26 Reasons why you're losing hair & how to prevent hair fall
Let's face it: from an evolutionary standpoint, hair is pretty much useless for modern humans. Regardless, the hair on a person's head is central to their perception of youth, vitality, and sexuality. This is even more true for women because of the way society has molded our idea of beauty. According to one study, 28% of men and 52% of women who suffer from hair loss felt "very upset" by it.
In other words, hair plays an important role in determining our self-image, social standing, and psychosocial functioning. Unfortunately, 25% of women and 45% of men will suffer from some degree of hair loss or alopecia (baldness) by the time they turn 50. Therefore, identifying the reasons for hair loss and acting to prevent it is of major concern to many.
All of the hair on your scalp is in one of two phases: a growing or anagen phase, and a resting or telogen phase. Each strand of hair usually goes through a five-year cycle of growth and rest before being shed, after which the process is repeated. In a healthy human, around 90% of the hair is in the anagen phase, and 10% in the telogen phase.
A healthy individual sheds up to 125 strands of hair a day, so hair loss is clinically defined as losing in excess of this number or a lack of regrowth. The four major types of hair loss, starting from the most common to the least, are male pattern baldness, female pattern baldness or androgenetic alopecia, telogen effluvium, and alopecia areata (bald patches caused due to an autoimmune disorder). The diagnosis and treatment of female pattern baldness or androgenetic alopecia have been covered in detail in our first blog post on hair loss. Telogen effluvium and alopecia treatments have similarly been discussed in another article.
In this particular post, we'll list out the various causes of hair fall and quick tips to avoid them. In general, the causes can be grouped into nutrition-related factors (deficiencies or excesses), internal factors (genetics, hormones, and so on), side-effects of medication and environmental factors such as stress and lifestyle.
An unhealthy diet can lead to many nutrient deficiencies, which will eventually cause hair breakage and hair fall. Nutrient deficiencies linked to hair loss include iron, zinc, biotin (vitamin B7), vitamin D, niacin (vitamin B3), and others. The good news is that all of the telogen effluvium that occurs through nutrient deficiencies can be fully reversed through a healthy diet and daily supplementation. Let's take a quick look at each of these specific nutrients.
2. Iron Deficiency
Iron is critical to the formation and healthy functioning of red blood cells. Common causes of iron deficiency among women include menstrual blood loss and pregnancy. In men, causes can vary from gastrointestinal blood loss to malabsorption. Moreover, following certain diets such as a vegan and vegetarian regimen can increase the risk of iron deficiency in both women and men.
Some studies suggest that iron deficiency may be associated with certain kinds of hair loss. A review published in the Journal of the American Academy of Dermatology states that iron is an important mineral for DNA production, and goes on to suggest that a deficiency in iron could result in inadequate levels of important enzymes that regrow hair.
To prevent iron deficiency, make iron-rich foods a regular part of your diet. Eggs, beans, spinach, Swiss chard leaves, cabbage, broccoli, and kale should be eaten daily. However, be wary of excessive iron consumption, as that has its own complications. A good way to get the correct dose is to take an iron supplement every day.
3. Zinc Deficiency
Research has shown that zinc plays an essential role in the health of our hair. Zinc is needed to synthesize proteins that play a critical part in the hair growth cycle. A deficiency in zinc reduces the ability to regrow hair, leading to hair loss.
Followers of plant-based diets, breastfeeding women, regular alcohol consumers, and people with poor diets are at increased risk of zinc deficiency. A study published in the Annals of Dermatology compared zinc blood levels of 312 subjects suffering from various hair loss diseases, and found that they had significantly lower zinc levels compared to a healthy control group.
The importance of avoiding a zinc deficiency cannot be understated, which is why a daily supplement is vital to maintaining the health of your hair. You can also include zinc-rich foods such as nuts, lentils, hemp seeds, oysters, oatmeal, chicken, mushrooms, yogurt, and tofu in your diet regime.
4. Niacin (Vitamin B3) Deficiency
It's well known amongst medical researchers that a niacin deficiency has hair loss among its many symptoms. Niacin or vitamin B3 converts carbohydrates into glucose and metabolizes dietary fats and proteins. As niacin is best found in meats and fish such as turkey and tuna, vegetarians and vegans are at a higher risk of scarcity. Crohn's disease also increases the risk of a vitamin B3 shortage. The best way to get the right dose of this and other essential B vitamins is through a daily supplement.
