42 yo F with suspected hypothyroid, adrenal fatigue, osteoporosis risk

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Welcome! Forums 42 yo F with suspected hypothyroid, adrenal fatigue, osteoporosis risk

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    • #1025
      Maija Tweeddale

      Hello, I would like some advice please with regard to the priority order of (and necessity for) testing for the client detailed below. I feel that several areas of testing are warranted but financial constraints will dictate how many can be undertaken.

      My client is a 42 year old woman with a healthy weight. Her current concerns are ongoing diffuse hair loss (approx. last 4 months), possible osteoporosis risk due to last 9 years of pregnancy with, and breastfeeding of, 3 children plus family history (mother and maternal grandmother both suffered with it), ongoing mild-moderate facial acne (20 years) with a likely hormonal element but not improved by 6 months of seed cycling, rosacea (approx. 1 year) and occasional night sweats (over last 12 months or so).

      Signs of hypo-functioning of thyroid include low basal body temperature (recently measured under the tongue on day 2, 3 and 4 of cycle results ranged from 36.02 – 36.11oC), dry skin (mainly on hands), puffy under the eyes and loss of hair.

      She is fairy pressured on a daily basis as a busy mum and is also starting up a business from home. She feels that recently she has developed a very short temper and an awareness of a feeling of a constant level of stress in herself whereas she has operated under fairly high stress conditions in the past and was able to cope.

      Her diet is really good – huge variety, lots of vegetables (full rainbow), plenty of good fats, quality protein, very low sugar, nothing excluded but low gluten and medium-low dairy. She includes homemade ferments regularly in the form of cow/goat milk kefir, kombucha, sauerkraut, kimchi and drinks homemade chicken bone broth 5-6 times a week. I have seen this woman before and at that time we introduced the idea of intermittent fasting, bone broth and a digestive enzyme with HCl for IBS and bloating, both mostly gone now, and seed cycling to improve the acne.

      The tests I am considering are a full thyroid panel, female hormones, vitamin and mineral screen, cortisol & DHEA and bone resorption. I would be grateful for some guidance as to which of these would be the best place to start and if there might be other areas to consider or diet modifications / supplements that would be useful.

      I have previously investigated the recommendation for tocotrienols but they seem to be very hard to come by! Out of stock in several places.


      Posted by Maija Tweeddale on 11.12.17

    • #1026
      Christine Bailey

      Dear Maija,

      Many thanks for your question about your client who is concerned particularly about her diffuse hair loss and risk of osteoporosis due to family history. You mention that you suspect issues with thyroid and abnormal adrenal function but these have not been tested. As you have raised the financial issue of testing I would ask her to also seek some of these tests through her own GP. For example, I suspect that if there is a family history of osteoporosis that her Doctor could organise a DEXA scan to check bone density.

      This, I think would be more valuable than a bone resorption test. Equally it may be possible for the GP to test her thyroid and also check vitamin D levels, Iron, B12 and folate. The latter are important for hair growth.  You could also ask the GP to check hormone levels too.

      You also mention her acne. This could have a link to gut health as you have previously mentioned IBS symptoms. It may be that you wish to check the gut via a comprehensive stool test if her symptoms are noticeable despite dietary changes. Yes, in many cases there can be a hormone element and it may be this could be checked via the GP.  I would also suggest cutting out dairy to see if this improves symptoms. In some cases, adding in detox support can also be helpful.

      Hair loss

      I agree with you that thyroid should be investigated in addition to iron and B vitamins. It appears that her protein intake is sufficient which is equally important. Zinc & Biotin are also important nutrients for hair growth and vitamin D.  Do you suspect it could have an autoimmune element? Alopecia areata, an autoimmune condition in which the immune system attacks hair follicles, can affect children and adults of both genders. As this is linked to gluten you may wish to consider whether a trial elimination of gluten could be helpful.

      Grover C, Khurana A. Telogen effluvium. Indian journal of dermatology, venereology and leprology. Sep-Oct 2013;79(5):591-603. https://tinyurl.com/y7cowbqn

      Ahsan H, Ahad A, Siddiqui WA. A review of characterization of tocotrienols from plant oils and foods. J Chem Biol. 2015;8(2):45-59. https://tinyurl.com/ycv8plu8

      Le Floc’h C, Cheniti A, Connetable S, Piccardi N, Vincenzi C, Tosti A. Effect of a nutritional supplement on hair loss in women. Journal of cosmetic dermatology. Mar 2015;14(1):76-82. https://tinyurl.com/yb9pb8jk


      Essential fatty acids

      A trial in women with early-stage hair loss found daily supplementation with fish oil, black currant seed oil (providing gamma-linolenic acid), lycopene, and vitamins C and E led to improved hair density compared with a control group.

