My hair and body hair fall out prematurely and then grow back. Everywhere I look there’s hair and body hair, pillows, socks, shoes.
Medical History and Laboratory Results
1\. Hair and Scalp Symptoms
* Severe hair shedding, with a small white bulb at the root.
* Brittle, dry hair that is difficult to moisturize.
* No significant perceived reduction in individual hair strand thickness.
2\. Body Hair Loss and Nail Changes
* Significant loss of leg hair.
* Loss of arm hair.
* Loss of intimate-area hair.
* Loss of armpit hair.
* Brittle nails.
### 3\. Vitamin and Mineral Tests
| Test | Result |
| ------------------- | -------------------------- |
| Vitamin B9 (Folate) | 2.4 ng/mL - Low |
| Vitamin B12 | 229 pg/mL - Low/borderline |
| Vitamin B2 | low |
| Vitamin D | 23 ng/mL - Insufficient |
| Homocysteine | 25 - High |
| Zinc | 83 µg/dL - Normal |
| Serum iron | 59 - Low/near lower limit |
| Ferritin | normal |
4\. Hormonal and Thyroid Tests
* Total testosterone: 1,268 ng/dL - High.
* SHBG: 106 - High.
* TSH: 0.7991.
* Free T4: 1.03.
* Total T3: Normal.
* Free T3: Normal.
5\. Autoimmune and Infectious Tests
* ANA/FAN: Negative.
* Lupus investigation: Reported normal.
* Syphilis: Reported normal.
* Hepatitis B and C: Negative.
* CRP: 0.04.
### 6\. Other Blood Tests
| Test | Result |
| ----------------- | ---------------- |
| Hemoglobin | 14.3 g/dL |
| RBC | 5.12 million/mm³ |
| MCV | 82.2 |
| WBC | 5,710 |
| Platelets | 239,000 |
| Glucose | 85 |
| Creatinine | 1.01 |
| Uric acid | 6.9 |
| AST | 16 |
| ALT | 13 |
| Total cholesterol | 150 |
| HDL | 44 |
| Triglycerides | 53 |
7\. Additional Tests With Normal Results
* Anti-TPO antibodies.
* Anti-thyroglobulin antibodies (Anti-Tg).
* Anti-intrinsic factor antibodies.
* Anti-parietal cell antibodies.
* ESR.
8\. Hair Loss Treatments With No Satisfactory Results
* Finasteride 5 mg daily for 5 months.
* Dutasteride 0.5 mg daily for 18 months.
* Oral minoxidil 5 mg daily for 18 months.
* Biotin 10 mg daily.
* High doses of Vitamin B9 and B12 supplementation for 1 year.
* Vitamin D supplementation for 1 year.
* Iron, zinc and copper supplementation.
* Methylfolate 5 mg daily for 1 year.
No satisfactory improvement in scalp hair loss or generalized body hair loss despite prolonged treatment and supplementation.
9\. Abdominal Ultrasound
Bilateral kidney stones (nephrolithiasis):
* Right kidney: 0.5 cm stone.
* Left kidney: 0.4 cm stone.
* Liver, gallbladder, pancreas, spleen and urinary bladder without significant abnormalities.
10\. Upper Endoscopy and Gastric Biopsy -
* Mild chronic antral gastritis.
* No active inflammation.
* H. pylori: Negative.
* Gastric body without significant abnormalities.
* No glandular atrophy.
* No intestinal metaplasia.
* Lymphocytic activity: Grade 1.
* Esophagitis.