Many of us take for granted a healthy, full head of Hair. But what if your shower drain is suddenly getting clogged with hair or you start seeing more scalp in the mirror? Is this just a normal part of aging or is it a sign of a deeper issue with your health?
Hair loss, or alopecia as it is known medically, is not uncommon. It’s more prevalent in older adults but can occur at any age, depending on what is causing it.
In fact, it’s normal to lose a little hair every day. The average person has about 250,000 hairs in their head and loses between 50 and 100 hairs per day1. If your hair is short or thin to begin with, your normal daily loss may be less.
The question becomes: Are you growing back enough hair to replace the numbers you lose each day? If the answer to that question is No, then it might be time to find out the cause(s) behind it.
Signs of Hair Loss
- Larger numbers of hair in the hairbrush and/or in the shower
- Seeing more of your scalp at the part
- Receding of the hairline in the front and/or the sides
- Patches of baldness
- Individual hairs become fine or brittle
- Itching or pain in the scalp
- Thinning eyebrows
These signs and symptoms may indicate an underlying health issue that is beneath the hair loss. If we want to halt and even reverse the thinning, it’s critical to find out why it’s happening.
Five Common Causes of Hair Loss
1. Hormones
Sometimes hormonal imbalance can contribute to hair loss.
Most of us are familiar with male-pattern baldness or androgenic alopecia as it is also known. The semi-myth here is that it only affects males. Actually, it can also affect females, most commonly in menopause. For this reason, it’s more properly called “pattern baldness”.
The pattern does vary between men and women. Men tend to lose the hair at the front hairline and at the crown. In women, it tends to be more diffuse2.
The common theme is the abnormal interaction of androgens (so-called male hormones like dihydrotestosterone) with the hair follicles in the scalp. Elevated androgen levels and/or increased sensitivity to them causes the hairs to fall out more than is considered normal.
This is why androgenic alopecia only occurs after puberty. It tends to have a gradual onset but can come on suddenly in women after reaching menopause.
The underlying cause of the androgen imbalance can vary from person to person, but stress, blood sugar imbalance, overburdened detoxification systems in the body, and genetic factors may contribute.
2. Nutritional Deficiencies
One of the first things to rule out with hair loss is an underlying nutrient deficiency.
Iron is an important mineral used by the body to make hemoglobin, the protein that carries oxygen in the blood. Low iron levels can reduce oxygen delivery to the cells, including those in the hair follicles. Hair loss is often one of the first signs of iron deficiency. Women of menstrual age and those on strict vegetarian/vegan diets should be particularly mindful of their iron levels.
Biotin is a vitamin that is critical for gene regulation and cell signalling3. When the body is deficient in biotin, hair thinning may occur which can eventually lead to loss of all body hair. However, biotin deficiency is relatively rare. Unless a person is in a generally malnourished state, taking a biotin supplement for hair loss most often has minimal or no effect.
The hair shaft is composed of keratin, a specialized protein in hair, skin, and nails4. Low protein intake from certain diets (some vegan diets may qualify) and/or reduced stomach acid can result in insufficient starting material to make keratin. This can result in reduced hair growth and thinning over time as the falling hairs are not replaced quickly enough.
Other nutrients, like Vitamin C, Vitamin D, Vitamin B12, and zinc, are also important for healthy and abundant hair.
3. Immune Imbalance
The immune system, as it is commonly understood, is present to protect the body from harmful organisms that are considered foreign to the body. It is also there to initiate the healing process after there is damage, like when a limb or the skin is injured, by creating inflammation. Sometimes the damage is chronic, due to accumulated inhaled or ingested toxins, for example. In these cases, the inflammation may be prolonged.
When chronic inflammation is not resolved, the immune system can turn on the body itself. This situation is known as an autoimmune condition, and it can occur in almost any cell in the body. The unresolved inflammation damages and, sometimes, destroys the cell, causing it to have impaired function or cease to exist altogether. If this happens on the scalp, it often leads to hair loss.
