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Reversible alopecia associated with high blood mercury levels and early menopause

a report of two cases

Peters, Jane B. BA2; Warren, Michelle P. MD1

doi: 10.1097/GME.0000000000001332
Case Report

Objective: The aim of this study was to report on two women in early menopause with alopecia and high mercury (Hg) levels which reversed with a decrease in toxic levels.

Methods: Retrospective chart review and case studies in a reproductive endocrinology practice.

Results: A 43-year-old woman initially evaluated for early menopause later experienced sudden circumscribed hair loss on the scalp. Blood tests indicated elevated Hg levels and further investigation revealed a diet high in tuna. Levels fell with elimination of dietary tuna. Another woman, 39 years old was complaining of severe hot flashes, night sweats, and menstrual irregularity also developed alopecia. Treated unsuccessfully for low testosterone, blood tests indicated high Hg levels and simultaneous hair loss was observed; recommendation to alter diet, including fish intake, was followed by a reversal of alopecia, along with a decrease in blood Hg levels. Literature searches were conducted with a focus on Hg toxicity or poisoning with symptom of alopecia.

Conclusions: Women of reproductive age frequently seek treatment for what is thought to be hormone-related hair loss especially at menopause. Two women demonstrated a strong temporal correlation to high Hg levels associated with early menopause, which was reversible. The development of alopecia in the setting of mild Hg intoxication has not been reported in the medical literature despite its appearance in the popular press. Measurement of Hg levels should be considered in women with alopecia and its relationship to early menopause is unclear but bears further research.

1The Center for Menopause, Hormonal Disorders & Women's Health, New York, NY

2Division of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, NY.

Address correspondence to: Michelle P. Warren, MD, The Center for Menopause, Hormonal Disorders & Women's Health, 134 East 73rd Street, New York, NY 10021. E-mail:

Received 6 January, 2019

Revised 14 February, 2019

Accepted 14 February, 2019

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Online date: April 1, 2019

© 2019 by The North American Menopause Society.