The ultimate goal of our medical consultation is to determine the cause of your hair loss. Starting treatment without knowing the cause is really not helpful, and often is costly both in time and money. There are many types of hair loss that women can experience, and each of these types can have several different causes. During the physical exam of your scalp and hair, we will closely examine your hair follicles using a highly magnified camera called a trichoscope, which will allow us to look for signs like miniaturization of the hair follicles, inflammation, or other specific features of the follicle that are not visible to the naked eye. While the physical examination is a critical piece of the puzzle when it comes to diagnosing the cause of hair loss, it is only one piece of the puzzle. We still need to review the patient’s medical and hair loss history, and for some patients we may also ask for specific blood tests to be done. While some women have had blood tests completed in the past, we only consider it relevant if it has been completed within the previous 12 months.
So, when does blood work play a role in the evaluation?
Patients Suspected of Telogen Effluvium
According to the American Hair Loss Association, Telogen Effluvium (TE) is the second most common form of hair loss. It presents as excessive shedding which seems to occur very suddenly and can be very mild or aggressive. While Telogen Effluvium is common, the good news is that it is usually reversible and complete regrowth usually occurs in about a year. However, it is extremely important to do a thorough evaluation for this problem to determine the cause. Treating Telogen Effluvium is really a two-step process. The first step is determining what is causing the “shock” to your hair. It is possible there was a singular traumatic event like surgery or an infection. However, one of the most common causes of TE is a nutritional deficiency, like iron, Vitamin D, or the B vitamins like B12 or Folate. When we suspect that a patient is experiencing a Telogen Effluvium, we usually recommend blood work so that we can evaluate those results for potential causes.
Patients Under 45
Another common cause of hair loss in women is hormonal imbalances. The most common cause of hair loss in women is Androgenic Alopecia. We know that this is a genetic problem that is primarily driven mostly by testosterone in men and women, but we also know in women, any imbalance of the female hormones, estrogen, and progesterone, can accelerate hair loss. Just prior to menopause, as hormones change, we often see worsening loss. Therefore, in these cases it is very important to check testosterone, estrogen, and progesterone levels. And in women who are experiencing hair loss at a very young age, hormone levels are particularly important to evaluate.
Usually once a woman passes through menopause, there can be a stabilization of hormones and evaluation of these levels is not necessary. However, if a woman is on HRT or hormone replacement therapy, it becomes essential to know if the hormone levels are in balance for good hair growth, and blood testing is essential.
History of thyroid disease
Both hypothyroid and hyperthyroid diseases can cause hair loss. When a woman has a history of thyroid disease in herself or other family members, we always check blood tests. Once again, all hormones need to be in proper balance to create healthy, strong hair.
Treating female hair thinning or loss without knowing the cause will often lead to poor results, frustrating both the patient and the practitioner. Often, the only way to know the entire story is to check blood tests. If you are experiencing hair loss make sure to see a hair loss specialist that can complete a full evaluation and determine if blood work would be beneficial for you.
Posted by Your Medi Tresse Team