Losing hair and poorly controlled type 2 diabetes

[Saralula]

Hi everyone, this is my first post on here. I’m just shy of 27 and was diagnosed with type 2 diabetes a year and a half ago. I attended the DESMOND programme a year ago and since then have taken Metformin since the spring of 2019 and then slow release later on in the year.

I’ve been prescribed 4x500mg of the slow release metformin but even with this version, my body gets nasty digestive problems if I take more than 2x500mg a day.

I get symptoms of IBS without taking sertraline anyway (and therefore do take sertraline daily). I’m vegetarian and take vitamins including B12. I have a lot of belly fat and my diet could be a lot better - I’ve found it really difficult to make changes. I work and study full time (psychological therapy field) and live alone. To add to this, around seven weeks ago, I dislocated both kneecaps and broke an ankle. As it’s been hard to mobilise myself, I made the decision to just stick with the 2x500mg of Metformin - going to the loo has been hard enough as it is recently without needing to rush or feel poorly.

Hair loss I’d noticed for a while has continued and I’m certain it has got worse. I have fine hair anyway but now my entire head of hair has thinned that I can see much more scalp and it’s really scared me.

I know I need to manage my diabetes much better but given all the above, I’m feeling overwhelmed and stuck. As vain as it sounds, aside from tiredness, the only symptom that particularly concerns me at present is the hair loss. At 26 I know intellectually that things are slowly going to worsen but emotionally I don’t feel like I’ve really taken this on board.

I’d really appreciate any thoughts you have, and thanks for reading.

Sara 🙂

 

[leonS]

The first question to ask is "Are you sure that you are type 2?" How was this diagnosis made?

Type 1 or type 2, a warm welcome to the forum.

 

[everydayupsanddowns]

At 26 I know intellectually that things are slowly going to worsen but emotionally I don’t feel like I’ve really taken this on board.

Hello Sara

Welcome to the forum, though sorry you have to be here.

I’m not aware of regular posts about hair loss and taking Metformin. Have you had your thyroid function checked?

And sorry to hear about your knees - that must have been extremely difficult for you.

I am wondering if you’ve had rather unfortunate and deflating information from a nurse or Dr about diabetes being ‘inevitably progressive’. I’m not quite sure where this attitude comes from, and why it is thought to be a helpful thing to say to people, but all I can say from my years on the forum is that it is absolutely NOT what we see here. Some people do see a progression or need different treatment modalities over time, but others can in the opposite direction and can see improved glucose management over years or decades simply by eating in a way that suits their metabolism.

As @leonS suggests, 26 younger than average to get a T2 diagnosis, but is right in the heartland of people who are later re-classified. Because you say you are carrying extra weight, there are some indications of T2 risk, but The rarer LADA (a form of slow onset T1) can confuse medics by initially appearing to respond to tablets, but tends to move towards insulin faster than would be common in T2 as more beta cells are lost.

It might be worth asking your GP for a cPeptide or GAD tests if you are unsure or if there are other clinical factors that raise question marks?

 

[Ljc]

Hello @Saralula , welcome to the forum. Oh you are in a right pickle atm .
I hope your injuries are healing well, they must be so painful though.

As for your Metformin tum their are other meds available , so please get back to your team/nurse ASAP.
In the meantime I suggest you reduce your carbohydrate intake especially the starchy carbs as our body turns them into its fuel, glucose, rapidly but due to a number of factors may not be able to utilise it so it stays in our blood.

With the hair loss, any number of things could be causing it including stress.

How did you come to be diagnosed.

 

[Docb]

Hi Sara, sounds like you are going through it at the moment. As far as I have seen hair loss is not something associated with diabetes so if it were me I would be asking my doctor about it as a separate issue.

 

[Saralula]

@Docb
@Ljc
@everydayupsanddowns
@leonS

Thanks for all the replies - I wasn’t expecting so many so quickly!

