Hair Loss Advice


Womens Hair Loss Thyroid


The thyroid gland, which is located in the neck, secretes hormones necessary for growth and proper metabolism. The gland plays an important role in the growth and mental development of both the fetus and child. It continues to play a strong role in heart rate and weight during adulthood. Metabolic disorders occur when the thyroid secretes too little or too much hormone.

It is interesting to note that diseases related to the thyroid are more common in women than in men. This is probably because thyroid disease is often autoimmune (antibody mediated) and most autoimmune conditions are more common in women.

The double-lobed thyroid gland creates two forms of thyroid hormone: thyroxine (T4) and triiodothyronine (T3). T4 is the more abundant hormone produced though the body converts T4 into T3, a more potent hormone. In general, thyroid hormones influence growth and metabolism.


thyroid hair lossHyperthyroidism occurs approximately eight to ten times more often in women than in men, with women in their twenties and thirties the most commonly affected.

This condition is the result of an excessive amount of thyroid hormone in a person’s system. There are a number of disorders associated with it.

The most common form of hyperthyroidism, Graves’ disease, is an autoimmune condition that results in the overproduction of thyroid hormone by an enlarged thyroid gland.

In addition to the classic features of increased production of thyroid hormone and a diffusely enlarged thyroid gland (goiter), some people with Graves’ disease may develop exophthalmos (prominent eyes that protrude from the sockets) and edema (swelling) of the legs.

For people in their seventies and eighties, hyperthyroidism is often the result of a thyroid with several nodules or lumps that make too much thyroid hormone. 

This condition, called Plummer’s disease, is often accompanied by apathy, depression, weight loss, and irregular heart-beats. It can also accelerate osteoporosis.

The following is a list of signs and symptoms commonly associated with hyperthyroidism:

Palpitations and rapid heart rate

Nervousness and anxiety

Enlarged thyroid gland

Weight loss or gain

Increased appetite

Frequent, loose bowel movements

Heat intolerance

Increased perspiration




Brisk reflexes

Difficulty exercising

Shoulder and thigh weakness

Prominent eyes

Lower leg swelling

Nail changes

Gritty eyes

Hair loss

Oily skin

Inability to concentrate

Emotional changes

Increased libido

Menstrual irregularities


The diagnosis of hyperthyroidism is confirmed by blood tests that show a decreased thyroid stimulating hormone (TSH) level and elevated T4 and T3 levels. TSH is a hormone made by the pituitary gland in the brain that tells the thyroid gland how much hormone to make. When there is too much thyroid hormone, the TSH will be low. A radioactive iodine scan (a test that uses injected radioactive iodine to examine the activity of the thyroid gland) will show an enlarged thyroid gland that is over-functioning.


Surgery is rarely necessary in the treatment of hyperthyroidism. Graves’ disease may be treated with radioactive iodine or antithyroid drugs, namely propylthiouracil (PTU) and methimazole (tapazole).

Radioactive iodine treatment 

One dose of radioactive iodine, taken by mouth, is usually sufficient to cure Graves’ disease. It works by destroying the ability of thyroid cells to make thyroid hormone. The iodine is predominantly excreted in the urine. I advise my patients to urinate promptly after their treatment to minimize the possibility of side-effects from the medication.

Those who undergo radioactive iodine treatment should not have prolonged contact with children for appro ximately three days – because children are more sensitive to radiation. I also advise patients who have recently undergone treatment to flush the toilet twice, rinse the sink twice after brushing their teeth and to use plastic silverware and paper plates. Alternatively, dishes and utensils may be cleaned in a dishwasher. As daunting as it may sound, the treatment of Graves’ disease with radioactive iodine has not been shown to increase the risk of cancer.

However, many people who receive radioactive iodine do subsequently become hypothyroid (described below) since the treatment destroys the ability of the thyroid cells to produce thyroid hormone. Hypothyroidism may occur months or even years after therapy. For people who have undergone this treatment, it’s best to have thyroid function tests performed yearly at least.

Radioactive iodine is not appropriate for pregnant women or those women who plan to conceive in the near future. I instruct all my patients of reproductive age not to become pregnant within nine months of treatment.

Radioactive iodine is also appropriate treatment for nodules in the elderly that produce excessive amounts of thyroid hormone.

Antithyroid drugs 

Unlike radioactive iodine treatment, which actually destroys thyroid tissue and thus the ability to make hormone, antithyroid drugs are used to inhibit thyroid hormone production. For this reason, they have only a 30 to 50% chance of actually curing Graves’ disease. They are generally taken for 12-24 months. Hyperthyroidism can be well controlled by these medications, but once the drugs are stopped, the disease may relapse. Propylthiouracil (PTU) is taken two to four times per day and tapazole one or two times per day. PTU additionally inhibits the conversion of T4 to T3.

A major adverse effect of antithyroid drugs is agranulocytosis, which is a severe decrease in the white blood cells necessary to fight infections. This condition can be life threatening for a person who gets sick with a dangerously low granulocyte (white blood cell) count. I instruct my patients to immediately stop their antithyroid medication if they get a fever, sore throat or any other sign of infection and have a complete blood count checked.

If the white blood cell count is normal, they may resume their antithyroid drugs. Agranulocytosis is usually reversible if the antithyroid medication is stopped. Other side effects of these drugs include rashes, hepatitis (liver inflammation), and joint aches.

After treatment 

I inform all hyperthyroid patients that they must be careful about the amount of food they eat following treatment if they do not want to gain weight. With the restoration of normal thyroid function, an increase in weight will accompany a persistently exaggerated appetite. 

