65 Year Old Female Sudden Rapid Hair Loss In One Month Leading To Alopecia Totalis After Np Thyroid

[lorraine]

Hi:
Recently experienced 90% of complete hair loss within one month Feb to March, 2017 with rapid, sudden onset. This may be complicated by being on new hrt med, NP Thyroid 90mg/60mg/90mg daily along with three coniciding incidents of severe, traumatic stress from life events (financial, fire owned tenant bulding, and lost real estate deatl) occurring from Feb. 2016 to Augs. 2016.

I am a 65 post menopausal, professional female who had years of subtle hair thinning since the onset of menopause at age 52, but always had a full head of hair disguised by styling. Was on Synthroid brand from age 52-64. Sought reproductive endocrinologist to prescribe NP Thyroid (form of Armour) instead of Synthroid who dosed up to 90 mg/60mg/90mg daily from Feb. to Aug., 2016. My PCP noticed elevated liver enzymes and took me off atorvastatin 80 mg day from Sept. 2016 to Feb. 2017 which I was taking for 12 years due to family history of high cholesterol and heart disease. I immediately started experiencing hair loss in Aug, 2016 and reported this to the endo who took me off NP thyroid from Sept. 2016 to Feb. 2017. More hair loss. When liver enzymes normalized in Feb., 2017, PCP put me on rosuvastatin 5 mg daily for high cholesterol and endo put me back on 90 mg/60mg daily.
I immediately starting rapid, sudden onset of hair loss and within 4 weeks from Feb. 2017-March 2017 have lost 90% of my hair with loss continuing rapidly! Will be completely bald shortly. My hairdresser whom I been going to for 25 years says my sudden hair loss and state of my hair looks like hair of women who have had chemo! Could this be PSTD after stress. Think this is Alopecia Totalis or possibly Universal because I have no hair on the rest of my body (except eyebrows) which has been like that for the last 5 years

Am a professional woman who prided herself in image and self confidence and am devastated beyond belief. Staying indoors and bought wig which is natural looking but uncomfortable. Husband is very supportive but our life has now changed dramatically as a result of this. Have been on spirolactone 200 mg daily and minoxidil 5% daily for over 12 years.
Dermatologist says it is telogen effluvium and doesn't know how long it will last (not sure I agree) and new endo says it is menopause and put me on propecia (finasteride) 5 mg daily which I started beginning of April, 2017 with no side effects. Hair still falling out and looks eaten. Very fine hair remains over almost bald head.

Have had all lab work done which shows basically normal results with low range of TSH, T4, T3, etc. but with lower range of DHEAS and high range of thyroid antibody TPO. Am going to Dr. Theodore Freidman in LA in May, 2017 who is a well known endocrinologist,and researcher in hard to diagnose endocrine female problems for testing and consult. He has a limited part time practice and acts as medical consultant to your local doctor. Google him, very impressive and informative website with videos on each endocrine condition. Anyone experienced this situation and/or have any feedback?

 

[hairblues]

I am so sorry you are going through this.

I don't have answers for you but I had been misdiagnosed briefly with Areata (wrong biopsy) and I had done a lot of research in the area as a result.

I would try on Facebook a private group Alopecia Areata--its run by a woman Melanie Moyers ( think that was her name) its very informative there are some women with all types of alopecia and all types of Areata and some nurses who answer questions.

I do know if you have one autoimmune disease it is easier or more likely to get a second--so do you have any autoimmune diseases that you know of? I also know the fingernails can sometimes look funny when you have Areata.

The immune system is odd--it can just be a combination of things that just 'push' the button to start an autoimmune response when you are pre dispositioned for.

Wigs--I would just keep experimenting with different kinds to find one you feel comfortable in..I don't wear a wig but i had done a ton of research on them at the time and that was one thing I kept in mind was the comfort of the 'cap' party..On youtube you can do a lot of research of brands and styles that people review.

I live in NY so I had seen an alopecia expert at Columbia...her name was Dr. Mckay Wiggans...She gave me proper diagnosis after i saw her that I have androgenic not areata--BUT she is one of the top Areata Doctors in USA. If you are in or around NYC maybe consider seeing her. She takes most insurance.

