One of the most common complaints I hear from patients, especially women, who come into the office for functional medicine consultations, is that their hair is thinning, dry, or even falling out. They have often tried every hair regrowth shampoo, conditioner, and topical treatment you can think of, making it even more frustrating. Hair loss is actually an indicator that there is something underlying going on. There are several things to consider to try to figure out what the root of the problem may be.
Hair Loss Patterns and What They Mean
Not all hair loss is due to the same factors. The first key to investigate is the pattern of hair loss.
- Thinning Hair: may be connected to thyroid or hormone imbalance
- Dry and thinning hair: may be due to iron deficiency or thyroid dysfunction
- Patchy hair loss: could be related to high stress that creates high cortisol, heavy metal toxicity, or B vitamin deficiency
- Top of head/male pattern baldness: can indicate a hormone imbalance, specifically in testosterone, estrogen, progesterone and cortisol
- Balding all over: could be related to poor circulation, protein deficiency, zinc or B vitamin deficiency
As you can see, there are many potential contributors to hair loss. The best way to definitively determine what is causing your hair loss is by getting lab work done.
What Labs Are Important to Assess for Hair Loss
Thyroid panel – TSH, T4, T3, Free T4, Free T3, RT3, anti-TPO and anti-thyroglobulin antibodies
- This helps identify if there truly is a thyroid dysfunction contributing. Even if you have been told your labs are normal, they should be assessed by a functional medicine practitioner for OPTIMAL values vs just “normal” values. Consider a thyroid problem if your hair has gotten very thin or dry.
Testosterone and Dihydrotestosterone (DHT)
- Yes, women can have elevated testosterone and DHT! Women with male pattern baldness and those with polycystic ovarian syndrome (PCOS) may have elevated testosterone leading to male pattern baldness. Other symptoms include excess facial hair and weight gain.
Estrogen, Progesterone, FSH, LH
- Imbalance of these hormones can cause loss of hair on the top of the head. Associated symptoms include irregular periods and PMS.
Complete Blood Count with Iron Panel
- A complete blood count looks at red blood cells and hemoglobin, while an iron panel will determine if iron or B vitamin anemia is present. A ferritin level below 50 is a sign of inadequate iron and is a key contributor to hair loss.
Cortisol
- Cortisol is secreted when you are experiencing stress. When cortisol is elevated, our bodies can shut down production of other hormones to make more cortisol. This leads to aging and hair loss.
Heavy Metal Toxicity
- Heavy metal exposure comes from silver fillings, pesticides, power plants, and even consuming non-organic rice. These exposures can create a myriad of symptoms, one being hair loss.
Fasting glucose, Hemoglobin A1C, and Fasting Insulin
- This will assess if blood sugar dysregulation is a contributor to hair loss. Poor blood sugar regulation and diabetes can create hormone imbalances in addition to circulatory problems.
As you can see, there are many potential contributors to hair loss. If you are experiencing this, your body is trying to tell you something. Don’t ignore it! Contact your functional medicine provider to get started. In next week’s blog, supplement and dietary tips you can use to stop hair loss and get it growing again.
Dr. Lori Jokinen, DC CACCP CFMP BA