People’s Pharmacy: Minoxidil stimulates hair growth, but will it last?
Q. About two years ago, I was seriously considering a wig because I was losing so much hair above my forehead. My doctor suggested minoxidil.
The bottle says to use it twice a day for at least six months before you will see a difference. I was faithful about using it, and it does work. My hairdresser is amazed at the difference.
Now I have cut back to using it just once a day and it’s still working. I have heard that if I quit using it, I will lose my hair again. I am not willing to try that! Is there anything I should know about this over-the-counter medicine?
A. Minoxidil (Loniten) was first approved as an oral blood pressure medication in 1979. A “side effect” of excessive hair growth prompted the manufacturer to investigate the topical application against hair loss. The Food and Drug Administration approved prescription Rogaine in 1988. Later, the FDA allowed over-the-counter sales of this topical compound.
While minoxidil does stimulate hair growth, there are some downsides. Skin irritation is one possible side effect.
An alternative to Rogaine is low-dose oral minoxidil. A review in the Journal of the American Academy of Dermatology (March 2021) concludes: “Oral minoxidil was found to be an effective and well-tolerated treatment alternative for healthy patients having difficulty with topical formulations.” This requires medical supervision because oral minoxidil, even in very low doses, may cause some side effects such as dizziness or fluid retention.
Q. I wish you would warn people that prednisone lowers vitamin D levels. Following a kidney transplant, I need prednisone to prevent rejection. I need to take a lot more vitamin D to maintain a healthy blood level.
A. Use of corticosteroids like prednisone dramatically reduces vitamin D levels (International Journal of Environmental Research and Public Health, January 2022). People on long-term prednisone should have their vitamin D levels monitored.
Q. I have Graves’ disease, a hyperactive thyroid. My doctor and I have been discussing how much thyroid-suppressing methimazole I should be taking. Despite having a T4 value in the normal range, I am sluggish and sleepy, slowly gaining weight and losing hair and always slightly constipated. She thinks this is not a problem; I disagree.
My doctor is urging me to have my thyroid removed. After that, she says, I can lead a lovely, normal life on the synthetic hormone levothyroxine. After reading about all of the problems people experience trying to manage hypothyroidism, I continue to resist her suggestion.
I wish all endocrinologists could experience what it feels like to be both hypo- and hyperthyroid. I don’t think they’d be so dismissive of their patients’ concerns if they knew firsthand how miserable both conditions can be.
A. When the thyroid gland is over- or underactive, people feel awful. Hyperthyroidism can cause anxiety, rapid pulse, insomnia, fatigue and weight loss for starters. Your symptoms are typical of hypothyroidism. That suggests your thyroid may be suppressed too much.
You might want to ask your doctor for a more complete thyroid panel. Adjusting the dose of methimazole you are taking to suppress your thyroid may help you feel better.
We discuss testing for both hypo- and hyperthyroidism and treatments for these conditions in our “eGuide to Thyroid Hormones.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”