Is Hair Loss Reversible?

Hair loss or thinning is mentioned by many of my patients, whether they are dealing with recent hair fall or hair fall in the past that never really grew back.

It is normal to lose about 100 hairs a day and it is normal to see hair changes with hormonal shifts like during pregnancy.

In women in general, hair fall tends to start at the top-back then moves to the top/middle, then the front.

Each of our hair follicles are in 1 of 3 phases at any given time:

• Anagen Phase (2-7 years) - hair growth 1 cm per month (80-90% of follicles are here)

• Catogen (2-3 weeks) – hair stops growing

• Telogen (3 months) - resting phase

• Exogen - old hair falls out and new hair pushes out (hair loss then baby hairs)

Why Does Hair Fall Out?

ROOT CAUSE #1 - STRESS

• Hair loss is not critical for survival; this is why it shuts down during stress 

• Hair loss may not be noted until 2-4 months after the event that caused the problem

• High cortisol inhibits the anagen (growing) phase. It also causes the telogen phase to become longer. This is called Telogen Effluvium.

• Hair follicles have their own peripheral HPA axis – even though the majority of cortisol is made in the adrenal glands, the hair follicle makes its own cortisol!

• "Stress" includes: chronic or acute illness (hypothyroid, diabetes, infection, stress, elevated mast cells, mold, etc.), pregnancy/childbirth, nutrient deficiency, mental/emotional/physical stress, inflammation in scalp/follicle, high prolactin, disordered eating, sudden and extreme diet changes, major surgery, certain medications and illicit drug use.

ROOT CAUSE #2 – ELEVATED ANDROGENS

• In Androgenic Alopecia, elevated androgens (testosterone) binds to the androgen receptor (AR)

• Hair follicles also make their own local androgens – this means that you can have normal testosterone levels on your bloodwork but have elevated levels at the hair follicle!

• DHT is a potent type of testosterone (5-8x more potent that testosterone) that can also cause female pattern baldness. It bind to the AR and causes miniaturization of the hair follicle – it shrinks, resulting in smaller finer hairs

• When 5a-reductase enzyme activity is high, then more DHT is produced

• Causes for high 5a-reductase enzyme activity – inflammation in the scalp (fungal infections like tinea capitis, dermatitis, chemicals in hair products), elevated insulin in PCOS, high levels of triglycerides, obesity, genetic variations

• Conventional treatments include Spironolactone (anti-androgen) and Anastrozole (5a-reductase inhibitor) - the issue with these is they have side effects such as depression, chronic fatigue and muscle atrophy

ROOT CAUSE #3 - AUTOIMMUNE

• In Alopecia Areata/Totalis, an autoimmune reaction occurs at the follicle, caused by viruses, mold, bacteria or elevated mast cell reactions

• Alopecia Areata is hair fall in patches whereas Alopecia Totalis is the advanced form where there is complete hair loss on the scalp

• It is associated with autoimmune conditions such as Celiac disease, Rheumatoid arthritis, Grave’s disease, Hashimoto’s, Lupus and Diabetes Type 1

ROOT CAUSE #3 – NUTRIENT DEFICIENCIES

• Iron deficiency is particularly common in women with hair loss due to heavy menstruation. Studies show that iron deficiency may impact both hair structure and hair growth, with acute telogen effluvium being a well-known effect of nutritional deficiency.

• Ferritin should be at least 50, if not 80-100 to be optimal for hair regrowth

• It is well known that B12, copper, zinc and biotin are essential to hair growth.

• B12 levels are optimal between 600-800

• Protein contains amino acids, which are the building blocks of hair. L-carnitine and Taurine are 2 amino acids that have been shown in studies to stimulate follicle growth and reduce cell death.

• Protein amount in grams is optimal between 90-120g per day

You may have some suspicion as to why you are experiencing hair loss.

Realistically, it can take as long as 1-3 months to start seeing new hair growth, and 2-6 months to start noticing thicker, fuller hair. Because it takes so long to see results, I believe it's vital to ensure you are aware of the root cause(s), so that you see faster and long-lasting results.

Here are some basics anyone with hair loss should do:

• Ensure a whole foods diet free of processed/packaged foods

• Consider a B Complex, Multivitamin and Protein supplement

• Get basic bloodwork done to rule out nutrient deficiencies - iron should not be supplemented if there is no known iron deficiency

• Stress management techniques such as deep breathing, epsom salt baths, and 7-8 hours of good quality sleep

• Switch to natural hair products, free of chemicals that destroy the scalp microbiome

• Scalp stimulation such as scalp massage with rosemary essential oil (in a carrier oil)

If you are struggling with hair loss, I am happy to guide you further! Let's chat in a 15-minute complimentary Discovery Call.

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Disclaimer: All content in this blog is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.