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Hair Loss/Thining hair on top and eyebrow loss

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QUESTION: Hello doctor i have big problem about hair loss and thinning all over my body(pubic hair and hair on arms).It started 6 months ago when i came back from barber i noticed that my hair got thinned on top, month before that i noticed that my  eyebrow got thinned too with eyelash faillling out, my hairline is the same before hairloss started.I went to dermatologist and she told me every cause of diffuse hair shedding and loss like thyroid, iron, diet, stress and etc..

I checked my iron and other stuff everything were normal, thyroid only remained, and here are the results

TSH 4,41 -  0.41-4.01mIu/L
FT3 2,02 -   2.0-4,9 pg/mL
FT4 0,94 -   0.82-163ng/dL

My endocrinologist did not give me any treatment or pills for thyroid, in her opinion this is ok, here answer was that hair loss is not normal in Hypothyroidism but only in the bad antibodies and Hyperthyroidsim and these resultsa are good for her.
You can see that ths is slightly above normal, and ft3,ft4 are on the limit..I did antibodies and echo of thyroid they were ok, i have alot other symptoms of hyprothyroidism too. I know that you are not endocrinologist but i want your opinion is this cause of my hairloss?

I am 16, also have bad sinuses(cant breathe on only one nostril), beside thyroid can sinuses be cause of hair loss generally with eyelash and eyebrow?

Sorry for my bad english, i hope that you will understand what I wanted to say.

ANSWER: Dear Dragan,
  I am not an endocrinologist as you know but it may be that you are Hypothyroid as you suspect because there is some controversy over where the upper limit of TSH should be. Other causes of diffuse loss may be a reaction to a severe stress -- your sinus infection would have had to be rather severe to have stressed all the growing hairs all over your body. If you are not suffering from a heavy metal poisoning which could cause diffuse hair loss

Below is a quote from a webpage http://thyroid.about.com/od/gettestedanddiagnosed/a/normaltshlevel.htm

Reference range is a critical component, and the validity of the entire TSH test as diagnostic tool depends on it. TSH reference range is what determines -- for the vast majority of physicians, who rely on blood tests almost exclusively -- whether or not thyroid disease is even diagnosed at all, much less treated, and when diagnosed, how it is treated.

A reference range is obtained by taking a large group of people in the population, measuring their TSH levels, and calculating a mean value. Supposedly, these people should be free of thyroid disease. What experts are now coming to understand, however, is that the upper range in the TSH normal reference range has included people who actually have mild or developing thyroid disease, and their higher TSH levels skewed the standard curve.

This understanding led to the recommendation in January 2003, by the American Association of Clinical Endocrinologists, that doctors "consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0." (Read AACE statement now).

This was backed up by research done by the National Academy of Clinical Biochemistry, part of the Academy of the American Association for Clinical Chemistry (AACC), and presented in their Laboratory Medicine Practice Guidelines for the Diagnosis and Monitoring of Thyroid Disease. Read the Guidelines now). Late in 2002, this group reported that: "In the future, it is likely that the upper limit of the serum TSH euthyroid reference range will be reduced to 2.5 mIU/L because more than 95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L."

More recently, researchers have looked at an important question: If the normal TSH range were narrowed, as has been recommended by AACE and the National Academy of Clinical Biochemistry, what are the implications?

One study found that using a TSH upper normal range of 5.0, approximately 5% of the population is hypothyroid.

However, if the upper portion of the normal range was lowered to 3.0, approximately 20% of the population would be hypothyroid.

Implications for Patients

It's now nearly a decade since the experts have established that this new, narrower TSH normal range of 0.3 to 3.0 is a more accurate one, and recommended that it become the standard of practice. Yet, the dithering continues. Some doctors use the new range for diagnosis and therapeutic management -- others refuse to consider anything unless it's marked "High" or "Low" on laboratory reports.
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I believe a more complete workup needs to be done to rule out other causes. My guess is that it will turn out to be Hypothyroidism as the cause but you need to make sure something else is not the cause. There is an excellent article by Dr Wilma Bergfeld available on the web which you care read ( I"m sure you will be able to understand it and use it to guide your doctors in your evaluation)0. You can find it at this site: _ it is too long to copy and paste here but I strongly recommend you read it, print it out and take it with you to your dermatologist.
http://www.ccjm.org/content/76/6/361.full

---------- FOLLOW-UP ----------

QUESTION: Thank you for fast answer, can you tell me please which cheks i should to do know that i am not suffering form metal poisoning, which test??

I eat alot tuna whihc i known for mercury special this from chinase sea.

Answer
You should talk to your regular doctor who can ask you questions which may help him make a decision as to which tests to order. Getting heavy metal poisoning is rare and the exposure to them come in different ways. I did not say I thought you had heavy metal poisoning but rather that diffuse hair loss can be caused by such a poisoning and you should rule it out.

    Depending on where you live and what work you do will depend on what tests should be ordered. - Each of these  arsenic, aluminum, cadmium, lead and mercury are found in different environments. Arsenic for example used to be be found in many pesticides.


http://www.healthtestingcenters.com/heavy-metal-blood-test.aspx

If you suspect heavy metal or toxin exposure you should get tested. You could be living or working work with toxins or other toxic substances and not even know. Exposure to certain hazardous materials such as heavy metals can quickly increase to dangerous levels. Heavy metal exposure may occur through your diet, from the environment, from medications, or from other aspects of your daily life.

There are some heavy metals that are necessary to support life in very small doses, but in large amounts are toxic and can present a health hazard if they build up in the system. Zinc is important to the body, as is cobalt atoms found in vitamin B-12. Iron is another good heavy metal, and so is copper, manganese, chromium and selenium. On the other hand lead, mercury and cadmium are heavy metals that are very toxic to humans, and have no known benefit to the body.

In medical usage, the term "heavy metal" is used as a general term for all metals and semimetals with human or environmental toxicity, regardless of their atomic weight. Lead, mercury, cadmium, and arsenic are the most common examples of toxic metal exposure (Heavy Metals Profile: Tests for Lead, Mercury, Cadmium, and Arsenic).   Other types of heavy metals that when exposed to can lead to toxic levels include chromium, copper, fluoride, zinc, and xylenes.


Toxicity of Heavy Metals

There are several determinants of the toxicity of heavy metals. The type of the metal, how much was absorbed, the age of the person absorbing the metal, and the way in which they were exposed are all important. Young children are very susceptible to lead poisoning because their brains are not as developed as adults, and even small amounts of lead exposure can cause brain damage. Mercury can be inert when absorbed through the skin, but when injected or inhaled mercury can be very toxic.


Exposure over a period of time to toxic heavy metals can result in physical, muscular and neurological damages. The effect on the body when exposed long-term can resemble Parkinsonís disease, multiple sclerosis, muscular dystrophy and even allergic reactions. According to the International Occupational Safety and Health Information Center, long-term exposure to heavy metals can even cause cancer.


Heavy metal poisoning is generally uncommon, but is rather serious when it does happen. It can reduce the quality of life for a person, and those who are suspected of being exposed should get a blood test for heavy metal toxicity.  If unrecognized or misdiagnosed, heavy metal poisoning can result in serious health problems and mortality. People can be exposed to dangerous heavy metals through diet, medications, medical procedures (such as titanium, cobalt and chromium from hip or joint replacement surgery), in the home (such as lead paint used in older homes), from the environment or even from working around dangerous chemicals. A complete medical and environmental history should be taken into consideration if exposure is suspected.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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