Serum vitamin D, ferritin, and TSH in patients with telogen effluvium: a retrospective epidemiological study

Background: Telogen effluvium (TE) is one of the most common causes of alopecia. It is a non-scarring type of hair loss. TE is mainly diagnosed clinically; however, it can be associated with laboratory abnormalities such as serum ferritin, vitamin D, and thyroid-stimulating hormone (TSH); thus, screening them in TE patients could potentially improve the treatment outcome. The present study is aimed at assessing serum vitamin D, ferritin, and TSH in patients with TE in the Saudi population. Methods: A retrospective chart review study was carried out at Qassim University's dermatology clinics. The inclusion criteria included all female patients above the age of 18 years who were diagnosed with TE by one of the consultant dermatologists at Qassim University's clinics and who had at least one of the three laboratory tests: serum ferritin, vitamin D, and TSH level. Results: Our results indicated that among patients who were diagnosed with TE, the percentage of TE patients with ferritin deficiency was found to be 35.4%. Besides, the percentage of TE patients with vitamin D deficiency was 34.2%, and 8.5% had an abnormal TSH, with 1.5% having a low TSH and 7.0% having high TSH. Conclusion: Based on the findings of our study, we suggest that serum ferritin and vitamin D should be added to the screening panel of TE patients. The prevalence of hypothyroidism in our study was 7%, which is somewhat similar to the prevalence of hypothyroidism in the general population of about 5%-10%. Thus, we suggest that adding TSH to the TE screening panel is better to be individualized according to the patient's clinical presentation rather than a routine test in all TE patients.