Are you noticing more hair on the floor or on your pillow? Does brushing your hair make you feel anxious? Have you tried taking a biotin supplement in hopes that it will bring your hair back? I understand how concerning it can be — and you’re not alone.
Hair thinning or hair loss is a common problem that affects many of us regardless of gender but still has serious mental health implications and could be a sign that something else is going on.
According to the American Academy of Dermatology, approximately 80 million people in the United States have hereditary hair loss. Additionally, about 50% of women will experience some degree of hair loss by the time they reach the age of fifty. While shedding 50-100 hairs a day is normal, losing hair can be a distressing experience, and it can affect body image and self-perception, which can in turn impact confidence and self-worth.
In this article, we’ll talk about potential causes of your hair loss/thinning, what kind of deeper evaluation should be considered, and natural options that can help with reducing hair loss and restoring your locks.
What Are The Common Causes Of Hair Loss Or Thinning?
Hair thinning can have various causes, both genetic and environmental. Here are some of the most common factors that can contribute to hair thinning:
Genetics & Age
Hereditary factors play a huge role in the density of hair that you have from the beginning. If your family has a history of hair loss, chances are you may be more likely to experience it yourself. Age is also a factor that naturally leads to hair thinning.
Hormonal Changes
When we think of hormonal changes and hair loss there could be a multitude of hormones at play. For example, changes during pregnancy & menopause lead to more hair loss on the top of the head. If your hair is thinning all over, it could be due to thyroid irregularities. Androgenetic alopecia results from higher levels of androgens (sex hormones) and in women, begins with gradual thinning at the part line and is followed by increasing diffuse hair loss from the top of the head. This pattern of hair loss is common in those with PCOS and insulin resistance.
Nutritional Deficiencies
A lack of proper nutrients in the diet such as zinc, B vitamins, vitamin D, selenium, protein, and fatty acids can lead to thinning hair. Additionally, low iron levels (usually due to heavy periods and not enough dietary or supplemental repletion) is also associated with hair loss.
Stress
Prolonged and chronic stress has been associated with a type of hair loss called telogen effluvium. The stress pushes a large number of hair follicles into a resting phase but the hair usually grows back in three to six months.
Medical Conditions & Medications
Certain medical conditions, such as alopecia areata (sudden hair loss that starts at one or more circular bald patches), scalp infections like tinea capitis (ringworm of the scalp), and autoimmune disorders can cause hair thinning. Also, medications like chemotherapy drugs, blood thinners, and antidepressants can cause hair thinning as a side effect.
Hairstyling practices:
Hairstyling practices, such as tight braids, cornrows, hair extensions, and ponytails, can cause hair thinning over time and is referred to as traction alopecia.
Keep reading to find out more about which lab values are useful for hair loss.
Evaluation Of Hair Loss: Labs & What They Tell Us
Ferritin
Ferritin is a marker that gives us an idea of your stored iron reserves. Studies show that a ferritin level <50 is highly associated with hair loss. Getting a CBC (Complete Blood Count) & an iron panel also gives us more information if you have iron deficiency.
Hemoglobin A1C, Fasting Insulin, Fasting Blood Glucose
These 3 are what I check for blood sugar regulation and if pre-diabetes/diabetes is at play. Improper blood sugar control can lead to higher levels of androgens and cause changes in blood circulation.
Thyroid Panel
While most endocrinologists just check TSH (thyroid stimulating hormone), I like to do a complete thyroid work-up including free T3, free T3, anti-TPO, anti-thyroglobulin, and reverse T3. This is because these markers give us a better picture of what is going on with your thyroid — especially since the majority of hyper- & hypothyroidism cases are autoimmune conditions (Grave’s & Hashimoto’s).
Vitamin D
Vitamin D functions like a hormone in the body and is intricately involved in various signaling pathways of growth and differentiation of hair follicles. Low vitamin D levels can disrupt hair growth and is associated with telogen effluvium, alopecia areata, and androgenetic alopecia.
I check vitamin D for all of my patients and like to see 25OHD levels around 80-100 nmol/L for most adults.
Read more about Vitamin D’s health benefits and symptoms of low vitamin D in my last blog post.
Androgens (Sex Hormones)
Sex hormones including estrogen, progesterone, testosterone, FSH, and LH should be checked if you’re experiencing hair loss. I also like to check DHT (dihydrotestosterone) which is the precursor to testosterone and higher levels of DHT can shrink hair follicles making hair appear thinner and more brittle.
Sex Hormone Binding Globulin (SHBG) is a protein that binds onto androgens and estrogens in the blood and helps control the amount of hormones that are actively working in the body. Low SHBG can lead to high free testosterone and therefore increased hair loss.
