Many patients with Graves’ disease experience hair loss, and while this might not be the most concerning symptom someone with this condition has, it is still very distressing for many people. This is especially true since Graves’ disease (as well as most other autoimmune conditions) is more common in women, and I can tell you that over the years I have worked with many women with Graves’ disease who were stressed out the most over their hair loss. I’ve written other blog posts and articles on hair loss, but I wanted to put together an updated post that focuses on Graves’ disease and hair loss, because while I do see hair loss in people with hypothyroidism and Hashimoto’s thyroiditis, it is more common in those with hyperthyroid conditions.
When I begin working with someone who has Graves’ disease, of course I want to address the underlying cause of their condition, but initially I want to make sure the person is safe since it’s quite common to have an elevated resting heart rate. Many endocrinologists [1] will try to lower the person’s resting heart rate through the use of antithyroid medication [2] (i.e. methimazole, PTU) and/or beta blockers [3] (i.e. propranolol, atenolol). