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Concerned About Hair Loss?

Have you noticed an increasing number of hairs in your sink or hairbrush? Are you beginning to see more of your scalp when you look in the mirror? If so, you are not alone! Millions of men and women experience hair loss as they age, sometimes starting as early as their 20s or 30s. Depending on the reason for your hair loss, you may be able to reverse it or at least slow it down.

First, let's recognize that some hair loss is normal. Hair experts estimate that a loss of approximately 50 to 150 strands of hair per day represents normal shedding for the human hair growth cycle. So, some hair in the sink or shower is nothing to be alarmed about. Sudden hair loss, or thinning hair over your entire head (and possibly other parts of your body), or clumps of hair falling out are considered unusual, and should be discussed with your healthcare practitioner. Depending on the severity of your symptoms, he or she may recommend seeing a dermatologist or a hair specialist, known as a trichologist.

The fear of losing more hair is usually what prompts people to seek medical attention. Although some people may be driven by vanity, for others hair loss is devastating to their self-esteem. This seems especially true for women. In The Hormone Solution: Stay Younger Longer, Dr. Thierry Hertoghe notes that a hormone imbalance is just as likely to feed fear and erode self-confidence as it is to contribute to hair loss. He says, "Addressing any imbalance will not only improve the situation on top of your head, but within it as well."

Possible Causes

Because hair cells are replenished more quickly and visibly than most other cells, the condition of your hair is like a barometer of your overall health. Sudden or excessive hair loss can indicate an underlying problem, such as a vitamin or mineral deficiency, a hormone imbalance, a toxicity brought on by something in your environment, or too much stress in your life.

Sometimes the cause for the hair loss can be treated or eliminated, resulting in new hair growth and healthier hair. Those individuals who have a genetic predisposition for early or excessive hair loss may not be able to fight it, but they can at least try to slow it down by being aware of factors that affect hair health.

Hair Conditions and Possible Factors

The hair conditions identified below may precede or occur in conjunction with hair loss. Paying attention to your hair condition and treating early symptoms may allow you to prevent or slow down hair loss.

Dry, brittle hair


  • Protein deficiency, possibly due to poor protein digestion
  • Essential fatty acid deficiency
  • Deficiencies in vitamin A, sulfur, silicon, or zinc
  • Imbalance involving thyroid hormones

Oily hair

  • Essential fatty acid deficiency
  • Deficiencies in zinc, vitamin B6, riboflavin, or folic acid

Coarse hair

  • Vitamin A deficiency and possible hypothyroidism (vitamin A metabolism requires adequate levels of thyroid hormones)
  • Protein deficiency

Split ends or untamed hair

  • Iron deficiency
  • Deficiencies in vitamin B6, magnesium, or zinc

Loss of texture or shine

  • Essential fatty acid deficiency
  • Deficiencies in vitamin B6, magnesium, or zinc
  • Imbalance involving growth hormone

Premature graying

  • Usually related to stress
  • Hormone imbalance (probably related to stress)
  • Deficiencies in B vitamins, sulfur, copper, or folic acid
  • Imbalance involving testosterone, growth hormone, or ACTH (a pituitary hormone)

Scalp disorders
(dandruff, seborrhea, psoriasis)

  • Fungal infection, accelerated by a high carbohydrate diet
  • Disruption of local and systemic immunity
  • Aggravated by stress
  • Essential fatty acid deficiency
  • Deficiencies in B vitamins, zinc, biotin, selenium, or copper (especially if sensitive to the sun)

Excessive hair loss

  • Poor blood flow or poor circulation to the scalp
  • Deficiencies in protein, essential fatty acids, B vitamins, silicon, and zinc
  • Imbalance involving thyroid, growth hormone (especially if hair loss is all over), or ACTH

Patchy hair loss

  • Metal poisoning
  • Deficiencies in folic acid and zinc
  • Imbalance involving ACTH or cortisol

Pubic or armpit hair loss

  • Imbalance involving DHEA

Hair loss on the top of head

  • Imbalance involving cortisol, estrogens, progesterone, or testosterone

Balding all over the head

  • Imbalance involving thyroid hormones, DHEA, or estrogens

Different hair conditions such as dandruff or breakage— prior to or in conjunction with hair loss—can be early warning signals for a variety of different problems or deficiencies (see chart above). For example, coarse or brittle hair may indicate low thyroid function. Scalp disorders such as dandruff, seborrhea, or psoriasis may indicate a fungal infection that has been accelerated by nutritional deficiencies.

