testing for hair loss

Question
Hi Dr. P., You have helped me so much in the past that I was hoping I could trouble you for another question.  I am going to see my endo this week to check my blood to make sure my Spiro isn't causing problems.  What else should I have her test?  We test for Serum Ferritin every visit - I am usually b/n 4-11 every time and can't seem to bring it up!!  She has checked my thyroid too, but I'm wondering if there is an aspect of the thyroid test that she is missing.  Generally, my Endo checks the "obvious" things.  I wanted to know if there is some other underlying problem that we're not addressing.  I am currently on Spiro, a high estrogen dose bcp and Rogaine.  I'm see lots of new growth in the last 3 months, but wonder if it is more to do with increased estrogen than anything else.  Any thoughts on what tests to make sure I have done this week?  Thanks so much.  -carla  


Answer
I do not know why you are wondering about other tests when your serum ferritin has shown you are TOO LOW. Your serum ferritin should be over 60 as a minimum. If you can not get it up to that level with the supplements you are taking you may need iron shots but I would suggest you see a "Hematologist" to find out why you are so low. I would not be looking for other causes and would not do repeated thyroid tests. The "obvious" things only need to be checked once and you now have an "obvious" cause for you loss. What is not "obvious" is the reason you have such a low serum ferritin and you need a blood specialist for that, or perhaps a gastroenterologist to find out why you are not absorbing the iron.