Male and Female Hair Loss
What Causes Hair Loss?
Two of the main causes of hair loss are androgenic alopecia and telogen effluvium, but the loss of hair in men and women occurs for many reasons:
- Iron deficiency or anemia
- Low thyroid function, hypothyroidism, hyperthyroidism
- High androgen or male hormone levels
- Hair loss from high stress levels
- Autoimmune diseases like alopecia, lupus, autoimmune thyroid or Hashimoto’s, etc
- Hair loss in pregnancy or after childbirth in the post-partum period
- Inflammation in your scalp from psoriasis, fungal infection, seborrheic dermatitis, or other inflammatory issues
- Syphilis causes a “moth-eaten” pattern of hair loss
- Certain medications cause hair to fall out
- Vitamin deficiencies
- Mineral deficiencies
- Protein malnutrition
- Anorexia or starvation
- Certain foods, particularly if your body has an immune reaction to the food
- Keto diet in some people because your body may find transitioning to ketosis stressful
- Family history or genetics may be a contributing factor, but by no means condemns you to be bald
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 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 lose hair at this level of ferritin.
T3, T4, TSH, and Reverse T3 (rT3)
Most likely in order to check your thyroid, your doctor only measured your TSH level. This gives a superficial indication of the function of your thyroid gland. It does not adequately determine what is happening to the thyroid hormone (T4) once it is 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. High reverse T3 causes hair loss. Also, your TSH may be in the normal range, but you produce antibodies that are attacking your thyroid. This is called Hashimoto’s disease or Hashimoto’s thyroiditis. Hashimoto’s also causes hair loss. Blood tests for Hashimoto’s include anti-TPO and anti-thyroglobulin antibodies.
Testosterone, DHEAs, DHT, estrogen, progesterone
High levels of testosterone, DHT and DHEAs contribute to hair loss. These also cause excess facial or body hair growth, acne and irregular periods. Chin hairs in women are NOT normal.
DHT is a potent form of testosterone that is rarely ever measured. But, high levels often correlate with hair loss in men and women. Sometimes testosterone, DHEAs and DHT levels are normal, but a lack of the female hormones estrogen and progesterone is the problem. Estrogen promotes hair growth, progesterone prevents the production of excessive amounts of DHT. Measure peak estrogen (estradiol) around ovulation at mid-cycle. Measure peak progesterone about a week before your next period is due. So, this is around day 21 assuming that you have a 28-day cycle.
We assess your stress subjectively. That is, how you report your stress level. Is stress low, medium or high? It causes or contributes to hair loss through a number of avenues. Stress increases cortisol, which leads to higher blood sugar. This then causes higher insulin levels. Higher insulin levels increase androgen (or male hormone) activity and/or levels.
Stress also uses up vitamins and minerals that are important for healthy hair. It also depletes the adrenal glands that help us deal with stressful situations. So, our capacity to handle stress goes down which makes the stress response even worse. Measuring your cortisol level may be useful. Measure it in the morning around 8-9 a.m. to determine your peak cortisol levels.
Vitamin D is important for the normal function of your ovaries. If your ovaries don’t work properly, then 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. This test screens for autoimmune conditions that can cause hair loss.
If hair loss is following the characteristic “moth-eaten” appearance that is associated with syphilis, then VDRL testing is appropriate.
Testing for Hair Loss
Patients can either approach their medical doctor about providing the above testing. In that case, OHIP covers most of it. Otherwise, I can test all of the above blood levels. But, patients are responsible for the actual cost of the testing. OHIP does not cover tests ordered by naturopathic doctors. I’m sorry but I cannot order tests for you prior to seeing you for a full first visit.
Symptoms Associated with Hair Loss
Along with hair falling you may also experience:
- Itchy or burning scalp
- Soreness or tenderness of the scalp
- Oily hair
- Oily scalp
- Excess facial or body hair growth
- Irregular periods
- Heavy periods or other cause of blood loss
- Hot flashes or night sweats
Additional Information that Helps Determine the Cause of your Hair Loss
In my initial intake for someone with hair loss, we will discuss in-depth all of the factors that may cause or contribute to it. Is there a family history of hair loss or auto-immune disorders? What is the pattern that you notice, is your hair falling at the front, temples, crown, part, all over or in patches? Have you struggled to maintain your iron level? Is there a family history of Celiac disease? Do you have other signs of hormone imbalance like acne, excessive facial or body hair, irregular periods, acanthosis nigricans, intense cramps or PMS?
Natural Treatment for Hair Loss
Once we determine the underlying cause of your hair loss, as a naturopath I treat it by:
Improving iron intake AND absorption
Sometimes you are taking in enough iron in your diet, but you are not absorbing it. It may be that your intake of iron is too low. You may also lose too much iron with your period every month. In any case, I can help correct the problem.
Enhancing the production and function of thyroid hormones, estrogen or progesterone
Hormonal balance is vital to healthy hair. Testing for these hormones is important. So is interpreting the results properly. These tests need an interpretation that is based on the optimal levels for hair growth. Not based on lab ranges, which are far from ideal.
Lowering excess levels of testosterone, DHEAs and/or DHT
High amounts of male hormones like these increase hair loss, particularly male pattern or female pattern baldness. These are moderated through diet, lifestyle, vitamins, minerals and herbal treatment.
Stress reduction techniques and adrenal gland support to allow healthy adaptation to stress
Ideally, it is best to divest yourself of the stress. If that’s not possible, then we help your body adapt to it more easily. So stress impacts you less.
Addressing food sensitivities, your gut and balancing your immune system in the case of autoimmune hair loss
Food sensitivities, lack of good bacteria, and latent infections are all things that keep your immune system overly fired up. Fixing these reduces inflammation and calms down the autoimmune reaction. The inflammatory prostaglandin PGD2 is one cause of scalp inflammation that causes hair loss. Herbal treatments like resveratrol and quercetin help to reduce PGD2.
What I find rarely works for hair loss
There is some evidence that biotin deficiency is linked to hair loss. For biotin supplementation to be effective, dosing needs to be quite high. Most of the people that put themselves on biotin aren’t taking enough. Even in the right amount, this only seems to help a small percentage of the time.
There is very little evidence that supplementing silica prevents or treats hair loss. If the hair is fragile or prone to breakage silica helps in some cases, but it won’t help with hair loss from causes like your thyroid or hormones.
Hair Loss Products
Topical products and treatments for hair rarely do much because they are not addressing the root cause of why hair is falling out.
Putting Crazy Things on Your Scalp
Tempted to try putting things like guava leaves or onion juice on your scalp because you saw a post on Facebook about it? Well you can try it for yourself if you don’t believe me, but really I wouldn’t waste your time. These are not going to fix a hormone imbalance, iron deficiency or low thyroid.
The Benefits to Naturopathic Treatment for Hair Loss
The benefits of natural medicine for hair loss include:
- It addresses the root cause of the problem for more lasting results
- An improved organ system function
- Better hormone balance
- Improved stress coping mechanisms
- A healthier immune system and reduced inflammation
- Fewer side effects than hair loss drugs
Will hair loss grow back?
Hair loss can be temporary or permanent, depending on the cause. In order to reverse hair loss, the cause needs to be investigated and properly addressed. If it is due to poor diet, iron deficiency, PCOS, stress, hypothyroidism, or anxiety, and these issues are corrected, hair can grow back. Looking for information about Telogen Effluvium specifically? Check out this page.
For help with this or any other health problem, book an appointment here or call the office for more information at 416-481-0222.
Authored by Dr. Pamela Frank, BSc(Hons), ND
Hair Loss Research
We can summarize our results by observing that Serenoa repens improves 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 are 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.