Hair Loss in Women: Myths, Truths and Solutions

Ok, let’s get real here – real and personal. We’re talking about hair loss. Specifically, we’re chatting about diffuse hair loss in women – meaning general excessive shedding from the scalp. The correct medical term for this is called Telogen Effluvium. We are looking at you – postpartum mamas, hormonally imbalanced women, those with nutrient deficiencies, and women, like me, who are blessed with the genetic predisposition for diffuse hair loss.

Hair Loss in Men

Hair loss is difficult – difficult for everyone. My handsome brother-in-law suffered hair loss in his late teens, and at age 21, he took the plunge and shaved what was left. It doesn’t even occur to us that Rob is bald. It’s not a defining characteristic. He’s just Rob. Our nephews in the Dominican Republic lovingly call him “Tio Calvo” (translated: Uncle Bald). He laughs with the kids and I truly think he feels endeared by the nickname. When I asked him about his journey for purposes of writing this piece, he told me he doesn’t remember being emotional or feeling less attractive about it. He recalled his friends busting his chops and pressuring him to shave it all off. In the end he said, and I quote, “Thankfully I have a round smooth head.”

Hair Loss in Women

By highlighting Rob’s low-level emotional journey to baldness, I do not intend to discount the emotions of other men in similar situations. I know it is difficult for many. Each year, men spend countless dollars on quite invasive hair restoration solutions. But when hair loss occurs in women let’s just say perhaps, that it is a bit more of a struggle, a “hushed topic,” that no one really speaks about. It’s an emotional rollercoaster scattered with strands of hair stuck to your clothes, in your shower drain, on the floor, found in the food you’ve prepared, and the worst of all: stuck inside your vacuum to the point where the vacuum no longer works and requires a pair of scissors and emotional grit to free it from the strands. Oof.

What to do if you are experiencing hair loss

I’m blessed because I’m a talker, and I’m friends with talkers. So amidst my chatty friends, I’ve found 3 other amazing women who experience similar hair loss. Our journeys are all different but when they asked me about nutrition and supplements and their effects on our precious locks, it was my pleasure to dive in. 

At the onset of women experiencing excessive hair loss, or diffuse hair shedding, the internet is typically our first stop. It’s a dangerous place sometimes, the internet. There we find gadgets (I may or may not have owned an infrared light helmet that claimed to stimulate hair growth) and nutritional supplement after nutritional supplement that promises to slow the shedding and the prompt growth of baby hairs. It’s a slippery slope to start taking non-FDA regulated supplements without a doctor’s prior consent and prior to the doctor testing for nutrient deficiency. These highly marketed supplements contain an abundance of nutrients while reviews of studies find little evidence supporting their use. In the absence of a deficiency, supplementation may actually be worse for our hair. Research shows that there is a link between hair loss and over supplementation of some nutrients like selenium, Vitamin A and Vitamin E.

Step 1 – Visit the Dermatologist

Step one should really be to visit a specialized dermatologist who focuses exclusively on the evaluation of nonsurgical treatment of hair loss. These fine doctors will work with patients step by step with varying degrees of diagnostic tools to find the root cause of the shedding. The list of labs they draw is beyond comprehensive and runs the gamut from all hormones to our nutrient-related chemistry. They use physical tools and techniques to mark and measure the rate of the shedding. And when a plan is in place, they employ the same tools to mark successful growth and positive changes to the hair follicles. If you’re in the New York / New Jersey area and looking for a referral, reach out to us because we know the good ones!

Step 2 – Check in with your Dietitian

Step two, before the light-up helmets and promising supplementation, should really be a serious check-in with your diet. Your RD can help you with this. Sometimes we don’t even realize that slight tweaks to our intake can make a huge difference. Even without deficiency, taking in nutrients via food will very rarely cause the toxicities that supplementation may cause. With that said, let’s focus on the nutrients that govern our precious hair follicles.

Nutrients that Impact Hair Follicles

Iron

Iron deficiency is the most common nutritional deficiency and is a well-known cause of hair loss.
Anyone can be at risk for iron deficiency and not realize it.

Postpartum mamas or those with dysmenorrhea are at a bit of higher risk for iron deficiency. Be sure to include dietary forms of iron daily. Vegans and vegetarians are also at higher risk. This is because the iron that is found in plant protein sources has lower bioavailability (meaning: the iron that enters circulation during digestion is not as easily absorbed) than high biological value proteins found in animal protein. To increase the bioavailability of the proteins found in plant-based foods, medical practitioners recommend consuming them together with sources of vitamin C. For those who do eat animal protein, the highest sources of iron are found in red meat, clams, and fish. For a more comprehensive list, visit the listing on the Red Cross website.

Biotin

I’m listing this one second to iron because I know from being one of those internet stalkers that mostly every hair growth supplement on the market contains biotin. Here’s the thing though – biotin deficiency is rare. Our talented intestinal bacteria adequately produce biotin. Also, no clinical trials have shown that treating hair loss with biotin supplements actually works. It has, however, shown positive effects in the treatment of brittle fingernails. If your goal is stronger nails, by all means, try some biotin as it’s not known to be toxic in supplemental forms. It’s my job to help you say hello to dietary sources though – it can be found across food groups in salmon, beef, sweet potatoes, almonds, tuna, broccoli, and oatmeal. 

Zinc

Zinc is an essential mineral – hundreds of enzymes in our bodies require it. Deficiency of zinc plays a role in malabsorption syndromes such as inflammatory bowel disease. Specialty dermatologists will test for zinc deficiency. If a doctor diagnosis a deficiency, he or she will work closely with patients on supplementation. Like iron, zinc is not as bioavailable in plant-based diets but let’s let the doctors dose supplementation for that situation. If accidental zinc toxicity occurs, not-so-pretty bowel reactions, and even more excessive hair loss may ensue. Maintaining dietary sources of zinc is always harmless and a good idea though. Harvard gives us a great comprehensive write up here.

Selenium

Selenium is another trace element that plays several roles in the body. It aids in protecting cells from oxidative damage, as well as hair follicle morphogenesis (the dysfunction of a healthy hair follicle). This nutrient is incredibly bioavailable throughout many food groups like brazil nuts, tuna, beef, tofu, whole wheat, shrimp, and mushrooms. Here’s what’s shocking though, the supplement industry markets  some hair loss supplements as containing selenium. This is concerning because research shows that selenium toxicity results in generalized hair loss. Let’s be safe folks, and stick to those awesome dietary sources listed above. 

Vitamin A & Vitamin E

Neither of these vitamin compounds are scientifically proven ask links to hair loss and deficiency. However, BOTH Vitamin A and Vitamin E have been linked to hair loss from over-supplementation. Shocking again, as these are also common ingredients in the marketed supplementation. Save your money and steer clear of those vitamins that pop up in your socials feeds. 

I know you’re inclined to jump into the deep dark hole that is the internet. I’ve done it too. But be and searching for the newest way to treat hair loss, try taking a look at your diet. Small changes and adjustments can make a huge difference. I know I’m biased – being a dietitian and all – but what we eat plays such an important role in so many systems and regions of our body – even our hair. This is what I’d tell my closest girlfriends, so this is what I’m telling you!