Thyroid Disorders Community
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Avatar universal

Hair loss from Levothyroxine

I started out on 25mcg Levothyroxine. Felt great about the 2nd month in, after the 3rd mo, I started feeling as exhausted as before.  Had blood work done again and the Endo doc said my #was still a little lower than she'd like, so she put me on 50mcg Levo. I feel no better whatsoever.  Pathetically drained, no energy, always tired, and NOW I am experiencing large amounts of hair being shedded in the shower especially.  It is disturbing how much is lost in the shower.  I can feel that the volume of my hair has been lost and it also feels like straw, it also isn't curling and defining as good as it used to (I have naturally curly hair).  I am not at all happy with this and am just afraid it will keep getting worse.  On the insert of the meds it says hair loss is a side effect but should stop once you become accustomed to the meds.  Well, 8 months later, still losing hair just as rapidly.  My Endo doc said this is a side effect and thought nothing more of it.  She also only treats based on TSH and T4 numbers.  She does not want anything to do with T3 and I am sure would not prescribe the natural thyroid meds which I don't even know if it would matter or not, and finding a doctor who will is also an issue.  I am seriously considering taking myself off the meds since I feel no improvement AND now that I am losing so much hair everyday.  I am convinced that my fatigue is thyroid because why would have I felt so great for one month when I started the meds if it wasn't doing something?  I have been tested for vit levels,sugar, etc. and everything is normal.  My recent TSH test came back normal as well.  I am starting to get very upset reading peoples comments about their hair loss from this medication.  I was NOT losing hair until I started on this medication about 3 months in, right around when I was feeling worse again.  I can't seem to find a doctor who will really help and I am getting so upset!  Helppppp!!!
57 Responses
Avatar universal
The active ingredient in Synthroid is a synthetic form of T4 just like all other T4 meds. The only difference among them is the filler/binder/dye.  Usually loss of hair is due to low thyroid hormone levels, especially Free T and Free T3, not the med itself.  

When hypo patients start on meds, frequently the serum levels do not increase, until the dose is increased several times.  You could know a lot more if your doctor was testing as he should, Free T3 and Free T4.  Members, myself included, say that hypo symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range.  Since hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin, you should make sure to have those tested as well.  Ferritin especially because low levels can also cause hair loss.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and  Free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  I think you can get some good insight from this link, written by a good thyroid doctor.


When you seek your doctor it would be a good idea to have a discussion about expanding tests and also about clinical treatment.  If the doctor is unwilling to do those, then you will need to find a good thyroid doctor that will do so.  
Avatar universal
Do you know the cause of your hypo, i.e. do you have Hashi's?

Please post whatever lab results you have and include reference ranges.  Ranges vary lab to lab and have to come from your own lab report.

Hair loss is a symptom of hypo.  Despite increasing to 50 mcg, the worsening of your other symptoms coincided with your hair loss, indicating that you were not sufficiently or properly medicated..  If your doctor won't test FT3, you should find one who will.

Where are you located?  One of our members maintains a list of doctors recommended by forum members.  We can see if there's someone in your area.
Avatar universal
Thank you for your response.  What do you mean by clinical treatment?
Avatar universal
Thank you so much for responding. Also thank you for asking for my labs and what to include.

I have no idea the cause.  My main issue was the tiredness, no energy at all, tired constantly, along with various other symptoms that definitely run in line with hypothyroidism.   I was told the test for Hashi's was normal (thyroid peroxidase AB = <10  ).  Also, I did have a sonogram and they saw a very small 4mm (I think?) mass.  Said it was too small to biopsy and will check it again in a year.

Please be aware, that I had NO hair loss at all until I was about a month in on the Levo meds.  And it has been increasingly been coming out ever since.  

I am located right on the border of NY, NJ, & PA.  Zip code 12771.  Port Jervis, NY.  I am finding that most doctors either don't take my insurance, or the ones that do only treat and test with TSH and T4.  A couple that I did look into who seem to be other types of doctors, and who do not even take insurance, and charge way too much for the average person to be able to afford.  

My results are as follows:


Cortisol 20.9(H)     ref:  a.m. 4.0 - 22.0 mcg / p.m. 3.0 - 17.0 mcg
Free T4 0.97         ref:  0.78 - 2.19
TSH 3.080            ref:  0.470 - 4.680
B12 331               ref:  239 - 931
VitD 42                ref:  30 - 100

9/23: (same reference ranges as above for all results)

Free T4  0.87
T3, Total  94        ref:  76 - 181
TSH 4.230


TSH  0.940

I am scheduled to see another doctor this week, on 1/23.  I know he isn't one who "believes" in doing all of the tests either, but for around here, he is suppose to be one of the better doctors.  If you have any other information for me that I can go in there with I would appreciate it.   I am still abnormally fatigued, cannot get through the day without sleeping for a few hours and in general, have no energy, and my hair IS still shedding abnormally which is more upsetting than anything else.  If I do not like what this doctor has to say or does, I may take myself off this medication totally because I am not feeling any better and i'm losing hair.  AT least before, yes I was feeling like this before the medication, but I still had all of the volume in my hair and wasn't losing it like this.  Thank you !!  May I ask how you are connected to this site, doctor, the site's administrator, or a thyroid patient??

