When my hairline started receding a year and a half ago, I thought it was one of two things: low iron (anemia) or my thyroid. That’s typically what comes to mind first. But it wasn’t either of those things. I had blood work done and my iron levels were surprisingly high, and my TSH (thyroid stimulating hormone – more on this later) was assessed by my primary care physician as normal at 2.5; the range 0.5 – 4.0 is deemed “normal” by labs. I found out through more testing that at that time my hair loss was due to a food sensitivity to bean agglutinins; the proteins in legumes. (Read about my experience here and why I recommend food sensitivity panels if you’re dealing with hair loss.)
But that was back in April of 2016. I switched up my diet accordingly and my hair started to slowly come back, but the progress was short lived. I was frustrated and desperate to find a solution and regain the confidence my once thick lustrous hair gave me.
Still struggling with hair loss and searching for answers in June 2016, I interviewed hair specialist Lucinda Ellery to write a blog article on why hair loss affects one third of the female population in the United States each year (and hopefully get answers for my own hair issues.) She spoke about the role hormones play influencing our hair growth cycles especially testosterone, estrogen and human growth hormone. (Read the full article here.)
Following this discussion, I began to experiment with hair products containing estrogen, like Alterna’s Caviar Hair Regrowth line which works to prevent DHT build up; Dihydrotestosterone binds to receptors in the scalp follicles causing them to shrink and/or fall out according to the American Hair Loss Association.
Again, the results were short lived and the chemical products began to irritate my scalp. I eventually developed a sensitivity to many synthetic preservatives and harsh chemical surfactants and turned to green beauty hair products as I discussed in Part I. I soon discovered eliminating harsh surfactants and irritating synthetic preservatives, that can cause the follicles to weaken and prematurely break, would make a huge difference in my hair. I even experimented with my diet and its effects on my hair. The conclusion: green beauty products + an anti-inflammatory diet + the right supplements = an amazing rebound of my hair! (Read this recent blog post for my full haircare routine, diet and supplements.)
I thought that’s where the story would end. But it doesn’t.
In Part I, I mentioned that my husband and I have been trying to get pregnant for some time now. But it’s been taking a while. I recently went in for a full pelvic examination and blood work testing. At which point my OBGYN Dr. Caroline Colin found my hormone levels to be imbalanced. We discussed options and I went for further X-rays and testing. This was in early August.
Now into September, I went to see her last week to review my tests and what she told me about my thyroid was startling: My TSH level was in normal range at 3.5, but the normal range was wrong. Huh?? She explained that even though my report said “normal,” combined with my symptoms – fertility issues, hair loss, stubborn weight gain, dry skin – she presumed I might have mild hypothyroidism. And informed me for optimal health and the best chance of conceiving and carrying a baby to term, my TSH levels needed to be between 1-2. She recommended starting me on levothyroxine, a synthetic thyroid hormone, immediately along with specific lifestyle adjustments (more on this below.)
I was stunned. If the ideal range is 1-2, then why were my other doctors (and lab results) telling me I was “normal” and “fine” when my thyroid stimulating hormone (TSH) levels were 2.5 and then 3.5?! I was stunned.
I began to research online and found other medical professionals, including Amy Meyers, MD and author of the New York Times Bestseller, The Thyroid Connection, also believes the optimal range for thyroid function is a TSH level 1-2.
(This blog article by ThyroidMom.com does a great job of breaking down the top five reasons doctors fail to detect thyroid issues and why the thyroid normal range is outdated.)
So let’s get to the nitty gritty and break down what TSH is, how your thyroid plays a role in your skin, hair and overall health and why if you’re dealing with hair loss, you definitely need to get your thyroid levels checked out, and be weary of a “normal” TSH report below or above 1-2.
What does the thyroid do?
According to the American Thyroid Association, “The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.”
So it’s important. Got it.
But I’m vain. What I really want to know is how does it affect my skin and HAIR?!
Short answer: it affects both, A LOT.
One study published in the Annals of Thyroid Research in 2014 reported that either a hypothyroid (under active) or hyperthyroid (overactive) thyroid causes severe changes in skin texture at the epidermis and dermis levels. Rough scaly texture, follicular plugging (blackheads and whiteheads), poorly hydrated skin (aka dry AF), and slow wound healing (those red acne marks taking forever?) were reported as the most common symptoms associated with an under active thyroid gland.
In terms of hair, the report gets scarier. It says that hypothyroidism can cause hair to be dry, coarse, brittle, directly slow grow and cause patchy diffusions of scalp hair loss. It’s also characteristic for there to be diminished body hair and facial hair (including eyebrows). This is due to the fact that cell proliferation is severely reduced in the hair bulbs of people with an under active thyroid. And the coarseness results from under active sebum glands in both the facial skin and scalp.
So…I suspect my hair loss is due to my thyroid. Now what?
It’s best to have your thyroid hormone levels checked by your medical professional. Here’s what testing with tell you:
T4 (thyroxine) & T3 (triiodothyronine):
Thyroxine, or T4 for short, is the major thyroid hormone secreted by the thyroid gland. It is converted into triiodothyronine (T3) by the liver or the brain. It has been reported that T3 is important for the function of sebum glands, the stimulation of dermal cell renewal, and affects hair growth directly (Annals of Thyroid Research).
(Typically, they won’t test your T4 or T3 levels unless you request it or your TSH levels are abnormal, since they test your TSH levels first.)
