The Women's Journal

A Solution For Hair Loss

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By Brian J. Shiple, D.O. & Kelly P. Shiple, PA-C


For the majority of women and many men, hair is part of one’s identity. Many patients who come to me for treatment as a result of their hair loss feel frustrated and defeated because they have tried everything – supplements, medications, Rogaine, steroid injections, biopsies, and even hair transplant surgery. Hair loss is an extremely common symptom of an underactive thyroid. Many of these patients who present with the chief complaint of hair shedding have had their thyroid levels tested and have been told they are “normal.” As you have probably figured out by now from our articles over the past several years, “normal” labs don’t mean much. If thyroid hormone levels are suboptimal, patients can still be symptomatic and require treatment. In my experience, there are two specific thyroid conditions that are more commonly associated with severe, uncontrollable hair thinning and shedding: Hashimoto’s Thyroiditis and Reverse T3 Syndrome.

Hashimoto’s Thyroiditis is an autoimmune thyroid condition. Autoimmune conditions occur when the body attacks itself, in this case the thyroid, for reasons unknown. This condition commonly appears suddenly after an acute trauma or significantly stressful event as hyperthyroidism, or an overactive thyroid. Symptoms of hyperthyroidism include an increased metabolism, more energy, and feeling hot all the time. The treatment for this is high doses of iodine. Then, the thyroid eventually burns out and becomes underactive or hypothyroid. Hypothyroidism is defined by symptoms that include fatigue, weight gain or difficulty losing weight, brain fog, poor cognition, trouble with memory, feeling cold all the time, and hair loss. Patients with Hashimoto’s more commonly present after they have been hypothyroid for extended periods of time because their symptoms gradually become worse and worse. This condition is diagnosed by checking thyroid antibody levels in the blood. Many times thyroid nodules are commonly associated with this condition so a thyroid ultrasound is often necessary to rule out malignancy. Treatment of Hashimoto’s can be somewhat controversial. The most commonly used treatment is Synthroid (synthetic T4 or liothyronine). Some do well with this treatment, but many Hashimoto’s patients do not and seek alternative treatment. Dr. David Brownstein developed a supplement protocol that we utilize to help reduce antibody levels and get patients feeling better in addition to a good dose of alternative, natural thyroid medications.

Synthroid is one of the most frequently prescribed brand-name medications in our country. However, many patients do not feel well on Synthroid and think it is the only option. The reason some do not feel well on T4 is because of reduced enzyme activity in the conversion of T4 to the active form of thyroid hormone T3. If we continue to give the body T4 and it cannot convert to T3, the extra T4 is useless and the patient will continue to be symptomatic. Let’s take this a step further – some people convert T4 to an unusable byproduct called reverse T3 that takes up T3 receptor sites on cells in the body and blocks any T3 from getting to these cells. This can also lead to persistent hypothyroid symptoms, such as hair loss, without proper treatment. This condition is called Reverse T3 Syndrome or Wilson’s Syndrome. The diagnosis is made by looking at the free T3 to reverse T3 ratio. Treatment involves T3 only, temporarily.

These specific, hypothyroid conditions are common causes of hair loss, shedding, and thinning, but are not commonly diagnosed or treated. Prognosis can be determined by the severity of hair loss, severity of shedding, and the length of time the patient has been experiencing symptoms. Specific blood tests are necessary for diagnosis and treatment.

Where do you want your thyroid hormone levels to be – normal or optimal?

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