Dr. Gott: Which medications can cause hair loss?

Dear Dr. Gott: I am 72 years young, active and do all my own housework. I recently read your letter concerning hair loss after taking medication. I am on three prescription medications and three over-the-counters. The first drug is lisinopril, 20-milligram tabs, one and a half pills every day. The second is prednisone, 4 milligrams daily, prescribed by a rheumatologist because of rheumatoid arthritis. The third is blood pressure medicine known as metoprolol, 50 milligrams, which I’ve been on for more than four years. I was taking one in the morning and a half every evening until my doctor increased the medication to two a day.

My over-the-counter drugs are a one-a-day multivitamin, 1,000 milligrams calcium plus vitamin D daily, and calcium citrate, 315 milligrams with 200 IU of vitamin D.

Years ago, I noticed hair loss and attributed it to the metoprolol. The problem keeps increasing and, in fact, if it continues, I will need a wig in another year. I mentioned the problem to my doctor, and her reply was that all medicines make people lose hair. Would I be wrong in asking my doctor to take me off the metoprolol and prescribe another medication for my high blood pressure? I showed her the drug information provided by my pharmacy indicating hair loss as a side effect.

I recently changed primary care physicians, since my first doctor wasn’t concerned at all about my hair loss. What can I do?

Dear Reader: Let me begin with some general information. Medications must go through several clinical studies before being approved. This is done by giving thousands of people a drug, while others are given a placebo. During the studies, no participant knows wheher he or she is taking the real thing or a placebo. An adverse reaction in more than 1 percent of the people studied in both categories is referred to as a common side effect, while less than that amount is referred to as rare. Once a drug is approved, it is no longer studied.

Now for the bad news. You are on lisinopril, metoprolol and prednisone. All three drugs can cause hair loss as a rare side effect. Steroids are known to precipitate hair loss in men, yet all women have some male hormones. Therefore, of the prescription medications you take, all three share a similar consequence. The good news, according to my resources, is that the hair loss is generally reversible once a drug is discontinued.

It could be difficult in your situation to determine which drug is causing your hair loss unless you kept meticulous records indicating when the pattern began. As we age, we suffer wrinkles, heart problems, hypertension, arthritis and more. It’s difficult enough dealing with the problems over which we have little control. We shouldn’t have to deal with balding when it is preventable. I recommend you speak with your new primary-care physician, who might be able to prescribe different medications in each instance without such an emotionally devastating side effect, no matter how rare it might be.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.