The connection between hypothyroidism and hair loss is undisputed - in fact, thyroid problems may be one of the most common hair loss causes in women.
If you're losing your hair - or if your hair seems excessively dry, brittle or thin - read on to discover more about hypothyroidism, just how it impacts your hair and the steps you can take to reverse the problem.
PLEASE NOTE: This information should not be taken as medical advice. If you are concerned that you are suffering from hypothyroidism and hair loss, please seek the advice of a medical professional.
If hypothyroidism is the cause of your hair loss, then it's likely you will also be experiencing some or all of the other typical symptoms too.
Many of us experience lots of these symptoms, but simply put them down to advancing age or the stresses and strains of a busy lifestyle, particularly as many of them seem to develop gradually.
However, there are other symptoms - more common in the later stages of hypothyroidism - that can be more readily attributed to the condition and show that the body's metabolism is slowing down.
If any of the symptoms from either of the above lists seem to apply to you, then it's important to visit your health care provider to discuss the possibility of hypothyroidism.
In the front of your neck, just below your larynx (or voice box) is a butterfly-shaped gland known as the thyroid. This little gland releases a hormone into your body... and that hormone is responsible for controlling your body's metabolism.
In effect, this means the hormone released by your thyroid...
In a nutshell, this hormone, then, is incredibly important to your overall well-being!
With hypothyroidism, the thyroid gland does not make enough of the thyroid hormone that your body needs. And THAT means that all the body processes listed above are impacted... leaving you feeling decidedly under the weather and experiencing some or all of the symptoms we mentioned earlier.
Hypothyroidism - often referred to as an underactive thyroid - is more common than you might think.
Endocrine Web suggests that 10 million people have the condition... and that as many as 10% are deficient in the thyroid hormone to some extent, often without even being aware of the problem.
The UK's NHS states that the condition affects 15 in 1000 women in the UK.
Hypothyroidism can affect anyone but is more common in women, particularly those over 50.
Myxedema coma is a rare but serious condition that can arise when the levels of thyroid hormone in the body become extremely low. It usually occurs in people with untreated hypothyroidism. It can be triggered by certain drugs, illness, infection or exposure to cold and is classed as a medical emergency.
Its symptoms include
Myxedema is treated with steroid medications and intravenous thyroid hormone replacement and sometimes involves intensive care treatment.
Although myxedema is rare, there are other problems that can occur if you have hypothyroidism but it is untreated.
Fertility can be affected because low levels of the thyroid hormone interfere with ovulation.
If you're pregnant, your hypothyroidism could cause birth defects in your developing baby.
The higher levels of 'low density lipoprotein (also known as LDL or 'bad') cholesterol in your body could lead to heart disease or heart failure.
Symptoms - in general - may worsen and the constant stimulation of the thyroid to produce more hormones can lead to an enlarged thyroid called a goiter (also spelled goitre).
Source: PubMed Health
Unfortunately, hypothyroidism can't be prevented - and there are quite a number of factors that can cause it!
*Iodine is a mineral that's crucial to the production of the thyroid hormone. It's found in plants grown in iodine-rich soil and also in seaweed, seafood and iodized salt. In fact, it's the addition of iodine to salt that's made iodine deficiency very rare in the US. And it's important to note that too MUCH iodine can actually CAUSE hypothyroidism.
For more information please see the article Thyroid, Iodine and Diet.
Some sources suggest stress may trigger hypothyroidism (although we haven't found any published medical research to back that up).
About.com has an interesting article looking at the relationship between fluoride and hypothyroidism. It explains how too much fluoride may lead to iodine deficiency, which - in turn - may lead to hypothyroidism
You're most at risk of developing hypothyroidism if...
If your doctor suspects you may be suffering from hypothyroidism then he/she may first carry out a physical examination.
This might include checking the size of the thyroid gland, which may be smaller than normal (although it's worth remembering that the gland may still be normal sized, even if you DO have hypothyroidism. It may even be enlarged - a goiter, as we mentioned earlier.)
Your doctor may also look at your skin, which may be dry, pale and cool to the touch, or may check for swelling in your arms and legs.
And, of course, (s)he will discuss your hair loss issues and will check your hair, which may be thin and brittle.
One of the most important signs of hypothyroidism that your doctor may pick up on is hair loss from your eyebrows - particularly the outer third of your eyebrow.
There are various laboratory tests for hypothyroidism, one of which is the TSH test.
A hormone called thyrotropin releasing hormone (we'll call it TRH!) is produced in a part of your brain called the hypothalamus.
The TRH then 'tells' the pituitary gland to make thyroid stimulating hormone (TSH). The TSH then 'tells' the thyroid gland to make the thyroid hormone that controls your body's metabolism.
If the right amount of thyroid hormone is present in the body, then the thyroid gland 'tells' the pituitary gland not to make so much TSH.
If, however, there is NOT enough thyroid hormone, then the thyroid hormone 'tells' the pituitary gland to compensate by making MORE TSH!
So if your doctor finds you have high levels of TSH in your blood, (s)he will know it's likely your thyroid hormone levels are low and that you may be suffering from hypothyroidism.
