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Hair loss is scarily common.

In fact, hair loss can affect up to 50% of women and 20% will have significant hair loss. In men, hair loss sits at about 70%. There are two broad categories of hair loss, diffuse and focal. Here we explore diffuse hair loss, and the lifestyle factors that can contribute to it. This article will explain to you:

  • Types of hair loss in women
  • Common causes of hair loss
  • Ways to manage your hair loss

But first, because it’s Kultured Wellness and I love a little nerdy science time, let’s take a look at how hair grows.

On your head you have between 100,000 and 350,000 hair follicles – now that doesn’t hold a candle to the microbiome, but it’s still an awful lot. We lose up to 200 hairs a day which is more noticeable with longer hair. Each hair is made up of keratin (a protein) which sits in a follicle and receives oxygen, nutrients and oil to lubricate the surface. You will also need keratin if you have feathers, claws or horns… oh, and skin. At any one time, about 90% of your hair is in a growth phase - we need to know this to understand why our hair falls out. There are 4 phases in a hair's life cycle.

  1. Anagen – it’s the growth phase and can last 2-7 years
  2. Catagen – this is a transitional phase in preparation for shedding
  3. Telogen – resting phase, lasts for around 10 days before shedding
  4. Exogen  - the phase where the telogen hair is actually released

You can see from the stages that most of the time, most of our hair is in a growth phase. We need certain vitamins, minerals and macronutrients to grow healthy hair. We also require balanced hormones. When we examine the causes of hair loss this will become evident to you.

Age can affect hair loss.  By the age of 40 our anagen phase does not keep at the same rate and we have a higher number of telogen hairs – you can tell this when you pull or brush your hair and a larger number of strands come away with little resistance. Other things besides age lead to hair loss, though.  In fact, lots of things in this modern world that place stress and strain on our body, the gut, and our hormones are seen through the state of our hair and skin.

The 5 main causes of diffuse hair loss in women:

1. Drugs

There are plenty of medications that can lead to hair loss. Chemotherapy is the most well known, but a lot of common medications can contribute. These include commonly prescribed drugs such as antibiotics, warfarin, antidepressants, anti-inflammatory drugs, reflux medications, gout medications and lipid-lowering drugs. That’s a pretty big list, and not a comprehensive one. The reason I mention this here is that when you are looking at causes, you can explore this avenue.

2. High levels of Androgens

This would have to be the most common cause and, in fact, has a name;  ‘Diffuse androgenic dependant alopecia’. Did you know ‘alopecia’ is actually the Greek word alōpēx, which means fox? This may seem random but, in fact, it is named after the hair shedding that occurs in foxes. Androgenic hair loss can affect up to 30% of women under the age of 50 years and so creates quite an emotional burden on us. As the name hints, in this case we have excess androgens. Females do require androgens, which are identified as a male hormone – you may be aware of testosterone as the most famous androgen. When we, as women, produce androgens in our ovaries and our adrenals, they are normally balanced, but tissues such as fat tissue can convert weak androgens into stronger ones. Common signs will be increased facial hair but thinning scalp hair. We see this occurring in people with the polycystic ovarian syndrome (PCOS), insulin resistance, and people with low levels of our master antioxidant, glutathione. Also of importance is avoiding xenoestrogen exposure from your environments such as plastics, skin care products, foods and chemicals. Our hormones need some love and care in this toxic world.

3. Nutrient deficiencies

Some of the most common offenders in this category include zinc, vitamin A, vitamin D, essential fatty acids and iron. Let’s break them down a little.