TSH (thyroid stimulating hormone)
According to the American Thyroid Association, the amount of T4 produced by the thyroid gland is controlled by another hormone: The thyroid stimulating hormone (TSH). The thyroid gland secretes T4 into the blood stream, but if it’s under active or over active, the pituitary gland uses TSH to regulate how much T4 the thyroid creates. If the pituitary gland detects that the thyroid gland is not creating enough T4, the pituitary gland will secrete TSH into the blood stream to tell the thyroid gland to produce more T4. This is why if your TSH levels are high, it means you have hypo-thyroidism function. And if it’s low, it means you have hyper-thyroidism.
Hormone Thyroid Therapy – Levothyroxine
Per my OBGYN’s recommendation, I’ve recently started taking thyroid hormone medication levothyroxine (and by recent I mean this week). It’s a little bit of a pain in the butt to take: I have to take it around the same time every day, on an empty stomach an hour before eating, and four hours apart from taking any iron, magnesium, or calcium supplements (University of Michigan Medicine).
It was tough in the beginning waking up and taking it then having to wait an hour to eat. But I read online the best way to take it is to set an alarm for 5 or 6am, take the pill, then go back to sleep. I’ve been following this method and once I wake up at 7:30/8am, I can follow my normal probiotic and breakfast routine.
So far I haven’t noticed any changes to my skin, hair or weight loss (The Journal Of Clinical Endocrinoldoy & Metabolism published a study in 2011 that reported thyroid hormone replacement in individuals with hypothyroidism resulted in significant weight loss). But the half life of this drug is very long, so it takes a while to build up in your system. Meaning it takes 3-4 weeks before improvements are generally noticed.
In three months, I will be posting an update on my experiences taking levothyroxine and what improvements I experience.
One potential side effect of Levothyroxine is hair loss.
I read on Thyroid Mom’s blog that levothyroxine can potentially cause hair loss! This sent me into a tizzy. But upon further investigation, I discovered that it happens in specific cases when there is too much T4 in the blood system. Remember T4 needs to be converted to T3. If the body is unable to convert T4 to T3, then taking levothyroxine (T4) synthetic hormone will only increase T4 levels which can cause hair loss as reported by Indian Dermatology Online Journal in 2015.
This is why it’s best to have your TSH, T4 and T3 levels checked by your medical professional so they can assess if your issues are caused because a) your thyroid isn’t creating enough T4 or b) your thyroid isn’t able to convert the T4 into T3.
And most medical professionals will start you off on a very low dose of levothyroxine to avoid negative side effects, monitor your levels and adjust the medication based on your needs.
I began to wonder how my thyroid went from 2.5 to 3.5 in less than a year. I asked my OBGYN if there were any lifestyle changes I should make to better support my thyroid function and she called out two: iodine and kale.
Why I switched from Himalayan pink salt to Morton’s Iodized Salt
I have been using Himalayan pink salt for years. Many health articles tout it for being “pure” and “free of pollutants” since it comes from high up in the mountains. Yes, this is true, but it lacks iodine; a crucial component to a healthy thyroid.
My OBGYN explained to me that iodine is essential for the thyroid gland to create thyroid hormone. And since the body is unable to make iodine, it needs to be sourced from our diet. Iodine deficiency can lead to hypothyroidism. And many people may be iodine deficient and not even realize it since testing for iodine is rarely done. (40% of the world’s population is at risk for iodine deficiency American Thyroid Association).
Upon discovering this, I freaked out and immediately went out and bought Morton’s Iodized Salt, you know the one with the girl and the umbrella. I also ordered the below iodine supplements.
(Please consult with your medical professional before beginning any new supplements.)
- J.Crow’s Lugol’s Iodine Solution
- Now Foods Selenium (Selenium protects the thyroid gland from oxidative damage and supports thyroid function.)
- Optimox Iodoral High Potency Iodine/Potassium Iodide Supplement
The dangers of too much raw KALE
Kale is a superfood, yes. But too much raw kale and your may be impairing your thyroid function.
Kale is part of the cruciferous vegetable family and when eaten raw and in large quantities, vegetables in this category can impede the body’s absorption of iodine. See where I’m going with this? So if you’re not getting iodine from salt and you’re eating a shit ton of raw kale, there’s a good chance you could be iodine deficient and your thyroid may be having a tough time making thyroid hormone.
I suspect this is what happened in my case.
If you’re been following along with my instastories, then you know how much I love my morning green smoothies. I have one almost every day, and for a while I was adding raw kale to them every morning. About a cup or so. We’re talking maybe 20 cups of raw kale a month. Which is considered wayyyy too much. The University of Oregon published a study reporting that an old woman developed severe hypothyroidism from consuming 15 cups of raw cruciferous vegetables a month for several months!?
Okay, no more raw kale. Got it. Yikes.
Wow. That’s a lot to digest. I’m still processing all of this myself and look forward to seeing what the next few months will bring for my hair, my skin and overall health.
I really wanted to share this information about my hair loss struggles because so many women have reached out to me about their own hair thinning issues, and I wonder if an undiagnosed thyroid issue or iodine deficiency could be to blame for those women too. I hope this blog post will provoke questions, online research and discussions with your medical professional if hair loss is an issue for you. And remember these are just my personal experiences. I am not a medical professional. I highly recommend you speak with your medical professional if you think you may have thyroid issues.
As always, thanks so much for taking the time to read this rather long blog post and feel free to reach out with any questions. Hair struggles are the worst and we’re all in this together.