I always had very thick curly hair. Around the age of 30 I started noticing my hair clogging the shower drain from time to time. However since I still had so much hair, it wasn’t high on my personal list of worst hypothyroidism symptoms.
Then all of a sudden one close look in the mirror last year at age 43 changed all that.
As I was brushing my hair something caught my eye in the mirror.
Wait…is that my scalp showing through?
A closer look.
My hair was noticeably thinner on both sides of my head above my ears, front, and at the temples.
My gut reaction was a scream, then tears.
What happened to my hair?
Hey Thyroid, Do NOT mess with me.
I went into deep research mode, searching for every article I could get my hands on related to thyroid hair loss.
I was determined to save my hair…
AND I DID IT.
Now my hair appears fuller, far less scalp shows through, baby hair has grown back at my temples, and the rate of hair loss has dramatically slowed down. I’m so thankful. Yes I know that may sound vain to be focused on my physical appearance but losing my hair was devastating to me. I have a feeling I’m not alone.
It took over one year of research, extensive lab testing, and trying various supplements to write this article (plus a fierce determination to get my hair back), so yes this article is lengthy.
(An incredible thing happened when I first posted this article on my Hypothyroid Mom Facebook page on November 6, 2014 at 3:50PM ET. So many followers tried to access this article that we crashed the server by 4:00PM ET. What a powerful group of Facebook followers gathering on my page capable of crashing the server within 10 minutes.)
Please note that I am not a doctor. I’m just sharing the ten things that worked for me in the hopes that you will discover what works for you too. I’ve included links to brands of supplements that I personally take. As with all things in particular supplements mentioned at Hypothyroid Mom, consult with your doctor to be sure they are right for you and that you are taking the right dosage for your body. Our physiology is unique so what works for each of us will be unique too. Always consult with your doctor before taking supplements if you are pregnant or breastfeeding.
1. Optimal Thyroid Treatment
Every part of the body requires thyroid hormone for proper functioning, and that includes the hair follicles. In 2008, the Journal of Clinical Endocrinology and Metabolism presented the first evidence that human hair follicles are direct targets of thyroid hormones. This research demonstrated that the thyroid hormones T4 and T3 modulate multiple hair biology parameters from cycling to pigmentation.
You’ll notice that I bolded the words thyroid hormones T4 and T3. Why is this so important for those of us with hair loss?
In mainstream medicine, Levothyroxine drugs are the gold standard for the treatment of hypothyroidism. While these drugs work for some people, they fail for others. Levothyroxine drugs contain T4 thyroid hormone only. Our bodies are supposed to convert that T4 thyroid hormone to the active T3 hormone our cells need. For some of us our bodies don’t convert T4 to T3 properly, leaving us symptomatic. This is why many of us do better on a combination of T4 and T3 thyroid hormone replacement treatment.
The noticeable hair loss was a red flag for me that I needed to get to my doctor for thyroid testing. I’m on the natural desiccated thyroid Nature-throid plus a compounded time-release T3. My doctor did comprehensive testing including the essential thyroid tests TSH, Free T4, Free T3, Reverse T3, and thyroid antibodies. Turned out my Free T3 was middle of the range. I personally feel terrible when my Free T3 is low or even middle of the range. Optimal Free T3 for my body is when it reaches top quarter of the normal range, so adjusting my thyroid medication dosage was an essential piece to my thyroid hair loss. What is optimal is individual and it’s about finding what’s right for you.
There are many different thyroid medication options. Finding a doctor open the treatment options to find what is right for you is key. Sadly not all doctors are open to the options and it can be a very frustrating journey. I’ve put together resources to help readers locate great thyroid doctors across the globe. Given that comprehensive testing has been important in saving my hair I will include links in this article to lab testing you can order on your own in case your doctor refuses.
A trusted online place where you can order lab testing yourself is True Health Labs. They have comprehensive thyroid assessments that include TSH, Free T4, Free T3, Reverse T3, thyroid antibodies and more. The advantage of True Health Labs is that they offer one-on-one results review with one of their Functional Medicine doctors so that you understand your lab test results and next steps. If you have a Flex Spending Account (FSA) with your employer, all lab tests ordered online at True Health Labs are FSA-friendly!
