Sunday, April 20, 2008

Telogen effluvium following subclinical hypothyroidism

Telogen effluvium is the name for the periodic heavy shedding that hair goes through—usually in response to some physical stress: surgery, fever, hormonal fluctuation. Hair from all over the scalp falls out, anywhere from one to six months following the stressor. And telogen effluvium is happening to me right now.

My hair was already looking a little ratty from all that I had lost last summer and fall. Hyperthyroidism tends to make hair fall out and thin its caliber (make it finer). Then anti-thyroid meds such as the ones I took tend to worsen the problem, most likely because they induce hypothyroidism. In my case, I was on the verge of overt hypothyroidism shortly after beginning Tapazole. (Here's hoping the trend is still reversing).

It is still looking ratty as I pull it out by the drain-clogging handful. I'm lucky to have a lot of hair to begin with, with lots of body, but the hair loss is still fairly evident.

The bright side of telogen effluvium is that by the time one notices it, new hair is growing in, pushing out the old. The scalp is soon covered with prickles and a new fringe of virgin hair is growing in. I managed to miss the hair growing back in the last time this happened to me, probably because I was still toxic then, metabolism working overtime.

Other "benefits" of subtle hypothyroidism: Nails become thickened, jowls become heavier, eyes become puffier and weight gets put on. Up 7 pounds since December. And my mind has become sluggish; processing speed is slower and the end result of all that labor is usually not a pearl of wisdom.

If I could do this over again, I would have really put the brakes on the ATDs a month after treatment began, because letting myself get so close to hypothyroidism did me no favors whatsoever.

8 comments:

kelly said...

Hi- I have a few questions:

1. You are on PTU is this correct? How much are you taking a day?

2. How often do you have your blood drawn?

3. How long will it take for you (your hormones) to get back to the 'normal' non-hypo range?

4. Are you noticing more eye twitching that is accompanying the eye lid retraction? Or no new or increased symptoms at all?

I learned from my endo, whom I saw this past Tuesday, that I don't ever have to go off PTU if I don't want to. I think back to my symptoms before I was diagnosed and went on PTU and that really scares me to get even near that again. Do you think you'll ever do the RAI? What are your long term plans at this point regarding your thyroid? I must say that as I read these blogs and hear everyone's stories, in some way it depresses me. I guess I really will be dealing with this forever. I really hate that...I just want to feel good, not have to worry about my eyes and be done with this already, but I guess it is ever present. Even though, currently, I am feeling pretty good and normal. I think I am at the wane part of my eye disease- to the point that I have really not been thinking about it. But I know that could change. I see my specialist this coming Thursday...Good luck to you! I hope the eye part burns out soon. I wish that for both of us!

Thank you,
Kelly

etaoin shrdlu said...

Hi Kelly,

1. Correct: PTU 100 mg/ day
2. Every four weeks
3. Wish I knew. I will know more after getting this month's report. It may be that I will have to stop the PTU for a few days and then restart on a smaller dosage.
4. Yes, the eye twitching is on the upswing.

I will not consider RAI, ever. I don't want to run the risk of looking like Marty Feldman, even if the evidence for any such link to worsening GO is tenuous.

I'm hoping to stay on PTU long enough to induce remission. I am also interested in lifestyle modifications that will "heal" my immune system, beginning with jettisoning aggravating food, and alleviating stressors.

I know the sinking feeling when reading other people's stories and realizing that Graves' is a forever thing. But the "nice" parts are that Graves' seldom kills anyone, and is a warning shot across our bows to take better care of our bodies than we have in the past.

Glad to know that your GO is of a milder type and running a short course!

kelly said...

Thanks for getting back so quick! Both of my little boys are sleeping- I need to wake them-it's a little after 5 here is San Diego, but the peace and quiet is just too nice interrupt!

I see this from your comment from Linda's blog from back in March:

Hypothyroidism can make eyes puffy (myxedema) and can also cause GO-like ophthalmopathy in the case of Hashimoto's thyroiditis (although less common). It can aggravate GO in the case of Graves'.

So, if we go hypo even for a short time we have to still worry about the eye stuff? What happens once the GO runs it's course? If we get hypo in the future, do we have to worry about the GO again? Maybe I should ask my specialist this. Just checking to see if you know, I'll ask on Thursday.

And if we do go hypo, it is necessarily Hashimoto's? And since we've been diagnosed with Graves, will we always be considered Graves patients? Even if we achieve remission? Again, maybe I should ask my endo and eye specialist.

I HOPE my GO stays mild...I'll feel comfortable saying that this time next year...but not yet. I really like your sense of humor that you pepper throughout your comments- makes me smile and not take this so seriously, even though it's hard not too- a constant stuggle. One day at time as they say....

Unknown said...

I don't know what to say about Hashimoto's vs. Graves'. What I have heard (and maybe experienced) is that the eyes get worse with the onset of hypothyroidism. There is a correlation between becoming euthyroid and calming down GO, so perhaps any fluctuation in thyroid profile will aggravate the thyroid-sensitive eyes.

Emma said...

This is really interesting - I've got Graves' Disease (diagnosed at the beginning of this year) and have just had a very severe pixie-crop haircut because my hair was starting to fall out and it was really bothering me. I've been doing some reading and I think this is happening because the drugs I'm on (Carbimazole) are suppressing my thyroid function to the extent that I'm becoming mildly hypothyroid. I've got a review with my endocrinologist next week, but in the meantime I'm taking the liberty of reducing my Carbimazole dose to 5 mg daily, down from 10. I'm seeing my endocrinologist next week anyway so I don't feel I can pester her with a phonecall, especially as I'm an NHS patient and thus have to be content with get my alloted 3 minutes every two months.

It's so funny you should mention Marty Feldman - I live in daily terror of getting "the Marty Feldman eyes", as I tell everyone. For what it's worth, your picture looks really good, I'd never guess you had Graves'.

I also can't consider RAI - I have a one year old baby, and the thought of not being able to go near her for a month is just too upsetting to contemplate. I'd be all for thyroidectomy if the scars didn't look so forbiddingly Frankenstein-like. I hope the drug therapy will work for me on its own, but I'm not liking those 50/50 odds.

I'm glad I found your blog and will keep up with your progress.

Emma said...

I forgot to mention: I'm in the UK.

etaoin shrdlu said...

Hi Emma, and thanks for stopping by. Your allotment of time with your seems to be comparable to what I get, and I have really good private insurance. Rationing is rationing.

Best wishes with whatever you decide. For what it is worth, my grandmother had a thyroidectomy when she wa sin her forties and as I remember, the scar was not very noticeable. It was a fine white line a strand of pearls would have covered.

Hope to hear how you are doing as time goes by.

Russell Moris said...

I was on Synthroid for six months. I couldn't walk, because of water retention so after reading about desiccated bovine thyroid decided to try it. The doctor didn't want to prescribe it to me but I insisted, and he gave it to me. Wow what a big difference , within two days. All the water retention the Synthroid caused disappered and I am now on it for years. So glad I got my life was back.

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