Positively Beautiful: Many factors can contribute to loss of hair

Regardless of whether we are golden blondes, redheads or brunettes, hair is our crowning glory, our best accessory whether we are male or female. We spend more than $25 billion on hair-care products annually in the U.S. So losing hair is very str...

Dr. Susan Mathison

Regardless of whether we are golden blondes, redheads or brunettes, hair is our crowning glory, our best accessory whether we are male or female.

We spend more than

$25 billion on hair-care products annually in the U.S. So losing hair is very stressful. Genetics certainly play a role for both sexes, but sometimes hair loss can be an important message from your body.

We have about 100,000-150,000 hairs on our head, and usually lose 50-100 hairs per day. Since 90 percent of our hair follicles are in growth phase, these hairs are rapidly replaced and do not cause noticeable thinning.

But certain situations can cause such significant loss with which natural hair regrowth can't keep up. Hormone shifts caused by pregnancy, menopause and starting or stopping birth control can exacerbate hair loss. So can intense stress.


We may not be able to combat genetics, and sometimes stress happens, but there are some underlying causes that should be investigated to see if hair loss might respond to therapy.

1. Low iron levels are the most common cause of unexplained hair loss. A blood test called serum ferritin is the most sensitive way to measure this. If ferritin levels are low, new hair isn't generated.

Look for dietary means of increasing iron intake, like spinach and red meat, and consider a supplement as well. Remember that getting too much iron is detrimental for your body, so make sure to monitor this with your physician.

2. Low thyroid function is the next most common issue. Patients often complain of feeling tired, along with dry skin and dull, thinning hair.

A blood test called TSH is the first step in investigating this problem, and further testing of thyroid function might include T3 and T4. We now know that TSH should be below 3.0, and many women's health experts feel that a level between 1 and 1.5 is optimal for feeling good and having great hair.

3. Insulin resistance increases risk of hair loss. As we become more aware of the impact of our high-sugar diet, we understand the impact of rapid surges of insulin production.

Our cells are becoming desensitized to the effects of insulin. Glucose sticks around longer, there is increased fat storage and it sets up an inflammatory cascade that affects all parts of us, including our hair. A fasting glucose blood test can help evaluate this possibility.

4. Auto-immune disease may be responsible for alopecia areata, which causes patchy to complete hair loss.


For unknown reasons, the immune system gangs up on the hair follicles and causes sudden patches of baldness. In 90 percent of cases it grows back over time but may be a different thickness and color when it returns.

Diseases such as lupus can also cause hair loss.

5. Hormone imbalances can cause hair loss.

I've mentioned pregnancy. As estrogen and progesterone plummet after delivery, many women find that the shower floor is peppered with lost strands of hair. This normalizes when hormones balance back to their pre-pregnancy levels.

Some women can have excess male hormones such as DHEA and testosterone, which can cause hair loss.

6. Vitamins A and D, and selenium excesses can cause hair loss.

Sometimes too much of a good thing is not good!

7. Fungal infections like ringworm can invade the scalp and cause hair loss, but topical treatment is curative.


8. Chemotherapy is infamous for hair loss. Research is ongoing for topically applied treatments targeting genes p53 and CDK2 that may hold this traumatic side effect at bay.

9. Hair treatments like perms and straighteners can cause hair to be brittle and prone to breakage.

Aggressively styling your hair with tight braid, corn rows or buns can literally pull hair out by its roots. Over time, this can become permanent loss. Likewise, neurotic picking of hair, brows or lashes can cause permanent loss.

Next week, I'll give you lots of options for treating problems.

This column was written exclusively for The Forum.

Dr. Susan Mathison founded Catalyst Medical Center in Fargo and created Email her at .

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