Use coupon code Limited_5 for 5% off all orders for Hypothyroid Mom fans.
Comprehensive Thyroid Assessment for USA (not available in NY, NJ, MA & RI)
Comprehensive Thyroid Assessment Kit for Canada (this kit can also be used in the USA except in NY, helpful if you are not near a Quest draw center, reside in a rural area, or live in Canada)
Comprehensive Thyroid Assessment for Europe
While optimal thyroid treatment was an essential piece of the puzzle, there were additional pieces critical to my hair loss solution.
2. Low Ferritin
Low ferritin (the stored form of iron) is one of the most common causes of hair loss in women. Given low ferritin is also a common problem for hypothyroid people, it is important to have iron testing including ferritin especially if you are experiencing hair loss. It is not enough to be told by your doctor that your iron levels are ‘normal’. Ferritin levels are not always tested. Get a copy of your lab results and be sure ferritin has been specifically tested. Even if ferritin is within the ‘normal’ range that doesn’t make it ‘optimal’.
Dr. Philip Kingsley is called the ‘Hair Guru’ by the New York Times. Why Is Ferritin Important? appears on his website:
Correct ferritin levels maximize your hair’s “anagen” or “growing” phase and encourage your hairs to grow to their full length. When you aren’t getting enough iron through your diet, your body takes ferritin stored in non-essential tissue, like your hair bulb, and gives it to essential tissue, such as your heart. Because your hair bulb is where all your hair cells are produced, this leeching of ferritin can cause your hair to shed before it reaches its maximum length.
The average reference ranges for ferritin are 14-170 micrograms per litre, but our research shows that ferritin should be at least 80 ug/L(micrograms per litre) in women for hair follicles to function at their best.
Treating low ferritin was another major piece of my hair loss solution. It’s not surprising to me at all that I had low ferritin given the decades I spent with irregular heavy menstrual cycles (which is another symptom of hypothyroidism by the way) and my doctors all those years never tested to see if I was low.
I tried various iron supplements and many of them gave me digestive issues including gas, stomach cramps, and constipation. With a life-long history of constipation, that was the last thing I needed. I have personally found that iron in the form of liver concentrate such as the brand Carlson Labs Buffalo Liver works well for my body. My doctor regularly checks my iron levels including ferritin to be sure I am taking the right dosage of iron supplements for my body and that I’m not taking too much because over-dosing on iron can be dangerous.
I’m careful to take iron supplements including multivitamins with iron at least 3 hours apart from my thyroid medication to ensure the iron doesn’t interfere with the absorption of my thyroid medication.
True Health Labs offers this Iron Test Panel for US (not available in NY, NJ, MA, RI).
3. Low Stomach Acid
I read a fascinating interview with Dr. Jonathan Wright by Suzanne Somers Honey, I Shrunk My Ponytail! Turns out this article would change the fate of my hair.
DR. WRIGHT: If stomach acid is low, protein isn’t efficiently digested – and hair and nails are made up of… protein! If we are deficient in protein, our bodies know that we can live without hair or nail proteins, but we can’t survive without heart muscle proteins or other important body proteins. So if we are short in supply of protein, the hair or nails are the first to go.
Turns out low stomach acid results in malabsorption of iron (which as you know is necessary for maintaining our hair) and many other essential nutrients. Thanks to this article I discovered my own issues with low stomach acid and now take this Betaine Hydrochloric Acid with Pepsin just before heavy meals. This has also helped me personally with heartburn, gas, acid reflux, and bloating.
There are two additional ways that I increase my low stomach acid. Every morning before breakfast I drink warm water and lemon. Before the larger meals of the day I take 1 tablespoon of apple cider vinegar in water. I use Bragg’s Apple Cider Vinegar. This raw organic apple cider vinegar contains the ‘mother’ of the vinegar. The ‘mother’ is made up of beneficial living nutrients and bacteria.