In addition, environmental conditions and harsh hair products can damage healthy hair and accelerate hair loss brought on by other factors. For example, heavy metals and toxic chemicals can build up in your system and interfere with your body's absorption of nutrients or production of hormones. (In fact, hair testing is one of the EPA's means of testing for toxins.) Many people also participate in hobbies or have occupations that expose them to toxins, including painting, arts and crafts, landscaping or gardening (unless you are careful to use only organic products), electrical work, soldering, radiation therapy, and others. Limiting or eliminating your exposure to these toxins and harsh products should be one of the first things to try if you have excessive hair loss.

Many of the ingredients listed in shampoos, conditioners, and other hair treatments are known allergenics. These ingredients can cause dermatitis in some people, and may even be toxic.

Image depicting various forms of hair loss, including thinning hair as a result of excessive hair loss, or circular bald patches that appear where clumps of hair have fallen out. Medical Conditions

Various diseases and medical conditions can also lead to thinning hair or bald patches. Thyroid disease (discussed below) is one of the most common explanations for hair loss. It may also occur with diabetes and autoimmune diseases such as lupus and HIV. Sudden, severe hair loss may indicate a liver dysfunction or other serious illness, so it is wise to bring it to the attention of your healthcare practitioner.

Parasites, such as ringworm, and fungal or yeast infections can also cause hair loss. If left untreated, these conditions can rob the body of nutrients by preventing the proper absorption of proteins, vitamins, and minerals necessary for healthy hair. Recognizing and treating an infection, especially a scalp infection, is critical to preventing total hair loss.

People often lose some hair about 2 to 4 months after the start of a severe or prolonged illness, or major surgery. This type of hair loss is most likely due to the stress of the illness or surgery and is also temporary, with hair returning as the body heals and regains its balance.

Hair loss due to chemotherapy is also usually temporary, with new hair beginning to grow once the treatment is stopped.

Women typically lose some of their hair shortly after pregnancy and during menopause, most likely as a result of changing hormone levels. Most healthcare practitioners will first explore hormone imbalance as a possible cause for hair loss, if there is no other obvious explanation. Fortunately, when this proves to be true, hormone treatments can usually reverse the trend.

Prescription Drugs

Many different prescription drugs identify hair loss as a potential side-effect. If it is listed, some people may be affected, while others are not, due to subtle differences in body chemistry.

Medications known to promote hair loss include many commonly prescribed drugs, including birth control pills, blood thinners, those that lower cholesterol, antidepressants, anticonvulsants, and drugs for high blood pressure, to name just a few.

Nutrition and Digestion

Healthy hair requires good nutrition, involving a wide variety of vitamins, trace minerals, amino acids, and essential fatty acids (see chart on page 2). As a result, poor nutrition will have a fairly immediate and obvious effect on hair health. Starvation dieting, rapid weight loss, and eating disorders often trigger some hair breakage or hair loss.

Sometimes just introducing different foods into your diet, such as eating a lot of fried food over a period of days when you're not used to it, can change the appearance and health of your hair.

Dr. Cass Ingram explains that the vegetable oils commonly used to fry foods can block the absorption of compounds critical to hair health. Dr. Jonathan Wright concurs, saying that "margarine and hydrogenated fats are detrimental to fatty acid metabolism and should be strictly avoided." Healthy hair requires the proper combination of vitamins, minerals, and trace elements. For example, hair loss can result from too much vitamin A, not enough iron (anemia), low levels of zinc, and a host of other deficiencies or excesses. The difficulty in providing proper nutritional balance is hinted at by the number of nutrients identified in the chart above. Dr. Hertoghe provides more specific information in his book regarding the various nutrients required and the recommended doses for maintaining healthy hair.

Improper digestion is another factor that can contribute to hair loss. Dr. Wright explains that a lack of pepsin (an enzyme essential for protein digestion) will interfere with the absorption of key nutrients. According to Dr. Ingram, "To have healthy hair, all eight essential amino acids are required. The hair, being mostly protein, will readily reflect poor protein status." Many elderly people have problems with digestion, which can accelerate age-related hair loss.

