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Your Good Health: Worsening hair loss isn’t due to a thyroid issue

There are many causes of hair loss, but “pattern” hair loss is the most common
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Dr. Keith Roach

Dear Dr. Roach: For many years now, I’ve been experiencing hair loss, and lately, it just seems to be getting worse. I am so worried because my hair has gotten so thin, and I am afraid that I will soon be bald. I am a 70-year-old female who always had a decent amount of hair.

I have always thought that my hair loss was due to my thyroid problem and the medication that I take for it (levothyroxine), so I asked my doctor to put me on something else to see if the hair loss would stop. But he doesn’t want to do this and said to try Rogaine (which doesn’t work). Then he said if Rogaine doesn’t work, he could put me on a medication that would make hair grow, but it would also cause hair to grow in other places. I haven’t tried this yet.

If I got off levothyroxine and started another medication to replace it, would it help?

B.S.R.

Hair loss often affects people — both men and women — very deeply, and physicians should be compassionate about how personally traumatic this can be.

There are many causes of hair loss, but “pattern” hair loss is the most common. Female pattern hair loss usually consists of diffuse thinning, and it’s most apparent where the hair parts, while men develop a receding hairline and lose the hair on top of their head. General physicians can usually diagnose this accurately, but an expert, such as a dermatologist, may be necessary if the diagnosis is unclear or if there is scarring on the scalp.

The type of hair loss commonly associated with thyroid disease is called alopecia areata, and it most classically results in circular or oval patches of complete hair loss. It’s the thyroid disease, not levothyroxine, that is responsible for hair loss. However, the pattern of thinning that you describe is not likely due to thyroid disease.

Since you are taking thyroid replacement, you really should not stop it, as there are serious potential harms from stopping it and almost no likelihood of benefit.

For women with female pattern hair loss, Rogaine can be given topically or orally, and there are other treatments, such as spironolactone and finasteride. If those fail, I have had patients try platelet-rich plasma injections and low-level laser therapy. But my personal experience with these treatments in the few patients who’ve used them has not been spectacular. However, a little benefit is worth a lot sometimes.

Dear Dr. Roach: There are many claims in the literature that eating coloured foods containing potential antioxidants (like polyphenolic anthocyanins in blueberries and red cabbage) can improve a person’s health. Has there been any systematic studies that support these claims?

A.F.

There is abundant evidence that a diet rich in fruits and vegetables reduces the risk of many chronic diseases, including heart disease and cancer. While brightly coloured vegetables are high in some healthy plant compounds such as the ones you name, even plants with no particular colour (cauliflower, mushrooms and white onions, for example) also have different compounds that help prevent disease.

Having a diverse diet is best, so choosing lots of different fruits and vegetables not only helps prevent chronic diseases, but also makes for a fun diet. Still, the colours you choose can include more-coloured and less-coloured foods, too.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]