increased hair loss

Question
Dear doctor,



Thank you for being so kind and always answering my questions. I will resume my problem: I am 39 years old. I have been losing my hair for at least five years now. It used to be so extremely thick that it took me several years to notice that I was actually losing it, and another year to find a doctor who would take my problem seriously. I have by now lost about 80% of my hair. My mother is also losing her hair, but first now, in her old age.



In June 2009 I started with the following treatment:

5% minoxidil

Diane 35

Androcur, 50 mg during the first 10 days of Diane

100 mg of ferrous sulfate (Tardyferon) every day, since January



From September to December 2009 my hair loss was reduced to 25% of what it was before the treatment. Unfortunately, I had some side effects and a doctor told me to start taking only 25 mg of Androcur, instead of 50.



Very quickly, my hair loss increased by 50%. After a month, I saw an endocrinologist, and she changed my treatment: I am now taking Estreva instead of Diane, and Androcur 21 days a month. I started only two weeks ago, and I am only losing more and more hair. Is this due to a hormonal change? Is this hair loss going to stop after some weeks with the new treatment? Do you think that more Androcur can help, even if Estreva contains less estrogen than Diane?



Another thing: despite of all the ferrous sulfate that I have been taking for more than a year now, my ferritin level is only 50. My dermatologist doesn't seem to be worried, but I am. Should I try with a higher dose, 200 mg instead of 100? I am always taking it with 500 mg of vitamin C.



And the last question: I see that my pubic hair has become thinner too. I can see the skin trough it, which was not possible before. I cant say when this change has started. Is it a result of my AGA, of my treatments, of the aging process, or of something else?



Thanks again for all your patience,

your answers mean so much to me!


Answer
Ivana,

 You seem to be getting the best advice possible from your endocrinologist and I would not think of suggesting a change in your current program. A serum ferritin of 50 is not enough to worry about as the cause of your loss. I prefer to see my patients reach 60 before being comfortable with the amount of supplemental ferrous sulfate taken. Most of my patients take 325mg ferrous sulfate daily and some take that dose twice a day. Continue the Vitamin C at the dose you are taking now. The changes you see in hair growth now are due to something affecting the hairs a month or two before so it is very difficult to make a judgment as to the reason for your continued thinning now. The thin pubic hair could be a combination of a chronic telogen effluvium and early AGA. I wish I could contribute more but at this point you will need to stay with the therapy outlined by your endocrinologist for the next four to six months to see the hairs change cycles and get some increase in density.