Episode - Hair loss and Hyperthyroidism


Hair loss and Hyperthyroidism

Hair loss is very common for those with hyperthyroidism.  And while the elevated thyroid hormone levels are frequently responsible for the hair loss, there can be other factors responsible for this as well.  So in this episode Dr. Eric will discuss some of the different causes of hair loss, and some actions steps you can take.

  • The impact of thyroid hormone imbalances
  • How antithyroid medication can affect hair loss
  • Which nutrient deficiencies can play a role in hair loss
  • Other potential causes of hair loss
  • What you can do to reverse hair loss

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Here is the transcript for this episode:

Welcome back to the Save My Thyroid podcast. This is Dr. Eric Osansky, and in this episode, I am going to discuss hair loss, which is very common not only in hyperthyroidism but also in hypothyroidism.

Let’s start off by discussing the impact of thyroid hormone imbalances. Once again, high or low thyroid hormone levels can cause hair loss. I see hair loss probably more in my hyperthyroid patients. Balancing the thyroid hormone levels is obviously necessary when this is the cause of the hair loss. It can take a good amount of time for the hair loss to stop and grow back, even after correcting the thyroid hormone imbalance.

Next, I’d like to discuss antithyroid agents in hair loss. Taking antithyroid medication such as methimazole, PTU, or carbimazole (for people who live overseas) can either improve or exacerbate the hair loss. I have worked with hyperthyroid patients who took methimazole for example and had an improvement in their hair loss. I have had others have their hair loss worsen upon taking antithyroid medication. Some people with hyperthyroidism don’t experience any hair loss until they start taking antithyroid medication. There are people who experience extreme hair loss once they start becoming hyperthyroid, but some people are okay. They don’t experience much hair loss or any hair loss until they begin taking antithyroid medication.

Frequently, what happens is a person takes too high of a dosage of methimazole. This of course makes them hypothyroid cand can cause hair loss. This isn’t always what happens, but I do see a lot of patients put on higher doses of methimazole, like 40mg. Sometimes even 20mg will do it. Sometimes even lower doses.

How about bugleweed? Bugleweed is an herb with antithyroid properties. This is what I took when I dealt with Graves’ Disease. I did not take antithyroid medication although I do have a lot of patients who take antithyroid medication so I am not opposed to people taking antithyroid medication. Because bugleweed isn’t as potent as antithyroid medication, it is less likely to cause a huge swing in thyroid hormone levels over a short period of time. As a result, taking bugleweed doesn’t usually cause hair loss,..at least not as much as taking antithyroid medication.

Again, a lot of people take bugleweed. Most people who take bugleweed probably don’t experience hair loss. I would say the same for antithyroid medication. A lot of people who take antithyroid medication don’t experience hair loss. I just don’t want you to think that if you take any type of antithyroid medication or herb, you will experience hair loss if you are not experiencing hair loss already. But it is something to consider: If you are not experiencing hair loss already, the antithyroid medication might cause it. Bugleweed is less likely, but there is also that possibility as well.

I just want to remind everyone listening that antithyroid drugs and herbs don’t do anything to address the cause of the problem. While it might help with hair loss by lowering the thyroid hormone levels, it’s still important to address the underlying cause of the condition. Because if all you do is take antithyroid medication or antithyroid herbs such as bugleweed, and you don’t do anything to address the underlying cause, then taking these meds or herbs, this might temporarily help with hair loss associated with hyperthyroidism. But once you stop taking these thyroid hormone lowering agents, the hyperthyroidism is likely to return along with the hair loss.

Now I’d like to discuss some other causes of hair loss. I am going to start by discussing nutrient deficiencies. Nutrient deficiencies are common and can cause hair loss. It’s arguably the second most common cause of hair loss in my thyroid patients. Overall, when it comes to hair loss, it may be #1 (not in my patients). Nutrient deficiencies can play a huge role when it comes to losing hair.

Some of the nutrient deficiencies that can cause or contribute to hair loss include zinc, iron, selenium, biotin, and GLA. When looking to address nutrient deficiencies, it’s important to look into factors that cause these deficiencies. Of course, having a healthy gut is necessary for optimal immune system health. But many people have an unhealthy gut, which in turn can affect nutrient absorption. I talk a lot about having a healthy gut, especially for those with Graves’ Disease because Graves’ is an autoimmune condition. Most of the immune systems are located in the gut, but we also need to consider that having an unhealthy gut can also lead to malabsorption, which can lead to nutrient deficiencies.

For example, H-pylori is a potential trigger of Graves’ Disease as well as Hashimoto’s. A number of different studies show that H-pylori can affect iron absorption. This in turn can cause hair loss. There could be other causes of malabsorption such as Celiac Disease or inflammatory bowel disease such as Crohn’s or ulcerative colitis.

You also want to make sure to incorporate what is called the 5-R protocol. I will briefly say there are 5 Rs that are necessary to restore your gut health.

First is to remove the factor that is causing the compromised gut, or the leaky gut. An example would be H-pylori, which you’d want to remove.

The second is replace. You can replace things such as digestive enzymes, bile acids, stomach acid.

Three is to reinoculate with prebiotics and/or probiotics.

Four is repair. You can do it through foods such as bone broth. If you are a vegan or vegetarian, cabbage juice can support the gut. From a supplement standpoint, agents such as el-glutamine can help.

