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I am a year old female whose first symtom was dry and

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I am a 69 year...
I am a 69 year old female whose first symtom was dry and brittle hair which caused diffuse hair thinning.(in March). The next symptoms were loss of sleep, loss of appetite, cold hands and feet. Could you list the conditions that can cause this and tests that I should have done. Also please list the normal range for these tests. If you could explain what is happening I would appreciate it. I also had a titanium tooth implant in December, 2009.
Submitted: 8 years ago.Category: Medical
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Answered in 1 minute by:
6/9/2010
Doctor: Dr. Cameron, Doctor replied 8 years ago
Dr. Cameron
Dr. Cameron, Doctor
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when was the tsh done? any other medical problems or medications?
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Customer reply replied 8 years ago
I had the TSH done on May 26, 2010 and I wasn't taking any medications other than a little progesterone cream. (1/4 tsp. of 100MG/GM) I thought I was in good condition until this started with no other medical problems.
Doctor: Dr. Cameron, Doctor replied 8 years ago
Did you have a free T4 done? How about any tests for vitamin deficiencies?
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Customer reply replied 8 years ago
No T4 orT3 was done . What vitamin defciency tests should I take. I didn't have any of those tests.
Doctor: Dr. Cameron, Doctor replied 8 years ago
Okay, well, in order to really rule out low thyroid, you need to have a free T4 level done. You can certainly have signs and symptoms of hypothyroidism and still have a normal/high-normal TSH level. In fact, in some cases, even with a normal T4 level, some endocrinologists will give you thyroid replacement hormone to see if the symptoms abate.
Other possibilities include low thiamine, vitamin B12 and folic acid.
You should get tested for these as well....

warm regards
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Customer reply replied 8 years ago

Doctor Rich,

How do I get checked for thiamine, vitamin b12 and folic acid? i was taking supplements for B-12 . Also, what is a normal T4 and do you think I could have hypothyroidism...If all these tests are normal what other dieases could be causing this? It seens like my body is attacking my hair follicles. Thank you

Doctor: Dr. Cameron, Doctor replied 8 years ago
They are blood tests.
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Customer reply replied 8 years ago
Relist: Answer quality.
My symtoms would have been better answered by an endocrinologist. I asked for all the causes of my symptoms and was only given TSH or vitamin defiency. I need other options to look into if these tests come back as o.k.
Doctor: Dr. Monica, Board Certified Physician replied 8 years ago
Dr. Monica
Dr. Monica, Board Certified Physician
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Hello-

An endocrinologist would start with ruling out thyroid disease first with the free T4 and T3. Then you would also need the blood tests for the vitamin B12 and folic acid. If all these are normal, to rule out an immunological disorder (since you mention your body attacking your hair follicles) you can also get the following blood tests: ANA, ESR, CRP, possibly C3 and C4, and others if any of those are positive. The normal ranges for each test will vary from lab to lab, but are always included on the lab report.

If none of the above are positive for disease, and your doctor feels most more serious conditions have been ruled out, consider stress, anxiety, and/or depression as a cause of your symptoms. Those conditions can also cause the symptoms you are complaining of. If it turns out that stress is causing the hair loss, it can take many months to start growing back. You can discuss this further with your dermatologist, but unless they find a different cause, there is not usually much they can do for stress-induced hair thinning.

This is the best way to start, and then you can always discuss what the next step is after getting these basic labs.

Hope that helps, please let me know if I can clarify.

Best,
Dr. Monica
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Customer reply replied 8 years ago

Dr Monica-

Could you tell me more about each blood test and what the initials stand for. I would like to know what each blood test is looking for. Thanks

Doctor: The Physician, Doctor replied 8 years ago
The Physician
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Hello

Greetings

Let me try and put everything in perspective for your understanding and information and maybe we can work out a course of action.

The Maintenance of the hair growth is a combination of the usual growth factor for all cells in the body -Nutrition(protein, energy and minerals), but the hair in addition is controlled by a special balance between hormones (This is now where gender, and individual xteristics occur)

The balance of hormones (both in male and female) a delicate equilibrium between testosterone/related hormones and estrogen /related hormones.

These related hormones include TSH, Growth hormone and adrenal hormones.

Before menopause, the female hormone estrogen over-rules DHEA (a type of testosterone found in women produced by the adrenal gland) So the hair is 'vibrant', because the follicle are enjoying a normal 'good time', but after menopause DHEA begin to exert more influence, counter-acting the effect of estrogen and causing the hair to loose the quality especially the conformation of the di-sulfide bond in the keratin.

Therefore any changes in the aforementioned factors as follws, could affect hairgrowth

Nutritional: Vitamins and minerals especially Vit Bs, vit E, magnesium and Zinc

Hormonal: Menopause(reduced estrogen and increased DHEA), adrenal gland issues(cortisol, aldosterone which affect the hormonal balance), Thyroid issues ( low thyroid function).

Immunity: It has been found that certain auto-immune factors can attack the hair root ( tests Anti-nuclear Antibodies ANA, Rheumatoid factor and C-Reative protein CRP will detect this)

Toxins: There are environmental toxins that could affect hair . Lead and Mercury

CONCLUSION:

The symptoms of Hair changes, lack of sleep(insomnia) lack of appetite (anorexia) and cold extremities raise the flag on 1) Thyroid d efficiency 2) Adrenal gland deficiency 3) menopause related metabolic changes (calcium, B12, estrogen, 4) stress and/or depression 5) Auto-immune disorders (remote/ unlikely)

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