  • Zinc – we hold 2-3 g of zinc in our skin at any given time. It is a cofactor for over 1000 enzymatic reactions within our body, not to mention immune function. When we are low in zinc the hair moves from anagen to telogen phase prematurely. To look for zinc deficiency you can look at your nail beds. Those white spots indicating often unnoticed trauma or bumps to the nail bed occur when we have low zinc. Almost all types of hair loss are made worse by zinc deficiency.
  • Vitamin A – this antioxidant, when deficient, can contribute to hair thinning. Have a look at the backs of your arms for ‘hyperkeratosis’. Within that word is the clue word ‘keratin’ the protein found in your hair and skin. Hyperkeratosis is a thickening of the skin often found on the back of your arms and can signal a need to investigate further.
  • Vitamin D – we get most of our vitamin D from the sun and we are only just scratching the surface of all the wonderful ways this really special compound keeps us healthy. What we do know is that vitamin D receptors are a key part of anagen stimulation – so to grow hair we need healthy amounts of vitamin d and working vitamin d receptors. We also know that people with adequate amounts of vitamin D are less likely to have a hair loss problem. Telogen Effluvium, a fancy word for sudden onset of hair loss due to shock or stress, correlates with vitamin D deficiency. What this means is that the worse the deficiency, the worse the hair loss in this group. My totally fav way to supplement is called sunshine and accessing nature.
  • Essential Fatty Acids (EFA) – a deficiency in this can often occur at the same time as zinc. If you consume too many trans fats it can lead to EFA deficiency, as well. A good look at your dietary intake and getting the right omega 3 ratios will be key here. A little clue is to look at your skin again. Is it dry? This can occur when you need to ramp up your EFA intake.
  • Iron – how common is iron deficiency? Have you ever heard of iron deficiency anaemia? Well, you do not need to be anaemic to have low iron levels affect your hair. Subclinical low iron (that is, you’re not anaemic yet) can still lead to hair loss. You can get your ferritin tested at the doctor if this is a concern to you.

A couple of things to note here. This is where the ‘Canary in the coal mine’ reference comes in… the theory is that the body will divert crucial resources into more important tissue than hair when we are deficient. So when you are not overtly or obviously deficient, the hair loss can start first while your body is still making do where it needs to. This is your opportunity to make a few changes. Number two, make sure your gut is able to digest and absorb nutrients. There is no point supplementing unless you can actually absorb them. I’m all about gut health here and getting the gut to a point where you can break down and digest food and really take as much goodness as possible from each meal. Check out our consulting programs if you think this is you.

4. Hypothyroidism

Thyroid hormones are closely linked with driving hair growth and the various stages of the hair life cycle. One of the suspects in hair loss is iodine. I iodine paint to ensure I have adequate levels. This allows me to produce balanced amounts of thyroid hormone – and the benefits are far greater than a nice head of hair. Hypothyroidism can affect up to 20% of the population and it is a classic cause of hair thinning. Get your thyroid properly assessed if you are experiencing hair thinning.

5. Autoimmune-mediated

There is an autoimmune condition called Alopecia Areata where we produce antibodies leading to hair loss. Interestingly, these antibodies can cross-react with anti-gliadin antibodies found in coeliac disease. Consider gluten intolerance as an avenue for investigation if you have unexplained hair loss.

What to do about hair loss

The first thing to do is to adopt a whole foods approach to eating, loads of beautiful healthy fats, loads of vegetables, and proteins. I didn’t mention protein above because we are not often short of protein in the standard Australian diet (SAD), but in circumstances where starvation occurs, hair loss will result. Keratin is a protein and you do need the building blocks to create the hair.

Now you’re eating a beautiful, healthy diet with plenty of fats, and plenty of vitamins and minerals, you can start to investigate further. An integrative practitioner can support you with the correct supplementation once your gut is working properly. The good news is that nutrient deficiencies are correctable and hair loss can resolve when these are addressed.

In summary

  • Get your gut working properly
  • Eat a nourishing diet high in nutrients and good fats
  • Balance your hormones
  • Manage stress
  • Work with a practitioner to drill down further into unexplained hair loss

Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852775/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751255/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560543/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682371/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939003/

Pizzorno, J.E. and Murray, M.T. (2013) Textbook of Natural Medicine 4th Edition. Churchill Livingstone: Missouri USA. ISBN: 978-1-4377-2333-5

Gaby, A.R. (2017) Nutritional Medicine 2nd Edition. Fritz Perlberg Publishing: Concord NH. ISBN: 978-1-5323-2209-9 

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