Skip to main content

Female Hair Loss: Lab Testing

My expertise in treating hair loss in women started with a personal experience of hair loss in my 20s. After being dismissed by my Medical Doctor who assured me it was “totally normal” I persisted in understanding why a healthy woman in her 20s would start losing hair.

Laboratory Testing for Female Hair Loss

As I discuss in my article, Getting to the Root of Female Hair Loss, treating hair loss can only be effective if you understand the root cause – why is a woman losing hair? Through laboratory testing an answer can often be found.

When I am working with women with hair loss I generally advocate for a tiered approach to lab testing for hair loss – starting with the most likely causes and progressing to the more complex.

For myself, the issue was an iron deficiency. By correcting that iron deficiency I was able to resolve my hair loss in under a year and it hasn’t recurred since.

Use the checklist below with your Medical Doctor or Naturopathic Doctor to determine the root cause of your hair loss. And if you’re ready to work with someone experienced in hair loss in women, get in touch and book an appointment today.

Female Hair Loss – Printable PDF

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

Alopecia Areata – The Naturopathic Approach

Hair loss can be a devastating symptom for men and women alike.  When it happens during adolescence or young adulthood it can be even more so.  Alopecia areata, a type of hair loss that affects up to 0.2% of the population (that’s over 50 000 people in Toronto alone) most often starts in people under 20 years of age.

Men and women suffer equally from alopecia areata and it occurs in all ethnic groups.  While we don’t know exactly what causes alopecia areata the evidence suggests it is an autoimmune condition with genetics and environmental factors contributing to its onset.

DIAGNOSIS of ALOPECIA AREATA

Alopecia areata has a characteristic appearance of well-defined round or oval areas of hair loss.  Typically occurring on the scalp, the circular patches of hair loss are free from scarring and the skin is not discoloured.  Around the patch of hair loss some hairs will have an “exclamation point” appearance showing signs of the abnormal transition of the hair through it’s growth phase.

While alopecia areata usually occurs as defined patches on the scalp, alopecia totalis occurs when there is  total loss of the scalp hair and alopecia universalis refers to loss of all hair on the scalp and body.

Diagnosis of alopecia areata should consist of a detailed history, a thorough clinical examination and appropriate laboratory testing.   Markers of inflammation and nutritional status should be included in any blood work to identify potential contributing factors in the onset and development of alopecia areata.

TREATMENT of ALOPECIA AREATA

Treatment of alopecia areata is difficult to assess because spontaneous recovery and hair regrowth occurs within 6 to 12 months for more than half of all patients.  However, recurrence is high so efforts should be made to determine the underlying cause of alopecia areata and treat accordingly.

While many things can contribute to the development of alopecia areata research suggests that some of the most significant factors are:

  • Stress (physical or emotional)
  • Hormone fluctuations
  • Infectious diseases or illnesses
  • Autoimmune conditions
  • Pre-existing health conditions such as celiac disease, ulcerative colitis, psoriasis, multiple sclerosis, vitiligo and lupus
  • Nutritional deficiencies – especially zinc and iron
crisp bread
Seeds are a good source of zinc.

As a Naturopathic Doctor my focus is on uncovering potential imbalances that may be contributing to the development of disease.  With alopecia areata there are often multiple factors that must be addressed – nutrient deficient diets, stress, poor immune function and hormone imbalances being the most common.

Potential natural treatments depend on individual needs – unfortunately there is no one diet or supplement that can cure alopecia areata.  The best course of action is to understand your health – what are the potential causes of your hair loss and how can they be addressed through dietary, nutritional and supplemental support.

To learn more about my individualized approach to hair loss, book a complimentary 15 minute meet-and-greet.  Learn how you can improve your health today.

References:

  1. Shapiro J. Hair Loss in Women. N Engl J Med. 2007;357:1620-1630.
  2. Springer K, Brown M, Stulberg DL. Common hair loss disorders. Am Fam Physician. 2003;68(1):93-102.
  3. Tosti A. Diseases of hair and nails. In: Goldman L, Schafer AI eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 450.
  4. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update part I. Clinical picture, histopathology and pathogenesis. J Am Acad Dermatol. 2010;62(2):177-188.
  5. Brajac I, Tkalcic M, Dragojevic DM, Gruber F. Roles of stress, stress perception and trait-anxiety in the onset and course of alopecia areata. J Dermatol 2003;30:871-878.
  6. Harries MJ, Sun J, Paus R, King LE Jr. Management of alopecia areata. BMJ. 2010;341:c3671.
  7. Rushton DH. Nutritional factors and hair loss.  Clin Exp Dermatol. 2002;27(5):396-404. Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss.  J Am Acad Dermatol. 2006;54(5):824-844.
  8. Park H, Woo Kim C, Seok Kim S, Wook Park C.  The therapeutic effect and the changed serum zinc level after zinc supplementation in alopecia areata patients who had a low serum zinc level. Ann Dermatol. 2009;21(2)142-146.

 

Getting to the Root of Female Hair Loss

Hair loss is a condition affecting many adults – both men and women.  Women are more likely to question why they are experiencing hair loss and may be more negatively affected by the hair loss than men.  Women with hair loss report lower self esteem and often have higher levels of fear, stress, depression and anxiety.

Conventional medicine is often dismissive of female hair loss.  The hair loss is most often not severe alopecia (the medical term for hair loss) and it is often diffuse (scattered over the scalp).