Some examples of autoimmune (AI) related hair loss are:
- Alopecia areata – a diffuse or patchy autoimmune condition of the hair follicles that can affect the scalp and sometimes other parts of the body
- System Lupus Erythematosus (“SLE” or “Lupus”) – an autoimmune condition that can affect many areas of the body, including the hair follicles, leading to hair loss
- Psoriasis – a condition of the skin that can sometimes affect the scalp, contributing to hair loss
- Crohn’s and Inflammatory Bowel Diseases – inflammation in the intestines can lead to nutrient deficiencies from poor absorption, which may contribute to hair loss
- Hashimoto’s Thyroiditis – an AI condition of the thyroid gland that leads to hypothyroidism, a common cause of hair loss
- Graves’ Disease – another autoimmune condition that affects the thyroid gland, but it causes hyperthyroidism which also leads to hair loss on the scalp
Autoimmune conditions often occur in multiples. If you’ve been diagnosed with alopecia areata or another AI condition that affects the scalp, make sure you work with your health care practitioner to rule out other autoimmune problems.
4. Stress
You’ve probably heard the story of someone who had a fright and their hair fell out (or turned white). Although commonly considered an urban myth, there may be something to this story.
Short- and long-term stress can lead to overproduction of stress hormones, like adrenaline and cortisol. The latter is part of a group of hormones called corticosteroids, that are produced in the cortex regions of the adrenal glands.
Research suggests that chronic over-production of these hormones can contribute to both greying and loss of hair5. The exact mechanism for this has not been confirmed, but cortisol’s negative effect on thyroid hormone function may play a roll.
I know from experience that, when someone enters my office concerned about their hair loss, there is always stress involved. Certainly, the hair loss itself is stressful and may lead to a vicious circle that can be hard to escape.
5. Thyroid Imbalance
In addition to androgens, there are other hormones that affect hair growth.
The thyroid gland is responsible for producing hormones that promote metabolism. It is part of a thyroid system that manages body temperature, energy, weight, digestion, skin health, and hair growth. If the thyroid hormones go out of balance, low body temperature, fatigue, weight gain, digestive problems, dry skin, and hair loss can be the result.
Hypothyroidism, or underactive thyroid, is a condition where too little active thyroid hormone (called T3) is being produced by the thyroid system. Because the hair follicles rely on this hormone to function, too little T3 will result in fine, unhealthy hairs that fall out more quickly. The hypothyroidism also slows down the rate of hair regrowth, leading to overall thinning. As discussed above, Hashimoto’s Thyroiditis is a common cause of underactive thyroid.
Overactive thyroid (hyperthyroidism) is an overproduction of thyroid hormones. The excessive T3 will overstimulate the hair follicles, causing the hairs to progress through their life cycle too quickly. This results in hairs that fall out quicker than they can be replaced. The end result is thinning hair, just as in hypothyroidism. Graves’ Disease is the most common cause of hyperthyroidism.
Short of full-fledged hypothyroidism and hyperthyroidism, there is a stress-related condition of the thyroid system known as Wilson’s Temperature Syndrome (WTS). High levels (or low levels) of cortisol due to stress can lead to poor conversion of the thyroid precursor hormone, T4, into the active thyroid hormone, T3. By weakening digestion, stress also can lead to deficiencies in zinc and selenium, two minerals needed for the T4 to T3 conversion. The resulting low levels of T3 hormone in the follicles will contribute to hair loss.
The Take-Home Message
Whether it’s an ongoing issue or if it has “come out of nowhere”, hair loss can be distressing. This is especially true when you have no idea what may be causing it.
It’s important to consider that hair loss is not a condition in and of itself, but, rather, a symptom of an underlying health imbalance. This may include disruptions to the body’s natural hormone balance, deficiencies in important nutrients, disorders of the immune system, and even stress.
Hormone balance may be achieved by promoting detoxification through the liver and the other organs of elimination. Replacing deficient nutrients and improving digestion can help restore the building blocks to healthy hair. Reducing inflammation in the gut can assist in restoring a healthy immune system. Managing stress goes a long way toward supporting these processes, giving you the best chance to restore a healthy head of hair.
Of course, everyone is an individual and may be suffering from hair loss for a variety of reasons. Finding out what those reasons are is the journey that each person must take.
An assessment from a qualified health practitioner may be helpful for getting to the root of your hair loss.
1. https://health.clevelandclinic.org/how-much-hair-is-normal-to-lose-in-the-shower/
2. https://pubmed.ncbi.nlm.nih.gov/32901526/
3. https://fdc.nal.usda.gov/fdc-app.html#/food-details/169097/nutrients
4. https://en.wikipedia.org/wiki/Keratin
5. https://pubmed.ncbi.nlm.nih.gov/33790465/
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