Dear Dr. Roach: I have been suffering from hair loss for years and it seems to have gotten worse recently. My hair is thinning and I am worried that I may soon be bald. I am a 70-year-old woman and have had a fair amount of hair up until now.
I always thought my hair loss was due to a thyroid problem and the medication I was taking for it (Levothyroxine), so I asked my doctor to prescribe me a different medication to see if it would stop the hair loss. He didn’t want to do that and told me to try Rogaine (which didn’t work), and said that if Rogaine didn’t work, he could prescribe a medication that would make my hair grow, but it would cause hair to grow in other places too. I haven’t tried this yet.
If I stopped taking levothyroxine and started taking another medication instead, would that help? – BSR
A: Hair loss often has a very serious impact on both men and women, and doctors should be compassionate about how personally traumatic this can be.
There are many causes of hair loss, but “pattern” hair loss is the most common. Female pattern hair loss is usually widespread thinning, most noticeable at the parting, while male pattern hair loss is characterized by a receding hairline and hair loss on the crown of the head. Your general practitioner can usually diagnose this accurately, but if the diagnosis is unclear or there is scalp scarring, you may need to see a specialist such as a dermatologist.
The type of hair loss that commonly accompanies thyroid disease is called alopecia areata, and most typically results in round or oval patches of complete baldness. The cause of the hair loss is not levothyroxine, but the thyroid disease. However, the pattern of hair loss you are describing does not seem to be due to thyroid disease.
You are on thyroid replacement therapy and should not stop taking it as stopping could cause serious harm and is unlikely to provide any benefit.
For women with female pattern hair loss, there is Rogaine, which can be administered topically or orally. There are also other treatments, such as spironolactone and finasteride. If these treatments don’t work, I’ve had patients try platelet-rich plasma injections and low-level laser therapy. However, my personal experience with the few patients who have had these treatments has been unremarkable. But even small gains can sometimes be of great value.
Dear Dr. Roach: There are many claims in the literature that eating colored foods with antioxidant potential (such as the polyphenol anthocyanins found in blueberries and red cabbage) can improve health. Are there any systematic studies to support these claims? – AF
Answer: There’s a lot of evidence that a diet high in fruits and vegetables reduces the risk of many chronic diseases, including heart disease and cancer. Brightly colored vegetables contain many of the healthful plant compounds you mention, but even plants that don’t have much color (like cauliflower, mushrooms, and white onions) contain a variety of compounds that help prevent disease.
It’s best to eat a varied diet. Choosing a variety of fruits and vegetables not only helps prevent chronic disease, but it also makes eating more enjoyable. However, you can also choose foods with dark and light colors.
Dr. Roach regrets that he cannot respond to individual letters but will incorporate them into the column whenever possible. Readers may submit questions by email to ToYourGoodHealth@med.cornell.edu or by mail to 628 Virginia Dr., Orlando, FL 32803.
