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Q:  Is hair growth associated with any problems of the thyroid gland? Do any medications used to treat the thyroid contribute to excess hair growth?

A: Many books and articles mention thyroid conditions as causes of hair loss. However this is uncommon. Most female alopecia is due to the effect of testosterone -- either high levels or oversensitivity of the hair follicles -- or to lowering levels of estrogen at perimenopause or menopause.
The thyroid can be involved in two ways. First, alopecia areata, in which hair is lost from patchy areas can be associated with Hashimoto's thyroiditis, a common cause of underactive thyroid. Both are autoimmune -- the person's own immune system attacks the hair follicles or the thyroid or both. If someone has alopecia areata, it is important to check the thyroid
and treat it, if underactive. However the treatment does not help the alopecia.
When the thyroid is severely over- or underactive, the hair becomes abnormal. With treatment the abnormal hair may fall out but normal hair later grows in to replace it. Taking an excessive dose of thyroid probably can also cause some shedding.

I recommend that any woman with alopecia have a TSH test. This will quickly tell if her thyroid is normal or not. If it is normal, then it is not causing the hair loss. If not normal, then of course a diagnosis and treatment are necessary.

Geoffrey Redmond, MD

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