Hair loss is one of the most distressing and common symptoms I see in my practice and something I myself have dealt with on and off for years. And I wish I could tell you that addressing the causes of hair loss is easy and results can be seen overnight, but that would be very far from the truth! For a lot of women with hair loss, the root cause of it is way more complex than just thyroid hormone imbalance.

Today, I am going to cover the main causes of hair loss I see in my practice, how you can find out if you have it, and what to do about it.

Before we dive in, I wanted to say that recovery from hair loss is possible for most but it’s not a quick process. It also depends on how long the situation has been going on for and the type of hair loss. For instance, hair loss induced by nutrient deficiencies will be easier to address than say, hair loss of androgenetic origin.

The two most common types of diffuse hair loss I see in my clients are:

1. Androgenetic / Androgenic Alopecia (AGA)

This type involves a genetic predisposition and hormonal factors (high androgen hormones like testosterone). It leads to gradual miniaturisation of hair follicles, showing up as diffuse hair loss (but more prominent on top of your head and behind the hairline).

2. Acute or Chronic Telogen Effluvium (TE)

Triggered by a significant physiological or emotional stressor, leads to an increased number of hair follicles to enter the telogen (resting) phase prematurely. This leads to excessive shedding, typically noticeable a few months after the triggering event. Can become chronic. Shows up as diffuse thinning, usually most noticeable at the temples and the sides

Different conditions and functional imbalances can trigger different types of hair loss. The type of hair loss and the root cause will determine how you need to address it.

Suboptimal thyroid hormone levels

Too-high and too low levels of thyroid hormones can shorten the hair growth cycle, and trigger TE.

That’s why it’s super important to make sure the levels are not only normal but optimal!  Suboptimal levels will also affect the quality of hair, causing it to become more brittle and dry due to a slowed production of oils in the scalp.

How to check: Full thyroid panel blood test that will include FT3, FT4 and TSH. You can get your full thyroid panel via Blue Horizon or Medichecks.

How to address: There are three key areas to look at.

• Thyroid cofactors status  (like selenium, zinc, magnesium)
• Optimising your gut and liver detox pathways (the organs responsible for conversion)
• Targeted supplementation

I highly recommend you check out my 21-day course Thyroid Fundamentals where I explain exactly, step by step, how to do that.

Autoimmunity

Something I see a lot in my practice is higher level of hair loss in clients who have high antibody level (90% of thyroid issues are due to autoimmunity!).

This is partially due to autoimmunity affecting the thyroid function and therefore hair cycle (see the point above) and partially due to the inflammation directly impacting hair follicles.

How to check: You want to check for antibodies levels using one of the tests mentioned above (or you can try asking your GP)

What to do about it: Address the root cause!! Everyone has a different unique set of triggers and driver for their autoimmunity.

• gut dysbiosis/ leaky gut,
• viral/bacterial infectiions,
• adrenal dysfunction,
• toxin exposure,
• trauma and chronic stress

It is rarely just one! If you’d like to learn a little more about my approach to addressing it, check out my Hashimoto’s and Graves’ masterclasses.

Iron and Biotin and Lysine

Your nutrient status is uber important as a whole, so making sure your diet is as nourishing as possible is absolutely key (and one of reasons why I am not a fan of strict elimination protocols).

The three nutrients that have been linked to some of the causes of hair loss (known to trigger chronic TE), and how to check for each are:

• Iron: you can test your ferritin levels (aim for levels above 60)
• Biotin: little trickier to test, I use metabolic organic acid testing
• Lysine: this is an amino acid obtained from protein sources. Therefore, if your diet lacks sufficient protein, especially for those following a vegan or vegetarian lifestyle, the likelihood is that your lysine levels may be low

How to address: consider supplementation. I recommend beginning by optimizing your nutrition. You should definitely join Thyroid Fundamentals to learn how to do that 😉.

High Androgens

High levels of androgens, particularly elevated testosterone and its metabolite DHT, can contribute to androgenic alopecia. This is a common symptom of polycystic ovary syndrome (PCOS), which often coexists with Hashimoto’s.

How to check: DUTCH TEST aka dried urine testing for comprehensive hormones (a functional test I run for most of my 121 clients.

Other Symptoms: Acne, Excessive hair growth on face and body (hirsutism), irregular periods.

How to address: Reducing inflammation and supporting liver detox pathways will help. Addressing the drivers (listed below) like insulin resistance and high cortisol. Considering anti androgenic supplementation: peppermint and saw palmetto is what I use in my practice!

Insulin resistance

Linked with high androgen levels and PCOS. High insulin can lead to an increase of androgen hormones (DHT in particular) and high androgens can make insulin resistance worse! High insulin is also linked with high cortisol which is another one of the root causes of hair loss.

Insulin resistance is also very common in inflammatory autoimmune conditions like Hashimoto’s.

How to check: symptoms like fatigue, energy crashes, troubles loosing weight, also testing like insulin/ HbA1c testing (via your GP).

How to address:

• balance blood sugar levels
• work on metabolic flexibility
• strength training
• work on sleep
• nervous system regulation!

Again, Thyroid Fundamentals is a great start if you’re looking to learn how to support your blood glucose. It’s one of my favourite subjects and something I support clients with all the time!

High cortisol

High cortisol can lead to TE as well as an increase in androgen hormones (possibility of androgenic alopecia).

How to check:

• Cortisol saliva testing is by far the gold standard here.
• DUTCH Complete includes cortisol testing or you can opt in for a separate adrenal test. You can also test cortisol from blood (your doc might run this for you) but it’s not as accurate as it only checks morning cortisol levels vs the daily patterns
• Symptoms like fatigue, anxiety, mood imbalances, issues with brain fog and focus

How to address:

Nervous system regulation baby! Ability to self regulate will be the biggest needle mover here. Check out my 3 day mini course THYROID CALM  if you need help getting started!

Also things like optimising sleep and working on your circadian rhythm is crucial, alongside targeted supplementation!

Menopause 

Low oestrogen and progesterone can impact hair growth cycle, worsening of AGA is also common in menopause if the genetic predisposition is present.

How to check:

Your GP will test for oestrogen, progesterone and FSH and you might also want to consider DUTCH.

How to address:

Consider HRT or supplementing with phytoestrogens and hormone modulating herbs. Working on reducing inflammation and improving your nutrient status is also key! These are not just separate issues though.

• Thyroid conditions (both hyper and hypo lead to issues with absorption which leads to  suboptimal nutrient levels)
• Thyroid hormones affect all the other hormones in the body often exist with PCOS and high testosterone
• Thyroid hormones also impact glucose metabolism and insulin resistance is very common in hypothyroidism 
• Nervous system deregulation, chronic stress, and trauma are both the trigger and driver of thyroid conditions often resulting in high cortisol levels 

As you can see there’s so much that can be at play contributing to this situation and identifying the root cause is key!

It is possible to reduce the shedding and in time even restore your locks to their former glory, but your approach needs to be smart and just popping and hair loss supplement is unlikely to produce a long-term improvement. Nor is blaming your thyroid and hoping levothyroxine will fix the problem.

You need to understand and effectively address the causes of hair loss

If you’re looking for more in-depth tailored support, Iearn more about my 121 programme and BLOOM and follow me on Instagram!