Why you’re losing hair: 8 common causes for hair loss in women – and what to do about it

By Dr. Brian Lum, DC

1. Hypothyroidism
Under-active thyroid
Thyroid disorders are the most common cause of hair loss in women, with 90 percent of cases being Hashimoto’s Thyroiditis. This is a disease that causes the immune system to attack and destroy thyroid tissue, lowering hormone levels. The standard of care is to replace the depleted thyroid hormone to hopefully relieve symptoms. This approach while often necessary, fails to address the multiple factors causing the immune system to destroy the thyroid.

SOLUTION: Functional medicine can treat the underlying problem, stop the damage to the organ, and in most cases restore healthy function of the thyroid, and thereby fixes the hair loss problem. (Look for a Hashimoto’s Thyroiditis article upcoming in the future.)

2. Anemia
Approximately 1 out 10 women suffers from anemia caused by iron deficiency. Associated symptoms include fatigue, cold hands and feet, headache and dizziness.

SOLUTION: Your doctor can order a simple blood test to see whether you have this type of anemia. In most cases additional iron intake either through food or medicine is necessary. But be cautious: Supplementation without doctor supervision can be dangerous because excessive iron can initiate inflammation throughout the body.

3. Telogen Effluvium
This condition causes hair growth to temporarily stop and become dormant. Potential causes include the flu, stress, pregnancy, or stopping birth control pills.2,3

SOLUTION: Depending on the cause, hormone balancing treatment, stress management, and/or immune system support may be indicated.

4. Trichotillomania
This psychological disorder causes a strong impulse to pull out hair. It most commonly affects younger girls.

SOLUTION: Monoamine amino acid therapy has been shown to yield successful results.

5. Medication Induced
Medications that can cause hair loss include: Cholesterol lowering drugs, Parkinson’s medications4, antiulcer drugs5, anticoagulants6, anti-arthritics7, drugs derived from vitamin A8, anticonvulsants9, beta-blockers10, and anti-thyroid drugs11.

SOLUTION: It’s important to know what you’re taking and the risks/benefits of each medication. Potential side effects should be discussed with your doctor.

6. Nutritional Deficiencies/Therapies

  • Biotin Deficiency: Biotin is a water-soluble vitamin necessary for healthy hair growth and maintenance. Supplementing with 1mg/daily has been shown to improve hair loss (especially hair thinning) if biotin deficiency is present and the causative factor12. Effects can be seen as soon as 1 week of consistent repletion.
  • L-arginine: L-arginine is used to produce nitric oxide, a key factor in maintaining and promoting new hair growth.
  • Vitamin E: Vitamin E has the potential to support youthful hair thickness and growth. In a study with 30 people, nearly all subjects showed improvement in hair thickness and density13. Note: It is important to only take pharmaceutical-grade mixed tocopherols for the best results and ensured safety.
  • Lack of Protein: If protein intake is low, or the body is not able to digest and use protein efficiently, the body will begin to shut down hair growth. For an adult recreational exerciser, the recommended dosage is 0.5-0.75 grams of protein per pound of weight.
  • Vitamin B Deficiency: This is often seen in women who are dieting off and on for long periods of time, those who experience dramatic weight loss, or those taking over-the-counter or prescription antacid medication. Antacids decrease stomach acid and will therefore hinder B vitamin absorption. It is often necessary to identify the cause to truly fix the deficiency, as well as to increase vitamin B ingestion. For supplementation, it is best to take a vitamin B complex, as this will increase the likelihood of balanced repletion.
    Note: Chronic antacid use contributes to B vitamin deficiencies and B12 in particular because stomach acid is necessary for B12 absorption. Chronic B12 deficiency can cause nerve pain, depression symptoms, and/or fatigue.

    7. Lupus: autoimmune disease
    This is an autoimmune disease where the body’s immune system attacks and damages connective tissue as well as other organs, including hair. If autoimmune disease is in your family history, it may be important to see your doctor for testing.

    SOLUTION: Lupus is a serious disease with many potential complications. Functional medicine can be used to identify and treat the specific factors that may be causing your immune system to attack your body. This allows for the best possible outcome to be achieved.

    8. Polycystic Ovary Syndrome (PCOS)
    PCOS is the most common female hormone disorder. Symptoms of this disorder include excess facial hair, acne, weight gain and infertility. Those affected commonly have insulin resistance and excess androgen production (testosterone) resulting in body hair, acne and hair loss.
    It is the most common cause of female infertility and is associated with developing type 2 diabetes.

    SOLUTION: Underlying causes include insulin resistance and hormonal imbalance. Standard of care often neglects to treat insulin resistance through lifestyle and specific nutritional interventions.

  • Nutritional therapies proven to improve insulin resistance includes in PCOS:
    1. Myo-inositol: improves insulin sensitivity; beneficially lowers testosterone, blood pressure, and triglycerides; promotes weight loss; and increases ovulation frequency.14,15,16,17,18
    2. N-acetyl cysteine(NAC): improves insulin sensitivity in PCOS; can contribute to fertility restoration.19,20
    3. Magnesium: These women tend to be magnesium deficient, which can significantly contribute to insulin resistance and elevated blood glucose levels.21,22
    4. Chromium: improves insulin sensitivity23
    5. Lipoic Acid: can improve insulin sensitivity, promote weight loss, reduce blood pressure, improve cholesterol profile, and is a powerful antioxidant.24,25
    6. Vitamin D: contributes to healthy insulin levels and normal menstrual cycle regulation26,27
    7. Omega-3 Fatty Acids: can reduce liver fat content and improve cardiovascular health in women with PCOS.28
    8. Cinnamon: can improve insulin resistance and can produce a 20-fold increase in sugar metabolism29,30,31

    Note: It is important to seek the care of a dermatologist at first sign of hair loss to ascertain a proper diagnosis and appropriate treatment.

