Hair loss cause & reversal for 41 year old woman

Patient

Q: What is causing my hair fall, & how can I stop it? I am 41 yrs female, no pcos, ferritin serum approx 110 (was low in May but I supplemented and now has been over 100 since August), normal B12 level, taking Vit D supplements for 3 months. No menopause, periods have shortened slightly since March from 5 days to 3 - 4 days, testosterone tests are normal, FSH normal, DHEA normal, thyroid function tests are normal, cortisol is normal but on low side (approx 4), no hereditary hair loss to the extent I am suffering. Hair fall is diffuse and all over the head and now with skin showing over top of my head, more pronounced at 'widow's peaks', starting in March this year. My diet is on good side of average (not perfect), I don't pull my hair tightly or use a lot of chemicals on it. I had PRP sessions twice over past 2 months, and tried Regaine (minoxodil) 2% but it made me light-headed and fatigued so I stopped. Slightly more hair on my chin area for past 8 months, no weight gain more than 1 - 2 kgs in this time maximum, I don't take contraceptive pill, no smoking and rarely drink. Dermatologist has run out of options except for minoxodil, can't find cause, gynaecologist doesn't know cause, endocrinologist said maybe low cortisol is causing some problem.

Symptoms:  My hair falling every day since March, more than 150 hairs daily from all over my head.
Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

As i can see that you have gone pillar to post from dermatologist to endocrinologist to gynaecologist, finding that all your reports are normal including your hormonal profile. The most common reason of hair fall is stress and poor hydration and blood supply locally which causes the hair follicle to enter the Telogen stage sooner.
The dictum goes, " A stressful period or an insult to circulation to scalp can lead to hair fall after 3 months and if the replenishment and hydration fraction have been started from today then the results of new hair growth would be seen only after next 3 months from today".

So as it has only been 2 months since you have noticed hairball, I suggest that instead of minoxidil , which can cause allergies and flushing side effects often, all you need to do is increase your water intake to 4-5 litres a day and try to keep yourself stress free and i am sure the results would be evident by next 3 months. More so, 150 hairs per day fall can be attributed to be normal hairfall associated with raging considering that there are 10million hair on the scalp.
So just relax and follow the practice.
I hope i have answered your query,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: Please note - I advised in "symptoms" that I have had hair fall since March, which is now 6 months, not 2 months as you have said, so this answer doesn't make sense.

Also, may I request that you kindly identify yourself - name, medical qualification and specialisation?

Thank you
Doctor: the fact that you have been using minoxidil which should ideally be used for a period of at least 6 months before any effects can be seen over hair growth, so if there is a fall then it can be arrested only by reducing the stressors and maintaining a good blood supply. if your dermatologist and endocrinologist feel that there is nothing much can be offered medically as of now , then it is possible that there is a genetic predisposition to your hair fall and the only remedy following would be a hair transplantation.
Regards
Patient: Would you kindly identify yourself - name, medical qualification and specialisation?
Thank you.
Doctor: I am Dr. Sameer. MS OBSTERICS AND GYNECOLOGY, FELLOWSHIP AND DIPLOMA IN LAPAROSCOPIC SURGERY.
Thanks

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