Just came back from the doctor. Any advice?

[Catie]

Hi Ladies,

I hope you are all having a good week. I wanted to ask for some advice, I just returned from the follow-up visit after the scalp biopsy and now I’m more confused than ever.

Here’s my story in a nutshell to give a little background: I am 24 years old. When I graduated college, I decided to move abroad to work for a non-profit. Within a few months of the move, my hair started falling out like crazy. Normally, I would be in the 50-90 a day range and now I’m in the 250 range. I went to a doctor in a big, metropolitan city and had all my blood work done. Everything was normal except I was a little bit anemic. I began taking ferrous sulfate iron pills, thinking this was the problem.

This all happened about a year ago and my hair loss is still going strong. I finally did a scalp biopsy and the diagnosis was chronic (because it’s been more than 6 months) telogen effluvium. I went to my doctor for a follow-up, which brings me to today. He said most of my hairs are in the telogen stage, but he doesn’t see any miniaturization, which means it’s not AGA. He was not very helpful regarding treatment and said that you have to eliminate the trigger for TE. In my case, it’s very hard because my blood work came back “normal”.

Here’s where I need your advice (wonderful ladies who have been through this also) in trying to find the trigger. I have narrowed it down to three things and I am wondering if anyone has any thoughts or experiences. Any advice would be greatly appreciated!

1. Iron. My ferratin levels are 47.4 (normal range is 11.0-306.8). What makes me slightly anemic is my hematocrit level is low, 36 (normal range is 37-47). The thing is, after over a year of taking the ferrous sulfate supplements (Rite Aid brand), there has been no change in either of the levels, which means I’m probably not absorbing it properly. Has anyone had any experience with this? My doctor prescribed me the ferrous fumarate (3 times a day) because he said it’s better for absorption.

2. If it’s not iron, could it be something to do with hormones? I often times read that hair loss can be hormonal but my doctor says this is unlikely in my case due to my age and the fact that I have normal menstruation and clear skin. Is he oversimplifying things?

3. Finally, the last thing I can think of is the environment. I know that stress didn’t cause hair loss (although it probably plays a role in perpetuating it) since it wasn’t a stressful move at all – in fact, it was the opposite since I was so excited. But the place I live now is in the developing world and very polluted. Could it be that this is causing my hair loss? If I move back to the states, is there a chance that it could get better? Has anyone had experience of hair loss due to environmental changes or a move to a different city/country?

Thanks so much for listening, I know I wrote a lot. I am thinking of you all as we go through this crazy hair loss journey. Wishing you all the best :>

Catie

[Lise]

Hi Catie,

Sorry to hear about the hair loss. I obviously have no idea what is going on with your situation but I can say that I believe it is possible to have hair loss due to hormones while having normal levels. When I was off my current meds I had mild/moderate acne, excessive facial/body hair and alopecia (my period was also irregular). I never had my hormone levels tested prior to going on meds because the symtpoms seemed pretty obvious to me that they were caused by hormones (specifically testosterone).

When I finally did get tested my levels of all hormones were in the normal range (though my testosterone was at the high end). The last two time I have had my testosterone tested I am in the low-normal range, and I still have to deal with excessive body/facial hair and alopecia. I say this because I believe that some of us are just genetically more succeptible to our hormone levels and some of us are succeptible in different ways.

I'm not suggesting this is your problem, only that it might be unwise to dismiss it just because hormone levels are normal.

I hope you get answers to your questions.

[Butterflywings]

Hi Catie. I don't know if you will come by to read this but I too have been taking iron pills. I was told that my iron was in the low range but not enough for anemia. I , however, took it upon myself to take iron. I have seen hairs on the sides growing. I noticed hair that I couldn't put in a pony tail, which was really exciting! One thing some people do not understand is the absorption of iron. It must be taken with Vitamin C for it to release into your blood stream. I've had low iron for many years. I cannot donate blood. I get weak without it. I do not believe it is my savior to my hair loss but it is a start.

Try taking your iron with a glass of OJ or take it with the chewable's you can buy at your local vitamin store. Just be sure to drink lots of water and vitamin C.

[Catie]

Hi Lise and Butterflywings,

Thanks so much for your insight. I will be sure to look further into the role hormones play in my hair loss. And as for iron, I am now taking it with Vitamin C and hopefully that will help with the absorbtion.

This hair loss mess is like an awful treasure hunt - trying to find clues with no end in sight. It's so helpful to have the help of the wonderful women on this site. It truly is as they say, you just don't know how it feels unless you go through this yourself.

Take care and keep me posted if you notice any changes. Wishing you both the best!

Catie

[Butterflywings]

Thank you Catie! Im glad I could have been some help. I really hope the "treasure hunt" ends for you with very happy results. We can only hope right!? Let me know how the iron goes for you!