5. Selenium Deficiency
Selenium is an essential trace element that has several benefits for the body, including thyroid hormone metabolism, DNA synthesis, and protection of oxidative stress. Some specialists state that the hair and skin may lose their coloring in selenium-deficient states. Moreover, thyroid abnormalities have been conclusively linked to hair loss.
Selenium deficiency is relatively rare, but an increased risk can be found in those who are undergoing dialysis treatment, diagnosed with HIV or have a gastrointestinal disorder. To obtain selenium, your diet should consist of onions, meat, mushrooms, sunflower seeds, fish, Brazil nuts, poultry, grains, shellfish, and eggs. However, avoid ingesting more than 55 mcg of selenium a day, as an overdose can actually lead to increased hair loss.
6. Vitamin D3 Deficiency
Vitamin D commonly referred to as the "sunshine vitamin", plays a key role in maintaining hair health. In a 2013 study, vitamin D3 blood levels were compared between women with telogen effluvium and healthy females. The results showed that subjects with hair loss had significantly lower vitamin D3 levels. The mechanism behind vitamin D's function in hair regrowth continues to be researched, with strong links demonstrated in animal studies.
The best way to generate vitamin D in the body is daily exposure to the morning or evening sun for 20 minutes. Foods such as swordfish, whitefish, mackerel, maitake and portabella mushrooms, eel, salmon, and halibut are rich in vitamin D3 and should also be consumed regularly. Since this might not be a practical option for many people, especially vegetarians and vegans, a vitamin D3 daily supplement is recommended instead.
7. Biotin (Vitamin B7) Deficiency
Biotin, a part of the vitamin B complex, is different in that it can be synthesized in the gut. The water-soluble vitamin B7 performs a range of important roles in the body. The European Food Standard Agency (EFSA) has stated that a daily dietary intake of biotin "contributes to the maintenance of normal hair". A review assessing the impacts of biotin deficiency, published in the Seminars of Dermatology, supports the link between biotin inadequacy and alopecia.
To prevent this, a vitamin B-complex supplement should be taken daily. Alternatively, include foods such as eggs, chicken, avocado, legumes, potatoes, and nuts as a regular part of your diet. Furthermore, avoid eating raw or uncooked egg whites, since they impair the absorption of biotin.
8. Amino Acids & Protein Deficiency
Amino acids are the building blocks of proteins, which are required for creating and repairing muscle tissue. Moreover, proteins are also important for maintaining healthy hair. Since protein is a major constituent of hair fibers, reduced protein intake can impair hair growth. Dietary and lifestyle factors that increase the risks of protein deficiency include depression, anorexia, chronic illness anemia, and malnutrition.
Beans, nuts, poultry, seafood, quinoa, soy, eggs, and dairy products are good sources for proteins. However, only quinoa and soy provide all of the essential amino acids among plant-based sources, so vegans should support their diet with a nutritional supplement.
9. Vitamin A Overdose
Vitamin A provides many benefits to the body, including maintaining a healthy skin and promoting iron absorption. However, an excess of vitamin A can have adverse effects on health, including hair loss. Medical professionals state that the recommended dietary intake of 900 mcg and 700 mcg for men and women respectively should not be exceeded.
10. Vitamin E Overdose
Vitamin E functions as a powerful antioxidant, protecting cells from oxidative stress. However, it can also have harmful effects when consumed in excess. Signs and symptoms of vitamin E toxicity include an increased risk of bleeding, decreased thyroid production, and a possible adverse effect on hair growth. Therefore, the daily supplementary allowance of 15 mg for adults should not be exceeded.
Women are prone to anemia (a low red blood cell count), especially those who suffer from prolonged or heavy menstrual bleeding. The condition is known as menorrhagia, which can lead to hair loss due to iron-deficiency anemia. Causes of menorrhagia can derive from hormonal imbalances, dysfunction of the ovaries, polyps, and medications such as anti-inflammatory and hormonal drugs.
