Will PRP injections help slow/reverse telogen effluvium hair loss for a patient with hypothyroidism?

Question

I have Graves Disease and had RAI in February, became hypothyroid, started taking Synthroid the end of May. In June I started to lose a significant amount of hair. This has slowed down but I'm still losing a lot and can notice a difference in the thickness of my hair as well as being able to see my scalp. My endo said this is telogen effluvium since that the hairs lost all seem to have the bulb at the end. Will PRP help slow the shedding/re-grow my hair? Is it possible to lose more hair w/PRP?

Amiya Prasad, MD · Answer

Thank you for your question. You are asking whether PRP will help reverse hair loss caused by telogen effluvium associated with hypothyroidism. You’ve described in your question that you were diagnosed with Graves’ disease and underwent radioactive iodine treatment in February. In May the same year, you were diagnosed as hypothyroid and placed on Synthroid. In June, you shed of a lot of hair, and your doctor stated it’s most likely telogen effluvium based on the appearance. You’re asking whether or not PRP can help stimulate hair growth. You’ve also noticed that the hair looks a bit thinner, and you’re concerned whether or not PRP can worsen the hair loss.
I can share with you my perspective on this type of situation. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a system we developed based on observations made during hair transplant when we were using materials Acellular matrix and PRP. We’ve developed a system to help patients from around the world with male and female pattern hair loss. 
In addition, as an oculofacial plastic surgeon, I have extensive experience with Graves’ disease or thyroid related immune orbitopathy. I’ve helped many patients who needed surgery to improve the appearance of their eyes after being diagnosed with Graves’ disease. In a situation like this, it’s very important to understand that the cause of your hair loss is more related to your thyroid. Since it is related to your thyroid, a treatment such as PRP or Hair Regeneration or our system TrichoStem™ Hair Regeneration can have a certain degree of stimulatory effect on the hair. Basically, PRP alone will stimulate hair growth, but sustaining that hair growth will also be impacted by hormonal status. 
In our practice, we mostly help patients, men and women, with androgenetic alopecia or genetic pattern hair loss that causes progressive hair thinning. Particularly in women, we have seen there can be concurrently telogen effluvium, whether it’s chronic telogen effluvium which has been postulated as related to hormonal fluctuations when dealing with estrogen, as well as men and women dealing with telogen effluvium related to stress. 
I always tell my patients that even if we diagnose them with genetic pattern hair loss or androgenetic alopecia, their scalp didn't read the textbook so they can have concurrent issues. Even with the significant impact we’ve made with Hair Regeneration helping patients for the past 7 years, the result of a lot of study into optimizing the treatment for different patients based on age, degree of hair loss, gender, age of onset, the rate of progression and other medical variables, we’ve been able to stimulate growth very effectively. However, when someone has issues with hormones, hormones tend to dominate. It’s probably not in your best interest to do a treatment that’s local to the scalp while you’re going through this normalization process with your thyroid. 
There’s always a lag between these hormonal fluctuations and the effect on the hair. Generally, I would tell a patient like yourself to allow at least 6 months of stable thyroid levels, and observe the quality of your hair. Like I said, your scalp didn’t read a textbook, and it is possible to have concurrent genetic pattern loss. Although it is scientifically reasonable to state you can get some stimulatory effect with an injection, if the hormone levels are going to fluctuate, it’s not going to be as sustainable. 
I recommend you maintain this continuous dialogue with your endocrinologist, and allow for the stabilization of all hormonal levels. Speak to your endocrinologist about checking the hormonal levels relevant to your situation including estrogen, testosterone, Vitamin D3, and make sure everything is right systemically. We often have our patients see their medical doctor first to check hormone and lab values overall before we do our treatment. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Craig L. Ziering, DO · Answer

Telogen Effluvium is relatively common with thyroid disease. Getting your thyroid levels normal with medication should help to stabilize your hair loss and regrowth should begin on its own. PRP shifts hair follicles that are in the resting telogen state to the actively growing anagen state; therefore slowing the shedding and accelerating the growth. While there may be an initial shedding after PRP, there should be a net overall gain with this treatment.

Edmond Griffin, MD · Answer

What you are experiencing is not uncommon, and may even be only temporary. At any given time, from 6% to 8% of the hair follicles on the scalp are naturally in the telogen or “resting” phase, which usually lasts for about 100 days. Various factors, like accidents, illnesses, and significant hormonal shifts, can disrupt this cycle, forcing a disproportionate amount of follicles into the telogen phase at once. When this occurs, the effects are not necessarily noticeable right away, and patients may not experience widespread shedding until up to three months after the initial disruption. Once the underlying problem has been dealt with the hair follicles will usually resume their natural growth cycle, so hair that is lost as a result of telogen effluvium will most likely regrow by itself over the course of the next year.
This assumes, of course, that the underlying medical issues have been addressed. Platelet rich plasma works primarily by accelerating the transition of the hair follicle from the dormant telogen state back to the actively growing anagen state, so if your hormone levels have stabilized PRP therapy may definitely help. However, if you are still having thyroid problems, any change resulting from PRP will be minimal. I would recommend that you make sure your hormone levels have stabilized and wait to see whether your hair begins to regrow by itself. Telogen effluvium does not result in permanent damage to the hair follicles, so PRP will still be a viable option at that point.

Will PRP injections help slow/reverse telogen effluvium hair loss for a patient with hypothyroidism?

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Will PRP injections help slow/reverse telogen effluvium hair loss for a patient with hypothyroidism?

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Everything you need to know about PRP for Hair Loss

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