Thyroid Diseaseand

Hair Loss

Types of Hair LossGeneralized shedding

More hair in drains, on brushNo specific patches of loss or baldnessMost common in thyroid disease

Discrete patches of lossAssociated with fungal infection or autoimmune

alopecia

Male pattern baldnessMen and womenLoss concentrated of temples and top of headConversion of testosterone to dihydrotestosterone

Causes

Untreated/Undertreated Thyroid Disease

Hypo- or hyperthyroidism

Thyroid gland unable to provide hormones for hair follicle’s proper metabolismLoss of necessary supply of proteins and amino

acidsLoss of ability to absorb vital minerals and

vitamins Inability to grow properlyRedirection of energy needed for hair growth to

other parts of body

Medication Side EffectLevothyroxine (Synthroid)

According to patient information, may cause generalized hair loss

Treatment for thyroid cancer

Treatments Normalize thyroid levels

May benefit from addition of T3 (Cytomel) or T4/T3 drug (Thyrolar, Armour) versus pure synthetic T4 (Synthroid)

May take several months to see improvement

Alternative supplements Evening primrose oil (EPO)

Source of essential fatty acids Lysine supplementation (meat, fish, eggs) Aromatherapy of essential oils (thyme, cedar wood, lavendar, rosemary)

Hair transplantation

Treatments to AvoidDHT inhibitors (Propecia)

Growth stimulators (Minoxidil)

These medications have not been shown to be effective in patients with thyroid imbalances

Eyebrow LossMore common in hypothroidism

Primarily affects outer third of brow – may be completely absent

TreatmentsSimilar to head hair loss (thyroid meds, evening

primrose oil, supplements)

Transplantation (micrografts, single hair)

Permanent makeup (tattoo)

Eyelash LossHypo – or hyperthroidism

Eyelash hair follicles have thyroid hormone receptors on their surface

Uncommon to be the presenting sign in thyroid disease

Rule out other causes trichotillomania DM vitiligo pernicious anemia Addison’s

TreatmentsSimilar to other treatments discussed

Additional treatmentsFNS Nutrilash

Mixture of vitamins, minerals and amino acids

LatisseBimatoprost ophthalmic solutionSide effects: increased brown

pigmentation of iris, eyelid

skin darkening, eye

redness, itching)

LiLashProstaglandin analogSide effects: eyelid darkening,

eye redness, itching