Unlocking the Mysteries of Hair Loss

Overstyling, such as chemical straightening, bleach, and wearing hair in the same, tight style daily can all lead to hair breakage, resulting in more pieces of hair on your brush, in your hands, or in the shower drain. But hair loss - where the hair is shed from the follicle at rates beyond the expected 50-150 strands per day - typically has an internal root cause. Due to the cyclical phases of hair growth, loss typically ‘kicks in’ three months after the onset of the cause.

The first step to correction is identifying the root cause. We recommend working closely with a Naturopathic Doctor to determine if one or many of these factors are playing a role in the hair loss you are noticing:

Iron Deficiency Hair Loss

Without sufficient iron, your body cannot produce enough hemoglobin to carry oxygen to cells in the body, including the cells that manage hair growth. Since oxygen is required by cells throughout the body, the symptoms of iron deficiency can be widespread, and in addition to hair loss, you may notice shortness of breath, weakness, brittle nails, and fatigue.

Iron status is easy to investigate - your Doctor can test your ferritin (iron stores), as well as your hemoglobin level through a simple blood test.

Hypothyroidism Hair Loss

When the thyroid does not produce sufficient amounts of T3 and T4, two hormones that play a large role in our metabolism, hair growth is affected. A ‘classic sign’ of hypothyroidism is thinning of the lateral edge of the eyebrow; however, hair loss due to thyroid imbalances can occur anywhere on the body.

Your Doctor can assess the health of your thyroid. Typically this is done via measuring Thyroid Stimulating Hormone (TSH) in the blood, but this is a limited and narrow evaluation of thyroid health; we recommend testing free T3 and free T4, in addition to TSH, as well as thyroid antibodies that can rule in or out whether hypothyroidism is due to an autoimmune condition.

Postpartum Hair Loss

Elevated estrogen during pregnancy prevents normal hair shedding, leading the scalp to hold on to hair that would have been shed over those months, resulting in thicker, voluminous hair. Unfortunately, post-pregnancy the estrogen level drops and hair shedding kicks in in a big way, suddenly allowing all the hair that had been held to shed rapidly. Typically this evens out over time, as long as additional imbalances in iron or other nutrients do not go unchecked.

We typically recommend post-partum nutrient supplementation, as well as bloodwork to evaluate nutrient status and hormonal health.

Menopausal Hair Loss

Hair loss during menopause is similar to postpartum hair loss in that it is related to a decline in estrogen. However, it is often also exacerbated by a dip in progesterone, and a subsequent increase in androgens. This combo can paradoxically lead to a loss of scalp hair, alongside new facial hair. All of these hormone fluctuations can also influence thyroid health; many menopausal women experience hypothyroidism which can further exacerbate this hair loss.

At the onset of menopause, particularly if you are experiencing uncomfortable symptoms, we usually recommend a complex hormone panel, such as a DUTCH Panel, in addition to a complete thyroid panel, to fully evaluate your hormonal system.

Autoimmune Hair Loss

Autoimmune hypothyroidism, known as Hashimoto’s Thyroiditis, can lead to hair loss, as outlined above. Additionally, many other autoimmune conditions include hair loss as a symptom, such as Lupus, Graves’, Psoriasis, Crohn’s, Celiac, and Ulcerative colitis. For some of these conditions the connection is clear, such as with Celiac where the absorption of key hair nutrients can be severely compromised. For others, it is suspected that antibodies created by the body infiltrate the hair follicles themselves, leading to increased shedding. In alopecia areata, the body creates antibodies that specifically target the hair follicle, leading to patches of hair losses.

Autoimmune diseases can be challenging to diagnose, particularly if the symptoms are widespread, vague, and develop slowly; investigating levels of antibodies in the blood, such as anti-TPO, anti-TG, anti-TTG, and ANA, are a great starting point for evaluating for an autoimmune disease.

Significant Stress Hair Loss

Periods of high stress can affect our hair in many ways - our appetite may be reduced, we may chose nutrient-poor food more often, we may experience increased gut transit time, or may not produce sufficient stomach acid or digestive enzymes - all of which can lead to decreased absorption of nutrients required for healthy hair. Additionally, increased levels of cortisol, our stress hormone, pushes large amounts of hair follicles out of the growth phase, and into a ‘resting phase’. 

Within a few months, all of those hairs can shed suddenly, known as telogen effluvium. This connection has become very clear over the course of the pandemic as many patients report hair loss in the months following infection with COVID-19.

In an effort to evaluate the root cause of your hair loss, your Doctor may test your cortisol levels, and may also evaluate your nutrient intake, digestive health, and current day-to-day stress levels.

Contact our patient care coordinators to schedule an initial consultation with one of our Naturopathic Doctors to get started on finding the root cause of your concerns today.