What type of doctor for female hair loss?
August 8, 2019 5:11 PM   Subscribe

My GP, while wonderful, is a bit stumped and the hair just keeps shedding. So what doctor may be next?

Going on 12+ months. We’ve checked my hormones a few times. Theories are hormones, illness side effects, or med reaction.

My GP is aware, and I can follow up with her but I think it’s time for a specialist. Going to discuss it at my next OB/GYN apt, along with some other hormone cycle issues. I have a dermatologist I’ve seen once, but for acne/skin screening. I don’t have an endocrinologist.

Who do I see?
What other tests may help figure this out?
In the meantime, should I try a natural topical? What?

(I’m not interested in supplements / medicated topicals before checking with my doctor)
posted by Crystalinne to Health & Fitness (13 answers total) 6 users marked this as a favorite
Have you had a lot of procedures or surgeries using anesthesia lately?
posted by jitterbug perfume at 5:27 PM on August 8, 2019

Definitely bring it up at your next OB/GYN appointment, because hair loss + hormone cycle issues are potential symptoms of PCOS, which they will be familiar with (and which, despite the name, doesn't always manifest with ovarian cysts). Usually there's a first-pass diagnosis based on your reporting of your symptoms, and if those symptoms appear to indicate PCOS, they'll do actual testing (depending on your GYN, this could be done in-house or referred out to an endocrinologist). You may have already had your hormones tested, but it's possible it was either a different battery of tests, or the same one with results interpreted differently.

As one data point, I have PCOS with significant hair loss, and treatment (medication and diet) has pretty much halted the hair loss as well as the other bothersome symptoms.
posted by rhiannonstone at 5:32 PM on August 8, 2019 [2 favorites]

Low iron can cause this. Have your ferritin in particular checked.
posted by Amy93 at 6:03 PM on August 8, 2019 [2 favorites]

I have this too (along with hormone & cycle weirdness) and in my fantasy of having time for things I am going to see a dermatologist (bc I have some stubborn problems with my scalp in general so maybe related? ¯\_(ツ)_/¯) and a real endocrinologist (my gp is like hm the armour isn't working? Try taking less? Iunno try coming to me with real problems I can see in test results? ¯\_(ツ)_/¯ )
posted by bleep at 6:15 PM on August 8, 2019

Well shit, now I wonder if I ALSO have PCOS. (I guess my removed ovary pathology may be a clue. But I dunno why my doctors haven't mentioned it as an option. ??? "The ovary is 4 x 3 x 2.2 cm and an uncut section shows multiple smooth walled clear fluid filled cysts and hemorrhagic cysts that are up to 1.3 cm in diameter." ) My (top rated) endo surgeon said they seemed normal.
posted by Crystalinne at 6:24 PM on August 8, 2019

dermatologist is the person to see for hair loss. Non-intuitive, but that's the specialty that deals with it.
posted by fingersandtoes at 6:33 PM on August 8, 2019 [5 favorites]

How are your prolactin levels? The first clue to the prolactinoma that took over my pituitary gland was me losing half my hair in two years. THEN the other symptoms — loss of menstruation, lactation — kicked in. If you haven’t checked your prolactin, your GP or ob/gyn can do that. Get them to also look at your cortisol levels; that tends to also affect hair.
posted by sobell at 7:52 PM on August 8, 2019

Yeah, dermatologist.

Mine ordered some tests and ultimately prescribed a supplement with a lot of zinc and told me to keep up my iron supplementation - you could just start on those ASAP, unless you want baseline levels tested first. Anyway, mine was probably related to being really sick several weeks before, but those supplements seem to be helpful - my hair's better than it was.
posted by amtho at 9:07 PM on August 8, 2019

Gynecologist for hormone/PCOS testing then dermatologist to work with the skin/hair issues. You'll want to get a blood test and an ultrasound because sometimes (in my case) one can have normal levels of testosterone MOST of the time but elevated levels during certain parts of your cycle and, if you're also fit and slender and don't have a lot of excessive facial/body hair or extreme male pattern balding and have fairly normal periods, it can go undetected until the ultrasound reveals cysts. Also yeah, get your iron tested.
posted by Young Kullervo at 5:25 AM on August 9, 2019

Test your thyroid, insulin/sugar curve and vitamin D too, those three contributed to my rapid hair loss.

I got through with a combination of endocrinologist for the above (though a competent GP can manage) and dermatologist for topical treatment (minoxidil plus initially a topical steroid). Yes, there was a moment with more hair loss, but three months into the treatment things started regrowing quite rapidly. Memail me if you want particulars.
posted by I claim sanctuary at 6:06 AM on August 9, 2019 [1 favorite]

For me it was severe anemia so maybe have that very detailed iron check done rather than the basic one.
posted by poffin boffin at 10:21 AM on August 9, 2019

Thanks so far. Just to clarify a little, my medical history is... very complex. From all my testing we can assume no anemia, thyroid issues, high blood sugar, prolactinoma (that was investigated, I have an inert microadenoma.) I'm supplementing for low vitamin D, low ferritin, but those have been here long before the hair loss, which is sudden and rapid. I have endometriosis I had a hysterectomy 6 months ago so I don't know where my "periods" are other than ovulation testing and symptoms. (The hair loss started well before the hysto/one ovary removal and why I have pathology on that ovary.)

I think at this point I'm going to pursue with my OB/GYN about PCOS/further hormone testing (and if they recommend me to an endocrinologist), and then if needed see my dermatologist. I've had multiple ultrasounds and a couple doctors poke at/remove ovary cysts, but perhaps my doctors didn't bring it up because I don't have other typical symptoms? Though uh, I don't think I can tolerate combo birth control, so that's fun.
posted by Crystalinne at 10:41 AM on August 9, 2019

Check B12 levels. Treat any level below 500, regardless of what your doctor recommends, with a sublingual daily vitamin. (American doctors have a much lower cutoff for treating low B12 than other countries - Google for more info). Good luck!
posted by equipoise at 10:42 AM on August 9, 2019

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