    1.) Hibino T, Nishiyama T. Role of TGF-beta2 in the human hair cycle. J Dermatol Sci. 2004 Jun;35(1):9-18.
    2.) Whiting DA. Chronic telogen effluvium. Dermatol Clin. 1996 Oct;14(4):723-31.
    3.) Hadshiew IM, Foitzik K et al. Burden of hair loss: stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol. 2004 Sep;123(3):455-7
    4.) Yamada K, Goto S. Bilateral subthalamic nucleus stimulation results in reversal of alopecia in Parkinson’s disease. Parkinsonism Relat Disord. 2004 Aug;10(6):353-5.
    5.) Borum ML, Cannava M. Diffuse alopecia associated with omeprazole. Am J Gastroenterol. 1997 Sep;92(9):1576.
    6.) Sarris E, Tsele E et al. Diffuse alopecia in a hemodialysis patient caused by a low-molecular-weight heparin, tinzaparin. Am J Kidney Dis. 2003 May;41(5):E15
    7.) Ettefagh L, Nedorost S et al. Alopecia areata in a patient using infliximab: new insights into the role of tumor necrosis factor on human hair follicles. Arch Dermatol. 2004 Aug;140(8):1012.
    8.) Chave TA, Mortimer NJ et al. Agranulocytosis and total scalp alopecia following acitretin. Br J Dermatol. 2003 May;148(5):1063-4
    9.) Kohno Y, Ishii A et al. [A case of hair loss induced by carbamazepine]. Rinsho Shinkeigaku. 2004 Jun;44(6):379-81.
    10.) Gautam M. Alopecia due to psychotropic medications. Ann Pharmacother. 1999 May;33(5):631-7
    11.) Shelley ED, Shelley WB. Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol. Cutis. 1985 Feb;35(2):148-9.
    12.) Tosti A, Piraccini BM, Sisti A, Duqu-Estrada B. Hair loss in women. Minerva Ginecol. 2009 Oct;61(5):445-52.
    13.) Yuen Kah Hay, B. Randomized clinical trial of tocotrienols supplementation vs. placebo for androgenetic alopecia. School of Pharmaceutical Sciences, Universiti Sains, Malaysia.
    14.) Costantino D et al. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci. 2009 Mar-Apr;13(2):105-10
    15.) Genazzani AD, Lanzoni C, Ricchieri F, JasonniVM. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. GynecolEndocrinol. 2008 Mar;24(3):139-44.
    16.) Gerli S et al. Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci. 2007 Sep-Oct;11(5):347-54
    17.) Papaleo E, Unfer V, Baillargeon JP, Chiu TT. Contribution of myo-inositol to reproduction. Eur J ObstetGynecolReprod Biol. 2009 Dec;147(2):120-3
    18.) Zacchè MM, Caputo L, Filippis S, et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. GynecolEndocrinol. 2009 Aug;25(8):508-13
    19.) Abu Hashim H, Anwar K, El-Fatah RA. N-acetyl cysteine plus clomiphene citrate versus metformin and clomiphene citrate in treatment of clomiphene-resistant polycystic ovary syndrome: a randomized controlled trial. J Womens Health (Larchmt). 2010 November; 19(11): 2043-8
    20.) Badawy A, State O, Abdelgawad S. N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross-over trial. ActaObstetGynecol Scand. 2007;86(2):218-22
    21.) Kauffman RP, Tullar PE, Nipp RD, Castracane VD. Serum magnesium concentrations and metabolic variables in polycystic ovary syndrome. ActaObstetGynecol Scand. 2011 Jan 4
    22.) Mooren FC, Kruger K, Völker S, Golf W, Wadepuhl M, Kraus A. Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects – a double-blind, placebo-controlled, randomized trial. Diabetes, Obesity and Metabolism. 2011 March; 13 (3): 281-84
    23.) Lucidi RS, et al. Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome. FertilSteril. 2005 December; 84(6):1755-7
    24.) Pershadsingh HA. Alpha-lipoic acid: physiologic mechanisms and indications for the treatment of metabolic syndrome. Expert OpinInvestig Drugs. 2007 Mar;16(3):291-302
    25.) Masharani U, Gjerde C, Evans JL, YoungrenJF, GoldfineID.Effects of controlled-release alpha lipoic acid in lean, nondiabetic patients with polycystic ovary syndrome. J Diabetes Sci Technol. 2010 Mar 1;4(2):359-64.
    26.) Wehr EB et al. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol. 2011 Mar 9
    27.) Rashidi B et al. The effects of calcium-vitamin D and metformin on polycystic ovary syndrome: a pilot study. Taiwan J Obstet Gynecol. 2009 Jun;48(2):142-7.
    28.) Cussons AJ, et al. Omega-3 fatty acid supplementation decreases liver fat content in polycystic ovary syndrome: a randomized controlled trial employing proton magnetic resonance spectroscopy. J ClinEndocrinolMetab. 2009 October; 94(10):3842-8
    29.) Broadhurst L, Polansky MM, Anderson, RA. Insulin-like biological activity of culinary and medicinal plant aqueous extracts in vitro. J Agric Food Chem. 2000 Mar; 48(3):849–52
    30.) Cao H, Graves DJ, Anderson RA. Cinnamon extract regulates glucose transporter and insulin-signaling gene expression in mouse adipocytes. Phytomedicine. 2010 Nov;17(13):1027-32
    31.) Anderson RA, Broadhurst CL, Polansky MM, et al. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem. 2004 Jan 14;52(1):65-70

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