Suggest Treatment For Excessive Hair Loss In A Patient With Hypothyroidism

Posted on Wed, 25 Feb 2015

Question: Hello,
C/o...Excessive Hair Loss.
H/O.....1. Having Hypothyroidism but under control.Taking 'THYRONORM'/75mg.
2.Diagnosed with PCOS 1yr ago,have been taking "DRONIS'/20mg .
I consulted a gynecologist one yr ago with the complaint of excessive hair loss.He suspeceted and later I was diagnosed with PCOS. Aodominal and Transvaginal USG proved that . I was also asked for the test DHEA and that came out as normal. There was and is no other sympotoms of PCOS.
Since then ,following his advise I have been taking "DRONIS 20' and within 1 and1/2 months hair loss reduced dramatically and eventually stopped.
But after 1 yr ,recently for last 2 months ahain facing huge hair loss. Did allthe tests again,including thyroid profile,routine blood,blood sugar and the results were normal. Did again abdominal and tranvaginal USG and consulted my gynaecologist again.He said the gynae part is ok and no further alteration regarding medication has been advised.
It's him who referred me for a dermatologist now .

Apart from this , I have been taking 1.Biotin 10mg daily.
2. SawPalmetto 320mg daily
3. Minoxidil 2% topically.
4. Multivitamin ,specially for hair .

Please help.
You may ask me about my issues, well I haven't one and also planned not to have one ever .I it's not that I have difficulties to conceive. It's just my choice .

Thanks and regards,
XXXXXX

Answered by Dr. Geetika Paul (16 minutes later)

Brief Answer:
Kindly provide pictures and details

Detailed Answer:
Hi

I understand your concern regarding your skin problem and I hope I am able to help you in the same.
You seem to be having hair loss.
I would like to know certain more details from you .
Is the hair fall generalised from all over the scalp or is it more from the central region causing widening of central partition.
Any stress in the recent months?
Any illness or surgery ,other than the pcod problem.
If possible,Please click some close up pictures of the affected area and upload them here on this page.

I am sure I will be able to help you better once you provide me the pictures along with the above details.

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Geetika Paul (1 hour later)

Hello,
Thanks Dr. XXXXXXX for your quick response.

Come to the queries,you raised ,the answers are.......
The hair fall is generalized or diffused ,not from only a particular region.
No, no recent happening of stress in the recent times.
No, there is no other illness.

Since, there is no pointed affected region of scalp,I think any picture won't help you.

Thanks and regards,
XXXXXXX

Answered by Dr. Geetika Paul (1 hour later)

Brief Answer:
Generalised hair loss ,need for regular treatment

Detailed Answer:
Hi again

Thanks for the details

From the description you have provided,it looks like you have developed telogen effluvium which is basically a generalised hair fall .
Both thyroid disease and pcod can cause such a hair loss but the good thing is that the condition is completely treatable .
It is very important that you get your thyroid levels checked regularly.
I do not see any problems with the hair fall treatment that you are following already .
My approach in such a patient would have included tablet biotin with topical minoxidil application .You seem to be using both .
You need to understand that hair regrowth takes time . It takes atleast three months of regular treatment to stop further hair fall and then another three months to regain the lost hair .
So be patient ,and follow the treatment regularly . Just be careful about the thyroid reports ,get it checked regularly .

Hope it helps

Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Geetika Paul (7 hours later)

Hello , Thanks very much for your valuable advise.I would definitely follow what you said. But I would also like to know what you think about 'Finasteride' and 'Spironolactone'? Would they do any help in my case? I think I am already taking Spironolactone like compound in my "Dronis 20' tab.Would further dose hike of Spironolactone be required? Thanks and regards.

Answered by Dr. Geetika Paul (1 hour later)

Brief Answer:
Medicines

Detailed Answer:
You can continue to take Dronis .Since these agents act slowly ,I would advise you not to be hasty sbout increasing the dose.
Also I prefer not to give oral finasteride in female patients .

Dr Geetika Paul

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar