Ask Doug: Why is my Hair falling out?!?
This month I got a great question asking for why a person’s hair may fall out. I thought I’d give some ideas and what functional medicine would have to say about it. Hair falling out can be extremely frustrating and getting to the root cause can make a big difference. Some of the most common root causes for hair loss are nutrient driven or hormonal.
Some of the nutrients involved in hair loss include Vitamin B12, zinc, biotin, iron, and selenium. I’ll touch on a couple of these:
- Vitamin B12 is responsible for assisting with the process of methylation (protecting DNA and detoxification among other things), but also important to keep red blood cells small and nimble. Having small red blood cells helps deliver oxygen and key nutrients to the body, including the hair follicles. B12 is found in animal proteins, but requires good digestion to be absorbed. Your prescriber can easily check a b12 level in your blood–shoot for the upper third of the reference range. If you do eat plenty of meat, but your b12 isn’t up there, consider asking why and figuring that out before you just add a supplement. Eating hygiene and having sufficient stomach acid are two big reasons!
- Iron is another nutrient that can be at play with hair loss as well. Checking your levels before supplementing is a good idea, as you can get too much. Ensure your provider checks a ferritin level as this will give an idea of your iron stores in the body (how much is hanging around just in case). If you are a menstruating woman, I find women feel better when ferritin is at least 50 ng/ml–70ng/ml may be even better. Iron is important in hair loss for a couple reasons, for one, it is required for optimal T4–>T3 conversion and thyroid function. Iron is also required to make hemoglobin in the red blood cells, which carries the oxygen to our cells (including hair growth stimulating cell).
Iron is another nutrient that needs good, strong stomach acid to absorb. If you are low in iron and want to supplement, consider a chelated version of iron like Iron Bisglylcinate. Reacted Iron is a version I have used with clients successfully that won’t interfere with any GI distress. You can find it here at my dispensary if interested!
- Biotin: biotin is in a lot of over the counter products advertised for hair, skin, and nails. I find it works best if clients are low in biotin, but it can certainly be worth a try and some people swear it works for them! Caution however, before doing any blood work I recommend stopping any biotin containing supplements as it can cause the bloodwork to be skewed. This is especially true for thyroid labs.
Hormones! The main hormones involved at the root cause of hair loss include thyroid, cortisol, and testosterone.
- Thyroid: Hypothyroidism is a common reason for hair loss and subclinical hypothyroidism is rampant in our society. I would recommend a full thyroid panel, which includes TSH, Free T4, Free T3, Reverse T3, and TPO / TG antibodies. Hypothyroidism may be the result of insufficient nutrients, such as iron (see above), selenium, and vitamin A. Stress can also cause the thyroid hormones to be less effective, so managing stress in a healthy manner can help immensely.
- Cortisol: Cortisol is our ‘stress’ hormone and can impact hair loss by increasing reverse T3 levels (purposefully dialing down metabolism), but also directly affecting the hair follicle, turning off the ‘grow button’ and pushing hair follicles into their resting state. Resting for too long can cause the hair to fall out with simple acts like washing or combing your hair. You can read more about this connection here.
- Testosterone: Testosterone or its downstream metabolite Dihidrotestosterone (DHT) is also at play in hair loss. I find that clients may make normal amounts of testosterone, but their unique body prefers to push the testosterone down the pathway to make more DHT. A hormone test such as the Dutch test can help identify if you are more prone to this conversion. DHT is more androgenic that testosterone and leads to hair loss around the temples (male pattern baldness also) and can lead to jaw-line acne. Insufficient zinc can upregulate this pathway, as can high levels of insulin (diabetes, pre-diabetes, insulin resistance), or inflammation (GI tract, joint pain, muscle ache).
Other practical ideas: Essential oils such as peppermint, spearmint, or eucalyptus oil can help promote hair growth by directly stimulating the hair follicle and increasing blood flow, delivering more nutrients to the scalp. Consider applying a diluted spearmint or peppermint oil (in a carrier oil such as medium chain triglycerides) to the scalp prior to washing to improve blood flow to the hair–or find a good shampoo (Check the Environmental Working Group‘s site to ensure it’s a clean product) with these oils in there. The ‘tingly’ feeling helps you know it’s working 🙂
I hope these tips are helpful to you finding the cause of your hair loss! If you want to explore these ideas and get to the ‘Roots’ of your hair loss, Schedule a free discovery call to see what it’s all about!