4. Nutrient Deficiencies
Nutrient deficiencies are a common issue for those of us with hypothyroidism. Not only are nutrients essential for thyroid function, but they also play an important role in keeping the hair on our heads from falling. A good quality multi-vitamin is important and of course a healthy diet is essential, but still nutrient testing is important because many like me will require additional supplementation to bring us to optimal. Testing should include iodine, zinc, vitamin D, B12, and magnesium (for each nutrient listed I attached an article that explains its connection to hair loss).
Nutrient deficiencies are an issue for me personally. I supplement every day to maintain my nutrients at optimum. When I noticed a worsening of my hair loss last year, nutrient testing revealed that I was deficient in all those nutrients necessary for hair health.
5. Drug-Induced Hair Loss
There are many different types of drugs that can cause hair loss. Here is a list of What Types of Drugs Cause Hair Loss by WebMD:
- Acne medications containing vitamin A (retinoids)
- Antibiotics and antifungal drugs
- Birth control pills
- Anticlotting drugs
- Cholesterol-lowering drugs
- Drugs that suppress the immune system
- Drugs that treat breast cancer
- Epilepsy drugs (anticonvulsants)
- High blood pressure medications (anti-hypertensives), such as beta-blockers, ACE inhibitors, and diuretics
- Hormone replacement therapy
- Mood stabilizers
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Parkinson’s disease drugs
- Thyroid medications
- Weight loss drugs
Did you notice that I highlighted thyroid medications on that list?
I’ve heard from many readers who had sudden worsening of their hair loss when they started one or another thyroid drug brand. Think back to the start of your hair loss, did it happen at the same time you started a specific thyroid medication?
Recently I was a guest on a Gluten-Free Twitter Chat devoted to thyroid hosted by Jennifer Fugo, founder of Gluten Free School. Fellow guests included thyroid disease expert Mary Shomon and Naturopathic Doctor Dr. Kevin Passero from Green Healing Wellness Center. Mary is author of the book Living Well with Hypothyroidism: What Your Doctor Doesn’t Tell You…That You Need to Know. Here is an important Tweet she made about hair loss.
6. Alopecia Areata
Alopecia Areata is a hair-loss condition that typically causes patchy bald spots on the scalp. It is an autoimmune disorder in which the immune system attacks the hair follicles.
What does this have to do with hypothyroidism? A lot.
It is estimated that 90% of people with hypothyroidism have the thyroid autoimmune condition known as Hashimoto’s Thyroiditis. Hashimoto’s is an autoimmune condition in which the body attacks its own thyroid gland. Despite the prevalence of Hashimoto’s, thyroid antibodies are often NOT tested. You may have Hashimoto’s and not even know it. There are two thyroid antibodies to test for Hashimoto’s: Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).
When you have one autoimmune disease, you are at high risk of developing other autoimmune diseases. In her guest post for Hypothyroid Mom Autoimmune Diseases Brew In Your Body FOR YEARS Before Diagnosis Functional Medicine nutritionist Tracy Konoske wrote:
Dr. Gerald Mullin from Johns Hopkins says statistically somebody with an autoimmune disease is at risk of a total of 7 autoimmune diseases in his or her lifetime.
I hear from readers all the time with multiple autoimmune diseases including Hashimoto’s and Alopecia. If this turns out to be the cause for your hair loss, it is important to address the underlying autoimmune issue.
7. Sex Hormone Imbalances
Perimenopause…are you freakin’ kidding me?!
The signs were there. My menstrual cycles changed very suddenly and became much shorter in length. At that exact same time my hair loss accelerated. Coincidence? I don’t think so.
I went to my doctor and had my sex hormones tested.
For me it turned out I was in perimenopause. What is perimenopause? It’s that rocky road of hormonal shifts leading to menopause. When perimenopause starts varies for each woman, but it can start 10 years before menopause.
In my case, sex hormone testing revealed that I had estrogen dominance, too much estrogen relative to progesterone. The term estrogen dominance was coined by Dr. John Lee, author of the books What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Hormone Balance and What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life From Thirty to Fifty.
Sex hormone issues are common in women with hypothyroidism and even more reason why they should be part of thyroid testing for every person presenting with thyroid issues. Thanks to Dr. Lee’s premenopause book I discovered the benefits of natural progesterone cream (which turned out to be a major help in saving my hair).
