Hair today, gone tomorrow

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DEAR DR. DONOHUE: I am a 57-year-old woman in good health. I went into menopause seven years ago. I have hypothyroidism and take Synthroid for it. Lately I have been losing my hair at an alarming rate, and I’m trying to figure out the cause. My thyroid tests are normal. My blood test shows I’m not anemic. Approximately three months ago, I became extremely ill and dehydrated, and had to be hospitalized. It turned out to be salmonella poisoning. It took me a month to bounce back. I lost 15 pounds. I also had severe stress this past summer due to a family incident. I wonder if these two things could have something to do with my hair loss. — P.C.

ANSWER: Your story makes a good case for a condition called telogen effluvium. Hair grows in three stages. Anagen is the growing phase, which lasts about three years. Anagen hair accounts for 85 percent of the scalp hair. The catagen stage is an intermediate stage between growth and rest. Less than 1 percent of hair is in this stage. The rest of the hair is in a resting stage, telogen. It accounts for up to 15 percent of hair. This phase lasts three to five months. Hairs in this stage are destined to fall out.

Normal hair loss is 100 to 150 hairs a day.

Telogen effluvium is the sudden onset of increased loss of telogen hair, up to 400 hairs a day. It occurs three to five months after a stressful situation — surgery, childbirth, an illness with high fever or an emotional stress. Your salmonella infection could have been the trigger for it. A doctor can determine if your hair loss is telogen hair by examining one of the fallen-out hairs. These hairs have a distinctive bulb where they attached to the scalp. Telogen effluvium stops in a matter of months without treatment. New hair grows back.

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To be sure about this diagnosis, a dermatologist can identify telogen hair for you and can prove or disprove my idea of a telogen effluvium.

DEAR DR. DONOHUE: For all my life I had never had anything going for me except my hair. It was thick and gorgeous. Now it is thin and lifeless. I’m gaining weight and am tired all the time. I know it’s not my thyroid. I’m taking thyroid hormone. I am 70. Can I take anything else for it? — R.L.

ANSWER: It’s not abnormal for women in their 70s to lose hair. It’s like the kind of hair loss men start to experience in their 50s. However, in women, the hair loss takes place throughout the scalp, so it’s a thinning of hair that results. Women don’t ordinarily get the kind of hair loss men do with baldness at the temples and the back of the head.

Iron deficiency, thyroid illnesses, renal disease and an overdose of vitamin A can be involved in female hair loss. Your family doctor can determine if you have any of these. You are being treated for a poorly functioning thyroid gland.

Have you ever thought of using Rogaine? It treats the kind of hair loss you have, and you can obtain it without a prescription.

DEAR DR. DONOHUE: Recently you said there is no treatment for eye floaters. I have so many that they interfere with vision. My doctor suggested vitrectomy. What do you say? — J.D.

ANSWER: You and others wrote to me about vitrectomy for floaters. The vitreous is the gellike material that fills the eye behind the lens. In childhood, the vitreous is clear. With age and with nearsightedness (cannot see objects in the distance), debris can accumulate in the vitreous. Parts of protein, particles from cells and other material find their way into the vitreous. As those particles float around, they cast shadows on the retina, which are seen as “floaters.” Vitrectomy is removal of the vitreous and replacement of it with saline solution.

When floaters are so extensive that they interfere greatly with vision, then vitrectomy is an answer. Complications like retinal tearing are possible. But restoration of vision is also quite possible. So long as the doctor is experienced and explains all the hypothetical outcomes, I would consider having it done.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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