Hormone Imbalances Related to Hair Loss

(adapted from Hertoghe)
ACTH: Circular, patchy hair loss; balding, hair turning gray or white
Cortisol: Patchy hair loss; in women, hair loss on top of head; unwanted body hair
DHEA: Balding all over the head; in women, hair loss in pubic area or armpits
Estrogens: Balding all over the head; in women, hair loss on top of head; unwanted body hair
Growth Hormone: Thin, wispy hair; hair that has lost its wave, body, or shine; hair thinning on top of head; hair loss around the ears; graying hair
Progesterone: Balding on top of the head; in women, hair loss on top of head; unwanted body hair
Testosterone: Balding on top of the head; graying hair; in men, losing body hair on abdomen, legs, chest, and having a sparse beard
Thyroid Hormones: Dry, brittle, slow-growing hair; balding all over the head

Hormones

Women often report hair loss as a result of a change in hormone balance, such as occurs with pregnancy and menopause. People who lose hair during a period of hormonal imbalance may be particularly sensitive to changes in their hormone levels, even though their hormone test results may fall within the "normal" range. This is especially true of thyroid hormones.

Hair loss is often associated with a thyroid problem and is typically one of the first clues that your thyroid gland may not be working properly. Ironically, hair loss is associated with both an excess (hyperthyroidism) and a deficiency (hypothyroidism) of thyroid hormones.

One of the possible explanations for hair loss associated with low thyroid function has to do with the drop in body temperature that is typical of hypothyroidism. Even a slightly lower body temperature can slow or stop body processes, including the chemical reactions that stimulate hair growth.

Dr. Hertoghe reports that women who experience hair loss on the top of their heads (a pattern that is usually more common in men), tend to have deficiencies in estrogen hormones and progesterone. He also suggests that low cortisol is another factor to consider, because that deficiency can lead to an excess in DHEA and testosterone, which suppresses production of estrogens and progesterone. He also notes that it is often an imbalance among the sex hormones (testosterone, progesterone, and the estrogens) that leads to hair loss, rather than an excess or deficiency of one specific hormone.

Almost any hormone imbalance can have an effect on hair health because of the intricate relationships that exist among the various hormones that regulate and control our body functions.

Hormones affect the absorption of nutrients, the body's growth processes, and nearly all aspects of health, so it is important to pursue and maintain optimum hormone balance to keep your hair healthy. See the chart on page 5 for a summary of additional hormones known to have an impact on hair growth and loss.

Treatments

The hair loss treatment industry is booming, along with the aging baby boomers. Unfortunately, many of the so-called treatments are scams that simply do not work. There is no "quick fix" to natural hair recovery.

There are two FDA-approved drugs for treating hair loss. The first is Rogaine® (minoxidil), which appears to work by increasing circulation to the scalp. It is available without a prescription and can be used by men and women. The second is Propecia® (finasteride), which is a smaller dose of a drug called Proscar®, which is used for treating an enlarged prostate.

Rogaine seems to work for some people, but must be used continuously to maintain results.

Propecia also seems to promote hair growth for some men (it is not recommended for women, and does not appear to work for women). However, serious and irreversible side effects affecting sexual function, emotional well-being and memory loss are coming to light, resulting in class action lawsuits in Israel and Canada, so it is a dangerous tradeoff.

Topical hormone treatments show some promise for treating hair loss. Some practitioners are now requesting pharmacies to add progesterone to shampoos, and there is research suggesting that melatonin in shampoo may also help reduce hair loss and foster new hair growth. A European study suggests that topical application of estrogen could also be a possible treatment for pattern baldness in both men and women.

Most treatments that deal with hair loss, especially hormone therapies, tend to work very slowly. Although you may feel other beneficial effects from the treatment relatively soon, new hair growth may take months. While you are undergoing treatment, Dr. Hertoghe recommends against the temptation to wear a wig because it "slows down the blood flow to the scalp, preventing full effectiveness of the helpful hormones."

Conclusion

Most hair loss can be corrected if the cause can be identified—and the sooner, the better—but proper testing is essential. Guessing based on symptoms can make matters worse or lead to a misdiagnosis because an excess of a nutrient or hormone can sometimes generate the same symptoms as a deficiency. Work with your healthcare practitioner to determine the cause, and you are more likely to find an effective treatment.

References

Connections is a publication of Women's International Pharmacy, which is dedicated to the education and management of PMS, menopause, infertility, postpartum depression, and other hormone-related conditions and therapies.

This publication is distributed with the understanding that it does not constitute medical advice for individual problems. Although material is intended to be accurate, proper medical advice should be sought from a competent healthcare professional.

Publisher: Constance Kindschi Hegerfeld, Executive VP, Women's International Pharmacy
Co-Editors: Julie Johnson and Carol Petersen, RPh, CNP; Women's International Pharmacy
Writer: Kathleen McCormick, McCormick Communications Illustrator: Amelia Janes, Midwest Educational Graphics

Copyright © October 2013, Women's International Pharmacy. This newsletter may be printed from the PDF version and photocopied for educational purposes, provided that your copy(s) include full copyright and contact information.
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