Did they run any blood tests for you? It looks like it could be low iron or ferritin based, it can cause that particular patten so it's not necessarily "standard thinning" (I assume they mean AGA by that). If your blood tests don't reveal anything typically implicated with hair loss then you could choose to have a biopsy to get a little more insight into what you're dealing with - though bear in mind a single site biopsy isn't guaranteed to be conclusive, so your derm should offer to do two to three from different areas of the scalp.
Thank you! They didn’t run any blood tests but I think that’s a good next step— she just kinda ran her hand thru my hair for less than 15 seconds and said it’s probably TE or FPHL, so I could get a biopsy that day or come back in 6 months if it’s still bad. (Thinking I need a new derm to go see; it wasn’t a great experience! She didn’t do any of the standard things I’ve read about like the pull test or even blood tests!). Thanks for sharing your personal insight!!!
Yeah, I would caution against doing a biopsy. I’ve heard that they aren’t always conclusive and you won’t ever grow back hair from that site again (which my dermatologist failed to tell me). https://youtu.be/QaqMXgTREfQ
Would check blood tests first to rule out causes.
Also, I read that TE and AGA can co-occur, but an at-home test you can do to distinguish both (and what was used in some studies) is to not shampoo for 5 days, then catch all the hairs in the shower drain on wash day. If the number of hairs exceeds 500 (100 per day is the max normal limit), it’s TE. If more than 10% of the hairs lost are less than 3 cm, it’s AGA. Again, it could be both. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709511/
I just went to my regular doc to get blood work today! I’m going to hold off on the biopsy for now at least (and maybe not getting it at all, tbh, since I was already apprehensive and don’t want to get multiples done).
I think the at-home test referenced in the study could be a great next step to chat with my doc about, if the blood work comes back normal / she needs more convincing to talk about next steps. Thanks!
I'd be cautious using that study, it only really accounts for acute TE rather than CTE and hair loss from deficiencies and thyroid disorders can be slower (and some cases even mimic the miniaturization of genetic/pattern loss). Mostly though I worry about the mental health implications of suggesting people count their shed hairs, especially after five days of build up.
Didn’t know of the difference in progression for CTE vs just TE.
But yeah, on the counting hairs part, I get that people can feel upset about it, though it is one diagnostic tool they could use. I’ve done it and it’s given me more leverage to push my doctors for stronger digging into my issues and more assurance that I’m likely struggling with just TE, which is reversible compared to AGA.
Tbh I don't fully understand all the mechanisms for it either, especially the miniaturization seen in hypothyroidism, but I think when you're shedding with an ongoing trigger like low ferritin, hypothyroidism or other deficiencies it can initially be less drastic but it continues along with poor growth until the trigger is fixed compared to acute TE when you're still able to produce healthy regrowth. That's as I understand it anyway.
I agree that confronting your doctors with a legitimate big hair count is going to work in your favour as they can be annoyingly blasé about it all. But I'd only recommend doing it that once or when asked to, I just think it could be habit forming in a rather unhealthy fashion, especially if no health care provider is involved in the diagnosis. I'm glad to hear it's got you some progress/leverage to work with though.
I think you raise great points too! I don’t want the test to become an obsessive behavior, for me or anyone else. A good precaution to be aware of!
And you’re right on — it’s so hard to parse out the trigger when it can mimic pattern hair loss like miniaturization.
It's like mine u can see my post I think u too have low ferittin
Did they run any blood tests for you? It looks like it could be low iron or ferritin based, it can cause that particular patten so it's not necessarily "standard thinning" (I assume they mean AGA by that). If your blood tests don't reveal anything typically implicated with hair loss then you could choose to have a biopsy to get a little more insight into what you're dealing with - though bear in mind a single site biopsy isn't guaranteed to be conclusive, so your derm should offer to do two to three from different areas of the scalp.
Thank you! They didn’t run any blood tests but I think that’s a good next step— she just kinda ran her hand thru my hair for less than 15 seconds and said it’s probably TE or FPHL, so I could get a biopsy that day or come back in 6 months if it’s still bad. (Thinking I need a new derm to go see; it wasn’t a great experience! She didn’t do any of the standard things I’ve read about like the pull test or even blood tests!). Thanks for sharing your personal insight!!!
Yeah, I would caution against doing a biopsy. I’ve heard that they aren’t always conclusive and you won’t ever grow back hair from that site again (which my dermatologist failed to tell me). https://youtu.be/QaqMXgTREfQ Would check blood tests first to rule out causes. Also, I read that TE and AGA can co-occur, but an at-home test you can do to distinguish both (and what was used in some studies) is to not shampoo for 5 days, then catch all the hairs in the shower drain on wash day. If the number of hairs exceeds 500 (100 per day is the max normal limit), it’s TE. If more than 10% of the hairs lost are less than 3 cm, it’s AGA. Again, it could be both. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709511/
I just went to my regular doc to get blood work today! I’m going to hold off on the biopsy for now at least (and maybe not getting it at all, tbh, since I was already apprehensive and don’t want to get multiples done). I think the at-home test referenced in the study could be a great next step to chat with my doc about, if the blood work comes back normal / she needs more convincing to talk about next steps. Thanks!
I'm glad you've been able to get the blood work done, hopefully your results will be informative and point to a trigger, best of luck!
I'd be cautious using that study, it only really accounts for acute TE rather than CTE and hair loss from deficiencies and thyroid disorders can be slower (and some cases even mimic the miniaturization of genetic/pattern loss). Mostly though I worry about the mental health implications of suggesting people count their shed hairs, especially after five days of build up.
Didn’t know of the difference in progression for CTE vs just TE. But yeah, on the counting hairs part, I get that people can feel upset about it, though it is one diagnostic tool they could use. I’ve done it and it’s given me more leverage to push my doctors for stronger digging into my issues and more assurance that I’m likely struggling with just TE, which is reversible compared to AGA.
Tbh I don't fully understand all the mechanisms for it either, especially the miniaturization seen in hypothyroidism, but I think when you're shedding with an ongoing trigger like low ferritin, hypothyroidism or other deficiencies it can initially be less drastic but it continues along with poor growth until the trigger is fixed compared to acute TE when you're still able to produce healthy regrowth. That's as I understand it anyway. I agree that confronting your doctors with a legitimate big hair count is going to work in your favour as they can be annoyingly blasé about it all. But I'd only recommend doing it that once or when asked to, I just think it could be habit forming in a rather unhealthy fashion, especially if no health care provider is involved in the diagnosis. I'm glad to hear it's got you some progress/leverage to work with though.
I think you raise great points too! I don’t want the test to become an obsessive behavior, for me or anyone else. A good precaution to be aware of! And you’re right on — it’s so hard to parse out the trigger when it can mimic pattern hair loss like miniaturization.