Okay, I’ve almost made the 6 month mark and things are going fairly smoothly. My labs are nearing normal, I’m going on a lower calcium/potassium bath so my diet will start being even more liberal, cannulation is going pretty well (hope I don’t jinx myself), however, in the last couple of months my hair is falling out by the handfuls.
Prior to the last couple of months I maybe had to clean my hairbrush of excess hair maybe every 3 months or so, now it is weekly.
I’ve read this could be a zinc deficiency. Is it safe to add a zinc supplement?? I don’t take any zinc at all. Anyone know of another cause?? At this rate I’ll be bald in 6 months!!
I think you have to be carefull with mineral suppliments - what does your doc say?
A PubMed search through Google Scholar turned up:
Hair loss following chronic hemodialysis - an article in German with the conclusion “Attention is drawn to the frequent occurrence of loss of hair in chronically dialysed patients. No examinations were undertaken to find the cause of this phenomenon. However it is possible that, besides insufficiently eliminated toxins, hypothyrosis is also involved.”
Hypothyrosis is when the thyroid under produces - I take synthyroid (.2 micrograms) a condition that predated my CKD.
Another article stated
(http://www.extenza-eps.com/extenza/loadHTML?objectIDValue=27496&type=abstract):
“Other causes of diffuse hair loss include telogen effluvium, thyroid disease, severe iron deficiency and protein deficiencies. These conditions lead to hair thinning over the whole scalp, in contrast to the frontovertical loss seen in androgenic alopecia. They can also exacerbate the hair thinning of androgenetic alopecia.”
Hairloss for me happened at one point during my dialysis years…not sure what it was but it occured and lasted for a few weeks and then went away. Most likely I believe it has to do with nutrition or maybe even metobilism or even an allergy…but really could be anything…
Maybe vitamin E ? Dunno, hope researching a bit more will find the exact problem…
Thanks guys, my thyroid was recently checked and okay, I do have low iron, but not below normal, only my transferrin saturation is below normal. I take iron supplements daily. Kidney school is where I read that it is often a zinc deficiency and I was trying to figure out if we lose zinc in dialysis (ie water soluable). I see my neph in a week or so and will ask him but he is not the most knowledgeable or helpful guy out there!!
I did a google scholar search of “zinc dialysis” and turned up an article from 1978: Hypogeusia and zinc depletion in chronic dialysis patients.
by - Atkin-Thor E, Goddard BW, O’Nion J, Stephen RL, Kolff WJ..
The PubMed summary is: Dialysis patients generally have a poor appetite, do not enjoy eating, and complain of food, particularly protein, as being disagreeable. Twenty dialysis patients with the above symptoms were tested for taste acuity, serum zinc (Zn), Zn concentrations in hair samples (intracellular Zn), and daily caloric intake. A double-blind, cross-over study was instituted using a Zn supplement and a placebo. After supplementation with Zn, taste acuity markedly improved in 95% of patients and Zn concentrations in hair increased in 85% of patients. The patients’ appetites were improved; the average caloric intake increased by 675 kcal/day, and intolerance to protein diminished. In addition 10 normal control subjects were studied pre- and post-Zn supplementation for fasting blood glucose, serum Zn levels, and hair Zn concentration. Side effects were noted, and these usually correlated with elevated serum Zn levels and were minimized or disappeared with decrease in dosage or cessation of therapy.
So I think zinc is somethng you should look at but it also sounds like one could get too much zinc so it should be monitored.
The Life Options Rehabilitation Program (also administered by Medical Education Institute, Inc. that administers Home Dialysis Central) has a fact sheet on skin and hair care for dialysis patients. The fact sheet can be found at www.lifeoptions.org/pdfs/teachtools/skinhafs.pdf. You might also want to visit MedlinePlus, a US government website, where you can follow links to information about hair loss published online by different organizations. You can find this site at www.nlm.nih.gov/medlineplus/hairdiseasesandhairloss.html. I hope that by reading this information, you will be able to develop a list of questions to to ask your doctor regarding the diagnosis and treatment of what might be causing your hair loss.
hi, I had the same problem, it is the heparin that has this side effect, now I switched to the low weight molecular heparin, it is my sixth week with it but I have seen no improvements, I know that in Austria a few patients swicthed to the regional citrate anticoagulant and solved the problem, in my country it is not used unfortunately.
Simone
According to the fact sheet on skin and hair care on dialysis that is posted on the Life Options website:
Why is my hair falling out?
[i]Hair is made of protein. If you become malnourished, a few months later your hair may break more easily and fall out. Eating enough good protein will help, but it takes a couple of months to see a change. Ask your dietitian about good protein sources.
