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LETTER TO THE EDITOR
Year : 2017  |  Volume : 8  |  Issue : 1  |  Page : 55-56  

Diffuse scalp hair loss due to levothyroxine overdose


Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Date of Web Publication20-Jan-2017

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, P. O. Box: 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.198769

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How to cite this article:
Al-Mendalawi MD. Diffuse scalp hair loss due to levothyroxine overdose. Indian Dermatol Online J 2017;8:55-6

How to cite this URL:
Al-Mendalawi MD. Diffuse scalp hair loss due to levothyroxine overdose. Indian Dermatol Online J [serial online] 2017 [cited 2019 Dec 12];8:55-6. Available from: http://www.idoj.in/text.asp?2017/8/1/55/198769

Sir,

I read with interest the case report by Kumar et al. on the hypothyroid infant with diffuse scalp hair loss due to levothyroxine overdose.[1] Although the authors addressed a causal relationship between the occurrence of alopecia and starting levothyroxine therapy based on clinical and biochemical responses, I presume that they should consider the following point which might significantly add to the development of alopecia in the case in question. It is obvious that Zinc (Zn) is an essential element for maintaining human body homeostasis and it is one of the major constituents of hormones, signal molecules, and enzymes. On one hand, marked alterations in Zn homeostasis in persons with thyroid disease is well established. Plasma Zn was found to be lower in hypothyroid subjects and correlated with serum albumin. Peripheral blood mononuclear cell Zn and urinary Zn were also found to be low in such patients.[2] On the other hand, Zn was noticed to help recover appropriate activities of metalloenzymes, hedgehog signaling, and immunomodulation, all of which are required for the normal control of hair growth cycle.[3] Apart from the levothyroxine-associated alopecia, I presume that concomitant Zn deficiency ought to be additionally considered in hypothyroid patients with alopecia as such association has been rarely reported in the literature.[4]

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Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Kumar KJ, Kumar MS, Kumar TS, Chavan A. Diffuse scalp hair loss due to levothyroxine overdose. Indian Dermatol Online J 2015;6 Suppl S1:58-60.  Back to cited text no. 1
    
2.
Dolev E, Deuster PA, Solomon B, Trostmann UH, Wartofsky L, Burman KD. Alterations in magnesium and zinc metabolism in thyroid disease. Metabolism 1988;37:61-7.  Back to cited text no. 2
    
3.
Karashima T, Tsuruta D, Hamada T, Ono F, Ishii N, Abe T, et al. Oral zinc therapy for zinc deficiency-related telogen effluvium. Dermatol Ther 2012;25:210-3.  Back to cited text no. 3
    
4.
Betsy A, Binitha M, Sarita S. Zinc deficiency associated with hypothyroidism: An overlooked cause of severe alopecia. Int J Trichology 2013;5:40-2.  Back to cited text no. 4
    




 

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