Eyelash Loss an early symptom?

[merry39]

Not sure if I'm in the right area-my 10-year old daughter has lost her eyelashes 3 times in one year!  She has seen her PCP twice, a dermatologist, and an opthamologist, and the final answer we are getting is "we don't know."  I am frustrated, she is devastated, and I feel it is up to me now to get more information.

She has had her thyroid checked by derm. and opth., as well as ASA and serum calcium.  All "normal", whatever that means.  Pulling them out has been ruled out, due to the consistency of the location (exactly the same central segments on both lids each time with the same few remaining), no inflammation, and sudden loss (within a day or 2).  Also, no one has ever seen her pullling them including teachers, and she is rarely alone!  Any kind of infection or parasite has also been ruled out.  She is not currently on any meds.

In my reading, I am seeing that this can be an early sign of hyperthyroidism.  Is it possible that thyroid issues don't show up on the bloodwork?  She also seems to have some of the other symptoms (has been dx w/ADD), and is often tired with dark circles under her eyes despite getting enough sleep.  I know these symptoms are vague, though, so I don't want to jump to conclusions.

I am about to call her PCP again- should I request an endocrinology referral? I feel like I am just being a hypochondriac.  If it didn't bother her, I probably wouldn't be pushing, and would take "we don't know" for an answer, but it is definitely noticeable, and bothering her.  I don't know what else to tell her.  She used to have gorgeous full, LONG eyelashes (and still does on most of her eye), so this is more upsetting than you might think, though we are keeping it in perspective...

Any info would be great-thanks!!

[gimel]

Most doctors treat their hypo patients with T4 meds.  That is fine as long as the T4 is adequately converted to T3.  If not, then T3 meds are needed, such as Cytomel and Armour Thyroid (contains both T4 and T3).  It is no risk to try these meds.  If optimal levels don't relieve symptoms then it is not a problem to just wean yourself off the med and things will return to prior status.  

You can get some info on low cortisol from this link.

https://blog.udemy.com/low-cortisol/

Yes, if cortisol is very low, it is often treated with low doses of hydrocortisone multiple times during the day.  Also, if very low it is recommended to raise the level before starting on thyroid med.  

[ingeb]

Thank you so much! Very comprehensive information. I´ll consult my doctor about all this tomorrow and ask for cortisol tests and more thyroid tests/ medicine to raise T3/ T4 levels.

[ingeb]

I have had my cortisol levels tested this week as GIMEL suggested. Iĺl have the test results in a couple of weeks. What can be done of cortisol/ adrenaline levels are out of balance? (I already do stress management/ therapy etc.). Is there any medicines that can balance cortisol levels out since you mentioned I need to get them checked?
I hope you can help. Your replies is of great value.
Best, Inge

[gimel]

Your TSH is relatively low in comparison to your Free T4 and Free T3 levels.   FT4/FT3 move in opposite direction from TSH.  When FT4 and FT3 are lower than needed, the pituitary puts out more TSH to try and stimulate the thyroid gland to produce more T4 and T3.  With primary hypothyroidism (Hashimoto's), the gland is unable to produce adequate thyroid hormone and the TSH rises in an attempt to stimulate more production.  With central hypothyroidism it is due to a dysfunction in the hypothalamus/pituitary system and there is insufficient TSH response to low levels of FT4 and FT3.   So they are quite different, yet both result in hypothyroidism.  

TSH does not cause symptoms, it merely stimulates the thyroid gland to produce hormone.  You cannot adjust TSH independently.  It changes due to changes in the FT4/FT3 levels.  So TSH is only a fair indicator of the status of the thyroid system.  Symptoms are far better indicators along with FT4 and FT3 levels.  

Your eyebrow loss is different from what we usually hear about; however, your FT4/FT3 test results point toward hypothyroidism and you also have other symptoms that can be related to being hypo.  So, I think you need to discuss with your doctor the possibility of central hypothyroidism and the need for a therapeutic trial of thyroid medication adequate to raise your FT4 to the middle of the range and your FT3 into the upper third of its range.  

Your ferritin level is good, as is your Vitamin D.  B12 is best when in the very upper end of its range.  So  you need to supplement with B12 to optimize.  

Your symptoms and test results also make me wonder if you could also have a cortisol deficiency.  I think it would be worthwhile to ask your doctor to test for cortisol.  The best test is a diurnal saliva (free) cortisol test taken at 4 times during the day.   Most doctors won't do that test, and instead run a morning serum cortisol test, which is total cortisol and not nearly as revealing as the saliva tests.