Hair loss can also be caused by thyroid problems, zinc deficiency, drug reactions, and other problems. Some patients have had hair loss when the unit changes the type of dialyzer (kidney) used. Talk with your doctor about this, or ask for a referral to a skin doctor.[/i]
if the thyroid, the iron and all the other minerals are ok and if it is not a stress induced hair loss there is no other doubt it is the heparin, I have been on dialysis for almost 2 years and now this problem is not as serious as it used to be in the first 5 months but it is existing.
Simone
I hope you didn’t think I was discounting your account. I was suggesting other possible conditions. You’re right that hair loss can be a side effect (although reportedly rare) of sytemic heparin that is used long-term. Dialysis patients definitely use heparin long-term and it is given systemically during dialysis. Here’s the list that includes some very interesting and common complaints of dialysis patients.
Less common or rare
Back or rib pain (with long-term use only); change in skin color, especially near the place of injection or in the fingers, toes, arms, or legs; chest pain; chills and/or fever; collection of blood under skin (blood blister) at place of injection; decrease in height (with long-term use only); frequent or persistent erection; irritation, pain, redness, or ulcers at place of injection; itching and burning feeling, especially on the bottom of the feet; nausea and/or vomiting; numbness or tingling in hands or feet; pain, coldness, or blue color of skin of arms or legs; peeling of skin; runny nose; tearing of eyes; unusual hair loss (with long-term use only)
From the article you cited, it appears that citrate dialysis helped with hair loss. I aldo found an article that said that citrate dialysis was effective with few side effects – one adverse side effect was increased calcium levels in patients using central venous catheters. I wonder what the chances are that dialysis clinics would switch to citrate dialysis.
it makes sense about the hair loss. A was on Peritoneal Dialysis for 4 years and ended up getting a very bad case of Peritonitis this summer and had to switch over to Hemo dialysis. But I had gotten so sick with this infection that I went from a size 14 to a size 3. That was in July and now it is Nov. My hair falls out daily in large handfulls. I have always had very thick thick hair and now you can see my scalp. I know my protien is low and so is my iron. They just gave me iron pills because I can’t afford the IV Iron (in Canada they used to cover that but they stopped covering that last year). I hope the pills help. If they don’t then maybe it is my hemo. I don’t know much about it since I just started it in July.
What province do you live in? I’m in Ontario, and my IV iron is definitely provided free of charge by the hospital my home dialysis unit is part of. Anything that is given while on dialysis is provided.
Pierre
Low protein can be a huge problem for someone on dialysis. Having albumin levels less than 4.0 – even worse if less than 3.5 – can put you at increased risk of getting infections, being hospitalized or even dying. I assume that people in Canada have access to dietitians who specialize in kidney disease. I’d suggest that you talk with your dietitian to find out what you can do to increase your protein intake and then monitor your labs to see if what you’re doing is improving your protein levels on your lab results.
Some other resources for diet and kidney disease include:
– Nutrition and Fluids for People on Dialysis in Kidney School, a modular based interactive learning system
Have you got any further with the hair loss research? I have noticed my hair is falling out a lot more than usual in the last couple of weeks and as I do Nocturnal I would hate to think it is the Heparin as around 8 mls is used per treatment! :shock:
Well I know everyone is different so I can only speak for my own situation. I read a lot on the net and there are many different reasons but for me I narrowed it down to malnutrician from when I was on PD and got peritonitis and was so sick and in so much pain I couldn’t eat and what ever I did eat I vomited back up. So with being malnurished I was losing my hair and now that I started pills called Replivite (Canadian … don’t know the American equivilant) which is Vitamins B and C for people on dialysis, and since I am eating again becuase my health is slowly picking up, I have noticed little short new growths on the top of my head and around the nape of my neck and where my bangs would normally be ( my hair is so thin I just brush my bangs to the side because they look so stringy now). I guess it takes a couple months for your hair to catch up when your health improves.
Also I have been trying to eat more protein and my protein levels are better now.
Thanks for all your advice everyone! I am also going to see the local skin specialist through my nephrologist just in case but it is a couple months wait …
Malnutrition is the #1 cause of many of the side-effects patients on dialysis go through…
Protein, iron…and more…you name it…those are taken out during treatment, to a point where only eating food can barely keep up with it…
Besides of just eating well, you need supplements. try some nutritional drinks made specificly for people on dialysis…one brand that I have tried is quite good is Novartis NovaSource Renal…
A dermatologist should be able to review your medical history, your family history, your lab reports, and your medicines and help you figure out what could be causing your hair loss. As I mentioned earlier in this thread, protein malnutrition, zinc and iron deficiencies, and thyroid problems are some possibilities besides side effects of some medications.
Ask your dietitian about your nutritional status. If your albumin is less than 4.0, ask what he/she recommends you do improve it. One thing the dietitian I used to work with often suggested was inexpensive powdered egg whites. You can add them to many foods to increase the amount of protein you’re getting in your diet. Your dietitian should know where you can get them.
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