Other tests for hypothyroidism might include checking the level of the thyroid hormone thyroxine (T4 test), checking cholesterol levels or carrying out a CBC (complete blood count).
We know of several women - dogged by hair loss, fatigue and that 'far away' feeling - dismayed to find that their tests for hypothyroidism came back 'normal'. And if you visit forums dealing with the condition, you'll find it's not at all uncommon for this to be the case.
If you find yourself in this situation, we strongly recommend that you seek a second opinion or further testing - YOU know your body better than anyone and sometimes you really need to push for a diagnosis!
Subclinical hypothyroidism - where blood tests don't indicate a problem but symptoms persist regardless - often goes undiagnosed.
So you may want to discuss the possibility of a TRH stimulation test with your medical provider.
This test, as the Salerno Center for Complementary Medicine explains here, is more sensitive than routine tests and may reveal a previously undetected thyroid problem.
Another issue may be that your body has enough thyroid hormone, but that it is 'bound' in the blood by thyroid binding globulin (TBG). If the thyroid hormone is bound in the blood - which can happen if your estrogen levels are too high - then it cannot be absorbed by the body. Please see our Estrogen and Hair Loss page for more information.
There's good news and bad news about hypothyroidism and hair loss.
The good news is that hypothyroidism is fully controllable with medication and care... the bad news is that most women have to continue taking thyroid medication for life.
The goal of hypothyroidism treatment is to replace the thyroid hormone that the body is lacking, which should - in turn - bring about an end to your symptoms.
Of course, things are never quite as simple as that... and there are quite a lot of things to be aware of and precautions to take if you're being treated for hypothyroidism.
Your doctor will probably prescribe a drug such as levothyroxine, a synthetic version of thyroxine, the thyroid hormone. Levothyroxine is fairly inexpensive and - because it replaces the body's natural hormone - should not produce side effects.
Please note that prescriptions for levothyroxine are free if you're in the UK - ask for a FP92A form at your doctor's surgery to claim.
Alternatively, your doctor may prescribe a natural extract containing a thyroid hormone derived from the thyroid gland of pigs (Armour Thyroid).
The most important thing to bear in mind is that there is no 'overnight cure' for hypothyroidism and hair loss won't stop immediately. But with care and attention your body should regain its equilibrium within a couple of months and you should start feeling - and seeing - the benefits.
Your doctor's aim is to prescribe the lowest possible dose of medication that will relieve your symptoms and get your hormone levels back to where they should be.
So he or she will run tests every couple of months to see how you're doing, adjusting the dose as necessary to achieve this aim.
There are a few important points to keep in mind.
The medication is replacing the hormone your body should be producing naturally... but it's not curing the problem.
That means you need to carry on taking your medication even when you feel better.
It's better to stick with the same brand of medication. In the US, there are four brand name preparations of levothyroxine
Generic levothyroxine is also available, which is made by different pharmaceutical companies.
The problem is that the different brand name and different generic tablets may contain different amounts of levothyroxine, or a different amount may be absorbed by your body.
And THAT means your hormone levels may fluctuate, with you either receiving too much hormone... or not enough.
If you notice any of the following symptoms, you may be getting too much thyroid hormone and you need to notify your doctor...
It's important to get your dose back to the correct level, as too much thyroid hormone can eventually lead to a risk of osteoporosis, angina and even heart attack.
You want your body to receive a consistent dose of thyroxine in order to keep your symptoms at bay and ensure you start to see a reversal in your hair loss.
So it's important to avoid doing anything that can affect or limit the amount of thyroxine your body absorbs.
Your Diet and Your Medication
Soy products (like tofu) and high fiber foods (like whole grains and bran) may inhibit thyroxine absorption.
To avoid the problem, the best option is to take your thyroid medication on an empty stomach.
John C Morris, Division of Endocrinology at the Mayo Clinic (1), says
"...The most effective way and reproducible way of taking levothyroxine is ingesting the tablets on an empty stomach and avoiding ingesting other medications or foods for 30 to 60 minutes."
In addition, you should let your doctor know if your diet consistently contains many soy products and high fiber foods.
How Your Thyroid Medication May Conflict with Other Medication and Supplements
The article by John C Morris mentioned above goes on to explain that a 'large and growing' number of medications and dietary supplements can influence the amount of thyroid medication your body absorbs.
Any of the following medications and supplements should not be taken within 1 hour of taking your thyroid medication...
1. John C Morris. How Do You Approach the Problem of TSH Elevation in a Patient on High Dose Thyroid Hormone Replacement? Int J Qual Health Care. 2009;70(5):671-673
Eating the right foods can play a big part in making your hair and body as healthy as possible and helping keep hypothyroidism and hair loss symptoms at bay.
Goitrogens - there's a word you've probably never heard before!
But if you've been diagnosed with hypothyroidism, these naturally occurring substances are something with which you need to become very familiar, as they can affect the function of the thyroid gland.
For people WITHOUT thyroid problems, goitrogens need not be avoided - but if you're already dealing with thyroid issues, it may be better to avoid consuming them in excessive amounts and to cook them, rather than serve them raw.
