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Q. Are Hashimoto’s, and ankylosing spondylitis the reason for severe hair loss?

Answered by
Dr. Ashwini. V. Swamy
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on May 04, 2019

Hello doctor,

I have had a lot of hair loss in the past year. Mostly on top of my head. Lost half my hair. My regular doctor did not find anything wrong with my blood test and said hair loss affects a lot of women and accept it. My new Naturopath thought my numbers seemed low and suggested iron and thyroid supplements. I need another opinion.

I have tested positive for Hashimoto’s, and I have ankylosing spondylitis. The dermatologist did scalp bio negative for inflammation. My TSH is 3.71, T4 is 99, T3 is 110, and FSH is 8.1. The values of zinc is 82, ferritin 36, Iron 93 and TIBC 315. Please help me know what I should do?

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Hello,

Welcome to icliniq.com.

Hair loss in females can be due to many causes, most common being

1. Telogen effluvium stress-induced, due to illness, a diet with low protein intake, surgery, post-pregnancy, and mental stress.

2. Female pattern alopecia is genetic and hormone-mediated, runs in the family.

3. Diffuse alopecia areata is autoimmune condition usually associated with other autoimmune disorders like diabetes, thyroid disorders, and ulcerative colitis.

4. Drugs such as Isotretinoin, and Chemotherapy drugs induce hair fall.

5. Lupus, scarring alopecia.

With your description, it seems like diffuse hair loss, but I cannot confirm unless I see the pictures. In your situation, I feel it is autoimmune condition most probably diffuse alopecia areata, because you have been diagnosed with Hashimoto's and ankylosing spondylitis.

I do not know if you have taken an injection of corticosteroids (Triamcinolone) for the scalp. This is very helpful in an autoimmune condition. I am considering the most probable cause, and it could even be female pattern alopecia. Do you have a family history of baldness, history of surgery, illness, stressful events before you noticed hair loss? Please send the pictures of the scalp.

Thank you doctor,

No family history of baldness. Although I have always had thin hair just not this bad. Half my hair is gone. I have not had any scalp shots as I have not been diagnosed with that yet. I have not undergone any surgeries, a negative blood test for lupus and no specific stressful event.

I do get these irritated, red spots on the back of my scalp every few weeks that itch, but it is not on the top of my head where the hair is missing. The doctor gave me a steroid liquid to put on that spot when it gets irritated.

#

Hello,

Welcome back to icliniq.com.

There is widened middle parting which is commonly seen in female pattern hair loss. Your condition could be either female pattern hair loss or diffuse alopecia areata. Since biopsy did not show any inflammation, I am leaning towards female pattern hair loss. Does not look like scarring alopecia.

Treatment options for female pattern hair loss are,

1. Topical Minoxidil solution or foam.

2. Hair and nail vitamins.

3. PRP- platelet rich plasma therapy.

Thank you doctor,

My Naturopath thinks my ferritin level and low end thyroid numbers may be a cause. And had suggested supplements. What is your opinion?

#

Hello,

Welcome back to icliniq.com.

Your ferritin level is towards the lower end but within the normal range. Taking iron supplements is good. Female pattern hair loss is hormonal. It is related to thyroid hormones too along with testosterone. Vitamin D deficiency causes hair loss. Hair and nail vitamin have a various combination of hair nutrients like biotin, zinc, and calcium that are helpful for hair growth.


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