IF it is Telogen Effluvium and even if it is Areata--that will mean the hair 'could' grow back. I am being cautious how i word it because I don't want to get hopes up..But the follicle is not damaged if it is Telogen Effluvium or Areata. Your body attacked your hair rejected it...but if that is reversed or you go into remission it will grow back.
Where Androgenic just shrinks the follicle.
There is also various types of scarring alopecia--but I do not believe it moves that fast or that aggressive in scope as you are describing..

What you described at lest sounds like Areata or Telogen Effluvium. Telogen Effluvium may have been from the medications I don't know enough about it though.

 

[lorraine]

Thank you so much for taking the time to read and reply. Your response is very helpful and informative. I forgot to mention I was diagnosed with Hashimoto's thyroidits at age 52 at the onset of menopause and I do live near NYC, so I will go see Dr. Mckay Wiggans, the alopecia expert at Coulumbia. Will also join private group Alopecia Areata on Facebook. Totally agree that the immune system is odd and whatever trigger I had was definitely pushed. Reaching out expands our knowledge base and hopefully helps all of us. So many thanks for your time and insight.

 

[hairblues]

Thank you so much for taking the time to read and reply. Your response is very helpful and informative. I forgot to mention I was diagnosed with Hashimoto's thyroidits at age 52 at the onset of menopause and I do live near NYC, so I will go see Dr. Mckay Wiggans, the alopecia expert at Coulumbia. Will also join private group Alopecia Areata on Facebook. Totally agree that the immune system is odd and whatever trigger I had was definitely pushed. Reaching out expands our knowledge base and hopefully helps all of us. So many thanks for your time and insight.

You are so welcome
If you go cant find that group on Facebook PM me and i will see if I can cut and paste it for you.

McKay Wiggans I believe also works with Dr. Christiano--who is working on the Jax inhibitor medications to help with Areata...I think it is still in trials but she may have some good information for you about medications if it turns out you have Areata..The oral meds are harsh and insanely expensive and toxic..but I think they are 'trying' to experiment with making it a topical..I am again cautious how I write this because I don't know how far along they are in their trials or progress. This is something that may not be available for years. But this is the area they are working in.
Also it is far off but you may want to research (again don't get hopes up just stay neutral) Dr Brotzu with Fidia pharmaceuticals that is supposed to be good for Areata and that is coming out 'supposedly' 2018 or '19. They are still doing trials though for efficiency.
If you have Telogen Effluvium i think its just about finding a trigger and then hair will grow back.

 

[Johnmpb]

Have you visited a derm in conjunction to your endo? They may have some input and possible treatment options

 

[lorraine]

You are so welcome
If you go cant find that group on Facebook PM me and i will see if I can cut and paste it for you.

McKay Wiggans I believe also works with Dr. Christiano--who is working on the Jax inhibitor medications to help with Areata...I think it is still in trials but she may have some good information for you about medications if it turns out you have Areata..The oral meds are harsh and insanely expensive and toxic..but I think they are 'trying' to experiment with making it a topical..I am again cautious how I write this because I don't know how far along they are in their trials or progress. This is something that may not be available for years. But this is the area they are working in.
Also it is far off but you may want to research (again don't get hopes up just stay neutral) Dr Brotzu with Fidia pharmaceuticals that is supposed to be good for Areata and that is coming out 'supposedly' 2018 or '19. They are still doing trials though for efficiency.
If you have Telogen Effluvium i think its just about finding a trigger and then hair will grow back.

Hi;

Am going to call Dr McKay Wiggins today and get appt. Will ask about trial info. Also will set up a personal Facebook to see Melanie Moyer info. Have a business Facebook now and don't want to use it. I saw Dr. Mark Avram, derm, in NYC recently who had been tracking me periodically over 10 years. Although I had a scalp biopsy in 2015 that diagnosed androgenetoc alopecia, Dr. Avram thought due to rapidity and severity and inordinate stress that it was telogen effluvium. He said biopsy results didn't negate Telogen Effluvium. He recommended finasteride, PRP therapy 3 x over 5 months and light laser therapy. Not necessarily all three of them. He thought PRP was best; costs $5,000. No guarantees he said because if it was Telogen Effluvium he thought Hair might come back on its own. Curious to get another opinion from Dr Wiggins.
Am going to LA to see Dr. Theodore Friedman, endo and researchrer on May 23. I want to get to bottom of hormone issues may have PCOS along w Hashimoto's, etc. I see hair is being eaten up and yesterday noticed complete balding behind ears and nape of neck along w existing balding all over. Had very bad day and am regrouping. I really appreciate your kind response and suggestions. These sites and Facebook are so helpful.

