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Loosing hair. Have had hormone, iron and thyroid test. All normal. Suggest?

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What test should I have done to determine why I'am loosing hair, aside from the hormone tests,I have Iron and thyroid ,anything else?
Posted Sat, 10 Aug 2013 in Pregnancy
Answered by Dr. Timothy Raichle 2 hours later
I would be happy to help you with your question.

First, a few questions for you:
1. When exactly did your hair loss begin?
2. Did you have thinning of your hair over any time period before you starting losing the hair (in other words, when did you FIRST notice any changes and what is the story over time)?
3. Do you have any medical problems like high blood pressure or diabetes
4. Was there any recent change in medications, medical history, life style, etc.

Thank you.
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Follow-up: Loosing hair. Have had hormone, iron and thyroid test. All normal. Suggest? 6 hours later
My hair has been thinking slowly over a ten year period, some times stopping. In the last 3wks is massive ,I will start the long process of figuring out the problem. I will start with checking for hormone in balances ,and go from there. No medical problems at all. Will have my thyroid levels check this wk also. Also I done take any other than vitamins and HRT,I don't think anything stressful happened,but maybe I should add cortisol test, as that also can lead to hair loss.
Answered by Dr. Timothy Raichle 3 hours later
Thank you for the followup clarification.

Based on what you are saying, the long term thinning over time is different from the more recent rapid hair loss. The longer term thinning is classic "androgenetic alopecia". Thoughts on the shorter term hair loss include the following causes:

1. TELOGEN EFFLUVIUM — Telogen effluvium is the most common cause of diffuse hair loss. The disease results in reversible diffuse loss of mature, terminal hairs, usually following a significant stressful event. Common triggers (that might relate to you) include significant weight loss (including with dieting), major illnesses and surgery, and traumatic psychological events. I think that it is reasonable to check cortisol levels.

2. Thyroid disease - check TSH and free thyroid hormone levels

3. Connective tissue diseases - check XXXXXXX titers

4. Nutritional deficiencies of zinc or biotin (not sure if these levels can be checked, but supplements cannot hurt)

5. Iron deficiency - Check CBC and ferritin levels

6. Androgen excess - check total and free testosterone, dehydroepiandrosterone sulfate (DHEAS), and prolactin levels.

I hope that this helps in terms of the workup! Please let me know if you have additional questions!
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