Dr. Rahul Ramji Kackar
Endocrinology
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Patient's Query
Hello doctor,
I get reactive hypoglycemia and dark spots on the side of my face. Now all of a sudden, I have at least 50 % body hair loss. I possibly thought it is Addison's. Please help.
Hello,
Welcome to icliniq.com.
I want to know more about past illnesses, stress levels, medication history, and gut health. Are any labs done in the recent past? Is there itching also over the area of hair loss to rule out a fungal infection? I will suggest some tests like complete blood count, thyroid profile, serum cortisol at 8 AM and 4 PM, serum insulin levels, fasting, and electrolytes. Any underlying autoimmune disease present? Do not take processed foods. Avoid dairy, and cut down wheat products. Practice mindfulness, and pranayama for stress reduction.
Patient's Query
Thank you doctor,
The more stress, the more sensitivity I have. I do not have an upset stomach, but I have nausea when I do not eat right. I always have a very soft stool. No itching in the areas of hair loss. Hair loss occurs in the legs, chest, arms, and eyelashes. My fasting insulin is 95, and I did not take any medications.
Hello,
Welcome back to icliniq.com.
Do 16:8 intermittent fasting. Avoid sugars. Take probiotics and a course of Rifaximin. Practice stress reduction techniques. What is the range of insulin level? And please get other tests done.
Patient's Query
Thank you doctor,
When my diet was not good, I got into the low 40s to 50s at one time. But with a good diet, I usually keep it between 60 and 70. When it gets low, I get extreme fatigue. I have to eat too many carbs or more sugars at times to get back to normal.
Hello,
Welcome back to icliniq.com.
Get a CT (computed tomography) scan of the abdomen done to see if the pancreas are overproducing the insulin. You can go for a continuous glucose monitoring system for one week to see the trend of blood sugar.
Patient's Query
Thank you doctor,
What do you think the hair loss is from?
Hello,
Welcome back to icliniq.com.
Hair loss could be due to some hormonal imbalance. But cortisol is less likely and more suspicious towards the thyroid. But knowing the cause of hypoglycemia is more important and needs to be addressed first on an urgent basis. I want to be sure that the pancreas are clear and no insulin overproduction is there.
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Endocrinology
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