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Hair Loss/Telogen effluvium

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Hi there,
I am looking for some additional guidance after seeking help from every hair expert you can think of over the past 4 years (sounds familiar right?). I know women suffer with this but I am having such a difficult time unraveling the mystery. My first episode of TE started 4 years ago and we attributed it to an SSRI medication. Stopped the med and after 2-3 months the shedding stopped and I thought the nightmare was over. 1 year later I was on topamax for terrible migraines and the loss started all over. But again tolerable and over in 3 months. Soon after I started spironolactone for cystic acne. It worked great in that regard and hair loss was quiet for over a year. Then I made a dose adjustment and 2 months later hair loss was back. Another episode of shedding. UGh! I figured it is time to stop this medication and be on nothing. I revamped my diet from good to great, increased my exercise, started meditating and doing yoga again and 6 months later the hairs still fall steadily all day long. Just not sure what else I can do. I am taking iron as my ferritin has been low all along, I now have it up to 62, still shedding. I also take L lysine, b complex, D, Vitamin C, biotin and omega3 fish oil. Still shedding. I have had many labs...mostly fine. Night time cortisol is slightly elevated and my estrogen to progesterone is a little low showing more estrogen dominance, but minimal. Recently I had a very mildly low T3 which had been fine all along and my TSH stays normal as well. I often tell my doctors as this has become more of a chronic problem it makes me feel as if I am missing something and as if there is something greater wrong with me. I have no scalp issues to speak of. No redness, occasional itch but nothing to write home about. I am allergic to hair dye so it really looks awful as the greys come in with the thinness and gaps. I am getting regrowth and have been all along, but I have had to cut my hair shorter and still have such a hard time maintaining any style or shape to it at all. I have anxiety just at the thought of showering as I know there will be hairs everywhere. So...hoping you may have some insight, anything at all that I can try. Anything you can offer would be greatly appreciated! Thank you so much for taking the time to help other women:)

Answer
Idiopathic telogen effluvium is the name given to telogen effluvium with a chronic fluctuating course and no identifiable trigger. It is often difficult to pinpoint the exact cause of telogen effluvium. In some cases there may be more than one factor involved. Instead of one thing being way off, it could be a few things being a little off.
Some people have a very sensitive hair growth cycle causing even minor disturbances or imbalances to trigger telogen effluvium.
It sounds like your system may be sensitive to new medications as you mention that all your bouts of telogen effluvium started after beginning (or changing dosages)  medications. It is also important to keep in mind that the body was experiencing internal imbalances that caused you to use medications in the first place. Are you still on medication for migraines? Do you still have migraines? Is cystic acne still prevalent?
Raising your ferritin levels, as you are, is a positive step. Some experts who have studied the relationship between hair loss and ferritin, recommend obtaining a ferritin level of 70 to initiate healthy hair growth. This is not to say that low ferritin levels caused the hair loss, just that it is easier to re-establish healthy hair growth with ferritin level of 70. Hair follicles contain ferritin. When levels are low elsewhere the body will steal from hair follicles.
It is also important to determine why ferritin is low, especially if diet contains adequate iron. Could there be a possible mal-absorption issue? When iron is low, it is not uncommon for other nutritional deficients to exist as well.
Improving your physical and emotional health, as you are doing is the best thing you can do when the cause of hair loss is unknown. When the body is well and healthy, it is easier for the hair growth cycle to repair itself. Any and all improvements are helpful. Other than having anxiety about hair loss, how do you feel in general? What type of diet are you on?
I use henna and indigo to color my hair. That may be an option for you to cover gray since you are allergic to dye. I only use pure, body art henna from Henna for Hair. It is much different from the stuff that is available at retail shops.
Essential oil scalp treatments have been very helpful fro me and many of my clients. Essential oils help stimulate new healthy hair growth by increasing nourishment and energy directly to follicle and root of hair. Essential oils contain all the nutrients of the plant they are derived from. They also have a vasco-dilating effect that help keep he follicles open and energized.
I feel you are on the right track by taking excellent self-care. As you continue on your path you will find new ways to fine-tune your self care. Feel free to send  more information regarding the question I've asked.
Sincerely, Melanie Vonzabuesnig

Hair Loss

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Melanie Vonzabuesnig

Expertise

Female hair loss is my main focus. Women today are very susceptible to several types of hair loss including telogen effluvium, alopecia areata, and androgenetic alopecia. I can answer questions about the causes and types of female hair loss. I can share information about natural holistic remedies to improve female hair loss conditions.

Experience

My interest in female hair loss sprung from my own experience with extensive hair loss. Determined to grow my hair back, I diligently studied every piece of information I could find on the biology of hair growth. After successfully re-growing my hair with safe and effective natural products, I felt compelled to learn more and to share this information with other women. I am experienced in blending custom hair loss formulas. I am also experienced in writing about female hair loss issues.

Publications
My hair loss information has been included in The Truth about Womens Hair Loss by Spencer Kobren, Naturally Healthy Skin by Stephanie Tourles, Alternative Healing by Bill Gottleib and Natural Health Magazine. I am the author of several books on hair loss.

Education/Credentials
I am a certified aromatherapist specializing in formulas for scalp and hair conditions.

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