Hypothyroidism in Pregnancy

Several symptoms are common to both pregnancy and hyperthyroidism. These symptoms include: palpitations, anxiety, shortness of breath and fatigue. Ideally, hyperthyroidism should be definitively treated prior to becoming pregnant. If this is not possible, antithyroid drugs are the best treatment option during pregnancy.

Both PTU and methimazole are transferred from the mother to the fetus through the umbilical cord, but PTU is the preferable drug since it is less transferred. It has been suggested that an abnormality of the fetal scalp may be associated with methimazole. I use the lowest possible dose of PTU in my pregnant patients and try to stop treatment in the third trimester if possible.

Women who are pregnant and hyperthyroid should be carefully monitored throughout their pregnancy. As well, because the drug is in the mothers’ system, women who take antithyroid medication should bottle-feed instead of nurse.


Where hyperthyroid people make too much thyroid hormone, hypothyroid people don’t make enough. Again, women develop hypothyroidism more frequently than men, and it is most often diagnosed in people between the ages of thirty and sixty.

A common form of hypothyroidism results from the treatment of Graves’ disease with radioactive iodine. Hashimoto’s thyroiditis is the most common non-drug induced form of hypothyroidism. In this condition, antibodies (normally used to fight infections) are produced against the TSH receptor which inhibits production of thyroid hormone.

Clinical features 

The following is a list of signs and symptoms commonly associated with hypothyroidism:


Weight gain


Decreased pulse rate

Cold intolerance

Diminished reflexes


Dry skin

Dry hair

Hair loss

Brittle nails


Decreased libido

Menstrual irregularities

Decreased fertility

Muscle aches

Swelling of the eyelids, hands and feet

Increased cholesterol


The diagnosis of hypothyroidism is confirmed by blood tests that show an increase in TSH and decreased levels of T4 and T3.


There is no cure for hypothyroidism. Synthetic T4 (levothyroxine), an oral medication taken daily, is the treatment of choice. When used appropriately, this is a very safe medication.

Hypothyroidisim in Pregnancy

Levothyroxine may be taken during pregnancy and breast-feeding. During pregnancy, the thyroid gland enlarges and thyroid hormone requirements may increase. I carefully monitor all hypothyroid pregnant women and increase their thyroid hormone doses as necessary. All babies born in American hospitals are routinely screened for hypothyroidism.


Post-partum thyroiditis 

Post-partum thyroiditis is an inflammation of the thyroid gland that occurs following delivery, and it is estimated that this condition occurs in up to 20% of mothers. It often goes undiagnosed, as it is a painless condition and it’s symptoms, such as nervousness, fatigue, weight loss and emotional changes are often attributed to the natural post-partum state. If you suspect you are experiencing a post-partum depression, you should have your thyroid hormone blood levels checked. In post-partum thyroiditis, there is an initial hyperthyroid phase that may last two to three months, which is then followed by a hypothyroid phase of up to nine months. I often treat women with T4 during the hypothyroid phase. In approximately 10% of women with post-partum thyroiditis, the hypothyroidism is permanent; however the majority fully recover.

Women with Hashimoto’s thyroiditis and Graves’ disease have an increased incidence of post-partum thyroiditis, which may recur with subsequent pregnancies.

Subacute thyroiditis 

In contrast to post-partum thyroiditis, which is painless, subacute thyroiditis is painful. It often occurs in conjunction with an upper respiratory infection but does not resolve as rapidly as the infection. Women are affected more frequently than men, most often between the ages of thirty and fifty. A person with subacute thyroiditis may experience pain radiating from the thyroid to the jaw or ear on either one or both sides of his or her face. 

The thyroid gland may be exquisitely tender in the initial phase, and the person may experience symptoms of hyperthyroidism (see above). The initial hyperthyroid phase is followed by a hypothyroid phase, which may require treatment with T4. Approximately 10% of those affected become permanently hypothyroid. Aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen may suffice for the pain. In more severe cases, steroids are useful. Subacute thyroiditis may recur.

Thyroid Nodules

Thyroid nodules, or ‘lumps’ on the thyroid, are also more common in women than in men. The thyroid often functions normally in the setting of both benign and malignant nodules. Multiple nodules within the same thyroid gland are generally benign.

If you have a single thyroid nodule, or one that is clearly larger than the others, you should have a fine needle aspiration biopsy performed, which involves retrieving cells from the nodule with a thin needle so the cells can be studied. Benign (non-cancerous) thyroid nodules may be followed by observation and suppressive treatment with T4. Malignant (tending to spread) thyroid nodules should be surgically removed.

Thyroiditis Cancer

Papillary carcinoma 

The most common form of thyroid cancer is papillary carcinoma. Women develop this disease three times as often as men, and most people with papillary carcinoma are diagnosed between the ages of thirty and fifty. When diagnosed before age forty, papillary carcinoma is unlikely to be aggressive and may not alter a person’s lifespan.

Following thyroidectomy, thyroid hormone replacement is taken by the patient. Radioactive iodine may be administered in large doses to destroy any remaining thyroid tissue.

Follicular carcinoma 

Follicular carcinoma, the second most common type of thyroid cancer, also affects women three times more often than men. The average age of those who are diagnosed with follicular carcinoma is sixty, and it tends to be more aggressive than papillary carcinoma. Follicular carcinoma may metastasize (spread) to the bones and lungs.

Treatment includes surgical removal of the thyroid, T4 replacement, radioactive iodine, and occasionally radiation and chemotherapy if required.


Thyroid disease occurs with much greater frequency in women than in men. Many different organ systems can be affected by the presence of abnormal levels of thyroid hormone resulting in a whole host of symptoms.

There are a number of treatments available for diseases related to the thyroid. If you suspect you may be experiencing symptoms similar to the ones listed above, discuss them with your doctor.

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