Low ferritin (the stored form of iron) is one of the most common causes of hair loss in women. Given low ferritin is also a common problem for hypothyroid people, it is important to have iron testing including ferritin especially if you are experiencing hair loss. It is not enough to be told by your doctor that your iron levels are ‘normal’. Ferritin levels are not always tested. Get a copy of your lab results and be sure ferritin has been specifically tested. Even if ferritin is within the ‘normal’ range that doesn’t make it ‘optimal’.
Finasteride (Propecia): This medication is FDA approved for use in only men with androgenic hair loss. Finasteride is in a class of medications called 5-alpha reductase inhibitors. It helps reduce hair loss by blocking the action of natural hormones in scalp hair follicles. Propecia is a lower-dose version of a commercially available drug called Proscar that helps shrink enlarged prostates in middle-aged and older men. Women of child-bearing potential should avoid finasteride. Propecia 1 mg tablets are available by prescription and taken once daily. Propecia may grow and thicken hair to some extent for some people, but its main use is to keep (maintain) hair that's still there. Studies have shown that this medication works well in some types of hair loss, and patients should use it for about six to 12 months before full effects are determined. This medication does not "work" in days to weeks, and its onset of visible improvement tends to be gradual. It may be best for men who still have enough hair to retain but also can help some regrow hair. Possible but very unlikely side effects include impotence or a decreased sex drive (libido). Studies show that these side effects were possibly slightly more common than seen in the general population and are reversible when patients stop taking the drug. The cost is about $70-$100/month, and most health insurers do not reimburse for the expense.
There’s no such thing as a drug that’s without side effects completely. However, finasteride isn’t as harmful as some of the other types of medicine on the market. In fact, such a small percentage of men experience side effects at all, making the medicine effective and safe. With that said, there are a few things that you should know about the drug before you start taking it.
Some hair loss can also result from the psychological condition trichotillomania. “People with this condition compulsively pull out their hair when they are stressed or even when they are concentrating, e.g. studying hard,” says Burg. “Sometimes the individual doesn’t know they are pulling their hair out, doing the activity absent-mindedly, and only notice once the bald patches appear.” Over time the hair follicles can become so damaged that they die and leave permanent bald patches. Find out why you shouldn’t pull out gray hairs either.
The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.

These medicines slow thinning of the hair and increase coverage of the scalp by growing new hair. They also thicken the shafts of your existing hair so that it grows in thicker. If you stop using the medicine, any hair that has grown in will gradually be lost. Within 6 to 12 months after you stop using the medicine, your scalp will most likely look the same as it did before treatment.


Hair multiplication. Similar to the idea of cloning, this treatment involves taking out donor cells from the hair follicles and then growing and multiplying them in a laboratory. Once sufficient samples have been multiplied, these hair cells are then injected into the bald patches to stimulate hair growth. As a relatively new treatment, hair cloning is still in its research phase.
Laser treatments. Low-level laser therapy (LLLT) is used for the prevention and reversal of hair loss. Also known as red light therapy, cold laser, and soft laser, it is a form of light/heat treatment (therefore generally safer) that is used on cases of pattern baldness and alopecia areata. The procedure uses a device that emits light that penetrates into the scalp. The more commonly used lasers are the excimer, helium-neon and fractional erbium-glass. The procedure can increase the blood flow in the scalp to stimulate the follicles that are in resting or dormant phase to go into anagen, and at the same time, prevent the production of DHT, which destroys the hair follicles.
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.
Correct ferritin levels maximize your hair’s “anagen” or “growing” phase and encourage your hairs to grow to their full length. When you aren’t getting enough iron through your diet, your body takes ferritin stored in non-essential tissue, like your hair bulb, and gives it to essential tissue, such as your heart. Because your hair bulb is where all your hair cells are produced, this leeching of ferritin can cause your hair to shed before it reaches its maximum length.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

Sex hormone testing, especially for women and men with hair loss, should include DHT (DiHydroxy Testosterone). DHT is a derivative of the male hormone testosterone. In women, perimenopause and menopause marks a drop in estrogen which leaves hair particularly vulnerable to DHT. Women with PCOS struggling with hirsutism (excessive body hair in women in areas where men typically grown hair including the fat, check, and back ) and male-pattern hair loss should be sure testosterone and DHT are part of their lab testing too. The American Hair Loss Association describes DHT as “the enemy of hair follicles on your head”:
Has your doctor told you that your blood sugar levels are too high? Low thyroid is one potential cause of diabetes, and it may be your red flag to have your thyroid re-evaluated. When my doctor once mentioned that my blood sugar was at the high pre-diabetic level and suggested starting diabetes medication, I asked for 6 months to try replacing my regular multivitamin with this one Designs for Health Metabolic Synergy (created by a nationally prominent doctor specializing in blood sugar) and by my follow-up appointment my blood sugar was completely normal and diabetes medication was not needed (what a relief). 

