hair loss in women female hair loss
Hair Loss

Hair Loss in Women

by Dr. Pamela Frank, BSc(Hons), ND

Causes of Hair Loss

These are some of the many reasons why women may lose hair:

  1. Iron deficiency
  2. Low thyroid function
  3. High androgen levels
  4. High stress levels
  5. Autoimmune disorders – lupus, Hashimoto’s, etc
  6. Post-partum hair loss

Hair Loss Tests

To accurately determine the reason for your hair loss, each of the above causes needs to be thoroughly investigated. Odds are your medical doctor has NOT done several of these tests. I recommend the following blood tests be done, I can perform these tests for you or you can request them from your medical doctor:
Ferritin – this is a storage form of iron, low levels indicate an iron deficiency.  Some labs will consider a ferritin level greater than 10 ng/ml as normal. Ferritin should be at least 30-40 ng/ml, some labs even say greater than 80 ng/ml is a normal ferritin level.  So if your doctor looked at your ferritin level and it was 11 ng/ml, he or she will tell you it’s normal, however you can certainly be losing hair at this level of ferritin.
T3, T4, TSH and rT3 – most likely to check your thyroid, your doctor has only measured TSH.   This gives a superficial indication of the function of the thyroid gland itself, but does not adequately determine what is happening to the thyroid hormone once it has been produced. If excessive T3 is being converted to rT3 (reverse T3, which is an INACTIVE form of T3), then your thyroid hormone FUNCTION is low, which can manifest as hair loss. Also, TSH may be in the normal range, but you may be producing antibodies that are attacking your thyroid. This is called Hashimoto’s disease or Hashimoto’s thyroiditis. Hashimoto’s can also cause hair loss. Blood tests for Hashimoto’s include anti-TPO and anti-thyroglobulin antibodies.
Testosterone, DHEAs, DHT, estrogen, progesterone – elevated testosterone and DHEAs can contribute to hair loss, but also excess facial or body hair growth. Chin hairs in women are NOT normal.  DHT is a potent form of testosterone that is rarely ever measured, but I have often found that elevated levels correlate with hair loss in women. Sometimes testosterone, DHEAs and DHT levels are normal, but a lack of the female hormones estrogen and progesterone can also lead to hair loss. Peak estrogen (estradiol) is best measured around mid-cycle, peak progesterone is best measured about a week before your next period is due, around day 21 assuming a 28 day cycle.
Stress is mainly assessed subjectively, that is, how the patient reports that they perceive their stress level i.e. low, medium or high. Stress can cause or contribute to hair loss through a number of avenues: elevated cortisol›blood sugar›insulin levels, higher insulin levels lead to higher androgen (male hormone) activity and/or levels.  Stress can deplete vitamins and minerals that are important for healthy hair.  Stress can also deplete the adrenal glands that help us deal with stress, so our capacity to handle stress goes down which makes the stress response worse.
Vitamin D – Vitamin D is important for the function of the ovaries, if the ovaries don’t function properly, they aren’t producing normal levels of the hormones that influence hair growth.
ANA – ANA stands for Anti-nuclear antibody.  If there is patchy hair loss/balding (alopecia), the cause is likely autoimmune.  ANA can help to screen for autoimmune conditions that can cause hair loss.

Naturopathic Treatment of Hair Loss in Women

Patients can either approach their medical doctor about providing the above testing, in which case most of it would be covered by OHIP. Otherwise, I can test all of the above blood levels, but patients would be responsible for the actual cost of the testing, as tests ordered by naturopathic doctors are not covered by OHIP.

Once the underlying cause of the condition is determined, hair loss can be addressed using naturopathic medicine by:
• Improving iron intake AND absorption
• Enhancing production and function of thyroid hormones, estrogen or progesterone
• Lowering excess testosterone, DHEAs and/or DHT
• Stress reduction techniques and adrenal gland support to allow healthy adaptation to stress
• Address food sensitivities in the case of autoimmune hair loss

What I find rarely works for hair loss:
1. Biotin – there is some evidence that biotin deficiency is linked to hair loss. For biotin supplementation to have any effect dosing needs to be quite high.
2. Silica – there is very little evidence that supplementing silica prevents or treats hair loss. If hair is fragile or prone to breakage silica may help, but it won’t help with hair loss.

Benefits to Naturopathic Treatment of Hair Loss

1. Addresses the root cause of the problem for more lasting results
2. Improved organ system function
3. Better hormone balance
4. Improved stress coping mechanisms
5. Healthier immune system function


DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this web site.

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