Hypothyroidism and Hair Loss

How to Identify an Underactive Thyroid and Restore Your Hair

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. 

Symptoms of Hypothyroidism

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. 

These include

  • Feeling very sensitive to cold, sometimes to the point of actually shivering
  • Dry skin / pale skin
  • Depression or an overwhelming feeling of sadness / being tearful
  • Brittle fingernails
  • Fatigue and general weakness - often to the point that it can have a severe impact on day-to-day life
  • Pain in the muscles and / or joints
  • Heavy periods
  • Constipation or hard stools
  • Unexplained weight gain
  • Forgetfulness
  • High cholesterol levels

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. 

These include

  • Hoarseness
  • Thinning of eyebrows (this can be one of the clearest indications of hypothyroidism)
  • Puffy feet, hands or face
  • Slow speech
  • Diminished sense of taste and smell
  • Thickening of the skin

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. 

So What is Hypothyroidism?

Location of thyroid gland

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... 

  • Helps control your body temperature
  • Affects your heart rate 
  • Influences the way your body uses carbohydrates and fats
  • Affects the body's production of proteins

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.


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What Happens if Hypothyroidism is Left Untreated?

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

  • Breathing problems 
  • Low blood pressure 
  • Low blood sugar 
  • Low body temperature 
  • Unresponsiveness

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

What are the Causes of Hypothyroidism? 

Unfortunately, hypothyroidism can't be prevented - and there are quite a number of factors that can cause it!

  • A respiratory infection or a cold 
  • Thyroiditis - the cells of the thyroid can become damaged by the inflammation 
  • Pregnancy - this is because pregnant women sometimes produce antibodies to their own thyroid gland. It's important that the problem is assessed promptly by a doctor to avoid either damage to the fetus, miscarriage, premature delivery or pre-eclampsia.
  • Certain medications, such as lithium 
  • Radioactive iodine treatment for an OVERactive thyroid (if the thyroid produces too much hormone, the condition is known as HYPERthyroidism. But the unfortunate side effect of treating hyperthyroidism can be hypothyroidism). 
  • Radiation treatment for cancer 
  • Surgical removal of the thyroid gland (or just a part of it) 
  • Heavy bleeding during childbirth or pregnancy, leading to the destruction of the pituitary gland (known as Sheehan syndrome) 
  • Iodine deficiency * 

*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 

Who's Most at Risk of Developing Hypothyroidism?

You're most at risk of developing hypothyroidism if... 

  • You've had hypothyroidism during pregnancy - although pregnancy-related hypothyroidism often resolves itself, it can leave you at a higher risk of developing hypothyroidism later on. 
  • You're over 50 
  • You have an existing autoimmune disease 
  • You have a family history of autoimmune disease 
  • You're received treatment for an overactive thyroid, particularly if treated with radioactive iodine 
  • You've received radiation to your upper chest or neck 
  • You've had thyroid surgery 
  • You have a history of Turner syndrome or Graves disease

How is Hypothyroidism Diagnosed?

Checking the thyroid gland

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.

How the TSH Test Works

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). 

What If You THINK You're Suffering From Hypothyroidism... But the Tests Say You're Not?

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.



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Hypothyroidism  and Hair Loss: How is it Treated... and Will My Hair Grow Back?

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. 

Hypothyroidism Medication

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). 

Both synthetic thyroxine and the natural version are only available by prescription and it's important NOT to confuse them with the glandular concentrates you may have seen available in natural food stores. These concentrates are not regulated by the FDA, so there is no guarantee of their purity or strength.

What You Need to Know When Taking Medication for Hypothyroidism

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. 

The Right Dose for YOU!

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 

  • Synthroid 
  • Unithroid 
  • Levoxyl
  • Levothroid 

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. 

How to Tell if Your Dose is Too High

If you notice any of the following symptoms, you may be getting too much thyroid hormone and you need to notify your doctor... 

  • shakiness 
  • a feeling of restlessness 
  • heart palpitations 
  • unexplained and rapid weight loss 
  • excessive sweating 

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. 

What Can Affect How Much Thyroxine (Thyroid Hormone) Your Body Absorbs? 

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...  

  • calcium supplements 
  • iron supplements 
  • fiber supplements 
  • multivitamins 
  • aluminum hydroxide 
  • antacids 
  • medications that bind bile acids 
  • colestipol 

How calcium supplements may interfere with thyroid treatment

Reference:
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

Hypothyroidism and Hair Loss - Tips for a Healthy Diet

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. 

Learn About Goitrogens

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... 

  • soybeans and soy products 
  • broccoli 
  • cauliflower 
  • cabbage 
  • rutabaga/swede 
  • Brussels sprouts 
  • kohlrabi 
  • turnips 
  • radishes 
  • spinach 
  • peanuts 
  • peaches 
  • millet 
  • strawberries 

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... 

  • Cooking with olive oil  
  • Baking with pure coconut oil or using it in dressings (ensure it's unrefined - it should smell deliciously coconutty!) 
  • Eating plenty of avocado, fish and nuts
  • Adding flax seeds to baked goods and sprinkling them over salads or anything else (milled flax is best as its nutrients are more easily absorbed) 

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.

Sea salt with iodine is a better iodine source than iodine-enriched table salt.

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

Hypothyroidism and Hair Loss - Reclaim Your Crowning Glory! 

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). 

Why Is There Such a Connection Between Hypothyroidism and Hair Loss?

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. 

Hypothyroidism and Hair Loss... I'm on Medication, But There's No Improvement. Why?

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. 



Other Tips for Dealing With Hypothyroidism and Hair Loss

Restore the moisture in the air and your hair!

Hypothyroidism can cause dry skin AND dry hair. Using a humidifier can alleviate both.


Find out more...

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:

Bumble and Bumble Gentle Shampoo

Bumble and Bumble Deeep

Enjoy Luxury Duo (Shampoo and Conditioner)

Also see: Best Hair Loss Shampoos


Have Your Hair Evaluated by a Dermatologist

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.

Hypothyroidism and hair loss - find a hair loss specialist

American Hair Loss Council

Get your iron levels checked!

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.

Learn more about iron, and why even levels that appear 'normal' may be too low for healthy hair

Fight Hypothyroidism and Hair Loss with Nature's Help! 

Fight hypothyrodism and hair loss naturally!

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. 

Causes of hair loss

Hair Loss Causes

How smoking affects the hair

Does Smoking Cause Thinning Hair?

What's causing your itchy scalp?

What's Causing Your Itchy Scalp?

A surprising itchy scalp/dandruff cure

The benefits of biotin

Hair loss shampoo


Hypothyroidism and Hair Loss: Other sources and references for more information

The Mayo Clinic
WebMD
Patient.co.uk



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