Foods that help prevent anemia include soybeans, spinach, whole grain bread, eggs, beets, honey, peanut butter, and nuts. A daily iron supplement is also a good option.
Malabsorption is clinically defined as an impairment in the absorption capacity of the digestive system. This leads to an inability to metabolize certain nutrients, thus leading to a deficiency. Signs and symptoms of malabsorption include bloating, chronic fatigue, diarrhea, weight loss, and scaly skin rashes. Conditions associated with malabsorption include cystic fibrosis, celiac disease, and Crohn's disease.
Natural herbs such as alfalfa dandelion root, horehound, fennel seeds, ginger, nettle, aloe vera, peppermint, goldenseal, buchu, yellow dock, Irish moss, and rhubarb all help various parts of the digestive system function to its optimal ability. Alternatively, Probiotic and Milk Thistle supplements will do wonders to aid your digestive functioning.
13. Kidney Dysfunction
The kidneys play a vital role in maintaining good health, including hair growth. A study that looked at nutrient deficiencies in people with impaired kidney function found that they had reduced levels of essential elements such as zinc. Researchers put this down to a disturbance in the process of renal excretion, among other reasons. Thus, they concluded that kidney damage can lead to the malabsorption of minerals such as Zinc that is vital for healthy hair.
A poor diet, obesity, and smoking have been conclusively linked to an increased risk of kidney disease. The best way to prevent kidney damage is to drink plenty of water and urinate at least once every 3 hours. In addition, cut down on sodium (salt), soda beverages, sugar, red meat, and processed foods such as potato wafers and cheese spreads.
14. Hypothyroidism & Hyperthyroidism
The thyroid gland is a part of the endocrine system, which affects many critical functions in the body. The main thyroid hormones are T3 and T4, which help regulate metabolism, core temperature, and heart rate. Insufficient thyroid production, known as hypothyroidism, can lead to weight gain and fatigue, whereas people who suffer from excessive thyroid production (hyperthyroidism) may show symptoms of weight loss and nervousness. Moreover, the International Journal of Trichology states: "it is a well-established fact that endocrine disorders such as hypothyroidism and hyperthyroidism can cause hair loss". This is attributed to the essential role that the thyroid hormone plays in the development and maintenance of the hair follicle (a tiny sac under the skin in which a single hair strand grows).
Seaweeds such as nori, kombu, and kelp are rich sources of iodine and good for treating hypothyroidism. On the other hand, cruciferous vegetables such as cabbage, cauliflower, Brussels sprouts, kale, and broccoli should not be consumed raw, since they contain chemicals called goitrogens that disrupt thyroid production. It's easy to detect thyroid problems through a simple blood test though, and your physician can prescribe various treatment options that will restore the balance and regenerate lost hair.
15. Hormonal Imbalance Due To Pregnancy & Contraceptive Pills
Pregnancy is a highly stressful period, both emotionally and physically. The requirements for essential nutrients such as iron, folate, and zinc increase during pregnancy to ensure the optimal health for you and your baby. Even if nutrition is not the issue, 40-50% of women may experience hair loss during pregnancy. A scientific review suggested that hair loss during pregnancy could be a result of hormonal imbalances that occur up until the time of delivery.
Several women find that they may suffer an acute case of telogen effluvium immediately after pregnancy, or as a side effect of discontinuing birth control pills. In these cases, the hair loss will automatically stop once the body adjusts to the new conditions. Note that it may take up to three months for the telogen effluvium to start after the change in hormone levels has been triggered, and another three months before fresh growth occurs to replace the loss. Hence, it's important not to press the panic button as soon as you observe increased hair fall in these cases.
One study found that thyme oil applied to the abdomen on women may reduce hormonal imbalances by boosting the production of progesterone. However, this is far from clinching evidence, so check with your physician first.
Signs of hair thinning and hair loss are common as we age. In fact, 25% of women experience significant hair thinning by the time they reach 50 years. In rare cases, this form of hair loss can occur from as early as 12 years. The condition is clinically called male or female pattern hair loss. While the disorder has not been fully understood, it is mostly ascribed to hereditary reasons. Alternatively, an excess of male sex hormones (androgens) in women can also lead to hair loss, and this condition is called androgenetic alopecia.