Don’t forget testosterone testing too…yes testosterone. Harvard-trained MD and author of the New York Times Best Seller The Hormone Cure Dr. Sara Gottfried had this to say about testosterone in her article The Horrors of Hair Loss for The Huffington Post:
Another possible reason for hair loss? Too much testosterone. That’s right: Women also produce the hormone testosterone. In fact, testosterone is what gets us in the mood, gives us self-confidence, and keeps us vital and sassy.
But if testosterone levels are too high in women — whether because of menopause, excess weight, or other causes — we see symptoms of male-pattern baldness and rogue hair growth on the face. The hairs on your head are falling out, but you’re finding new ones on your chin? Totally unfair!
High testosterone can cause hair loss but so can low testosterone. Be sure to have yours tested.
Dr. Josh Axe has a very helpful video on his website called 6 Secrets for Reversing Hair Loss. According to Dr. Axe, hair loss is also linked to an increase in an androgen hormone called DHT (DiHydroxy Testosterone).
I’m fortunate to have a great doctor who did extensive testing including DHT when I went in tears to her office about my thinning hair. I wonder though how many doctors know to test DHT? Hmmm…It means being an advocate for yourself and insisting on the right tests, or finding a good doctor who will do them.
True Health Labs offers a Premenopause Panel for USA (not available in New York State), Postmenopausal Panel for USA (not available in New York State), sex hormone testing for men, and DHT (not available in NY, NJ, MA, RI) in the US.
8. Blood Sugar Imbalance
Author of the book Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Dr. Izabella Wentz wrote the following information in her article Hashimoto’s And Getting Your Hair Back…
Balance your blood sugar! Blood sugar swings brought on by eating too many carbohydrates and not enough quality proteins and fats can wreak havoc on your health and hair! Blood sugar swings encourage the conversion of T4 to reverse T3. Reverse T3 is a inactive hormone that blocks the body’s utilization of T3, resulting in increased hair shedding.
In an interview with Hashimoto’s expert Dr. Datis Kharrazian, author of the book Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal, he said,
There’s just no question that many people that have Hashimoto’s and hypothyroidism have gluten sensitivity. For some patients, it’s life-changing when they go gluten-free.
I find these two sources very interesting because I’ve been on a gluten-free journey and I’ve been working on stabilizing my blood sugar levels. I was a white flour and sugar addict and I remember too well the swings up and down and crashes in my blood sugar throughout the day. Since going gluten-free I’ve been more mindful of my blood sugar levels and I don’t experience the sharp crashes in energy that I used to. I have to be honest and tell you that I find it hard to go 100% gluten-free but when I do I feel better and it motivates me to continue. What I’ve noticed is that when I do cheat and eat a heavy gluten meal my hair comes out in handfuls. Is it a coincidence? I don’t think so.
9. Hair Loss Supplements
Here are supplements that I take on a daily basis that have made an obvious difference in my hair.
Omega-3 Fatty Acids
Dr. Andrew Weil is a world-renowned leader and pioneer in the field of integrative medicine. In his article Two Supplements for Thinning Hair, he wrote:
Make sure you’re getting enough omega-3 fatty acids. Eat wild Alaskan salmon, sardines, herring or mackerel two or three times a week, or sprinkle two tablespoons of freshly ground flaxseeds per day on cereal or salads. You can also supplement with a high-quality fish oil.
Supplement your diet with GLA (gamma-linolenic acid) in the form of black currant oil or evening primrose oil. Take 500 mg of either twice a day for six to eight weeks to see if it helps.
I take this brand of Cod Liver Oil free of detectable levels of mercury every day and I take evening primrose oil as I’ll describe next.
Evening Primrose Oil
Mary Shomon wrote this in her article at About.com Thyroid Hair Loss Solutions For Thyroid Patients:
According to endocrinologist Dr. Kenneth Blanchard:
“For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it — if a woman is losing hair in partly a male pattern – -then, the problem is there is excessive conversion of testosterone to dihydrotestosterone (DHT) at the level of the hair follicle. Evening primrose oil is an inhibitor of that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.”
I use this brand of Evening Primrose Oil.
