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Hemoglobin, ferritin and thyroid profile in women with chronic telogen effluvium

Background Chronic telogen effluvium (CTE) is a distinct disorder characterized by an excessive, alarming and diffuse shedding of hair in females. CTE has a major psychological impact on women impairing their quality of life. In the Indian context, rise in the number of CTE patients due to changing and stressful life style, necessitates systematic studies of contributing factors of CTE.

Methods A prospective study of premenopausal women in the age group of 18-50 years, presenting with diffuse hair loss of more than 100 hairs (clinical count) for more than 6 months, was conducted after obtaining an informed consent. General physical examination and a thorough dermatological examination of the scalp were carried out. Laboratory tests for blood hemoglobin, serum ferritin and thyroid hormone levels were performed. A subset of patients was also evaluated for stress levels using the Hamilton Anxiety Index and Hamilton Depression Index scales.

Results One hundred patients with a mean age of 29 years, of which 35% in the age group 18-25 years participated in the study. Prevalence of CTE was high (91%) in the age group 18-40 years. Most of the women (71%) presented with complaints of hair loss, within 12 months of occurrence. Hemoglobin levels were found to be significantly low in 66%, low serum ferritin in 76%, and hypothyroidism in 24% of patients. Out of the 66 women with altered blood hemoglobin levels, 72.7% has significant stress levels and 60.4% of them were working women. Ten patients had significantly low serum ferritin levels of < 40 μg/L, in spite of having normal hemoglobin levels. Nine patients had low serum ferritin and low thyroid levels. As many as eight patients had lower than normal levels of all the three markers.

Conclusions A significant number of patients had low hemoglobin, serum ferritin and thyroid levels, confirming a strong association of anemic conditions with CTE. Therefore, hemoglobin level, serum ferritin and thyroid levels need to be determined in CTE patients. Stress also plays a significant role in the causation of hair loss in women.

Background Chronic telogen effluvium (CTE) is a distinct disorder characterized by an excessive, alarming and diffuse shedding of hair in females. CTE has a major psychological impact on women impairing their quality of life. In the Indian context, rise in the number of CTE patients due to changing and stressful life style, necessitates systematic studies of contributing factors of CTE.

Methods A prospective study of premenopausal women in the age group of 18-50 years, presenting with diffuse hair loss of more than 100 hairs (clinical count) for more than 6 months, was conducted after obtaining an informed consent. General physical examination and a thorough dermatological examination of the scalp were carried out. Laboratory tests for blood hemoglobin, serum ferritin and thyroid hormone levels were performed. A subset of patients was also evaluated for stress levels using the Hamilton Anxiety Index and Hamilton Depression Index scales.

Results One hundred patients with a mean age of 29 years, of which 35% in the age group 18-25 years participated in the study. Prevalence of CTE was high (91%) in the age group 18-40 years. Most of the women (71%) presented with complaints of hair loss, within 12 months of occurrence. Hemoglobin levels were found to be significantly low in 66%, low serum ferritin in 76%, and hypothyroidism in 24% of patients. Out of the 66 women with altered blood hemoglobin levels, 72.7% has significant stress levels and 60.4% of them were working women. Ten patients had significantly low serum ferritin levels of < 40 μg/L, in spite of having normal hemoglobin levels. Nine patients had low serum ferritin and low thyroid levels. As many as eight patients had lower than normal levels of all the three markers.

Conclusions A significant number of patients had low hemoglobin, serum ferritin and thyroid levels, confirming a strong association of anemic conditions with CTE. Therefore, hemoglobin level, serum ferritin and thyroid levels need to be determined in CTE patients. Stress also plays a significant role in the causation of hair loss in women. Keywords: Hemoglobin, Ferritin, Thyroid profile, Chronic telogen effluvium