Hair changes about as fast as grass grows, which is to say it’s extraordinarily slow and not visible to anyone checking impatiently in the mirror every day. But during regular follow-up appointments, Harklinikken uses high-tech equipment to photograph and magnify the scalp and count new hairs and active follicles, which motivates users to adhere to the regimen. Too many people give up on treatments like Rogaine and low-level-light devices before they’ve had a chance to work, Dr. Senna said.
Harsh hairstyles or treatments: Hairstyles that consistently use rubber bands, rollers or barrettes, or pull hair into tight styles such as cornrows, can inflame and scar hair follicles. So can incorrectly used chemical products such as dyes, bleaches, straighteners or permanent wave solutions. Depending on the degree of damage, resulting hair loss can be permanent.
Just like pregnancy, birth control pills mess with your hormone levels, causing them to fluctuate. In response, you might experience hair loss. “Hormones can interrupt the natural pattern of the hair cycle, causing hairs to shed more quickly than usual or to grow with less vigor,” explains Dominic Burg, PhD, chief scientist for Advangen. Oftentimes the hormone responsible for this is an androgen, such as testosterone, which is why the American Hair Loss Association recommends low-androgen birth control pills for those who are at an increased risk for hair loss.

Minoxidil: This medicine is applied to the scalp. It can stop hairs from getting thinner and stimulate hair growth on the top of the scalp. The U.S. Food and Drug Administration (FDA) has approved minoxidil to treat hair loss. It is the only hair re-growth product approved for men and women. A dermatologist may combine minoxidil with another treatment.
Losing your hair can be distressing, but if it is caused by thyroid disease it is most likely reversible. In the meantime, try to stave off further hair loss by treating your hair gently. Avoid brushing it excessively, using harsh coloring products, and hairstyles that pull on the hair (such as a tight bun). If you feel self-conscious about having thin hair or bald patches, consider wearing a scarf or wig while your hair grows back.
Hormonal changes and medical conditions. A variety of conditions can cause permanent or temporary hair loss, including hormonal changes due to pregnancy, childbirth, menopause and thyroid problems. Medical conditions include alopecia areata (al-o-PEE-she-uh ar-e-A-tuh), which causes patchy hair loss, scalp infections such as ringworm and a hair-pulling disorder called trichotillomania (trik-o-til-o-MAY-nee-uh).
If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
It is estimated that 90% of people with hypothyroidism have the thyroid autoimmune condition known as Hashimoto’s Thyroiditis. Hashimoto’s is an autoimmune condition in which the body attacks its own thyroid gland. Despite the prevalence of Hashimoto’s, thyroid antibodies are often NOT tested. You may have Hashimoto’s and not even know it. There are two thyroid antibodies to test for Hashimoto’s: Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).

Alopecia areata - bald patches develop on the scalp, beard, and possibly eyebrows. eyelashes may fall out as well. This is thought to be an autoimmune disease, where the immune system attacks the hair follicles and leads to hair loss on the scalp and other parts of the body. However, the hair follicles are alive so there is potential for hair to regrow when the underlying problem has resolved. Growth may occur even without treatment and even after many years. In most cases hair loss only happens in a few places, leaving a few bare patches. In some cases though, the disease can advance to total loss of hair from the head (alopecia areata totalis) or complete loss of hair on the head, face and body (alopecia areata universalis).
Trichotillomania, classified as an “impulse control disorder,” causes people to compulsively pull their hair out. “It’s sort of like a tic, the person is constantly playing and pulling their hair,” says Dr. Glashofer says. Unfortunately, this constant playing and pulling can actually strip your head of its natural protection: hair. Trichotillomania often begins before the age of 17 and is four times as common in women as in men.