The most common drug used to treat male or female pattern baldness is minoxidil. However, one study showed that rosemary oil played a similar role in preventing hair loss, but without any of the side-effects caused by minoxidil. Androgenetic alopecia and its various treatment options have been discussed extensively in a previous blog post.
17. H2 Blockers
H2 blockers are medications used to treat conditions such as heartburn (acid reflux) and stomach ulcers. However, long-term usage of these acid-lowering medications has been shown to negatively affect iron absorption, as it requires an acidic environment in the stomach. Consequently, long-term use of H2 blockers will eventually increase hair loss.
Drinking one ounce of aloe vera juice daily was shown in one study to naturally soothe heartburn, thus reducing the need for H2 blockers. Apple cider vinegar can also reportedly relieve acid reflux in some people, though the evidence is far less convincing. While a daily iron supplement might help address the iron deficiency issue, a regular intake of probiotics and milk thistle will boost digestive ability.
Anti-epileptics are a class of drugs used to treat epileptic seizures. Some medical specialists claim that hair loss can be a side effect of anti-epileptic medication, especially divalproex sodium (brand name Depakote). This is supported by a review article assessing the role of various vitamin deficiencies in patients with epilepsy. The study, published in the International Journal of Pharmacological Research, stated that a biotin deficiency was discovered in patients with epilepsy, attributed to anti-epileptic therapy. Therefore, those who are on therapeutic drugs for epilepsy should consider taking a B-complex supplement to prevent hair loss.
Anti-epileptic drugs can also be complemented with certain supplements. Certain studies have shown that there might exist a link between epileptic seizures and deficiencies of magnesium and vitamin E. Addressing these deficiencies might help in reducing the dosage of the anti-epileptic medication. However, much more research needs to be conducted in this area, so consult your doctor first.
19. Blood Pressure Medications
Anti-hypertensive drugs used to treat high blood pressure can cause hair loss by interfering with the hair growth cycle. An observational study carried out in 2014 found that different types of drugs determined the degree and severity of hair loss, but this was often reversible after withdrawing from the drug and following a healthy diet. As a natural alternative, garlic and chaga mushroom supplements have a proven effect on reducing blood pressure without any side-effects. As a dietary option, sweet potatoes, white beans, kale, broccoli, bananas, avocados, red bell peppers, tilapia, plain yogurt, kiwi fruit, peaches, nectarines, and quinoa can also lower blood pressure.
Prolonged use of antibiotics depletes gut microbiota, leading to a negative effect on digestion, nutrient absorption, and immune response. In particular, nutrient levels of biotin (vitamin B7) and iron are significantly affected. Biotin, an important nutrient for healthy hair, is synthesized by these "good" intestinal bacteria. Therefore, a reduction in the gut microbiome can directly lead to a deficiency in biotin.
The best way to combat this is to boost the intestinal flora by taking a probiotic supplement that has 13 different types of "good" bacteria vital to the healthy functioning of the gut. A daily dose of milk thistle is also beneficial for digestion. Another option is to make fermented foods a major part of your diet. Examples include yogurt, dark chocolate, sourdough bread, beer and wine, pickles, kefir, soft aged cheese, tempeh, green peas, green olives, kimchi, sauerkraut, miso, cottage cheese, natto, kombucha, and beet kvass. Finally, a B-complex supplement will help make up for the deficiency caused due to antibiotics.
21. Alcohol Abuse
Excessive alcohol intake increases the risk of nutrient deficiencies, including zinc and iron. A 2017 study in the European Journal of Nutrition found that alcohol abuse led to decreased zinc levels, which results in hair loss. Limiting alcohol intake and using supplements such as Schisandra, Milk Thistle, and Omega-3 to repair any liver damage is recommended. Alternatively, foods beneficial to the liver, such as cruciferous vegetables, tea, nuts, blueberries, cranberries, grapes, prickly pears, fatty fish, olive oil, coffee, beetroots, and grapefruit should be eaten regularly.
