Chronic Telogen Effluvium? - Hair Problems Message Board

kangarooaddict · 07-27-2009, 03:13 PM

About a year ago (I am now 19) I began to have cystic acne..maybe 5 small cysts at a time that were deep and small. However, I tend to overreact to everything especially when it involves the way I look. I was under so much stres..I didn't want to do anything, I wouldn't leave the house unless there was a family event, I cried every day, I was just extremely unhappy and depressed. Could this be enough to set off telogen effluvium, or would the emotional stress need to be severer?
I started taking antibiotics (and now a year later my cystic acne is under control) and a month later I noticed that the front of my hair was a lot thinner. I figured it might be the antibiotics. About 2 months ago I read that I could have a biotin deficiency due to long-term antibiotics, and I certainly do not eat heathily at all (I'm 5'0" and only 113 pounds).
It's still pretty thin, but I notice baby hairs around the front and it's not quite as thin as before..not sure if it's from the biotin or if they've always been there and haven't noticed them before. My hair has always shed the same amount, it just seems like it's not growing back at a fast enough rate to replace the normal hair fall (30-50 hairs a day..not a lot) My hairline has not receded, though there are thinner spots in the front and my hair is overall less thick, but not noticeable as I had so much hair to begin with. It seems like the front is just as thin as it was when I first noticed it 1 year ago (looking back at pictures)..so perhaps my hair is just stuck in a telogen limbo where ~50% of them are stuck in telogen phase.
I tested my ferritin..it was 9. I also tested my testosterone..it was 92 ng/dL (high which makes me worry about this being androgenic hair loss). Is this androgenic alopecia or chronic telogen effluvium? All of my hairs have clubs on the ends when they shed. Some uncles on my mother's side have receding hairlines, but none of the females have it. My father's side has extremely full heads of hair, all of them. My siblings have normal hairlines, they're all 7+ years older than me.

I wonder if the stress of my acne and/or the biotin deficiency from the antibiotics caused me to lose hair initially (like the catalyst), and that my low ferritin has just made my hair unable to regrow normally.

AuntieLeela · 07-28-2009, 10:37 AM

Hormones, poor diet, stress and antibiotics/medications can all cause mild hair loss all by themselves, with no medical term for it. When you say, "it just seems like it's not growing back at a fast enough rate", it sounds to me like a symptom of anemia and/or a dietary problem. Your iron looks low but I don't know how low - reference ranges are different lab to lab.

Do you use any benzoil peroxide? Some acne creams can bleach or weaken hair, especially the fine hairs around the face.

kangarooaddict · 07-28-2009, 11:25 AM

Except recently (2 or so weeks) I've never eaten well at all. The only vegetable I would eat was broccolli (and that was rarely) and I have been a vegetarian all my life and my periods are very heavy. I've always had low iron levels, and I'm very fair so I've avoided the sun all my life which resulted in a mild vitamin D deficiency which I'm supplementing.
I guess it makes sense that it could mostly be nutrition as there's no way I was getting enough nutrients in what I was eating. I try to tell myself this to calm myself down but for some reason I can't get myself to believe that it's nothing more serious than vitamin/mineral deficiencies..I always think the worst =\. When I feel my hair, it's probably half the hair I've had all my life and I fear every waking hour that I'm going to lose more and more until I have to wear a wig. I've also always had beautiful long curls more than halfway down my back, and I'm scared of getting to the point where I have to cut off what was kind of my signature. My hair grows so fast still, but no new hairs seem to be coming in to replace my regular hair fall.

My ferritin is below lab range, and no I don't use benxoyl peroxide. Thanks for replying

Audrey-B · 08-02-2009, 05:12 AM

Your ferritin is way too low and after reading about your diet i'd say that is the reason why. Do you supplement protein considering you are vegetarian? Even people who include lots of grains and pulses and nuts into their diet to supplement protein end up anemic as these are never the same as eating red meat or other meats.

You definitely need to be on an iron supplement and stay on it if you are going to stay vegetarian forever. Hair shedding has been known to be corrected once ferritin is raised higher.

I don't know about your testosterone levels as i've only done a testosterone saliva test and it uses 'pmol/L' while your tests where likely blood and measured in ng/dL. Testosterone excess can include acne and loss of scalp hair as symptoms.

I've never had acne, but my testosterone was high and i did have hair shedding which didn't stop once my ferritin rose. My problem was my thyroid. I was hypothyroid along with Hashimoto's which is a thyroid autoimmune disease. Once i was on medication for a while, my testosterone self corrected. My hair isn't shedding as much, but i'm working on it all with my doctor.

If your Vit D and ferritin are low, there is a chance your B12 could be low and in this case your wouldn't be absorbing enough folate. Your ferritin, Vit D and B12 need to be up at the higher end of the lab range. You should also get your thyroid checked which should include TSH, Free T3, Free T4 and Thyroid Antibodies.

Long term low ferritin can stuff up your thyroid so it's in your best interest to either improve your diet or take extra supplements.

While taking antibiotics, you should also be taking a quality probiotic to help rebuild your store of healthy bacteria in the gut. Not doing this will help the bad bacteria multiply and lead to growth of yeast, this in turn stops you from absorbing nutrients.

As you can see, there could be any number of things going on and all you can do is eliminate them one at a time and remember to take your supplements daily. The Anemia section of the boards can give you more advice on all things iron related.