their way, however, as I requested a copy. I do not actually see the doc until June. The endocrinologist is also sending me a new script for checking other various hormones, including testosterone, to try to get to the bottom of all of this hair loss. She is also checking me for B12 levels and iron, and checking for anemia. Lastly, she is running a vitamin d test, as I told her I have been deficient in the past. I will post my results from all as soon as I get them. I won't actually be getting the thyroid panel done again for another 8 weeks, but I will indeed request the free t3 test. Thank you again.
Sorry, forgot the link.
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
A couple of things for you to consider. For future testing, insist on Free T3, not Total T3. Total T3 is somewhat outdated and not as useful as FreeT3. Free T3 is the portion of total T3 that is not bound up with protein, which renders it inactive. FT3 is the most important test, as I detailed in prior post. Also be aware of this from my prior post. The ranges should be used as guidelines within which to adjust FT3 and FT4 to relieve symptoms. Again, symptom relief is the goal. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
Even though your T3 test is for Total, not Free T3, it is low in the range and consistent with being hypo. Your FT4 result is likewise low in the range and consistent with being hypo. If you look through the list of hypo symptoms in this link, do you have any others at this time besides hair loss?
As I mentioned, I am usually responding to patients who are taking T4/T3 type meds, rather than antithyroid meds; however, it appears that you need to discuss with your doctor further reducing your meds to increase your FT4 and FT3 levels, adequately to relieve hypo symptoms. A good target would be to get your FT4 and FT3 levels into the upper half of their ranges and then monitor for a while. I don't know how difficult it is to adjust, when taking antithyroid meds. Whatever adjustment you make, it would be a good idea to test fairly frequently until FT3 and FT4 levels are increased adequately and stabilized.
Also, don't forget the suggestions Stella made. I'm sure that right now you are willing to try that as well.
Even though your T3 test is for Total, not Free T3, it is low in the range and consistent with being hypo. Your FT4 result is likewise low in the range and consistent with being hypo. If you look through the list of hypo symptoms in this link, do you have any others at this time besides hair loss?
As I mentioned, I am usually responding to patients who are taking T4/T3 type meds, rather than antithyroid meds; however, it appears that you need to discuss with your doctor further reducing your meds to increase your FT4 and FT3 levels, adequately to relieve hypo symptoms. A good target would be to get your FT4 and FT3 levels into the upper half of their ranges and then monitor for a while. I don't know how difficult it is to adjust, when taking antithyroid meds. Whatever adjustment you make, it would be a good idea to test fairly frequently until FT3 and FT4 levels are increased adequately and stabilized.
Also, don't forget the suggestions Stella made. I'm sure that right now you are willing to try that as well.
Thank you gimel, for all of your insight. I apologize for not giving the complete labs, as it was my assumption it was the high TSH causing this. So here goes:
I was first tested 9/14/10. My levels were TSH less than .01 (undetectable)
free T4 3.1 (high)
Total t3 409..... (high)
and positive for TSI (Graves antibodies)
I was put on 30 mg of methimazole a day and retested on 11/11/10
TSH .01 (low)
free t4 0.8 (normal)
total t3 109 (normal)
The doctor made no adjustments to meds and had me retest on 1/28/11. Somewhere between these two tests I was not feeling well and started cutting my pills in half (after trying to reach his office with no response).
Test results (at this point had switched to 15 mg methimazole for a couple of weeks) for 1/28/11
TSH 17.340 (high)
free t4 .49 (low)
no t3 tested (don't know why)
An added note...I had had a bloodtest for my ob/gyn in the meantime and he tested TSH along with other "female" hormones. My TSH on 12/3/10 was .54
My doctor advised me to cut my meds in half after the January results. I told him I had already done that, so he adjusted to 10 mg a day. After a couple of weeks of that I still wasn't feeling right and my hair started falling out, so once again I tried reaching his office, with no luck. I cut the meds further on my own again, and then switched doctors.