[ingeb]

Thank you for fast & thorough responses and quick replies.

What kind of medicine do I have to take to rise T3+T4 levels? And is this the kind of medicine who when you start taking it you can never again stop taking it?(because the body stop producing it itself when this medicine is first taken). Would´t it be a risk for me to start on this medicine in that case? (in case its not SURE i have thyroid problems, then I would have started to take medicine that I can never stop taking that I should not be on/ not able to quit it again). I mean then I guess I can't try taking the medicine as a "test" to see if I get better?
What is your thoughts around this?

I have also been wondering about cortisol levels myself. Since I have constant heartbeat my assumption was that cortisol levels was too HIGH (not low as you indicate). Because I thought high cortisol led to increased release of adrenaline that gives heart rush and high/ flight responses (followed by fatigue because the body will always be on "high" gear). Are the same symptoms triggered BOTH by too low and too high cortisol levels? Do low cortisol really give symptoms of racing heart etc?

What can be done if my cortisol levels are too low/ high. Can this be medicated? I thought it could not.

Thanks a lot!!

[gimel]

From those test results your Free T4 is only at 8 % of its range, and your Free T3 is only at 30% of its range.  Your Free T4 is very low and it appears that your body is attempting to maintain thyroid function as best possible by converting more T4 to T3.  With your symptoms those test results are strong indications of being hypothyroid.  The relatively low TSH only seems to indicate the possibility that it is central hypothyroidism, which is a dysfunction in the hypothalamus/pituitary system that results in insufficient TSH to stimulate the thyroid gland.  

Due to the erroneous assumptions used to establish the FT4 and FT3 ranges, just being in the low end of the ranges does not mean that all is okay.  Many of us have found that to relieve symptoms takes a FT4 at the middle of the range at minimum and a FT3 in the upper third of its range, or as needed to relieve symptoms.

So you need to find a doctor that will recognize your hypothyroidism and adjust your Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important not just test results.  

You also need to get your Vitamin D up to about 55, and your B12 into the very upper end of its range.  I also recommend testing for ferritin.  Low ferritin can cause symptoms including hair loss.  Ferritin should be about 70.

[ingeb]

Thanks for you thought reply, seems like you know a lot about this.

I´m going to my doctor again tomorrow and will have him to have a second glance at my test results. What supplements/ medicine do I need to get T3+T4 on suggested levels?

You say my TSH is relatively low, what is a normal/ suggested TSH?

My ferritin is checked, it is 85 (range is 15-200). Is this ok?

My D-vitamin is 92 (range 50-150).
My B12 is 275 (range 170-650).

Do I need both B-vitamin and B12 to get higher?

Thanks so much for your help.

[ingeb]

Ps Could you explain why you read my TSH to be "relatively low". Is around 50% on the range "relatively low"? Should it be between 3-4 (instead of 2,1) to be in the upper range/ healthy? What would be a good-very good level on TSH (to have symptom relief)?

[ingeb]

And my last question. Does not my eyebrow loss seem different from eyebrow loss caused by thyroid issues? My brows are almost gone from a medial point (almost gone closest to the nose and under part), while they are fuller by the outer parts. The loss is also diffuse (thinning all over the brow). I thought eyebrow loss caused by thyroid issues caused eyebrows fall of on the outer parts (opposite from mine)? Have you ever heard of someone with a thyroid disorder with a similar eyebrow loss as mine?  

[gimel]

Yes, as I mentioned, treatment with low doses of hydrocortisone multiple times during the day, along with adequate DHEA-S to offset possible side effects of cortisol.

Have you discussed with the doctor your low levels of thyroid hormone?  

[ingeb]

And my autoimmune tests came back clear, except S-ANA = positive (should be negative). But my doctor says many people without a autoimmune disorder test positive on this one because it is "unspesific" she said.

[ingeb]

My other symptoms are chronic heartbeat/ panic attack (due to constant adrenalin rush I think), fatigue > both these gives me depression/ irritation/ anxiety + the eyebrow loss described over.

[ingeb]

Thanks for your fast reply.
My thyroid test results are (I'm Norwegian so excuse me if I'm not using the correct medical term in English):

S-TSH: 2,1 (reference 0,2-4,0)
S-free-T4: 12,1 (reference 11-24)
S-free T3: 4,4 (reference 3,5-6,5)
Homocysteine: 6,8 (reference 5-15)
Metylmalon: 0,15 (reference < 0,30)

[gimel]

Please post your thyroid related test results and reference ranges shown on the lab report.  What other symptoms  do you have?

