Hair loss is one of the most frustrating symptoms many of my patients with thyroid and autoimmune thyroid conditions experience. This is a problem with both hypothyroid and hyperthyroid conditions, and sometimes the hair loss can be very severe. In fact, it’s not uncommon for the patient to be most concerned about the hair loss, even if they are experiencing numerous other symptoms. As a result, many people who experience hair loss want to know what they can do to quickly stop this, and of course get their hair to grow back.
The good news is that most cases of thyroid hair loss are reversible. In other words, the hair loss will usually stop and eventually grow back. The bad news is that it can take a good amount of time for this to happen. When hair loss is a result of a thyroid hormone imbalance you would figure that the hair would stop falling out once the thyroid hormone levels have normalized. But unfortunately this usually isn’t the case, as while everyone is different, it commonly takes a number of months after the thyroid hormones have normalized for the hair loss to stop.
This understandably can be very stressful and frustrating, as someone might have normal thyroid function tests for a few months and still be experiencing hair loss. I receive emails all of the time from my patients asking when the hair loss will stop, and if there is anything they can take to slow it down and/or help it to grow back. Although there are supplements which can help with some cases of hair loss, in most cases these won’t help much if the cause of the hair loss is the thyroid hormone imbalance. In other words, if the main cause of your hair loss is the thyroid hormone fluctuations, then not surprisingly, addressing this problem is the best approach.
Other Factors Which Can Cause Hair Loss In Thyroid Patients
Although in most people with thyroid and autoimmune thyroid conditions the hair loss is a result of the thyroid hormone imbalance, there can be other factors which cause hair loss. So let’s go ahead and look at some of these other causes.
Nutrient Deficiencies. 30% of women before the age of 50 have hair loss due to some type of nutritional deficiency, with depleted iron stores being the most common cause (1) . A suboptimal intake of the amino acid lysine can also be a factor (1) . Getting back to iron, in women with hair loss, a ferritin level of 70 mcg/L is recommended (2) . However, keep in mind that ferritin can elevate due to inflammation, and so one can’t rely on the ferritin alone to determine the iron status. In addition to iron and lysine, a few studies have shown that a zinc deficiency can play a key role in hair loss (3)  (4) . A biotin deficiency can also result in hair loss (5) . Many women take evening primrose oil to help with hair loss, as this has gamma linolenic acid (as does borage oil and black currant seed oil), and supposedly a deficiency of GLA can be a factor in some cases of hair loss, although I wasn’t able to find any research studies confirming this.
Other Hormone Imbalances. In addition to having hyperthyroidism or hypothyroidism, other hormone imbalances can result in hair loss. One study showed that a low estrogen to androgen ratio (ratio of estradiol to free testosterone) might be responsible for triggering hair loss in women (6) . Problems with the estrogen and progesterone receptors can also be a factor in some people (7) . High levels of androgens in postmenopause can result in hair loss (8)  (9) . High levels of prolactin can also cause hair loss (10) .
Stress. There is evidence that neurohormones, neurotransmitters, and pro-inflammatory cytokines released during the stress response may also significantly influence the hair cycle (11)  (12)  (13) . In addition, acute emotional stress may cause alopecia areata by activating corticotropin-releasing hormone receptors around the hair follicles, leading to intense local inflammation (14) . This isn’t to suggest that most people with thyroid and autoimmune thyroid conditions have hair loss due to stress, although since many people with these conditions deal with a lot of stress this shouldn’t be overlooked. Plus, there is also the possibility that the thyroid hormone imbalance is what initially causes the hair loss in some people, but the increased anxiety and stress due to the hair loss is a contributing factor. In other words, even when the thyroid hormone imbalance or another factor causes the hair loss, the anxiety and stress associated with the hair loss might worsen the problem in some people.
Drugs and Other Toxic Agents. Taking certain medications can also lead to hair loss (15)  (16) . This usually isn’t the reason behind hair loss in most of my patients, although during those rare cases when drugs are causing hair loss, it is almost always reversible by stopping the medication. Many patients with hyperthyroidism and Graves’ Disease take beta blockers such as Propranolol and Metoprolol, and these also have the potential to increase hair loss in some people (17) . I wasn’t able to find studies showing that environmental toxins such as heavy metals or xenoestrogens can cause hair loss, but it wouldn’t be shocking if these were factors.
How Can One Determine The Cause Of The Hair Loss?
If someone has been dealing with a thyroid or autoimmune thyroid condition then there is a pretty good chance that this is what’s responsible for the hair loss. However, there is always a chance that one or more of the other factors I discussed can be responsible for the hair loss, or at least be a contributing factor. For example, someone could have had a nutrient deficiency or a sex hormone imbalance which directly or indirectly caused the thyroid or autoimmune thyroid condition. In this case it might be necessary to correct all of these imbalances in order to completely stop the hair loss.
Obviously one can also do some additional testing to see if someone has an imbalance of the sex hormones, test some of the nutrients (i.e. conduct an iron panel), and/or run an adrenal panel to see if someone has imbalances in cortisol and/or DHEA. But even if someone has one or more of these other imbalances it doesn’t necessarily mean these are responsible for the hair loss. However, if someone does have a nutrient deficiency or a hormone imbalance, even if these aren’t the causes of the hair loss it of course still would be a good idea to correct these imbalances.
Can You Just Take Some Supplements To See If It Will Help?
It’s very common for people to take some supplements and see if this will help with their hair loss. If the hair loss is due to a thyroid hormone imbalance then taking supplements probably won’t help that much. However, taking certain nutrients such as biotin, evening primrose oil, and low doses of zinc for a month or two usually won’t cause any problems, even if someone doesn’t have a deficiency in these nutrients. On the other hand, taking iron supplements can be problematic if someone doesn’t have an iron deficiency.
I’m fine with most patients taking some nutrients such as biotin, zinc, and a form of GLA. But many times this won’t have much of an impact with regards to hair loss. There is also evidence that peppermint oil can help with hair growth (18) . But in most cases, correcting the thyroid hormone imbalances and then waiting a few months for the hair to normalize is the best option, although I definitely would recommend getting an iron panel as well. While incorporating stress management techniques might not help much, it definitely won’t hurt, and most people can benefit from improving their stress handling skills.
In summary, hair loss is very common with both hypothyroid and hyperthyroid conditions. Although most cases of thyroid hair loss are reversible, it can take some time for the hair loss to stop and grow back. In addition to having a thyroid hormone imbalance, some other factors which can cause hair loss include nutrient deficiencies (i.e. iron, zinc, biotin, GLA), other hormone imbalances, stress, as well as drugs and other toxic agents. Please feel free to share your experience with hair loss in the comment section below.