Brief Answer: Hashimoto and Hyperparathyroidism can co-exist Detailed Answer: Hi ma'am, Thanks for your query. * Firstly, it is possible to have Hashimoto's and Hyperparathyroidism concurrently. Hashimoto's is a genetic and autoimmune disease, while a parathyroid hyperactive nodule(s) causes severe osteoporosis, apart from stones in the kidneys, aches and pains in muscles and joints. * Further, I do not feel that sudden occurrence of aggravation of your condition is due to Vitamin D3 dose. In the background of severe osteoporosis (as revealed by DEXA scan), acute onset of headache with stiff neck points towards either - a mild collapse of neck vertebrae or disc herniation, (both of which lead to compression upon the nerves) ; or, - mental stress/anxiety/apprehensions - which, in addition to headaches and stiff neck, may also account for persistent tiredness and lack of concentration. * All above-mentioned symptoms, along with excessive hair fall, are also typically seen in hypothyroidism (Hashimoto's). An increase in the dose of Synthroid may be required. * Excessive hair fall can also be due to increased levels of male hormones (androgens). Hence, in view of the above, I would suggest the following course of action:- 1. Continue with calcium and Vit D3 as before, till the test-reports are received. 2. Blood Parathyroid hormone and Thyroid hormone levels be estimated. --> If Parathyroid hormone level is normal, Parathyroid abnormality is excluded. In that event, I will recommend that you continue with the current doses of calcium and Vitamin D3 and, also ADD Tablet Alendronate weekly for strengthening of bones and joints. --> If TSH level is more than 3, the dose of synthroid should be increased. The target should be to maintain TSH levels to around 1. 3. CT/MRI scan of neck along with Parathyroid glands should be carried out to see for neck vertebral abnormalities, as well as for parathyroid nodules. 4. Ultrasound of kidneys should be done to look for kidney stones, if Parathyroid hormone levels are found to be high. 5. Blood Androgen levels as well as those of female hormones need to be done, to exclude/confirm increased androgen levels as the cause of excessive hair fall. 6. If you have mental stress or/and anxiety, a course of anti-anxiety & anti-depressant drugs will do you good. Lastly, consult your treating doctor, discuss my views and recommendations for medication + investigations. If he agrees with me, then he knows what is to be done. Hope I have answered your query. I will be pleased to address to further clarifications, if any. Fond regards, Dr. Rakesh Karanwal

---