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What causes hair loss in women?

Dr. Elizabeth Boham, MD, MS, RD
Nutrition & Dietetics Specialist

There are many possible causes of hair loss in women. The first three imbalances I check for in women who come to my office with increased hair loss is their thyroid, blood sugar balance and iron levels. Low iron levels are a very common cause of hair loss.  You do not have to have anemia (low red blood cell levels) for low iron to be the problem. So have your doctor do a full iron panel including ferritin levels to properly assess your iron levels. When I check for thyroid imbalances, I start with a TSH, free T3 and free T4. I also look for other signs of low thyroid, like thinning of the person's eyebrows, weight gain, constipation and fatigue.

It is also important to realize that all of our hormones in our body work together. When we are eating a diet high in sugar and refined carbohydrates, this can cause an increase in the hormone insulin. This can then change our female hormones and result in loss of hair on the top of their head for some women. Those women may also notice growth of hair where they do not want it, such as the stomach and face.

A healthy diet that is rich in fiber and has a balance of protein, whole food carbohydrates, and healthy fats at each meal is the key to improving your hormone balance and helping your hair grow.

Natasha Turner, ND
Alternative & Complementary Medicine Specialist

The first step to determining the treatment for hair loss is to identify the cause, of which there are many, including: poor nutrition, genetics, imbalanced hormones, medications such as chemotherapy, radiation treatment, infections, chronic stress, and rapid weight loss, to name a few. Certain illnesses and diseases can also cause hair loss or hair shedding. Examples include anemia (low iron) or hypothyroidism (low thyroid hormone levels). In all cases of hair loss, it's also important to ensure that the following blood tests are completed by your doctor in order to determine a cause:

  • TSH, free T3, free T4, and thyroid antibodies to assess thyroid gland function. All should be completed to properly diagnose a thyroid condition that may result in excessive hair loss. (Note: Optimally, your TSH should be less than 2.5).
  • Ferritin (This is the storage form of iron. Low iron (<70) is a very common cause of hair loss).
  • Vitamin B12 and folic acid (either of these nutrients in low levels may cause hair loss).
  • Free and total testosterone (high levels of testosterone in women may accelerate hair loss).
  • Low estrogen can cause hair loss as well as low progesterone

Also ensure that you are eating a balanced diet (crash dieting will cause hair loss), taking high quality vitamins and managing stress through yoga, regular exercise and meditation.

On average a woman loses 75-100 hairs a day as new hair grows in, so if you pull a small wad out of your hairbrush every night, it’s nothing to worry about. A condition called stress alopecia results when a large number of hair follicles inappropriately enter a resting phase, and therefore, fall out at the same time. This diffuse hair loss usually occurs around 3-4 months after a “stressful” event such as a sudden change in hormones from stopping birth control pills or delivering a baby.

Non-hormonal causes of stress alopecia can occur with certain medications, severe dieting, nutritional deficiencies, surgery, a high fever or a stressful event. Yes, going through a divorce can make your hair fall out! You are not going to go bald and there will be a gradual return to normal, but it will take at least 3-4 months. Medical conditions such as anemia or an over-active or under-active thyroid can also cause diffuse hair loss, so it is a good idea to see your doctor for an evaluation.

New studies reveal that a crop of external factors can have a damaging effect on the thickness and fullness of women’s hair.

In a study of 84 identical female twins, marital status emerged as the leading forecaster for thinning hair. Widows and divorcees experienced greater amounts of hair loss than their married counterparts—a phenomenon that scientists attribute to the effects of stress on the body.

Other factors that contributed significantly to hair loss included genetics, heavy smoking (tied to temple hair loss) and large weekly intake of alcohol (linked to thinning along the front hairline). Meanwhile, women who drank up to two alcoholic beverages a week showed significantly less hair loss than their twin, which one could conjecture to be the result of the calming effect of moderate amounts of alcohol consumption.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Most people think of balding as a male problem, but many women develop thinning hair and bald spots as they age. This inherited condition is called androgenetic alopecia. (Alopecia means hair loss.) There are other inherited forms of alopecia that can cause women to lose hair.

Women who require certain medical treatments, such as chemotherapy, may also lose hair. Other reasons why women lose hair include:

  • a poor diet
  • stress
  • hormone changes
  • certain infections

You can help to prevent hair loss by eating a healthy diet, managing stress, and following good hair-care habits. Using conditioner after you shampoo can help strengthen your hair.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.