rapid hair loss

[ccbldw]

In the last two weeks my hair has been falling out at an alarming rate. I see this every time I shampoo my hair. 10 weeks ago I started taking my Westhroid  once a day instead of dividing it into two doses.  Could this be the cause of my hair loss? Thank you for any help or opinions. The doctor who prescribed NDT did so at my request. He told me to take it once a day. I don't think that he is knowledgable enough about NDT to address this question. I have taken Naturethroid or Westhroid for years and have always divided my dose in half.

[goolarra]

You're very welcome.

One thing I should mention is that your TSH level could freak your doctor out.  Many of them believe TSH is the gold standard in thyroid testing, and go by that almost entirely.  However, thyroid meds, especially desiccated, with its high T3 content, often suppresses TSH, and it becomes useless as a tool in regulating dose.  FT3 and FT4 are a direct measure of thyroid status and should always carry more weight than TSH.  Of course, symptoms should trump all three.  

Best of luck with your doctor.  Let me know how it goes...

[ccbldw]

I was going to ask for the iron panel w/ferritin. I wanted to ask thyroid knowledgable people about the dosing before I discussed with my doctor. I wanted to go in armed with as much knowledge as possible ;-D
I'm so happy that I stumbled upon this website, what a great resourse for thyroid patients. I sincerely appreciate your advice and assistance. Thank you.

[goolarra]

Well, if your estrogen and testosterone have remained constant over five years, they are probably not the culprits, either.  

If I were you, I'd ask my doctor to increase my Westhroid a little.  Have you had an iron panel lately (to include ferritin)?  Low iron can also cause hair loss, and adequate ferritin levels are necessary for the metabolism of thyroid hormones at the cellular level.

[ccbldw]

For 5 years. My gynogologist has me on the next lowest dosage of estrogen and also testosterone, administed via subcutaneous pellets. I know that the testosterone could be the culpret with hair loss, but the suddenness of the hair loss makes me question whether it is the cause. I have an appointment in a few weeks with my GYN to discuss my October lab work. I am in my late 50's and I don't think that many women in their 50's and 60's know how much better testosterone can make you feel - energy and sense of well being. I hope that I don't have to give it up.

[goolarra]

Your FT4 is actually about the highest it's been.  So, FT4 probably isn't an issue.  Since starting 2 grains, your FT3 has been dropping, from 3.22 to 3.1 to 2.87.  It's gone from 47% of range down to 30%.  Estrogen is a thyroid hormone antagonist, so you might have to increase your dose a little to compensate.  How long have you been on the estrogen?  

[ccbldw]

Previous labs:
All test from same lab
August 2012, prior to changing doctors, taking 1Grain of  naturethroid/day

TSH  0.508
free T-3  2.04
free T-4   0.61
antimicrosomal  antibody <10  [<35 }
anti-thyroglobulin              <10. [<40]

July 2013 - changed doctors now on 2grains of WP thyroid

TSH - 0.055
free T3. 3.22
free T4.  0.87

Dec 2013

TSH - 0.044
free T3. 3.10
free T4. 0.65

Another part of the equation- I am on a low dose of bio-identical estrogen.
Thanks for taking a look!

[goolarra]

Both your FT3 and FT4 are on the low side.  FT4 is at 33% of range, and 50% is the guideline there, although it's often hard to achieve that on desiccated.  However, FT3 often has to be upper half to third of range on desiccated, and yours is only 30% of range.  

I'm wondering if a little increase might help.  Do you have previous labs to see it there's a trend?

[ccbldw]

TSH - 0.051. (0.340 - 5.600)
Free T4 0.97 ( 0.68 - 1.57 )
Free T3 2.87 (2.3 - 4.2 )

Lab report from 8-27-14, I always test before taking NDT
Started once a day dose 10-12-14

I really appreciate your feedback. My doctor is a nice person and open minded, but not knowledgable enough about thyroid to weigh in on this situation.  

[goolarra]

Most people split the dose.  If you take it all at once, there's an initial "rush" (which could explain the anxiety and palps), then a letdown later in the day (which could also explain the anxiety, palps and hair loss).  My guess is it's not the dump into your system of the T3 that's causing the hair loss, but the letdown later in the day which will leave your FT3 low until your next dose.

I think you were wise to go back to splitting.

Aside from that, are your FT3 and FT4 levels good?  If you want to post them, please include reference ranges because they vary lab to lab and have to come from your own lab report.  .    

[ccbldw]

No change in brand of NDT, on Westhroid for several years 130mg. The only change was in dosing. I started taking the 130mg once a day instead of splitting in half and taking twice a day. No change in daily total, but could this bigger dump into my bloodstream be causing the hairloss? I have switched back to twice a day dosing. Only symptoms other than hair loss have been, anxiety and some palpatations. Thank you for your reply!

[goolarra]

You know what works for you...go back to doing it the way you've always done.  The T3 in Westhroid is very fast-acting, so if you only take it once a day, your FT3 level is probably quite low for a good part of the day.  

What and how much were you taking before the switch to Westhroid?  How much Westhroid are you taking now?

Any other hypo symptoms creeping back?