Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Lily102 on November 24, 2023, 01:29:27 PM
-
Has anyone experienced hair loss with oestrogel, utorgestan &mitzrapine?
I started to have hair loss about 6 weeks ago and it feels like I have lost 50% of my hair. I'm 54 and had lots of hair - both parents had lots of hair. Hairdressers used to moan about the volume!
I contacted the doctor today and she said it might be due to low ferritin. Mine is 27. She said for hair loss purposes it should be 70. I track my blood results and I can see it was also 27 3 years ago and 33 6 years ago.
My HRT background:
Fem 2/10 (with dydrogesterone, a synthetic form of progesterone) for about 4 years until it stopped working last year.
Switched to oestrogel (2 -3 pumps per day) and utrogestan (taking the 100 tablets vaginally 25 days per month). The new regime of oestrogel and utrogestan took about 5 months to settle in though after 3 months I went on mirtazapine 15mg as my mood was low and I wasn't sleeping. In hindsight, I think the low mood was caused by 4 months of little sleep. My sleep is brilliant now thanks to mitrazipine. I tried coming off it 5 months ago - first not taking a table and then taking half a tablet. On both occasions, I woke up a 3am in the morning as I used to. I can't cope without sleep so went straight back on.
I initially thought mitzrapine was causing the loss as there are lots of articles and forums online saying it causes hair loss. Having read comments on here today I realise it could also be oestrogel, utrogestan, low iron or something else. I'll update in here if my situation improves after taking iron tablets.
-
I hope it improves for you with the iron tablets. The other thing to check is vitamin D as this is what caused my hair to thin and lose volume. Do you know your Vit D level?
Taz x
-
Thanks, Taz. Vitamin D is 80.8. I've recently started back on a highish dose so I should get it up to 100 soon which I think is pretty good. Did your hair get back to normal after taking the iron supplements? And what dose and type of iron supplements did you take? I have a proper call with the doctor next Thursday and I'll ask her to recommend a type. I got caught out when I rushed out to buy magnesium a while back - I bought citrate instead of glycinate!
-
Hi
My hair started to fall out quite rapidly about 4 months after starting hrt, evorel patches and utrogestan. That was in September 2022. I started taking iron, vitamin b12 and vitamin d about 3 months ago and it hasn't helped at all. I'm convinced it's the hrt but I have no intention of stopping.
I hope you find something that works, it's an awful thing to have happen.
xx
-
I did have low ferritin but that didn't affect my hair. The low vitamin D did. My level was 18. A good level is 50 or above so you are ok with your level of 80. I thought it was worth mentioning as it's not routinely tested for. It takes around sixteen weeks for hair to react I believe. Growing and resting and shedding phases can be affected by different things.
Taz x
-
Thanks Taz. Yes, it is not straightforward and may or may not be iron for me. I appear to have the symptoms for tefflum... (hope that's correct spelling) and everywhere seems to say no more than 70% of hair is lost so I'm clinging to that. I speak to the GP next week but don't expect I'll get massive clarity from that call.
-
Hi Lily102,
Some info you may find helpful from Dr. Jefferey Donovan, a Canadian hair loss specialist:
What level of ferritin should I aim for to keep my hair growing?
I’ve selected this question below for this week’s question of the week. It allows us to review some concepts in iron deficiency and the threshold level of ferritin to aim for.
Question
I have hair loss and my ferritin is 33. I’m a 37 year old woman and in excellent health. I am not vegetarian. I eat well and exercise every day. I’m wondering what level I should aim for? I’ve heard 40 is a good target but some say 70. What level is reasonable?
Answer
One of the biggest myths in the field of hair loss is that there is a magic number. Not so. I wish there was, but there is not.
Certainly it makes sense to aim for a ferritin level of 40-50 if one has hair loss.
However, the reality is many many people have zero iron related issues provided the ferritin is above 30. Sure, a very small proportion might. Now as ferritin levels dip down into the 20s, there will be some that have iron issues that are related to the hair. But lots and lots and lots of females have ferritin 24-32 and have zero hair loss issues at all. So it’s not a clear cut number!
The following table provides some insights into how I think about ferritin levels for most women. One can seen that as the ferritin dips down below 70, it becomes more and more likely that taking iron could help - especially if the levels are less than 26. With ferritin levels in the teens - it’s clear iron is needed!
Ferritin Level (ug/L) - Is supplementing iron going to help?
Greater than 70 - Extremely unlikely to help
41-70 - Unlikely - Only a small chance it will help
26-40 - Possibly - A good chance it won't help
16-25 - Possibly - A good chance it will help
10-15 - Likely - Only a small chance it won't help
Less than 10 - Extremely likely to help
In summary, there are hundreds of patients today with ferritin levels 32-40 who will be told “you just need to bring up your iron to 50 or 70 and you’ll be fine.” Most of the time increasing ferritin (when levels are in the 30s is simply not going to have any effect on the hair. Is it worth trying? Well that requires input from a health care provided. As ferritin gets lower and lower below 30 it becomes more and more likely that iron supplementation will help.
I would like to point out that I never just look at the ferritin. I look at B12 (which can make ferritin levels look artificially good if B12 is low) and I look at hemoglobin, MCV, MCH and RDW and transferrin saturation if available. Most importantly I look at prior labs to see how things used to be. If one wants a magic cut off number, I’d say 40 but it’s really not so simple and lots of people eat iron pills and get constipated just to reach a number that has absolutely no benefit.
If a patient has had ferritin of 34 for 20 years and now developed hair loss last year with a ferritin of 35, are we do tell the patient “Oh you lost hair because of low iron! Bring your ferritin up to 40 to 50 and you’ll be fine.” No, this is nonsense but a common scenario.
I hope this helps with understanding the complexities of iron.
- See original post and table at: https://donovanmedical.com/qow-posts/ferritin
-
Here's another Q&A from Dr. Donovan that you may find helpful.
How long does it take for shedding to stop once you've corrected the trigger?
Question
I think I have telogen effluvium from a drug I took. I have now stopped the drug and so it’s going out of my system. How long does it take shedding to stop once a person has found the right trigger and stopped it? I’ve heard it takes 9-12 months. Is that true?
Read the post here https://donovanmedical.com/qow-posts/te-timeline
-
@ana21 Thanks so much for posting that reply.
I went into the T E sections and found so much useful information and case studies with pictures. I'll start taking photos.
I recommend ladies with hair loss checking the articles and visiting the clinic if they live in Toronto, Canada. Unfortunately, not good for me as I live in the UK.
https://donovanmedical.com/qow-posts/category/Telogen+Effluvium
The point on iron is interesting. It made a difference to a person in one of the case studies -hers went from around 20 to 30 I think. Getting mine from 27 to 30 might help though focusing on iron only is not the approach. I think I'm prone to hyperthyroidism another possible cause - I've not been diagnosed but get an anxious sensation even though I'm not anxious.
-
Lily102,
Glad you found it helpful. I hope you find a good dermatologist. Hair grows slowly and shedding can occur during treatment, so it takes time to know whether any given treatment is working. For some of us, it can be a long journey of trial and error, years rather than months. Keep us posted.
-
An update. My hair situation improved a few weeks after posting this. My loss is now back to a normal shedding level. I took iron for just 2 days as I didn't think I needed it. In summary, I went through massive hair loss for what felt like close to 8 weeks. Maybe massive hair loss happens as part of menopause and then stops. My hair is a lot thinner than years ago and I think that thinning out has been happening for maybe 3 or 4 years and I just didn't notice it. Posting in case this is useful to to others.