Dr. Friedman describes how hair loss is diagnosed.
So you have to test each endocrine problem. So you want to check the thyroid when measuring TSH and possibly free T4. You want to check that the bio-available and total testosterone level, look for the polycystic ovarian syndrome.
You want to possibly measure an estradiol level, an FSH to see if the person is in perimenopause or menopause. I would say those would be the main tests that we do.
There’s another condition I would say, it’s very common that I see a lot of, it’s not terribly concerning the endocrine problem but it’s very important and it sort of affects how hormones work and that’s iron deficiency.
And we know that people that have rather severe iron deficiency can also have hair loss and even people with mild iron deficiency, they may not be anemic yet but their iron stores, which is measured in a test called a ferritin level, can be quite low.
And again this is something that’s easy to reverse; you can have the woman take iron and I have patients that come in to me that are 10 and 3 and 5 of their ferritin level and they are feeling tired or run down, and possibly also their thyroid hormone may not work optimally if they are iron deficient.
And I will replace their iron level and get it up to maybe 50 to 70 with iron supplementation and then their hair loss improves and their energy gets better, as well.
So part of my sort of screen for general people of hair loss and people that come in to see me most of the time for suspected endocrine problem is I usually measure this value called a ferritin.
And I think it’s more sensitive than measuring the CBC which measures your blood counts. I think the ferritin picks up more mild cases than the CBC does.
About Dr. Theodore Friedman, M.D., Ph.D., M.Phil.:
Dr. Theodore Friedman, M.D., Ph.D., M.Phil., specializes in hard-to-diagnose-and- treat cases of adrenal, pituitary, thyroid, and fatigue disorders. He's been with the University of California Los Angeles School of Medicine since 2005 and serves as Chief of the Endocrinology, Metabolism and Molecular Medicine Division at Charles R. Drew University of Medicine and Science. He also served as Director of the Multi-Disciplinary Chronic Fatigue Clinic at Cedars-Sinai Medical Center from 1998-2000.
Dr. Friedman has a private practice near Beverly Hills, California as well as privileges at Cedars-Sinai Medical Center and Martin Luther King Medical Center.