 

[hairblues]

Hi;

Am going to call Dr McKay Wiggins today and get appt. Will ask about trial info. Also will set up a personal Facebook to see Melanie Moyer info. Have a business Facebook now and don't want to use it. I saw Dr. Mark Avram, derm, in NYC recently who had been tracking me periodically over 10 years. Although I had a scalp biopsy in 2015 that diagnosed androgenetoc alopecia, Dr. Avram thought due to rapidity and severity and inordinate stress that it was telogen effluvium. He said biopsy results didn't negate Telogen Effluvium. He recommended finasteride, PRP therapy 3 x over 5 months and light laser therapy. Not necessarily all three of them. He thought PRP was best; costs $5,000. No guarantees he said because if it was Telogen Effluvium he thought Hair might come back on its own. Curious to get another opinion from Dr Wiggins.
Am going to LA to see Dr. Theodore Friedman, endo and researchrer on May 23. I want to get to bottom of hormone issues may have PCOS along w Hashimoto's, etc. I see hair is being eaten up and yesterday noticed complete balding behind ears and nape of neck along w existing balding all over. Had very bad day and am regrouping. I really appreciate your kind response and suggestions. These sites and Facebook are so helpful.

You could have both Androgenic and some type of Areata or Telogen Effluvium--there are some (sadly) few who have multiple types of hair loss.
Its hard to say I hope you do figure it out with the Dr. Wiggans.
Hormone changes can drastically increase Androgenic.. post menpasaual that is when it hit my Mother hard but should not come out like 'chemo'. I think that is unusual (as far as I know at least).

$5000 for 3x PRP alone is in my opinion is kind of expensive compared to other quotes and I would not do it before consulting with DR Mckay-wiggans because when I saw her last year I asked her about PRP and she said to me that their was not enough evidence yet that she felt comfortable recommending it BUT she would be learning more at a conference in March (that just passed). I was going to call her office and ask her thoughts on it now, but to be honest I have just been busy and my hair is doing pretty good for now since I started minoxidil in the Fall.

Be cautious and get a firm diagnosis and the thing I liked personally going to Columbia to Dr Mckay Wiggans is I felt confident if she could not figure out my case (which she did) there were other Doctors there who are high caliber as well, its also a research hospital working on treatments--so its like the mecca for alopecia..that and U Pennsylvania. U Penn has Dr Costarellis who is in my opinion the top Alopecia researcher in USA, he is hard to get into see as a new patient BUT if your Dermatologist writes a letter of medical necessity and faxes your records from their office (meaning he/she is stumped by an unusual case) they will go case by case for a new patient..If you need to try at some point PM me and i can give you his receptionists name and number--although they did reject me as a patient lol..but your case sounds unusual and hyper-aggressive so you never know...He is currently working on several patents for better treatments for andrgonic and even something called neogenesis (creating new hair follicles). This will be good (we hope) for androgenic hair loss http://www.follicabio.com There is no firm date of availability we talk about it a lot on message boards in 'research section'..We think it might be available end of 2018/2019.
Then there is a lot happening in Japan for andgrogeic with stem cells to potentially 'cure' androgenic hair loss but that is a bit far off unfortunately like 2020-2025. I also don't know about 'reversing'. Maybe combination therapies but unfortunately this is too far off for some of us.

But of course you do have to find out what is going on that is causing the mass shedding.

 

[lorraine]

Hi:

Can't thank you enough. Just got appt for 5/1 w associate of Dr. McKay Wiggins as she is no longer accepting new patients! Just my luck! They wouldn't budge on making an exception for my severe case either. The associate is Dr. Lindsay Bordone at the 880 3rd Ave location and they take my ins which is a miracle. I am sending her short write up and recent labs ahead of time. Other associate is a male, Dr. Filament Kabigting FYI. Will let you know how Dr. Bardone is. Am going to ask if she can run my case by Dr Wiggins.
Totally agree w you about PRP cost being high and that's why I opted for finasteride as first course of treatment.
Yes am post menopausal and this could be a serious factor in my severe, rapid hair loss along w taking NP Thyroid. Could have Androgenetic Alopecia and Telogen Effluvium w menopausal hormone decline. Confirmed my appt today w LA endo and will let you know how that goes. Read his patient reviews at goodhormones.com. He solves complex cases.
Will keep in mind Dr. Costarellis at UPenn for androgenic alopecia and look up that website too. Will be sure to help another person on site at some point to pass on info. Many thanks! Please let me know of anything else and will browse site.