So why are women in their 20s, 30s, and 40s experiencing hair loss?  There are a number of potential causes.  By addressing the root cause of the hair loss, many women are able to stop the hair loss and in some instances, reverse it.

Aging

Unfortunately, hair loss is a normal part of aging.  By the age of 40, the rate of hair growth slows down.  New hairs are not replaced as quickly as old ones are lost.  This age-related hair loss affects both men and women.  In men the hair loss can be more prominent due to the effects of androgens (male sex hormones – such as testosterone).

Androgens

Androgens can contribute to hair loss in women just like in men.  It has been known since the time of Hippocrates that male sex hormones (androgens) contribute to hair loss.  This androgen-related hair loss is very common in women.  A report published in the Clinical Dermatology journal states that it affects approximately 30% of women before age 50.   When it occurs in women it is often referred to as “female pattern hair loss”.

There are a number of reasons why a woman may be affected by androgen-related hair loss.  Genetics, excess androgens, insulin resistance, diabetes, polycystic ovarian syndrome, and low antioxidant status are all associated with female pattern hair loss.

Drug-Induced Hair Loss

A long list of pharmaceutical drugs can cause hair loss.  Some of the most common ones are:

  • Medications_hair loss
    Many common medications can contribute to female hair loss

    Antibiotics

  • Anticoagulants (Coumadin, heparin)
  • Antidepressants (Prozac, lithium)
  • Antiepileptics (Valproic acid, Dilantin)
  • Cardiovascular drugs (ACE inhibitors, beta-blockers)
  • Chemotherapy drugs
  • Endocrine drugs (Clomid, danazol)
  • Gout medications (Colchicine, allopurinol)
  • Lipid-lowering drugs
  • Non-steroidal anti-inflammatory drugs (Ibuprofen, naproxen)
  • Ulcer medications (Zantac, tagamet)

When possible, natural alternatives to these drugs should be considered if hair loss is occurring.

Nutritional Deficiencies

A deficiency of almost any essential nutrient can lead to hair loss.  A Naturopathic Doctor can assess your overall nutrient status, but there are a few signs you can look for at home.

Zinc – white lines on the nail can indicate poor wound healing, a common sign of low zinc levels.

Vitamin A – bumps on the back of the arms (called hyperkeratosis) is a common sign of vitamin A deficiency.

Essential Fatty Acids dry skin on the elbows and other parts of the body is a common sign of low essential fatty acid levels.

Another nutrient deficiencies that may lead to hair loss is iron.  A simple blood test is needed to determine iron levels.  Your Naturopathic Doctor can help you interpret this test – many labs have normal ranges that include low iron levels that should be corrected with iron supplements.

If you are deficient in any of these nutrients a test of hydrochloric acid (stomach acid) should be considered to determine if you are not absorbing nutrients properly from your diet.

Hypothyroidism

Hair loss is one of the first features noticed by most women with hypothyroidism.  10 to 20% of the adult population has mild to severe hypothyroidism.  A blood test can be done to determine if hypothyroidism is causing your female hair loss.

Celiac Disease and Gluten Intolerance

Gluten Free LogoCeliac disease is a medical condition where gluten (a protein found in wheat, barley, and rye grains) damages the small intestines and causes systemic symptoms by cross-reacting antibodies that attack various cells in the body, including hair follicles.  The hair loss with celiac disease is often complete – a condition known as alopecia areata.

In people with gluten intolerance, the condition may manifest as hair loss (not complete) rather than digestive symptoms (which are a predominant feature of celiac disease).

Consider being tested for celiac disease if you have any of the following symptoms:

  • Bulk, pale, frothy, foul-smelling bowel movements
  • Weight loss
  • Signs of multiple vitamin and mineral deficiencies

A gluten-free diet will virtually eliminate symptoms in people with celiac disease.  A trial elimination of all gluten containing foods is recommended for anyone with hair loss to determine if gluten sensitivity is a cause.

Treatment of Hair Loss in Women

One of the central philosophies of Naturopathic Medicine is to treat the cause.  The treatment for female hair loss depends on the underlying cause of the hair loss.

hormone balance_feet
Hormone balance, addressing nutrient deficiencies and addressing the cause will improve hair loss in women.

Treatment of Androgen-Related Hair Loss in Women

  • Address underlying causes of androgen excess
  • Improve blood glucose regulation – low glycemic index diet, blood glucose normalizing supplements (such as glucomannan, fenugreek, or bitter melon), and regular exercise
  • Increase antioxidant intake – vitamin C, vitamin E, selenium, green tea
  • Saw palmetto extract – reduces the formation of dihydrotestosterone (DHT) a more potent form of testosterone that is often elevated in male and female pattern hair loss.  Works in a similar manner to Propecia (finasteride) – a prescription drug often used in female hair loss.

Treatment of Nutrient Deficiency-Related Hair Loss in Women

  • Test hydrochloric acid levels to ensure nutrients from food are being absorbed and supplement when necessary
  • A high-potency multivitamin and mineral formula (with iron when indicated)
  • Flaxseed or fish oil daily as a source of essential omega-3 fatty acids

Hair loss in women is a concern that should be taken seriously.  Although some hair loss naturally occurs with aging there may be another underlying cause of hair loss.  Consult with your Naturopathic Doctor if hair loss is a concern for you.  There is help available.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.