With my dosage at 5mg a day for several weeks I had blood drawn on 3/1/11 with my new doctor.
TSH 4.82 (slightly high)
Free t4 .94 (normal)
T3 107 (normal)
So that's it in a nutshell. I hope you can help me further eveluate my hair loss situation. I have now been losing hair sice early February. I am in tears over it all the time, and I'm sure the stress of the hair loss is even causing more of it.
I was first tested 9/14/10. My levels were TSH less than .01 (undetectable)
free T4 3.1 (high)
Total t3 409..... (high)
and positive for TSI (Graves antibodies)
I was put on 30 mg of methimazole a day and retested on 11/11/10
TSH .01 (low)
free t4 0.8 (normal)
total t3 109 (normal)
The doctor made no adjustments to meds and had me retest on 1/28/11. Somewhere between these two tests I was not feeling well and started cutting my pills in half (after trying to reach his office with no response).
Test results (at this point had switched to 15 mg methimazole for a couple of weeks) for 1/28/11
TSH 17.340 (high)
free t4 .49 (low)
no t3 tested (don't know why)
An added note...I had had a bloodtest for my ob/gyn in the meantime and he tested TSH along with other "female" hormones. My TSH on 12/3/10 was .54
My doctor advised me to cut my meds in half after the January results. I told him I had already done that, so he adjusted to 10 mg a day. After a couple of weeks of that I still wasn't feeling right and my hair started falling out, so once again I tried reaching his office, with no luck. I cut the meds further on my own again, and then switched doctors.
With my dosage at 5mg a day for several weeks I had blood drawn on 3/1/11 with my new doctor.
TSH 4.82 (slightly high)
Free t4 .94 (normal)
T3 107 (normal)
So that's it in a nutshell. I hope you can help me further eveluate my hair loss situation. I have now been losing hair sice early February. I am in tears over it all the time, and I'm sure the stress of the hair loss is even causing more of it.
Keep in mind that if there is true Graves in this the thyroid could still be a problem and basing the whole treatment plan in just the TSH can be a stab in the dark for true wellness, as Gimel points out. You should get specific labs to really know where you are each time.
I ran into a very interesting article recently ( sorry, can't find the link right now) on deficiencies of minerals with hair loss. Magnesium was talked about heavily along with zinc and copper.
One relief many hair-loss thyroid patients find semi-helpful is using prime rose oil routinely to help. You can read about that and see if your situation fits in.
I ran into a very interesting article recently ( sorry, can't find the link right now) on deficiencies of minerals with hair loss. Magnesium was talked about heavily along with zinc and copper.
One relief many hair-loss thyroid patients find semi-helpful is using prime rose oil routinely to help. You can read about that and see if your situation fits in.
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TSH is a pituitary hormone that is affected by so many variables, that it is totally inadequate as the sole diagnostic for thyroid. At best it should be considered as an indicator to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, free T3 and free T4 (not the same as total T3 and total T4). The FT3 test is most important because FT3 largely regulates metabolism and many other body functions. Studies have also shown that FT3 correlated best with hypo symptoms while FT4 and TSH did not correlate.
A good thyroid doctor will treat a patient clinically, by testing and adjusting FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important for you, not test results. Test results are valuable mainly as indicators during diagnosis, and then to monitor FT3 and FT4 levels as meds are changed toward achieving symptom relief.
So I think you should request testing for FT3 and FT4, along with the TSH. If the doctor resists, then you should insist on it and don't take no for an answer. Remember that you are the customer. If you get these tests done, then the next thing to be aware of is that results that fall just within the lower part of the range do not mean that all is okay. The ranges are far too broad for that to be the case. The ranges should be used as guidelines within which to adjust FT3 and FT4 to relieve symptoms. Again, symptom relief is the goal. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
For most of us hypo patients, symptom relief comes from T4/T3 meds. Since you are a Graves' patient it is different, in that you are taking antithyroid meds. But the goal has to be the same, which is to get the FT3 and FT4 levels adjusted adequately to relieve symptoms.