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Terry
Terry, Nurse, RN, BSN
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Experience:  Adult/ Respiratory/ Neonatal ICU, Pediatric/Adolescent Care, Geriatrics, Patient/Parent Counseling
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My husband has lost nearly all of his hair, even his ...

Customer Question

My husband has lost nearly all of his hair, even his eyelashes and eyebrows. This happened suddenly over a period of about a month. He has no skin lesions, no soreness, no itching, flaking or other irritation. We went to the dermatologist who ordered blood tests that came back normal. He prescribed Rogaine. We were not satisfied with that so we went to an alternative physician who ordered another more extensive saliva test for hormonal imbalance. It turns out that my husbands cortisol levels are 440, but most everything else is normal or close to normal. He has not had any cortisone shots and is not using any form of steroid medication. The only meds he takes are a multi vitamin tablet, ginko, cinnamon and an extra vitamin B complex that the doctor suggested along with a formula for stress. My husband works as a letter carrier at the post office (very stressful place to work) so we think that probably stress is the cause, but we need to know what to do. He is 62
Submitted: 6 years ago.
Category: Health
Expert:  Dr. D. Evans replied 6 years ago.

With high cortisol, he may be suffering from a condition called Cushin's disease. Cushing's disease is due to excess amounts of a hormone in the body, called Cortisol. Hormones stimulate different organs of the body in different ways, and when cortisol is in excess, it can cause obesity, fatigue, fragile skin, weak bones, etc.

Cortisol is secreted by a gland called the adrenal gland, which lies on top of the kidneys. The adrenal gland releases cortisol only when it receives a chemical from the pituitary gland, called the ACTH. When there is a pituitary tumour, excess amounts of ACTH are released by the pituitary, and this causes release of excess amounts of cortisol, and this in turn causes Cushing's disease signs and symptoms.

You should approach your doctor, preferably an endocrinologist who specializes in hormones, and ask for investigations to rule this out.

You can look up here:
http://www.endocrine.niddk.nih.gov/pubs/cushings/cushings.htm

Causes of hair loss are:
Age related baldness: this may be male pattern (loss of hair starting from the center or from the temporal regions) or female pattern (thinning of hair throughout the scalp).
Disease: the three most common diseases that cause this are diabetes, thyroid disorders and Lupus.
Nutrition; poor diets not rich enough in protein or iron.
Medications: drugs used for gout, depression, blood thinners, anti-hypertensives, birth control pills, chemotherapy.
High fever or other illness: hair may thin out after about three months of a severe illness due to stress.

Hormonal changes: this can occur after pregnancy or with the use of birth control pills. Can also be related to menopause.


You need to do investigations like blood sugar and thyroid levels . If other causes are eliminated, then it is likely that you are having female pattern baldness.


The treatments that you can do is:
Iron supplements: you should take an iron supplement available OTC at pharmacies.
High proten diet
Minoxidil (Rogaine) : apply twice daily to the scalp. This is available OTC.
Finasteride (Propecia) : available on prescription for male pattern baldness.

In addition to investigations to rule out cushing's disease, yo can ask your doctor for a prescription for Finasteride which will work for him.

You can look up the following sites:
http://familydoctor.org/081.xml
http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm



I hope this answer was helpful. If you need more information, feel free to ask. For accepting this answer, please click on the green 'accept' button below. Feedback/Bonus will be warmly appreciated.




Customer: replied 6 years ago.
This answer is not acceptable. I indicated that this was my husband so pregnancy, menopause or female pattern baldness is not a possibility. I also noted that we did a complete blood workup and his sugar and thyroid are both well within normal ranges. He does not fit the profile for Cushings - does not have a weight problem, the round face or the fat hump. He is lean, fit and nearly hairless. Given his age additional iron in his diet is contraindicated, although we have some form of meat & green vegetables in nearly every pm meal. Please try again
Customer: replied 6 years ago.
Male pattern balnesss is an hereditary condition that is not evident in his family on either side and his baldnesss happened over a one month period. First the hair on his head turned white and then dropped out. Following that, slowly his body hair is thinning and falling out. It has been 4 months since this becan.
Expert:  Family Physician replied 6 years ago.
I'm sorry that you have not yet had an acceptable answer.