I can’t remember the specifics of how I was diagnosed aside from a blood test. There was some initial question around MODY but a specialist very robotically put some of my details into his calculator tool and it came out with a small percentage. My dad is white British and my mom is from Borneo/Malaysia. She developed gestational diabetes when pregnant with me (she has never really been overweight) and her mom also has diabetes. My dad has been told he has pre-diabetes but I’m not aware of any other history on his side of the family. My BMI is high (5’2 and a little under 12 stone).

I’m glad to hear there are other options of medications. I think the metformin is definitely linked to the tummy problems when I take more than the half dose, but I’m attributing the hair loss at the moment to my diabetes not being well controlled. I have discussed the hair loss with a GP some months ago (it’s stayed about the same but only now have I noticed that I can see more of my scalp) and was advised that it could be to do with stress, but that this typically takes three months to take effect. Three months ago I feel that I was doing okay/well with my mood.

The diabetes nurse I’ve had a couple of appointments with over the past ~10 months did advise that remission is possible but also said that my symptoms will gradually worsen in time. Somewhat of a contradiction but I suppose I took that as meaning that even if I improve my management and ‘reverse’ the diabetes that there will still be a gradual worsening over time. (Not sure if that makes sense).

I’ve managed to book a GP appointment for mid-November. In the meantime I think this has perhaps been a bit of a wake up call to make more of an effort with diet and lifestyle changes.

P.S. I’ve just asked some friends whether they think my hair loss is noticeable and they’ve said no, so that’s reassuring for the moment.

 

[Drummer]

As there are quite a few people who have returned their blood glucose and Hba1c to normal numbers by eating low carb, the dismal prognosis is not really justified for a type two.
It is more problematic if you don't eat meat or fish to keep your carbs low enough to turn things around - but there are suitable sources of fats to provide fuel, I'm sure.

 

[Flower]

Hello and welcome @Saralula, glad you've found us 🙂

Sorry you're going through the mill at themoment and hope your knees and ankle are mending.

What was your most recent HbA1c test result? - the one done every 3/6 months and do you test your blood sugar with a meter at home regularly to see what your levels do after foods? Testing before you eat then approx 2 hours after a meal is really useful to see what foods you can tolerate and which you need to cut down/exchange.

I would second the need for a thyroid function test as impaired thyroid fuction over a prolonged time can cause hair loss. Good to read your friends haven't noticed a difference 🙂 Also B12 levels are vital for healthy hair growth and like you as a vegetarian I needed a course of B12 injections to raise and maintain my levels sufficiently . The amount I was getting in my diet and through multivitamins was not enough.

A diagnosis is a lot to take on and it does take a while to get things stable. Speak to your gp and list the problems you're facing. I hope they will help you get to a better place with your control.

 

[Thebearcametoo]

Have a chat with your doctor as there are many reasons for hair loss including thyroid as mentioned but also anaemia. A few blood tests would rule those out and give you a chance to discuss things with the doctor.

 

[leonS]

Interesting that your Dr. method of diagnosis was to calculate the odds and go for the favourite. This will not always work, but he should be right most of the time. Unfortunate if you were the one that he got wrong.

In type 1 - not enough insulin, in type 2 sufficient insulin not used very well. The medication used to help type 2s use the insulin more efficiently will not work for type 1s, as their problem is lack of insulin.

This is why it is important to get the right diagnosis.
Type 2 treatment for slow onset type 1 often works for a short time as there is still some insulin being produced, but the results are more likely to be due to change in diet and increased exercise (lowering the requirement for insulin) than the medicines prescribed.

The need for you to use insulin, such a short time after diagnosis, changes the odds considerably!

When the body produces insulin if makes c-peptides as a by product, it is possible to test for these and to estimate how much insulin you are making. It is also possible to check for the antibodies which have destroyed the cells which produce the insulin. You should press for a c-peptide test, at least, or for both tests, to confirm diagnosis. These are the tests mentioned by @everydayupsanddowns here.

Your hair loss might just be due to a general loss of health caused by the diabetes not being well controlled - let's hope that it improves.