Why is my hair falling out?

Understanding Hair Loss: Causes, Solutions, and Prevention

Feeling as if your hair is falling or thinning can be an unnerving experience for many individuals. Hair is has a complex growth process which can be influenced by many different factors. 

How does hair grow?

Under healthy circumstances, the growth of our hair occurs in predictable phases starting at the follicle (a tube like shaft, essentially a pore, located at the root of our hair near our scalp). The hair follicle surrounds the root of the hair. 

The hair start in an active phase of growth called “anagen”. This is later followed by a “resting” phase (called telogen) when the hair is more mature. With time, eventually, the hair is shed and the anagen phase starts again. Normally, 85% of our hair is in the active anagen phase and the remaining 15% are in telogen phase. 

What type of hair loss am I experiencing?

There are a few different types of hair loss that individuals may experience, that each have different causes.

• Alopecia Areata

• Female Patterned Hair Loss

• Male Patterned Hair Loss

• Telogen Effluvium

What impacts hair growth?

Many different factors play a role in our hair growth. These include nutrient status, hormones, stress and even environmental or product related concerns

Nutrient related causes of hair loss

Hair growth is rapid, and at the root of our hair (the bulb) needs a lot of nutrients and minerals to produce the follicle (hair strand). Although we might not always feel this way, hair is considered less essential than other organ systems by our body – making it one of the first to have redistributed resources. 

Low or limited calories

When our total caloric intake is restricted (such as in eating disorders or extreme dieting), our body lacks the resources to grow hair properly and is under severe stress that may cause hair to shed or fall. We also may see hair loss with restricted protein intake.

Iron Deficiency

Low iron levels (often due to heavy bleeding, low iron intake in the diet, or hypothyroidism) can lead to hair loss. We think this is due to lower hemoglobin (the molecule that brings oxygen to cells in our body) which requires iron to complete its role. Often investigating iron deficiency and supplementing can be helpful for patients experiencing hair loss.

Vitamin D

Low vitamin D may be associated with hair loss from a variety of different mechanisms. Vitamin D receptors play a role in regulating cells growth phases. Additionally, vitamin D as a modulator of auto-immune health can help in the cases where hairloss is related to an auto-immune concerns like alopecia areata or Hashimoto’s thyroiditis. 

Vitamin C

In extreme cases of low vitamin C intake (like scurvy) hair loss may occur. For most individuals eating a diet full of fruits and vegetables, your vitamin C will be at an appropriate level.

Hormonal causes of hair loss

In addition to nutrition, our hormones can also play a role in hair growth and hair loss. These may be related to sex hormones, estrogen, progesterone and testosterone, or due to our thyroid hormones.

Poly Cystic Ovarian Syndrome (PCOS)

One of the trademarks of PCOS is an increase in the androgen hormone testosterone. When testosterone is elevated in a female patient can cause  hair growth on the face, neck, and chest, and hair loss at the front and temples of the head. When hair loss is in this area and follows this pattern we may suspect that testosterone is playing a role.

HypothyroidISM

Our thyroid controls many functions in our body related to metabolism, temperature regulation and other key functions in our body. When our thyroid underfunctions (doesn’t work as well as we want), such as in the case of Hashimoto’s, we may experience diffuse (all over) hair loss. This is because our thyroid hormones impact the hair cell growth cycle (leaving more cells in telogen phase). Patients with hypothyroidism often also have low iron, which may be impacting their hair growth.

Hormonal Transitions

Major change to our hormonal stage of life can cause changes to our hair. While estrogen and progesterone don’t typically impact hair growth or loss, when we are cycling normally, the major changes associated with pregnancy and perimenopause can lead them to impact hair growth.

Pregnancy & Post-Partum

In pregnancy our hair remains in the growth phase as our body changes. With childbirth, the drop in estrogen that occurs causes our hair to shed. Because so much more of our hair was in the growing phase during pregnancy than what is typical, this hair fall can be quite substantial and feel like “hair loss” when it is our hair growth cycle being a bit shifted. Most new moms notice their hair returning back to normal by their baby’s first birth day. It is important to chat with your healthcare provider about the role that iron and other nutrients may be playing in hair growth post partum as well.

Perimenopause

In perimenopause, the hormonal transition before menopause, we start to see changes to estrogen and progesterone that may impact the thickness and fullness of hair. Estrogen starts declining during this time, but first takes people on a bit of a rollercoaster of elevated and decreased levels. This combined with age, genetics, medication, potential low iron due to heavy bleeding, and relatively high testosterone in comparison to declining estrogen and progesterone can lead to thinning hair in older women. Learn more details in our menopause & hair blog post.

Other Factors

Stress

When our body undergoes a stress, the growth phases of our hair follicles shift. These stressors may include; caloric deficit, crash dieting, low protein, trauma, medications, surgery, psychological stress, mental-emotional, or severe illness. 

Under one of these circumstances we start to see about 70% percent of the hairs in the growth phase pushed into the resting phase (when typically 85% of all the hair follicles stay in the growth phase). Our hair stays in the resting or telogen phase from anywhere between 1 to 6 months, on average about 3 months. When the hair follicle restarts its growth phase, it pushes this resting hair follicle out causing shedding. 

The real life context for this is that patients often experience noticeable hair shedding about three months after a stressful event, as all these follicles that have pushed into resting phase earlier shed at the same time. While this is distressing, it is usually not permanent and our hair tends to growth back after the period of stress.

What can I do?

Assesment

Working with a health care provider to assess your hair loss can help determine the root cause of what might be going on. As discussed, there are many different causes of hair loss (and more than one can be going on at the same time!). We want to ensure that your treatment is tailored to your unique health needs.

Assessment will include a detailed health history with one of our naturopathic doctors, discussing symptoms, onset, other health conditions. It may include relevant physical exams, a review of products being used, and if necessary blood work.

Treatment

Treatment will take into account all areas of your health. It may include lifestyle recommendation (changes to nutrition, or tweaking of your daily diet), specific supplements or vitamins, topical treatments or products, as well as recommendations to support other health concerns that might be co-existing in your case.

Depending on the type of hair loss you are experiencing, it make take time to see results, but there are many evidence based things we can do to support you.

Interested in learning more? Book a complimentary meet and greet appointment with one of our naturopathic doctors to learn more!