      Forty-six women with diffuse alopecia received 200 mg per day of oral vitamin B5 plus daily intramuscular injections of vitamin B6 for 20–30 days. The treatment was repeated after six months and resulted in improved hair condition and reduced hair loss. Results from animal studies demonstrated vitamin B6, in combination with the amino acid L-cystine, prevented hair loss caused by the chemotherapy drug doxorubicin.

      Brzezinska-Wcislo L. [Evaluation of vitamin B6 and calcium pantothenate effectiveness on hair growth from clinical and trichographic aspects for treatment of diffuse alopecia in women]. Wiadomosci lekarskie (Warsaw, Poland: 1960).2001;54(1-2):11-18. https://tinyurl.com/y72t56ly

      D’Agostini F, Fiallo P, Ghio M, De Flora S. Chemoprevention of doxorubicin-induced alopecia in mice by dietary administration of L-cystine and vitamin B6. Archives of dermatological research. Jan 2013;305(1):25-34. https://tinyurl.com/yb5bx9x3



      A DEXA scan I think is relevant to ascertain her risk. Resistance training is one of the best long term approaches for support bone density and muscle mass so it would be useful for her to include this 2-3 times a week. Check vitamin D status and consider supplementing with a bone supporting formula and collagen powder which is an important protein in the bone. Again, those with coeliac disease are more prone to malabsorption and developing osteoporosis so cutting out gluten again may be important for this client.

      With regards to the hormone balance and acne you may wish to consider a supplement to support hormone balance – glandulars can be helpful in this case in addition to detox support.

      Keeping sugars and saturated fats low is important for skin health as well. I would cut out dairy for 4-6 weeks to see if this helps improve skin health.  I presume there is no underlying issue such as PCOS which is contributing to the acne?

      Lactoferrin, a protein with antimicrobial and anti-inflammatory effects, is a component of the innate immune system. In a trial of 39 subjects with acne, twice-daily lactoferrin tablets over eight weeks resulted in a significant decrease in the number of acne lesions in almost 77% of subjects.

      Mueller EA, Trapp S, Frentzel A, Kirch W, Brantl V. Efficacy and tolerability of oral lactoferrin supplementation in mild to moderate acne vulgaris: an exploratory study. Current medical research and opinion. Apr 2011;27(4):793-797. https://tinyurl.com/mvvezwr


      Nicotinamide. As a dietary supplement of 600 mg one to four times daily (in combination with azelaic acid, copper, folic acid, pyridoxine, and zinc), nicotinamide reduced symptoms by over 80% after eight weeks of treatment in a clinical trial of 235 subjects.

      Shahmoradi Z, Iraji F, Siadat AH, Ghorbaini A. Comparison of topical 5% nicotinamid gel versus 2% clindamycin gel in the treatment of the mild-moderate acne vulgaris: A double-blinded randomized clinical trial. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. Feb 2013;18(2):115-117. https://tinyurl.com/y9n9egwx


      Topically vitamin A can be helpful and this may also be useful internally as well.


      The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.

      Bone Support long term

      Osteo-B-Plus (BRC) – take 2 capsules daily – https://tinyurl.com/ybcu46am

      Arthred Collagen powder (ARG) – take 1tbsp three times daily – https://tinyurl.com/j2arfe4

      Hormone balance and skin health

      Equi-Fem (BRC) – take 2 tabs twice daily – https://tinyurl.com/y7v2dcbr


      Cytozyme-F (BRC) – take 1 at each meal

      Detox Support and probiotic support

      ProGreens (ARG) – take 1 scoop daily – https://tinyurl.com/gtqgbyo

      Topically, consider

      Liquid Iodine (BRC) – 1 dropperful on the skin daily – https://tinyurl.com/y75dbmjq

      Bio-Ae-Mulsion (BRC) apply topically – you can mix this into a little coconut oil and apply to the skin – https://tinyurl.com/jzwxmvd

      Additional hair and skin support

      EFA-Sirt Supreme (BRC) – take 2 capsules three times daily – https://tinyurl.com/h3czc9x

      B vitamin supplement

      Bio-3B-G (BRC) – take 2 tablets three times daily


      I hope this helps with your client


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