The foods involved are...
Learn more about goitrogens from the World's Healthiest Foods and discuss your intake of these foods with your doctor.
You should aim to include plenty of HEALTHY fats in your diet. Try...
Marcelle Pick, Ob/Gyn NP, has written a wonderfully informative article - "Eating to Support Your Thyroid" - in which she recommends a diet with plenty of selenium, zinc copper, iron and vitamins A, B2, B3, B6, C and E.
She also recommends some iodine and avoiding gluten. To see a complete list of the foods she recommends, you can read the full article here.
You may also like to visit the article "13 Ways to Treat Hypothyroidism Naturally" written by Holistic Nutrition Coach Jill Grunewald, who is on unmedicated remission from Hashimoto's thyroiditis.
And you'll find a helpful hypothyroidism support group at the National Academy of Hypothyroidism.
Rapid and extreme hair loss has be one of the worst symptoms of hypothyroidism as it has such an impact on your self esteem. We've heard from women - even teenagers - who've experienced their hair falling out in clumps as a result of hypothyroidism.
And even is your hair isn't actually falling out, the dramatic change to the texture - making it dry and brittle - can cause it to tangle easily, break constantly and leave it looking significantly thinner. As we mentioned earlier, hypothyroidism can even cause loss of eyebrow hair, or hair from other parts of the body (please see our Loss of Body Hair and Pubic Hair Loss pages for more information).
We've heard of the hair being described as a 'barometer of the body's health' and we think that's a very good description! As hypothyroidism affects so many of the body's processes, it stands to reason that the problem should show up in the hair.
Whenever there's some type of imbalance in the body, the hair cells tend to 'shut down', redirecting the energy to where it's needed at that time.
Charitable group The Hair Foundation explains that - in addition - the thyroid hormone plays an important part in cell division at the hair follicle. It's this division of cells that prompts and influences hair growth, so any disruption will result in hair loss.
The Hair Foundation also suggests that hair loss affects around half of people with hypothyroidism, and that people with the condition produce less sebum (natural oil) from the scalp than normal.
This is why your hair might be particularly dry and it also means you may be at a higher risk of fungal infection of the hair follicles.
Has the medication really 'kicked in' yet?
It can take a good 2 to 3 months for your hormones to stabilize once you've started your medication. It's only at that point that the condition of your hair and its rate of growth will begin to improve. Patience may be all that you need!
Is your dosage correct?
You'll need frequent monitoring by your doctor to ensure that your hormone levels are back where they should be. If you suspect that they're not, or you've changed brands, or you may be doing something that's affecting how much of your medication you're absorbing (see above), speak to your doctor to get your levels checked and your dose adjusted as necessary.
Is the medication itself causing problems for your hair?
Although some doctors may deny it, women seem to find that the thyroid medication they're using seems to CAUSE hair loss. If it seems to you that the problem has worsened - or even started! - AFTER diagnosis and the use of medication, discuss this with your doctor. Ask if there may be a suitable alternative you could try.
Are you pregnant?
The production of the thyroid hormone may slow down during pregnancy, so - again - your dose may need adjusting.
To give your confidence a little boost, try different hairstyles, hats, hair extensions or even a good quality wig to disguise or hide your hair loss.
Treat your fragile hair as gently as you can to avoid further damage. We find the following products to be helpful:
Also see: Best Hair Loss Shampoos
If your hair problems persist in spite of your hypothyroidism medication, it may be that it's not your hypothyroidism that's causing them! A dermatologist will consider - and test for - other possible causes.
Research published in Clinical and Experimental Dermatology Vol 27, Issue 5, shows that a lack of iron, coupled with a lack of lysine (the amino acid that helps transport iron) often causes hair loss. Protein-rich foods like meat, cheese, fish, nuts, eggs and legumes are good sources of iron too.
Take Dr Weil's advice and try a shoulder pose called the shoulder stand (sarvangasana). This pose increases the circulation to the thyroid, which should help with thyroid problems.
To do the shoulder stand
1. Lie on your back.
2. Keep your arms by your sides with the palms facing up.
3. Lift your legs until they're at a right angle to the floor.
4. Lift up your hips until your chin is resting on your chest.
5. With your elbows and upper arms on the floor to support you, stretch your legs and torso as straight as you can and hold the position for as long as possible.
6. Repeat daily, holding the pose for longer and longer, until you can do it for 5 minutes at a time.
Check with your doctor that you are fit to do this pose!
You shouldn't do it if you have glaucoma, high blood pressure, sinus problems or are pregnant or menstruating.
Dr Weil also recommends using a visualization technique - imagining the thyroid waking after a long period of rest and producing more thyroid hormone. It may sound silly... but we're big believers in the power of visualization. I actually visualized a slowly opening flower bud when in labor with one of my children and it both kept me in control and helped enormously with the pain.
As you can see, there are many positive steps you can take when dealing with hypothyroidism and hair loss. We hope you've found this information helpful and that your hair is soon on the road to recovery.
Hypothyroidism and Hair Loss: Other sources and references for more information