Chronic Fatigue, Excessive Thirst, and Hair Loss: Which Specialist to See? - Family Medicine

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Chronic fatigue... excessive thirst... significant hair loss?


Hello, I have been experiencing chronic fatigue, excessive thirst (no matter how much water I drink, I still feel thirsty), and significant hair loss.
The hair loss is severe enough that after washing my hair, the amount of hair that falls out can clog the drain, and I am now showing signs of baldness.
Which medical specialty should I consult?

Yu, 40~49 year old female. Ask Date: 2017/06/07

Dr. Chen Taicheng reply Family Medicine


● Fatigue is a non-specific complaint, and many internal medical conditions or psychological stressors can be associated with it.
● Common causes of thirst include diabetes mellitus, diabetes insipidus, hyperaldosteronism, and side effects from certain medications (such as diuretics, anticholinergics, and antipsychotics); a small number of cases may be due to primary polydipsia, so please consult a family medicine or endocrinology specialist for further evaluation.
● There are many causes of significant hair loss, such as anemia in women, telogen effluvium (which may gradually improve on its own), alopecia areata, androgenetic alopecia (which can also occur in women), thyroid disorders, infections (such as syphilis, fungal infections, etc.), autoimmune diseases, and deficiencies in trace elements like zinc.
Based on your description, androgenetic alopecia and telogen effluvium may be the primary concerns, so please see a dermatologist for further evaluation.
● Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital, Family Medicine Department, cares about you.

Reply Date: 2017/06/07

More Info


Based on your symptoms of chronic fatigue, excessive thirst, and significant hair loss, it is essential to approach your health concerns systematically. These symptoms could be indicative of various underlying medical conditions, and seeing the right specialist is crucial for accurate diagnosis and effective treatment.

1. Endocrinologist: Given your symptoms of excessive thirst and fatigue, it would be prudent to consult an endocrinologist. These specialists focus on hormonal imbalances and metabolic disorders, which can lead to symptoms like yours. Conditions such as diabetes mellitus, particularly type 1 or type 2 diabetes, can cause excessive thirst (polydipsia) and fatigue. Additionally, thyroid disorders, such as hypothyroidism or hyperthyroidism, can also lead to hair loss and fatigue. An endocrinologist can perform blood tests to evaluate your blood sugar levels, thyroid function, and other hormonal levels to determine if any endocrine disorders are present.

2. Dermatologist: Since you are experiencing significant hair loss, a dermatologist should also be part of your healthcare team. They specialize in skin, hair, and nail conditions and can assess the type of hair loss you are experiencing. Conditions like androgenetic alopecia (male or female pattern baldness), alopecia areata, or even hair loss due to stress or nutritional deficiencies can be evaluated by a dermatologist. They may also check for scalp conditions that could contribute to hair loss, such as seborrheic dermatitis or fungal infections.

3. Primary Care Physician (PCP): It is also advisable to start with your primary care physician. They can perform an initial assessment of your symptoms, order necessary laboratory tests, and refer you to specialists as needed. Your PCP can help coordinate your care and ensure that all aspects of your health are considered.

4. Nutritionist or Dietitian: If your hair loss is related to nutritional deficiencies, consulting with a nutritionist or dietitian may be beneficial. They can evaluate your diet and recommend changes or supplements that may help improve your overall health and potentially reduce hair loss.

5. Psychologist or Psychiatrist: Chronic fatigue and the stress of dealing with hair loss can take a toll on your mental health. If you find that your symptoms are affecting your mood or quality of life, seeking help from a mental health professional may be beneficial. They can provide support and coping strategies to manage the psychological impact of your physical symptoms.

In summary, it would be best to start with your primary care physician, who can guide you through the process of diagnosis and treatment. They can refer you to an endocrinologist for your fatigue and thirst, a dermatologist for your hair loss, and potentially other specialists based on their findings. Early intervention is crucial, especially since you are experiencing significant hair loss and other distressing symptoms. Addressing these issues holistically will help you regain control over your health and well-being.

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