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What tests are best to be done?
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Skin & Hair Concerns
Question #20997
45 days ago
106

What tests are best to be done? - #20997

Amelia

For over six months, I have been experiencing excessive hair loss. At first, I was sure it was due to anaemia because my iron and ferritin levels were low, but I normalised them and the problem persisted. My GP recommended that I have my thyroid and hormones tested. What exactly should I have tested in terms of my thyroid and hormones in relation to hair loss? Please help.

Age: 21
Chronic illnesses: depression, anaemia, anxiety
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Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
45 days ago
5

Hello,

1. Thyroid function TSH – main screening test Free T4 – to check thyroid hormone levels Optional: Free T3 – if TSH or T4 is abnormal Reason: Both hyperthyroidism and hypothyroidism can cause hair thinning.

2. Sex hormones (especially if hair loss is frontal or diffuse) Total testosterone – high levels can indicate androgen-related hair loss Free testosterone – optional, sometimes more sensitive DHEAS (Dehydroepiandrosterone sulfate) – adrenal androgen LH, FSH – to check ovarian function Prolactin – very high levels can cause hair thinning Estradiol – especially in women with irregular cycles

Reason: Hormonal imbalance can trigger female pattern hair loss / androgenic alopecia.

3. Nutritional / deficiency markers Ferritin – even if previously normal, low ferritin can cause hair shedding Vitamin D – deficiency is linked to hair loss Vitamin B12 – sometimes contributes

4. Other tests (if indicated) ANA / autoimmune panel – if hair loss is patchy (alopecia areata) Scalp biopsy – only if diagnosis is unclear

Key points Since you already corrected iron, focus on thyroid + hormones first. Tests should ideally be ordered and interpreted by a doctor, because hair loss often has multiple contributing factors.

Lifestyle factors (stress, anxiety, diet, medications) can also worsen hair shedding.

I trust this helps Thank you

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
44 days ago
5

Hello dear See thyroid hormone is required for basal metabolic rate. Excess can cause wasting of muscle and hyperactivity with exophthalmos while reduction can cause slowness and excess weight gain So please get below tests done for confirmation Serum tsh Thyroid antibodies Serum ferritin Serum pituitary Serum dhea Serum testosterone Regards

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Tests for hair loss often involve evaluating thyroid function and hormone levels since imbalances can contribute to the condition. For thyroid, you should have your TSH (Thyroid-Stimulating Hormone) level tested, which is the standard screening test. Depending on your TSH results, additional tests like Free T4 and Free T3 may be indicated to provide a clearer picture of your active thyroid hormone levels. These tests together can identify hypothyroidism or hyperthyroidism, both of which can affect hair health.

In terms of hormones, particularly relevant would be checking levels of DHEA-S (Dehydroepiandrosterone Sulfate), testosterone, and possibly SHBG (Sex Hormone Binding Globulin). These would assess for possible androgenic alopecia, which can cause hair loss when androgen levels are high. If you’re a woman, considering an evaluation of estrogen and progesterone levels, especially if there are additional symptoms of hormonal imbalance like changes in menstrual cycle, may be helpful.

If those tests don’t uncover any significant problems, it might be worth discussing with your doctor about further investigations into other potential causes, such as autoimmune issues like alopecia areata, or nutritional deficiencies beyond iron that affect hair growth, like zinc or vitamin D. Lifestyle factors might also play a role, so stress management, diet, and sleep quality should be assessed to ensure comprehensive care. Considering these options is all a part of making sure you’re not missing anything that could contribute to the ongoing hair loss issue.

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