If you are being told that your labs are normal but you’re still experiencing hair loss, seek out a second opinion from a naturopathic or integrative practitioner.
Natural & Conventional Options For Stopping Hair Loss And Regrowing Hair:
There are many options that can reduce hair shedding and help lost hair grow back ranging from correcting nutritional deficiencies and hormonal imbalances through supplements and diets, taking targeted supplements, applying oils on the scalp, or procedures like dermarolling & microneedling. Here are some of my top picks:
A Well-Balanced Diet
A balanced and nutritionally-dense diet with foods rich in antioxidants, protein, healthy essential fats, vitamins, and minerals like zinc can provide the necessary nutrients for healthy hair.
Supplement: Iron & Vitamin D
If you have low ferritin (<50) or have iron deficiency anemia, upping the iron in your diet may help but a supplement may be necessary. However, excess iron intake can also cause a slew of health problems so always consult with a medical professional before taking an iron supplement.
For low vitamin D levels, about 5000-6000IU of vitamin D3 (with vitamin K2) is where I like to start. But again, always consult with a PCP/HCP since taking excess vitamin D can lead to heart and clotting issues. Also, vitamin K2 is contraindicated to take with certain medications.
Natural DHT-Blockers: Pumpkin Seed Oil, Saw Palmetto, & Nettle Root Extract
Pumpkin seed oil is a great source of zinc and is a natural DHT-blocker that has been shown to increase scalp hair count with dosages around 400 mg everyday for 24 weeks.
Saw Palmetto is another herb that blocks DHT, helps maintain healthy hair follicles, and promotes hair growth. Effective dosages in studies have ranged from 100-320 mg.
Nettle Root extract can help reduce hair thinning and promote stronger hair growth.
Scalp Massage: Rosemary & Ayurvedic Herbs
Scalp massages feel great and actually help by improving blood circulation to the hair follicles.
Rosemary essential oil has been found in certain studies to be as effective as 2% minoxidil for androgenetic alopecia by increasing hair count and density. However, it has to be applied consistently for 6-7 months to see a change. Rosemary oil should also never be applied directly to the scalp and needs to be diluted with a carrier oil.
Ayurvedic medicine prioritized scalp &hair oil massages and there are an extensive amount of herbal oils that have been used for centuries to help with scalp health, hair thickness, and hair growth. These include Neem, Coconut, Moringa, Bhringraj, Fenugreek, Hibiscus, and Brahmi.
Not sponsored but the Fable & Mane HoliRoots Hair Oil is a fantastic Ayurvedic pre-wash treatment oil (also available at Sephora)
Stress Reduction & Exercise
Reducing stress through techniques such as Yoga, meditation, and exercise can help prevent hair thinning due to stress-related conditions such as telogen effluvium. Exercise such as cardio and strength-training is beneficial for blood sugar & hormonal imbalance and indicated for androgenetic alopecia.
Gentle Hair Care & Avoiding Harsh Chemicals:
Avoiding harsh chemicals such as hair dyes, relaxers, and styling products can help reduce hair thinning and breakage.
Using a gentle shampoo and conditioner, avoiding tight hairstyles, and limiting the use of heat styling tools can help prevent hair thinning.
Dermarolling or Microneedling:
This is a procedure that I’ve been getting a lot more inquiries about. Dermarolling involves using a small roller or device with tiny needles (usually 0.5-1.5 mm in length) to create small punctures in the skin. It has been theorized to stimulate the production of collagen and increase blood flow to the scalp, which can improve hair growth and was shown in studies to be effective for hair loss caused by androgenetic alopecia (the most common type of hair loss) that results in elevated DHT. *This should be done by trained professionals to avoid the risk of infection or other complications.
The Bottom Line:
If you’ve been noticing more hair loss or hair thinning, I know how scary it can be. This article covered causes, lab evaluation, and natural options for hair loss but it’s important to note that natural remedies may not always work for everyone and oral medication + topical prescription actives may be necessary. This is why I can’t stress how crucial it is to get work-up as soon as you can so we can figure out the underlying cause and develop an appropriate treatment plan.
If you’ve made it this far, thank you and I hope you found this article helpful!
Love always,
Dr. Avni Dalal
If you are interested in receiving naturopathic telehealth care for your hair loss & hormonal concerns, schedule your complimentary Discovery Call below!
Disclaimer: As always, none of the information in this blog is personal medical advice. This is purely for educational purposes and is not a substitution for proper medical diagnosis and treatment.