Hair Loss—a Hyperthyroid & Hypothyroid Symptom

Hair LossHair loss is brought up on both hyperthyroid and hypothyroid forums, and those who have been both, like me, have noticed their hair coming and going.  So what exactly is required for good hair?  There are few human studies to cite, but there’s a lot of anecdotal evidence that I can report, and some of my own theories.

Hair cycles through a growth phase called anagen, a regression stage called catagen, a resting phase called telogen, and finally, the hair is shed in the last stage called exogen.  I believe that when someone is hypothyroid, their whole body is in slow motion, so their hair stays in the resting phase far longer than normal.  That means no new hair grows until there’s enough thyroid hormone to start the growth phase again.  There is probably a minimum level of both T4 and T3 (the two thyroid hormones) required for normal hair growth.  If you’re only on T4 or levothyroxine, then you might need to add a small amount of T3 to get your hair growing again.  (A normal human secretes, on average, about 10 mcg of T3 daily.)  Note, however, that T3 cannot be tolerated in those with insufficient iron or cortisol levels, so those need to be tested and addressed too.  Cortisol, iodine, iron, selenium, zinc, and Vitamin A are all required for normal thyroid metabolism.

Hair loss is also reported by people with Graves’ Disease who are hyperthyroid, or on the T3-only protocol, or even on high doses of desiccated thyroid.  They’ve got plenty of T3, so what’s the problem?  Well unlike the hypothyroid body that’s in slow motion, a hyperthyroid body is moving at warp speed.  Each strand of hair has a limited lifespan, and it progresses through all the stages sequentially.  But the rate of the progression would be greatly increased in someone with too much T3.  Maybe hair cycles too quickly with too much T3 and finishes the growth stage and enters the resting stage prematurely.  My hairdresser noted that my hair strands were thinner when I was on too much T3.  The other possibility is that too much T3 simply overwhelms the hair follicles, in the same way that it causes damage to other parts of the body.  Excess T3 causes bone loss and muscle wasting, so the same type of mechanism may be at work that causes hair loss too.

T4, or levothyroxine, seems to have a positive effect on many patients’ hair.  I know my hair improved when I went from 100% desiccated thyroid to a combo with T4.  My hairdresser said my individual hair strands are thicker now.  And I have heard multiple anecdotal accounts reporting the same thing.  While some cells pull T3 straight out of the bloodstream, other cells prefer to get their T3 by conversion from T4.  That way, the cells are never overwhelmed with an excess of T3.  I believe hair follicles prefer T4 and know people on 100% T4 who have full heads of hair, but the lack of T3 causes other problems for them, like weight gain.

Hair loss may also be caused by androgenic hormones like DHEA or testosterone, which contribute to androgenetic alopecia or male pattern baldness.  Even pregnenolone can convert into testosterone in some women.  This is a male pattern type of hair loss, which consists of a receding hairline and hair loss at the temples.  Low thyroid hair loss is usually a general thinning throughout the entire scalp.  Evening primrose oil appears to help male pattern hair loss, and I’ve noticed positive effects from this supplement.

If your hair started thinning around menopause, then test your estradiol and progesterone levels and consider bioidentical hormone replacement.  Healthy hair requires good levels of both hormones.

Vitamin D has positive effects on skin and hair too, so don’t ignore that supplement if your levels are low.  Of course, as with all supplements mentioned, be aware of adverse reactions.  People have had negative reactions to Vitamin D, iodine, iron, zinc, and hydrocortisone (for cortisol), even though they are all found in the human body.

Both thyroid hormones, T3 and T4, need to be at good levels for an individual to have healthy hair.  Hair and eyebrows are really non-essential, and if there’s a deficit of thyroid hormone, the body will skimp on the hair’s portion and allocate it to more important organs where it’s needed.  In general, good health is found when both Free T3 and Free T4 are in the upper half of the range.  If raising T3 has not helped your thin hair and in fact made it worse, perhaps you need more T4 instead of more T3.  Read more about optimal thyroid labs and misleading reference ranges.

6 thoughts on “Hair Loss—a Hyperthyroid & Hypothyroid Symptom

  1. I was on t3 only for 2 years and my hair was horrible. It got very dry, didn’t grow much. A horrible mess. I started taking synthroid after two years on T3 only and my hair got so much better. It started growing again and it got thick! So, for me T4 works better for hair growth and overall thickness…I was on synthroid for 16 years and never had a problem until I was put on cytomel. I won’t say that for some t3 might be better or that at some point a person may need a little t3..But in my case T4 works better for my hair and skin!

  2. I love what you have shared here regarding signs and symptoms of hypothyroidism that is very helpful not only to me but also to many people who are having problem with the condition of their thyroid.

  3. not sure where to post a skin question -hypo and low cortisol but no meds yet, the rapidly increasing spots I have are unlike the irregular brown spots due to former stupidity in the sun/aging or patches referred to in Addison’s -perfectly round, light brown, flat, smooth and almost appear concave, began on the shins now everywhere -so many on the forearms now it looks strange and unhealthy and hormone doc had no idea what it is -anyone?

    • Dear Arielle –
      I’m not a doctor and I obviously can’t diagnose you. That said, I read your post and something came to mind immediately. I had spots like that in the past and was very sick. My doc’s thought I had Systemic Mastocytosis. It turned out I didn’t. You may want to look into it because the spots, especially the fact that they’re on the shins too sounds much like SM. Just a thought. I hope you get better soon.

  4. My first indication that something was desperately wrong with me was excessive hair loss and thinning. I always had really thick hair; seeing my scalp scared me to death. I have a clear conversion problem. T4 is in the higher end of the normal range and T3 was below the bottom of normal. I started on 1/4 grain of nature throid and saw an immediate reduction in hair loss, but I was too scared to take any more for over two years!! I, of course, got worse and started losing a lot of hair again. I finally got up the nerve to up the dose to 1/2 grain and felt good for about a month, then back to the same symptoms. I got up to 1.5 grains, but still had hypo-symptoms (always tired and cold) so I started taking a natural T3 supplement Biotics GTA – It helped at first, but when I upped the dose, I all of a sudden began losing tons of hair. I can get my body temp. to 98 degrees now, but I’m losing all my hair and don’t know what to do. My last labs showed T4 and T3 in the high range of normal and reverse T3 at 22.5. I’m still freezing cold, tired, and losing hair. Any suggestions? Thanks.

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