Hair Loss -- Extremely High SHBG, Low Ferritin, Ambien -- triggers? (photo)

Question

Diagnosed with TE diffuse hair loss from 3 different derms. Had an eating disorder (bulimia) when hair loss started but have been recovered for 6 months now. Have some regrowth. Had a low ferritin of 14, but it is currently 90 after supplementing. I've been on Yaz for 3+ years, recent blood showed SHBG to be 677 (range: 30-135). TSH (2.055), T3 (2.9) & T4 (1.1) tested and are normal. Only other drug I've taken is ambien 5-10mg for the last year. Stopped it in last month. Could this be a trigger?

Frank P. Fechner, MD · Answer

Hi Jennabuj! You have a few things listed here in your history that very likely contributed to the TE. There is currently no research evidence that Ambien could be a culprit for hair loss, but anything is possible with individual response to medications. With that said, I wouldn't look at the Ambien as the trigger right now. The truth is, it's often difficult to determine the initial trigger when there may be multiple. Often, it's the combination of a few things. The bulimia may have been the first trigger, however low ferritin alone could cause TE. You are currently at a healthy level (we like ferritin levels to be 70 or above for hair) but your body needs time to recover.  As for the SHBG, this could be a result from the bulimia, but also from the Yaz. Eating disorders and oral contraceptives can impact your sex hormones and may throw off your levels of estrogen and testosterone. This also can take a year or years for your body to stabilize. Hormone levels greatly impact hair health and imbalances in them can cause hair loss. My advice would be to give your body more time to recover. The fact that you are seeing regrowth at 6 months is fabulous! Like I mentioned, it often can take a full year after recovery and restoration of iron stores to start seeing regrowth. If anything, you can have your hormone levels checked again in another 6 months to see if they stabilize. Good luck!!

Jeff Donovan, MD, PhD · Answer

One needs alot more information and ideally to see the scalp to confirm the diagnosis of hair loss in women. One thing is for certain: you had a TE. The photo matches the story. Ambien can  cause hair loss, but that is extremely rare and probably not what is happening. The key questions now are: 1) Is there anything else going on in addition to a TE (particularly AGA) 2) have all potential triggers really resolved. This is not a little bit of growth you are showing but quite a bit. You'll know in 6 more months if your density is catching up to previous levels or not. Follow closely with your dermatologist, make changes in supplements, and treatments slowly and repeat your blood tests down the road per your physician's recommendations.

Hair Loss -- Extremely High SHBG, Low Ferritin, Ambien -- triggers? (photo)

Answers (2)

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