^ Jump up to: a b Blumeyer, A; Tosti, A; Messenger, A; Reygagne, P; Del Marmol, V; Spuls, PI; Trakatelli, M; Finner, A; Kiesewetter, F; Trüeb, R; Rzany, B; Blume-Peytavi, U; European Dermatology Forum, (EDF) (October 2011). "Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men". Journal of the German Society of Dermatology. 9 Suppl 6: S1–57. doi:10.1111/j.1610-0379.2011.07802.x. PMID 21980982.
Pregnancy may cause many changes in the scalp hair. As the hormones fluctuate during pregnancy, a large number of women feel their hair thickens and becomes fuller. This may be related to change in the number of hairs cycling in the growth phase of hair growth, but the exact reason is unknown. Quite often, there may be a loss of hair (telogen effluvium) after delivery or a few months later which will eventually normalize.
Every part of the body requires thyroid hormone for proper functioning, and that includes the hair follicles. In 2008, the Journal of Clinical Endocrinology and Metabolism presented the first evidence that human hair follicles are direct targets of thyroid hormones. This research demonstrated that the thyroid hormones T4 and T3 modulate multiple hair biology parameters from cycling to pigmentation.
“For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it — if a woman is losing hair in partly a male pattern – -then, the problem is there is excessive conversion of testosterone to dihydrotestosterone (DHT) at the level of the hair follicle. Evening primrose oil is an inhibitor of that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.”
Most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation (during strict dieting), and hormonal changes like those in pregnancy, puberty, and menopause may cause hair loss.
1. Hair color. Anytime you dye your hair, you’re increasing the diameter of each strand, which can help add volume when your hair is sparse and fine. As a general rule, ask your colorist to make sure highlights are finer at the top of the head, where hair is the thinnest, and more intense at the bottom, where it’s thickest, says Eva Scrivo, a hairstylist and the owner of the Eva Scrivo Salon in New York City. And beware: A color that contrasts with your scalp (blonde tones if your scalp is dark, deep brunettes if your scalp is light) will make any visible scalp more obvious.
Minoxidil (Rogaine) is a nonprescription medication approved for male pattern baldness and alopecia areata. In a liquid or foam, it is rubbed into the scalp twice a day. Some people have an allergic reaction to the propylene glycol in the minoxidil solution and a minoxidil foam was developed without propylene glycol. Not all users will regrow hair. The longer the hair has stopped growing, the less likely minoxidil will regrow hair. Minoxidil is not effective for other causes of hair loss. Hair regrowth can take 1 to 6 months to begin. Treatment must be continued indefinitely. If the treatment is stopped, hair loss resumes. Any regrown hair and any hair susceptible to being lost, while Minoxidil was used, will be lost. Most frequent side effects are mild scalp irritation, allergic contact dermatitis, and unwanted hair in other parts of the body.[30]

Nutrient deficiencies are an issue for me personally. I supplement every day to maintain my nutrients at optimum. When I noticed a worsening of my hair loss last year, nutrient testing revealed that I was deficient in all those nutrients necessary for hair health. This high quality multivitamin Pure Encapsulations PureLean Pure Pack (it helped me lose a few pounds too) which includes the healthy fat omega-3 has made a world of difference. I also like Pure Encapsulations Energize Plus Pure Pack for a boost of energy but it often sells out.


Less common causes of hair loss without inflammation or scarring include the pulling out of hair, certain medications including chemotherapy, HIV/AIDS, hypothyroidism, and malnutrition including iron deficiency.[2][3] Causes of hair loss that occurs with scarring or inflammation include fungal infection, lupus erythematosus, radiation therapy, and sarcoidosis.[2][3] Diagnosis of hair loss is partly based on the areas affected.[3]
Hair transplantation is usually carried out under local anaesthetic. A surgeon will move healthy hair from the back and sides of the head to areas of thinning. The procedure can take between four and eight hours, and additional sessions can be carried out to make hair even thicker. Transplanted hair falls out within a few weeks, but regrows permanently within months. Hair transplants, takes tiny plugs of skin, each which contains a few hairs, and implants the plugs into bald sections. The plugs are generally taken from the back or sides of the scalp. Several transplant sessions may be necessary.[33]
Beyond that, things get more controversial, with some doctors saying there's inadequate evidence for other treatments. Saxena thinks there is enough scientific evidence to support some of the alternatives and recommends them to patients. But they are not for women on tight budgets. There's Nutrafol, a "nutraceutical" that costs about $80 a month. Women can also get injections in the scalp of platelet-rich plasma made from their own blood. The first four treatments cost about $2,000 at Saxena's practice in Fort Washington or Lansdale. Maintenance injections, done every three to six months, cost $515 each. Women can also buy Theradome, a light-emitting helmet, for $895 online.  Saxena, who has hair loss herself, said she has had the injections and currently uses minoxidil, spironolactone, and Nutrafol. 
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