I get asked about hair loss A LOT. It’s distressing to see shiny scalp where once there were glossy, thick tresses. Or to be washing your hair and see far more strands in your hands than there used to be. Happily, you can normally get regrowth and thicker hair again once you’ve fixed the problem. But first, you have to find the problem.
Is it receding?
If your hair is receding from the forehead or from the top of the crown, it’s most likely ‘male pattern’ (androgenic) hair loss. In this case, you need to get the male hormone levels (testosterone, androgens, DHEA and DHT) back under control and it should regrow.
In men, the issue would probably be low testosterone levels, which often comes from not having enough DHEA, the precursor you make it from.
In women, it’s often from making too much DHT, the strong testosterone type. Any high testosterone or DHT levels might well point to PCOS, which is actually the most common cause of hair loss, certainly in premenopausal women. PCOS (polycystic ovary syndrome) is caused mainly by disordered insulin, metabolic and hormone control. Ask your GP to test for it. You don’t have to have cysts or be overweight: both common PCOS myths. For more on PCOS testing and treatment, check out my PCOS Factsheet.
Tip: Studies suggest massaging your scalp and using shampoos made with rosemary and grapeseed extract really helps because it seems to block the action of the DHT on hair follicles.
Or thinning?
If your hair is thinning along the parting rather than falling out, it is more likely to be from a drop in oestrogen, progesterone or thyroxine, so get those checked. A big clue to it being a lack of thyroxine (causing hypothyroid) is also losing the outer third of your eyebrows. Once you start to get those hormone levels controlled better, your hair will likely thicken up again.
You can find all female hormone tests here if you need them. And here for men.
Tip: When testing hormones, always look to see if your levels are within the upper or lower quartile – it will show within normal range but that is not normal for everyone – just the average! If it’s a bit borderline, assume a probable issue.
Other things to consider include:
Stress
Not actually as big a cause of hair loss as people think. Have your zinc, Vitamin C, magnesium or B vitamins, especially biotin, dropped? Don’t just take some though, think why your nutrients might be low? Is your diet good enough or are you malabsorbing for some reason — gluten, low stomach acid or enzymes, for example? Or, is your blood flow not taking the nutrients to where they need to be (more on this below)?
Are your adrenals maybe not firing on all four cylinders? An adrenal check would be good, especially if you are feeling like you don’t cope as well with life as well as you used to and/or your hormones are dropping. Post about 35, our ovaries and testes make less and less of our hormones and the adrenals take over. If they’re not up to the job, hormones will begin to drop and trouble will likely follow! See the factsheet on Adrenal Fatigue. You can use an adrenal test to check DHEA levels too.
Low blood pressure/poor circulation
Could it be poor circulation or low blood pressure causing poor blood flow and therefore nutrients not getting to the extremities, including the scalp? If so, improving oxygenation should help. If your blood pressure is lower than 120/80, it could be an issue for you, especially if your nose, hands and feet feel colder than they should, your nail beds look pale and you have fungal toenails — all clues of poor blood flow.
Or, could you be anaemic? Iron deficiency is surprisingly common and often ‘normal’ on results is not enough. Don’t necessarily believe female ferritin levels of less than 70, especially if your ESR inflammation marker is high.
Tip: If you do turn out to be anaemic and it won’t come up enough or stay up, definitely consider gluten below as it is a major cause of recurrent iron malabsorption, often the only clue to gluten issues.
Autoimmune
A very under-diagnosed, but quite common cause of hair loss is an autoimmune attack on the hair follicles. Over the years, I’ve found the main trigger for that is gluten. Test for gluten problems — coeliac disease and non-coeliac gluten sensitivity — don’t just stop eating it because it is more difficult to test when there is none in your system. Check the Gluten pages out here on my site for more on this.
OK. Hope that little checklist helps. The cause is likely to be one or more of those, so work through them to find what’s going on in your individual case. You can get lots more info and support from Alopecia UK and I thought their FAQ was particularly good.
Remember: it is very probably temporary, so try not to worry – especially as the stress is not going to help!