Based on the history that you provide I am confident that your husband is suffering from a condition known as alopecia areata. He would appear to have a variant known as alopecia totalis

This condition is felt to be a type of autoimmune disease (the body attacks itself). It may be seen more frequently in patients who are under stress.

http://www.dermnetnz.org/hair-nails-sweat/alopecia-areata.html
http://www.nlm.nih.gov/medlineplus/ency/article/001450.htm

Here is some information.
Customer: replied 6 years ago.
Allopecia Areata is a condition of patchy baldness on the scalp only. It is a progressive disease. My husband's condition is Allopecia Universalis. I already know this. His cortisol and DHEA hormones are what caused this condition. If you go back to my original post his cortisol level was 440. Normal is 24 to 42. We think it was brought on by stress. My question is what do I do about the high cortisol and what can I do to bring back his hair.
Expert:  Family Physician replied 6 years ago.
Most of the published studies on alopecia involve the use of immunosuppressive medications. There is one study which looked at the use of relaxation and image therapy.

I would suggest that he be seen by a dermatologist and a psychologist who deals with stress management (possibly some biofeedback)
Customer: replied 6 years ago.
We have already been to a dermatologist. That is who ordered the first set of tests that told us nothing and the second set of tests that also told us nothing we did not already know. I sincerely XXXXX XXXXX I will find a psychologist that knows anything about growing hair and my husband's stress is related to his job, our son's inability to secure work, our daughter's impending marriage and our resultant finances. The psychologist is likely only to add additional financial strain on our already over taxed budget. What I had hoped for was an answer to my original question; how to help my husband's adrenal glands return to homeostasis and maybe grow his hair back. So far, I have had answers ranging from pregnancy and menopause to Propecia for male pattern baldness (which he also doesn't have) and from Alopecia Areata (he has universalis) to biofeedback. Nurse Annie and Kerry whoever they are agreed with information I already had and so far, I have learned nothing I didn't already know and have even gotten answers that were not even gender appropriate. I must say I am more than disappointed.
Expert:  Terry replied 6 years ago.
Hi puppylove 978,

I praise you for doing extensive research to try to help your husband. Sometimes we find ourselves in the middle of a situation without the quick answer we need but we have to keep searching, and I guess that‘s why you came to Just Answer. Your husband presents with an interesting situation and I found some info for you to look at in case you haven't found it in your research already. This is about stress and sudden hair loss which definitely is part of the problem as you stated. Here is the website, below:

http://www.healthguidance.org/entry/4396/1/Sudden-Hair-Loss---Is-Stress-The-Cause.html

The diagnosis mentioned is Telogen Effluvium, it is the type of sudden hair loss due to sudden or severe stress. A full explanation is given along with some good treatment options for reducing stress. Perhaps your husband will try them. You described that he had a lot going on right now and his stress level is way up.

On the following website, scroll down to the second paragraph under the Introduction. It is a study revealing info about the ratio between a high cortisol level/low testosterone level as a result of stress. You'll notice the importance of getting the stress level down to decrease the cortisol level to prevent getting into stress induced cardiac problems. Some of this demonstrates animal studies but further down in the article you will see the study on humans. This confirms what you stated earlier about the high cortisol level contributing to the problem. It is a cycle that needs to be stopped so can get better.

http://www.circ.ahajournals.org/cgi/content/full/112/3/332

One more website for you below, demonstrates how to reduce stress with dietary supplements and therefore bring cortisol level down which is what you wanted to do. The paragraph below is from that website .

"With all this emphasis on balancing exercise with adequate recovery and eating the right amount of macronutrients for energy and tissue repair, where do dietary supplements fit in? Aside from avoiding stimulants, such as caffeine, ephedra and synephrine (which can increase cortisol levels when used for more than a few weeks), a variety of dietary supplements can help keep cortisol levels within normal ranges, even when a person is stressed. The first step is to take a daily multivitamin/mineral containing, at a minimum, calcium, magnesium, vitamin C and B-complex vitamins to help modulate the general stress response"

http://findarticles.com/p/articles/mi_m0675/is_6_21/ai_113852511/pg_2

Warm Regards,

Terry

Customer: replied 6 years ago.
Thank you for your efforts. I have just read the studies and reports and will assimilate the info into our daily stress reducing routine.

Sarah
Expert:  Terry replied 6 years ago.

Hi Sarah,

I am glad to hear it. I will continue to search for info. If I come upon somthing new that might help, I will post it for you.

Stay Strong!

Terry

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