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There are several issues to consider in this situation.
The first is to assess whether the dose of thyroid need to be adjusted and this would be based upon the TSH level. Most people do well once the TSH is in the normal range, but some people do better with a TSH that is low in the normal range, about 0.5-1.0.
If the TSH is well controlled and the minoxidil did not help, then the Kera XL is a reasonable next option. If this also does not work, then it may be reasonable to consider interventions that affect hormone. In a woman taking birth control pills, this can be done by adjusting the brand of birth control pill. Another approach would be the use of spironolactone, which antagonizes the hormones that can contribute to thinning hair.
If I can provide any further information, please let me know.
The above interventions may still be helpful, but with these other symptoms, it also would be appropriate to consider whether there may be an inflammatory/infectious condition of the scalp, such as a fungal infection that may respond to a ketoconazole shampoo.
You can try different shampoos, such as coal tar shampoo or selenium shampoo, plus the other interventions noted above.