Hair Loss in Women
Hair Loss: What Causes It?
Hair loss in mena and women may occur for many reasons:
- Iron deficiency
- Low thyroid function
- High androgen levels
- High stress levels
- Autoimmune disorders – lupus, Hashimoto’s, etc
- Post-partum hair loss
- Inflammation of your scalp
- Syphilis – causes a “moth-eaten” pattern of 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 that your medical doctor has NOT done several of these tests. I recommend the following blood tests be done if they are indicated. I can perform these tests for you or you can request them from your medical doctor:
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 Reverse T3 (rT3)
Most likely in order 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, DHT 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 are the problem. 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 that you have 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. It 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. It can also deplete vitamins and minerals that are important for healthy hair. Stress also depletes the adrenal glands that help us deal with stress, so our capacity to handle stress goes down which makes the stress response worse. Measuring cortisol levels may be useful. They are best measured in the morning around 8-9 a.m. to determine peak cortisol levels.
Vitamin D is important for the normal function of your ovaries. If your ovaries don’t function properly, they aren’t producing normal levels of the hormones that influence hair growth.
ANA stands for Anti-Nuclear Antibody. If there is patchy hair loss/bald spots (alopecia), the cause is likely autoimmune. ANA can help to screen for autoimmune conditions that can cause hair loss.
If hair loss is following the characteristic “moth-eaten” appearance associated with syphilis, then VDRL testing is appropriate.
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. Tests ordered by naturopathic doctors are not covered by OHIP. I’m sorry but I cannot order tests for you prior to seeing you for a full first visit.
Natural Treatment for Hair Loss
Once the underlying cause of the condition is determined, as a naturopath I can treat hair loss by:
• Improving iron intake AND absorption
• Enhancing the production and function of thyroid hormones, estrogen or progesterone
• Lowering excess levels of testosterone, DHEAs and/or DHT
• Stress reduction techniques and adrenal gland support to allow healthy adaptation to stress
• Address food sensitivities, the gut and balance the immune system 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. Most of the people that I see that have put themselves on biotin aren’t taking enough.
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 for 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. A healthier immune system
For help with this or any other health problem, book an appointment here or call the office for more information at 416-481-0222.
Hair Loss Research
We can summarize our results by observing that Serenoa repens could lead to an improvement of androgenetic alopecia. Source: Int J Immunopathol Pharmacol. 2012 Oct-Dec;25(4):1167-73. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study.
Rossi A, Mari E, Scarno M, Garelli V, Maxia C, Scali E, Iorio A, Carlesimo M.
This study establishes the effectiveness of naturally occurring 5-alpha reductase inhibitors against androgenetic alopecia for the first time. J Altern Complement Med. 2002 Apr;8(2):143-52. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. Prager N, Bickett K, French N, Marcovici G.
Overall, ricinoleic acid, acteoside, amentoflavone, quercetin-3-O-rutinoside and hinokiflavone were predicted to be PTGDS inhibitors with good pharmacokinetic properties and minimal adverse skin reactions. J Ethnopharmacol. 2015 Dec 4;175:470-80. doi: 10.1016/j.jep.2015.10.005. Epub 2015 Oct 9.
In silico prediction of prostaglandin D2 synthase inhibitors from herbal constituents for the treatment of hair loss.
Fong P1, Tong HH2, Ng KH2, Lao CK2, Chong CI2, Chao CM2.
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.