22. Vegan & Vegetarian Diet
Plant-based diets can be healthy for the most part. Studies have shown that long-term vegetarians have significantly lower body fat, cholesterol levels, and oxidative stress. Unfortunately, this comes at the price of an increased risk of hair loss due to deficiencies in iron, zinc, omega-3, and vitamin D. While these vital nutrients are not entirely absent from fruits and vegetables, their bioavailability (usable content) is far lesser than in meat sources. Therefore, nutritional supplements are a great way to make up the deficit, especially for vegans who have even greater dietary restrictions.
Stress causes the body goes into survival mode, discarding unnecessary functions (such as hair growth) in order to conserve energy for critical processes. A study published in the International Journal of Trichology found that male and female pattern hair loss was associated with an overproduction of androgen hormones seen in stressful states.
Since physical and emotional stresses have been identified as triggers for telogen effluvium and hair loss, it makes sense to use supplements and herbs that combat stress, such as vitamin B-complex, magnesium, ashwagandha, Schisandra, Gotu Kola, maca, and probiotics. For more information on how these substances reduce stress levels, refer to our article on telogen effluvium. Foods that reduce anxiety include almonds, seaweed, chocolate, acai berries, blueberries, and whole grains. Also, drink plenty of water to flush out toxins and waste products.
24. Hairstyling Errors
A phenomenon called traction alopecia occurs as a result of frequent pulling of hair strands or using harsh chemicals over several years. This is seen in specific hairstyles where the hair is pulled back or braided. A study of 1178 women published in the Journal of the American Academy of Dermatology found that symptoms of traction alopecia were higher in braided hair as compared to using chemical hair products. Among people of African descent, frequent straightening of the hair worsened the symptoms of traction alopecia.
If you think your hair loss could be caused due to your hairstyle, try using a wide-toothed comb to avoid hair breakage, dry the hair by blotting instead of rubbing, stop using hairsprays, and switch to a milder herbal shampoo that doesn't have synthetic chemical ingredients.
25. Dramatic Weight Loss & Crash Dieting
Weight loss caused by stress, illness, or crash diets can lead to hair loss. Fad diets are popular for their promises of making you thinner. However, they may actually end up being the very reason why you're losing hair. Calorie-restricted diets with a low intake of protein and negative nitrogen balance can lead to the body prioritizing energy production over tissue repair, which negatively impacts the hair growth cycle.
Fortunately, the negative effects of rapid weight loss can be easily reversed through proper nutrition. A study published in the Journal of the American Medical Association found that subjects who experienced telogen effluvium along with rapid weight loss showed signs of hair regrowth with increased protein in their diet. A daily dose of the supplements mentioned in the "Nutritional Causes" section will help ensure that the proper amount of nourishment reaches your hair follicles.
26. Cigarette Smoking
A study conducted on 740 men demonstrated a strong link between cigarette smoking and hair loss. Many factors are involved in the mechanism of hair fall through smoking. Most notably, certain chemicals in cigarettes cause damage to the hair follicle and promote oxidative stress, which leads to inflammation. These processes disrupt the hair growth cycle and lead to telogen effluvium.
The best way to counter this cause is, of course, to stop smoking altogether. Your lungs and heart will thank you for it. In addition, antioxidants will help counter oxidative damage, so daily supplements such as Turmeric, Garlic, Chaga, Reishi, Milk Thistle, and Vitamin C are a good idea. Foods that have plenty of antioxidants include fish, nuts, tea, sweet potatoes, orange vegetables, whole grains, dark green vegetables, beans, dark grapes, red berries, and blueberries.
Hair loss is an intensely researched topic, yet there are many things we still do not know about it. As you can see, its causes are many and varied, with a whole host of interconnected factors. Some causes such as genetics do not have a cure as of yet, while others such as hormonal imbalances or an autoimmune response are difficult to correct and may require lifelong treatment. However, many cases of hair loss or telogen effluvium can be reversed through adopting a healthy diet in combination with daily supplements. Unhealthy lifestyle choices that lead to a worsening of hair quality can be corrected, and their negative effects rectified as well. In general, boosting your dietary intake through supplementation is a convenient way to ensure you get the required nourishment, especially if you are at increased risk of nutrient deficiencies.
Ogunmekan AO, Hwang PA. A randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopheryl acetate (vitamin E) as add-on therapy for epilepsy in children. Epilepsia. 1989 Jan-Feb; 30(1):84-9.