Biotin is available at many local stores. I’ve read mixed reviews about biotin with some users loving biotin and others finding no improvement or they complain about adverse reactions like acne breakout. This particular brand of Biotin not only has great online reviews but also works well for me. Again we’re all different though.
Biotin is a very popular supplement recommended by many doctors, pharmacists, health food stores, TV shopping channels, health websites and more when it comes to hair loss but please note that in January 2016 the Endocrine News published this article January 2016: Thyroid Month: Beware of Biotin which stated that taking biotin supplements could cause falsely high and falsely low results in a variety of laboratory tests, including thyroid lab tests because biotin interferes with the test platform used for particular laboratory tests. If you are taking biotin and your thyroid lab results begin to change and not make sense in terms of your clinical symptoms remember this finding. I’ve discussed this article with my doctor and I discontinue my biotin several days before having my thyroid lab tests drawn to be sure there is no interference. This shows how important it is to always discuss supplements with your doctor.
I read this study on the benefits of a bioavailable form of silicon called choline-stabilized orthosilicic acid (ch-OSA) on skin, nails, and hair. Sure enough this silicon (ch-OSA) supplement called BIOSIL has made a difference not only in my hair but also my skin and nails.
10. Adrenal Fatigue
The body relies on the adrenal glands located on top of each kidney to manage stressful situations. Given our busy stressful lives it’s not surprising that many of us suffer from issues of adrenal dysfunction.
How would you know if you have adrenal fatigue?
Check out these symptoms…
fatigue, insomnia, chronic pain, headaches, migraines, anxiety, depression, weight gain, joint inflammation, gastrointestinal issues (constipation or diarrhea), tendonitis, bursitis, low libido, fibromyalgia, irritability, anger, fidgety, nervous, addictions, obsessive, frequent urination, heart disease, blood pressure problems, light-headedness, and dizziness upon rising from a bed or chair
Don’t many of these symptoms sound a lot like the symptoms of hypothyroidism? Hmmm…
I’ve read that many hypothyroid people also have adrenal fatigue (whether they realize it or not). From this very list of symptom that’s not surprising really.
At that time when my hair loss noticeably worsened, I was going through an extremely stressful time in my life. At that very same time my menstrual cycles dramatically changed and my progesterone levels plummeted. The thyroid, adrenals, and sex hormones are all so intricately connected, and my experience showed that loud and clear.
The problem is that the adrenals are often NOT tested. In fact adrenal fatigue is not even a recognized diagnosis in mainstream medicine yet the problem is a serious issue for thyroid patients.
An essential part of my hair loss solution was the testing and treatment of my adrenal fatigue. I’m fortunate to have an open-minded doctor who understands the importance of the adrenals in thyroid health.
I took a saliva test (where I took samples of my saliva at 4 different times over the course of one day) that tested my cortisol. Cortisol production varies throughout the day with levels normally highest in the morning and lowest in the evening before bed (did you know that too high cortisol at night can be a cause of insomnia!). The advantage of saliva testing is that it takes cortisol levels at different times of the day and lets you know how your cortisol levels vary during the day.
If your doctor doesn’t do saliva testing to test adrenal function, you can order your own testing.
Adrenal Cortisol Test for USA (not available in New York State)
My results showed that my cortisol levels were below normal throughout the day. I was obviously struggling with adrenal fatigue and I’m so fortunate to have discovered this.
There are different ways to treat adrenal issues and what’s right for a person is individual too. I personally do well on adaptogenic herbs including Ashwaghanda, Rhodiola, Holy Basil, and Schisandra. I take adaptogenic herbs in this supplement Gaia Herbs Adrenal Health.
Last year when I was losing so much hair I was under too much stress.
I’m not always good at being good to myself.
I put other people’s needs before my own and let myself fall to the bottom way too often.
I take on far more than I should because I feel guilty to say NO.
I’m not sure why that word is so hard for me to say.
I try to be everything to everyone, but me.
The particularly stressful events in my life at that time along with an unhealthy way of putting myself last wreaked havoc on my hair. I knew at that moment that I had to take better care of myself otherwise I would lose all my hair.
While all the testing, treatments, and supplements mentioned in this article were essential in stopping my hair loss, there was an even bigger thing that saved my hair above all else