Avatar universal
Also, thanks for that website link.  A lot of info on there.  Appreciate that!!
Avatar universal
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and  Free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels.
Avatar universal
I understand that you didn't start losing hair until a month into meds.  When we start meds, we often get a little more hypo for a while, until we find the dosage that is right for ups.

Was it after the 7/16 labs that you started meds, or were you already on them then?  As you can see, by 9/23 your FT4 had continued to drop, so you were becoming more, not less, hypo.  FT4 was very low in the range.  Rule of thumb for FT4 is midrange.  You have never been properly medicated.

If those are your latest labs, you also haven't been tested for anything but TSH in nearly 4 months.  That's much too long if you're still struggling with symptoms.  

I'd ask my new doctor to test FT3, FT4 and TSH every time you have labs.  I'd also ask him for an increase.  

Has anyone gotten back to you with names from the doctors list?

I'm going to be offline most of today due to computer maintenance.  I'll catch up with you tomorrow.  

Avatar universal
I started the meds on 25 mcg in July.  I think the tests were actually done late June and I started the meds around that date in July.  By late July I was starting some extra hair loss, not significant, but I saw more than usual.  Within 3 months on the meds I was losing a whole lot more and it hasn't stopped. I get confused reading the results because they seemed to have fluctuated so much (at least the TSH) that I'm not even sure what is normal and what isn't and what is going on exactly.

That is worrisome to read I became more hypo, not less.  Is that BECAUSE of the meds that I became more??  And what does that mean exactly?    My general doctor is the only one who ordered the FT4.  The endo docs (I have seen 2 in this time frame) weren't the ones who even ordered the FT4.

Those are my latest labs.  I go for another lab from the Endo doc next week, although I do not know exactly what the tests will be for.  I know that I have ASKED her to test me for T3 but she will not.  She says it doesn't show anything, or have anything to do with the TSH, which is what she goes by, and this is what the other doctor said as well.  

The first set of tests in June/July were ordered by my first endo doc and she said I may be borderline hypo with early symptoms of it which may be why i was experiencing some symptoms, so she put me on 25mcg Levo. My second set in Sept. were run by my general doctor because that was when I was starting to feel really tired again after about a month of feeling much better., and they are in the same practice so he could order the tests too.  His letter to me stated that my results were normal.  Although I did have an appt. with another Endo doc in that same practice right after that, and she is the one who upped my dose to 50mcg.  And she is the one who ordered the recent TSH test and auto immune test in Dec., and I got a letter from her saying my results were normal and nothing else was done or changed.

So is the Total T3 that my GP doc ordered the same as Free T3 as you suggested to have?  As you will see by the dates I mentioned, neither of Endo docs ordered any kind of T3 for me.  My GP doc is the one who did.  But I don't think I can rely on him for help because he did refer me to an Endo doc if I still wasn't feeling well after those results came back  :(

Obviously, if they won't order the T3, they also won't know how to treat me.  Pretty scarey if you ask me.   As far as increasing my Levo....that petrifies me because I am so scared that will make me wind up losing even more hair and I have already lost enough.  I am talking I am petrified of that.  Other people have suggested to me to ask for Armour or other names NDT meds.  I don't even know that that's what I need---T3 as well as T4, but I need to find someone who can tell me this.  I have also been told using both might help with losing hair like I am, and also that they fillers and artificial binders in the Levo meds might be causing the hair loss.  I have read that it is a side effect, as in a bad side effect where your body is not reacting properly with the medication and should not be chucked off as oh well, it's just a side effect of the meds pretty much like my Endo has done when I told her about it.  Makes me very angry actually. That is why I wanted to suggest to this this doctor when I go on Thurs. that I stop the meds if it means I can't feel any better and i'm losing hair with no real results anyway.

I have an appt. in April with a doc I found in Fishkill NY who takes my insurance and who will supposidly order T3, but as far as whether she knows how to read it and treat it correctly, I just don't know.  The office staff wasn't too encouraging when I asked them about it.  It is Mid Hudson Medical Group.  Meryl Reichman was the name I was given, but she is not accepting new patients so they referred me to Delia Stefan in the same group.   ??  So I have no idea??


Avatar universal
2ND paragraph in, I meant T3, not T4.  And I mentioned that same statement in another paragraph as well...sorry.
Avatar universal
Also, if I were to get the proper diagnosis and treatment, do you think my hair will go back to how it was?  My mom doesn't seem to think so.  She says when things like that go, you usually dont get them back.  I have read both yes and no on it from other people.  Which is my reasoning why I am afraid to go up with the dosage and if I went off the meds,, wouldn't my hair start filling back in to how full it once was??  It upsets me every minute of the day to know how and feel how the pretty fullness and volume that has always been there and I've always gotten compliments on is gone, and especially when the medication is basically helping with nothing .
Avatar universal
Just wanted to comment on your statement that, "I go for another lab from the Endo doc next week, although I do not know exactly what the tests will be for.  I know that I have ASKED her to test me for T3 but she will not.  She says it doesn't show anything, or have anything to do with the TSH, which is what she goes by, and this is what the other doctor said as well."

Any Endo that says that is just exposing her lack of knowledge about hypothyroidism and its effective treatment.  I would not waste another minute with those doctors.  
Avatar universal
From what I read I totally agree, it's just finding one that will do it and knows what they are doing with it, and who will take my insurance  :(
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