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Q:  Are you familiar with any relationship between low serrum ferritin levels and hair loss? Also, I have been taking Synthroid for a few years. I have read that Synthroid has been known to cause hair loss. Are you in agreement with this, and do you believe that more natural thyroid replacement is better for hair loss? Thank you for your response.

A: Many believe that low iron is a factor in hair loss but I regard this as unproven. However, it makes sense to be sure you have adequate iron stores so if someone has a low ferretin or iron, a course of iron can be considered. However, excessive iron levels are now thought to be harmful so treatment should be monitored. For most menstruating women, it is a good idea to take a standard multiple vitamin with iron in it.

Re the thyroid, this is not usually a cause of hair loss but for some reason it is listed as such in many articles and textbooks. To affect hair, the thyroid must be very over- or underactive. The most common thyroid condition, Hashimoto's thyroiditis, can be associated with autoimmune alopecia (alopecia areata) but most with this thyroid condition never get the alopecia.

Excessive doses of thyroid might contribute to hair loss so anyone on Synthroid or related medications such as Levoxyl or Unithroid should have their TSH monitored. So long as the dose is correct, the medication will not cause hair loss.

So-called "natural" thyroid preparations are actually ground-up pig thyroid. I am a vegetarian so I do not recommend them. Also, the dose is harder to regulate so they might actually be worse for hair.

I need to say once again what I say so often: Most female hair loss is related to testosterone or estrogen and so that is the first place to look in seeking the cause.

Hope this is helpful.

Geoffrey Redmond, MD

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