DEAR DR. GOTT: I am a 45-year-old female. I have two children, ages 10 and 7, and I’m in good physical condition. I exercise regularly, eat well, take a multivitamin and calcium supplement, and never miss my annual OB/gyn checkup and mammogram.

My problem is my hair has been thinning for about two years, and I don’t know how to stop or reverse it. My dermatologist dismissed it (took a blood test but never examined my scalp) as female pattern baldness, although no other females in my family seem to suffer from it (the men do, however). All my blood tests came back normal.

I have never had thick hair, but it’s always been nice, healthy hair. I do color it to cover gray, but I use a vegetable-based dye and have it done professionally.

A lot has been happening in my life for the last four years, so stress can be a part of it, but I’m in a happy marriage, so I would think other stressful events in my life could not be causing this (I know people with a lot more stress who have nice hair).

Now my face is breaking out like crazy, and I even have some acne on my scalp. I still have normal periods but am very moody (the hair loss doesn’t help that), fatigued, feeling somewhat depressed (again, the hair loss adds to that) and can’t seem to find any answers. I did take another blood test with my OB/gyn and am waiting for the results. I told him what was going on and for him to please look at hormone changes since maybe I’m in perimenopause.

All I know is for someone who appears to be very healthy, I have a lot of hair missing on top, and unless I wash it every day, it is lifeless. If it is a hormone imbalance, can I correct it and get my hair back to normal, or is this kind of hair loss permanent? I know this is not life-threatening, but it is so discouraging. I really try to take good care of myself, and suddenly I feel like my body is letting me down.

Is it reversible? I’m not expecting to have thick, beautiful hair; I just want what I had back. I want this fatigue and acne to go away, too. I also take a biotin supplement and AG Pro (amino acid supplement). Any suggestions would be greatly appreciated.

DEAR READER: Perimenopause is the body’s way of transitioning to menopause. It can cause menstrual irregularities, mood swings, decreased fertility, bone loss, hot flashes, sleep problems, vaginal and bladder problems, and a change in cholesterol levels. Many women also notice some degree of hair loss, even though it isn’t necessarily considered a symptom. This may be the cause of your symptoms, so I commend you on asking your gynecologist to test your hormone levels.Another possibility is thyroid levels. Low levels (hypothyroidism) can cause fatigue, depression, brittle hair and nails, constipation and dry skin. High levels (hyperthyroidism) may cause thinning of the hair, acne, irregular menses, sweats and mood changes.Having had blood tests doesn’t conclusively mean that you aren’t suffering from a thyroid problem. Some individuals may experience symptoms of hypothyroidism despite normal blood levels and may benefit from treatment. Request a referral to an endocrinologist to further investigate this possibility. You may also want to get another opinion from a second dermatologist.Readers who would like related information can order my Health Reports “Menopause” and “Thyroid Disorders” by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order for each report to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039. Be sure to mention the title(s), or print an order form from my website’s direct link: www.AskDrGottMD.com/order—form.pdf.—————-

Dr. Peter H. Gott is a retired physician and the author of several books, including “Live Longer, Live Better,” “Dr. Gott’s No Flour, No Sugar Diet” and “Dr. Gott’s No Flour, No Sugar Cookbook,” which are available at most bookstores or online. His website is www.AskDrGottMD.com.