 

[hairblues]

That sucks the timing. ugh. Sorry.
When they switch over to real research they must get too busy.
I saw Mckay-Wiggans at the actual hospital (next door actually but attached ) which is on 165th and Broadway..I just googled the address they gave you--it's still the 'Columbia Doctors' so they must know one another.
She probably is informed. It's your insurance so at least it's a start. If you don't like her I can help you find other Doctors. It is NY so I mean we are lucky in the area geographically compared to many other people who are in rural areas. They don't have any options its crazy.
I suspect that LA endo will be a lot of help once/if you rule out Areata or any other cause that is not Androgenic.

Just googled Dr you are seeing IF you have Areata--she sounds really good she is talked about on the blogs for the Areata trials at Columbia and she had good rating some review boards like Healthgrades and Doczoc.
If you google her you will find what I found easily--if not just ask me I will link them for you.

 

[hairblues]

@lorraine
This is your Dr she sounds good to me.

here is the other Dr you mentioned..>I like she specializes in Alopecia and mentions it BUT I also like that he is a Dermatologist and a Dermapathologist..but I doubt you have to worry about the derma pathologists these Doctors would use. I had one make a mistake at another Doctors office in diagnosis they later corrected.
She probably knows exactly what to ask for if she needs to do biopsies.
I would keep in mind wherever you did your original biopsy samples--those samples 'belong' to you so if you wanted the other Doctors derma pathologists or labs to re examine that tissue for a second opinion or to compare to new biopsy, you can have them make requests...This may be unnecessary information for you--but I did not know that until I learnt it so just passing that on so you know you have that right or option. Doctor may even mention it.

 

[lorraine]

What is your name! You are a godsend. Believe it or not I prayed for help and you answered. I chose the female derm because I think she is probably more empathic being a woman, but I think both docs have the same good credentials. Thank you for googling them because I was going to do that when I got home. I had the biopsy done on the frontal scalp in July 2015 which showed Androgenetic Alopecia and will keep in mind that I am entitled to the specimen. I don't know if it is still availabe and was thinking maybe they should do another biopsy. I will go on that other site for androgenetic alopeica. I want to get as much info from the derms as I can before I go to LA on 5/23. IF you go on Dr. Freidman's website below, you can see his wealth of knowledge with hormones. He has videos on many subjects and articles as well. His reveiws from his patients are all so positive and they were helped after going to many doctors. This hair thing is a journey for sure and is a process.

http://www.goodhormonehealth.com/meet_dr/meet_dr.html

 

[hairblues]

What is your name! You are a godsend. Believe it or not I prayed for help and you answered. I chose the female derm because I think she is probably more empathic being a woman, but I think both docs have the same good credentials. Thank you for googling them because I was going to do that when I got home. I had the biopsy done on the frontal scalp in July 2015 which showed Androgenetic Alopecia and will keep in mind that I am entitled to the specimen. I don't know if it is still availabe and was thinking maybe they should do another biopsy. I will go on that other site for androgenetic alopeica. I want to get as much info from the derms as I can before I go to LA on 5/23. IF you go on Dr. Freidman's website below, you can see his wealth of knowledge with hormones. He has videos on many subjects and articles as well. His reveiws from his patients are all so positive and they were helped after going to many doctors. This hair thing is a journey for sure and is a process.

http://www.goodhormonehealth.com/meet_dr/meet_dr.html

I will PM you my name..Im glad I helped..I hope it works out.
Im definitely going to check out the endo!
I would do fresh biopsy with new Dr--I just anted you to be aware because I never knew that I 'own' those samples.>its just good to know in case of any future medical issues. The Dr you see just has to request them with your permission. But just do new ones if you don't mind it.

 

[yetti]

Hi,

I really don't know if this doctor would be appropriate for your specific issue, but as you are in NY I thought I'd mention it. He's well known and well regarded. I saw him once for an appt. and he seemed top notch to me. So if for some reason your current doctors don't work out or you want another opinion at some point he might be worth a try. Also connected to Columbia.
https://www.bernsteinmedical.com/about-us/dr-bernstein/