It is estimated that 90% of people with hypothyroidism have the thyroid autoimmune condition known as Hashimoto’s Thyroiditis. Hashimoto’s is an autoimmune condition in which the body attacks its own thyroid gland. Despite the prevalence of Hashimoto’s, thyroid antibodies are often NOT tested. You may have Hashimoto’s and not even know it. There are two thyroid antibodies to test for Hashimoto’s: Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).
Managing hair loss is just as important as treating it. Now that we've talked about the different treatment options and cures available to reverse hair loss and promote increased growth, let's talk about how you can manage your condition and at the same time prevent further hair loss. The first is more psychological, while the second is more practical.
Hair may be all about vanity but hair conditions, such as hair loss and balding may have emotional, mental and psychological repercussions: insecurity, the loss of self-confidence, humiliation or embarrassment, self-imposed isolation out of fear of what people might think of how we look with that missing part of ourselves. Hair issues are more than vanity.
A group of topical medications called prostaglandin analogs have recently began undergoing testing for potential hair regrowth. They may be used in men and women. These drugs are not currently FDA approved for scalp hair loss. Currently, these are primarily used for eyelash enhancement. One of the new medications is called bimatoprost (Latisse). Further testing and studies are required to assess the efficacy of these products in scalp hair loss. Bimatoprost solution is sometimes used off-label for help in selected cases of hair loss. It is currently FDA approved for cosmetic eyelash enhancement. Studies have shown it can treat hypotrichosis (short or sparse) of the eyelashes by increasing their growth, including length, thickness, and darkness. This medication is also commercially available as Lumigan, which is used to treat glaucoma. It is not known exactly how this medication works in hair regrowth, but it is thought to lengthen the anagen phase (active phase) of hair growth. Interestingly, during routine medical use of Lumigan eyedrops for glaucoma patients, it was serendipitously found that eyelashes got longer and thicker in many users. This led to clinical trials and the approval of cosmetic use of Latisse for eyelashes.
3. Surgical hair replacement. If you opt for hair transplantation (which runs $5,000 and up), your dermatologist or hair-replacement surgeon will remove single hair follicles from the back of the head, near the nape of the neck, where your hair is fullest. Once those follicles are harvested, they are then dissected and reimplanted into an area of the scalp where hair is thinning. The procedure takes anywhere from three to six hours, and newly implanted hair will usually begin to grow on its own 3 to 12 months after the treatment session. Traditionally, hair transplantation required removal of an entire strip of scalp, Sadick says, but this new follicle-by-follicle technique looks more natural when it heals and allows patients to get heads of hair as dense-looking as before they started losing it.
Finasteride inhibits an enzyme that converts testosterone to DHT, or dihydrotestosterone, the hormone that causes hair loss in men, and unlike minoxidil, this drug can actually help hair grow back, as well as prevent further loss. All you have to do is take one pill a day, and according to Dr. Evan Rieder, dermatologist in the Ronald O. Perelman Department of Dermatology at NYU Langone Health, two-thirds of men taking this treatment will see improvements in hair density over time.
This refers to the habitual pulling or twisting of one's own hair. The scalp and eyelashes are often affected. Unlike alopecia areata patches, which are perfectly smooth, hair patches in trichotillomania show broken-off hairs. Treatment is often entirely behavioral. One has to notice the behavior and then consciously stop. Severe or resistant cases may require stress counseling with a therapist or psychologist or medical treatment with a psychiatrist. Several antidepressant or anti-anxiety medications can help with this condition.
Minoxidil (Rogaine): This topical medication is available over the counter, and no prescription is required. Men and women can use it. It works best on the crown, less on the frontal region. Minoxidil is available as a 2% solution, 4% solution, an extra-strength 5% solution, and a new foam or mousse preparation. Rogaine may grow a little hair, but it's better at holding onto what's still there. There are few side effects with Rogaine. The main problem with this treatment is the need to keep applying it once or twice daily, and most men get tired of it after a while. In addition, minoxidil tends to work less well on the front of the head, which is where baldness bothers most men. Inadvertent application to the face or neck skin can cause unwanted hair growth in those areas.
The test involves plucking about 50 hairs from the head, typically at the back of the scalp, so your dermatologist can look at them under a microscope and determine how much of the hair is in the resting, growth, and fall-out phases. Next, a vial of blood is sent to a lab to check hormone and nutrient levels ($100 and up, depending on insurance). If low levels of iron, or high levels of male hormones, like androgens, are contributing to your hair loss, for example, both can be treated through oral supplements or medication.
“For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it — if a woman is losing hair in partly a male pattern – -then, the problem is there is excessive conversion of testosterone to dihydrotestosterone (DHT) at the level of the hair follicle. Evening primrose oil is an inhibitor of that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.”
Hair concealers and hair fibers. These are one of the newest cosmetic answers to hair loss. As the name suggests, these products are applied on the scalp or hair to camouflage hair loss and give the appearance of fullness to thinning hair. Some of these are applied directly on the scalp, while others (hair fibers) are attached to the hair, much like hair extensions, to add volume.
Finasteride is the active ingredient in the men’s hair-loss treatment Propecia, which has been available in Australia since the late 1990s. One tablet a day will arrest further hair loss in over 95 per cent of men and stimulate partial hair regrowth in two thirds of men. Regrowth may be apparent at six months, but can take up to two years to be visible.
Most men experience hair loss as they get older, but for some it starts as early as their 20s or 30s. We offer both Finasteride and Propecia as prescription-only hair loss treatments. If you order Finasteride or Propecia from our discreet online service, you can pick it up from one of our pharmacies the same day, or have it delivered the following day.
SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
None of these need be life threatening, nor does hair loss usually follow them. (Moreover, it can happen after one pregnancy, but not the next.) But when the hair falls out, it's all over the place -- covering the pillow, clogging the drain, and so forth. Paradoxically, the more dramatic the hair loss, the better the prognosis, because when the body gets back into normal rhythm, most if not all of that hair comes back; these people need no special treatment. Normal shampooing can continue, because this only loosens hairs that were going to come out anyway.
Some hair loss treatments can cause side effects. Regaine for women can cause headache, skin irritation and changes in the colour or texture of your hair. It is normal to notice increased shedding during the first two weeks of treatment with Regaine. This indicates that the treatment is working. If you find that you are shedding an unusual amount of hair after the first 14 days of treatment, stop using Regaine and ask your doctor for advice.
Please note that in January 2016 the Endocrine News published this article January 2016: Thyroid Month: Beware of Biotin which stated that taking biotin supplements could cause falsely high and falsely low results in a variety of laboratory tests, including thyroid lab tests because biotin interferes with the test platform used for particular laboratory tests. If you are taking biotin and your thyroid lab results begin to change and not make sense in terms of your clinical symptoms speak with your doctor about doing a retest of your thyroid labs after several days of discontinuing your biotin supplement to be sure there is no interference.
"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.