Five is to rebalance the parasympathetic nervous system, which plays a very important role in digestion. You can do this through mind/body medicine. There are other things you can do to simulate the vagus nerve. Things like vigorous gargling and hot and cold showers can play a role.

It’s also important to mention that overdosing with certain nutrients can cause hair loss. Not just nutrient deficiencies but too high of a dose can also cause problems. This includes selenium, Vitamin E, Vitamin A, and iron. While it’s important to correct nutrient deficiencies, you don’t want to take very high doses of certain nutrients, especially not over a prolonged period of time, as this can lead to toxicity that can result in hair loss.

As far as nutrients that are necessary for healthy hair, iron, Vitamin C, and even Vitamin D are important. Vitamin D has many functions and can help with so many different conditions, and that includes having healthy hair. It can play a role. If someone has a Vitamin D deficiency, it may not be the main reason why you’re experiencing hair loss. This isn’t just my opinion, but according to the research, having Vitamin D can be important to have healthy hair.

As well as biotin. Many people know this and they supplement with biotin. You do want to be careful in that it can affect the thyroid markers when doing a blood test, especially when taking biotin separately. If you are taking a small amount in a multivitamin, it may not be a big deal, even though in this case, you still want to take a break for a few days before doing a blood draw. If you are taking a separate biotin supplement for any purpose, including for helping with hair loss, then you would want to stop taking the biotin at least three days before doing a blood draw.

Zinc is also important for healthy hair. Fatty acids. Not just Omega-3 fatty acids, but certain Omega-6 fatty acids. Amino acids such as lysine and cystine. Vitamin A. Selenium. Vitamin E. There is also silica, which is a trace element for collagen synthesis.

Another factor which can be responsible for hair loss is sex hormone imbalances. Imbalances of estrogen, progesterone, or testosterone can all cause hair loss. Elevated thyroid hormone levels will commonly cause sex hormone imbalances. I see this a lot in my hyperthyroid patients. Frequently, correcting the hyperthyroidism will resolve the sex hormone imbalance. When the hyperthyroidism is the factor responsible for the hair loss, when you correct the thyroid hormone imbalance, this will correct the sex hormone imbalance although sometimes additional action will be required to balance the sex hormones. In other words, if someone has hyperthyroidism, and that is causing sex hormone imbalances, then again, correcting the hyperthyroidism frequently will correct the sex hormone imbalance. Sometimes that is not the case. Or it’s the case, but it takes time for this to happen.

Another factor which can cause hair loss is a condition called alopecia areata. This is an autoimmune condition that causes hair loss in the scalp, face, and sometimes other areas of the body. A 2018 study shows that alopecia areatais significantly associated with Graves’ Disease as well as Hashimoto’s thyroiditis. Frequently, alopecia areata will develop first many times in childhood. Someone will have had alopecia areata for years, but maybe later on, some of these people will develop thyroid autoimmunity. In some cases, it is possible for Graves’ or Hashimoto’s to precede alopecia areata. But in most cases, the alopecia develops first though.

How long does it take to reverse hair loss? This of course depends on the person as well as the cause of the hair loss. If the thyroid hormone imbalance is the sole cause of the person’s hair loss, then it can take a few weeks to a few months before the hair loss stops. The same thing applies to sex hormone imbalances. Moderate to severe nutrient deficiencies will take time to correct. If this is responsible for the hair loss, then it will usually take longer for the hair loss to stop and grow back. Based on what I’ve said here, if some people aren’t noticing their hair loss improve within a few weeks of taking measures to correct their thyroid hormone imbalance, for some people, it will take a few months before they notice a significant improvement.

I’d like to briefly summarize how to reverse hair loss. Once again, you want to balance the thyroid hormone levels. You also want to address the underlying cause of the problem. If someone has hyperthyroidism and they are experiencing hair loss, taking antithyroid medication might help. I mentioned earlier how it also might cause hair loss.

But in the case where someone is experiencing hair loss before they take antithyroid medication, and then they take antithyroid medication or even bugleweed, if any antithyroid agents help, this is not addressing the underlying cause of the problem.

If someone happens to be listening who has hypothyroidism, and if it’s causing hair loss, you might decide to take thyroid hormone replacement. But you would want to address the underlying cause of the problem. If you have sex hormone imbalances related to estrogen, progesterone, testosterone, then these need to be addressed. If it’s being caused by hyperthyroidism, then you would want to of course address the hyperthyroidism although sometimes additional measures are needed.

Also, keep in mind you need to have healthy adrenals in order to have healthy sex hormones. When I say additional measures are needed, this very well might be what is needed to address the sex hormone problem. Also, I will say problems with adrenals are very common with hyperthyroidism, so you may need to address the adrenals in order to correct the hyperthyroidism. In fact, it’s very common, which is why I recommend adrenal testing in just about all of my patients.

And then of course, correcting nutritional deficiencies are very important when it comes to overcoming hair loss. Then healing the gut. You want to correct nutritional deficiencies, but if you have any type of malabsorption problem, if you just take nutrients through supplementation, of course you want to do as much as you can through diet as well. When you have nutrient deficiencies, eating well is important, but you may need, and probably will need, to supplement while correcting the deficiency. But if you have an unhealthy gut and have malabsorption problems, it is important to correct the malabsorption problem, or else it won’t correct the cause of the deficiency, and you will have to keep taking on supplements permanently.

That is all I want to discuss regarding how to overcome hair loss. Hopefully you learned a lot, and I look forward to seeing you on the very next episode.