[ingeb]

Updates on your condition?? Did you find out? Id love to hear updates..

I have lost my eyebrows slowly over several years. Now, the right one is nearly gone and left one starting to disappear. They are thinning from the nose and outwards. I have been to several doctors and they all just say they have never seen anything like it, and that they dont think it is Alopecia or telogen, because I only loose eyebrow hair (none on the head+ not in spots, but diffuse). Doctors have checked all; vitamin levels, thyroid tests etc..all come back clear. I have been under MAJOR stress for several years (with almost constant heartbeat/ adrenaline rush + following fatigue. I wonder if this can be the reason for the hair loss? My other assumption is some autoimmune disorder. Doctors checked for it, autoimmune tests came back clear, except one of the "general autoimmunes»that came back positive, but my doctor said also many people without a autoimmune disorder got a positive result on that one. I take no medicine, otherwise healthy (except the fatigue and heartbeat/ adrenalin rushes), low on B12 and D-vitamin, but take supplements. Any experiences/ ideas what is wrong with me? Is this due to stress? Have any experienced regrowth after years of thinning brows? Should I try to get a further check for autoimmune disorder?

[Guidancecounsler_05]

Hi, I know this is a little late but I have fourteen year old daughter with the EXACT same symptoms. It started with her eyelashes falling out when she was 11 her doctors told me it was tricotillomania (pulling of the hair). Two years later she began have problems focusing and her heart would randomly increase. We took her to a cardiologist many times and they found no issues she had bloodwork done but they kept coming back as "normal" finally I went ahead and scheduled an appointment with an endocrinologist they did a full blood routine and one test that checked for an enzyme. That enzyme test came back positive and it was determined she had stare thyroid condition called " hashimotos syndrome" this is very rare in children but it was relief to find after 3 years of trying to figure out what was wrong she is now fine and back to cheering lacrosse and field hockey just as before. As far as her eyelashes they have almost all grown back LONGER and fuller than before. She app us Vaseline to her eyes every night before bed. She had to take a very small pill once day for the heart issues because she had to go to the er twice for those issues once that finished, her thyroid had finally quit and they started her on a syntroid pill that regulates her metabolism. Her main concern was that she would gain weight because she has a poor diet and would always eat but could never work out she only gained around 6 pounds and lost it almost a month after getting back to sports. She is now  5'2 and weighs around 95 ponds. I hope this helps and relieves any concerns you or your daughter may have.(:

[ingeb]

Any updates on your daughters condition? Did all hair grew back?

I have lost my eyebrows slowly over several years. Now, the right one is nearly gone and left one starting to disappear. They are thinning from the nose and outwards. I have been to several doctors and they all just say they have never seen anything like it, and that they dont think it is Alopecia or telogen, because I only loose eyebrow hair (none on the head+ not in spots, but diffuse). Doctors have checked all; vitamin levels, thyroid tests etc..all come back clear. I have been under MAJOR stress for several years (with almost constant heartbeat/ adrenaline rush + following fatigue. I wonder if this can be the reason for the hair loss? My other assumption is some autoimmune disorder. Doctors checked for it, autoimmune tests came back clear, except one of the "general autoimmunes»that came back positive, but my doctor said also many people without a autoimmune disorder got a positive result on that one. I take no medicine, otherwise healthy (except the fatigue and heartbeat/ adrenalin rushes), low on B12 and D-vitamin, but take supplements. Any experiences/ ideas what is wrong with me? Is this due to stress? Have any experienced regrowth after years of thinning brows? Should I try to get a further check for autoimmune disorder?

[diazmommy]

Have you looked up alopecia areata? Due to an autoimmune issue........this happened to me at age 21.  Then several years later I was diagnosed with Hashimoto;s. Right now I just had a relapse after 9 years and it moved to my eyebrow. I have lost a good bit of hair and have to pencil it in.

My dermatologist indicated that it was alopecia areata due to my thyroid condition however I understand you can have it without thyroid issues.  The only thing that worked is actual steriod injections into my eyelid 9 years ago and that HURT but he hair came back and it stopped. Dermatologist are very hesitant to do this though----right now they are making me try protopic to get the hair to grow back (cream steriod).  Not working! It is frustrating. Good luck!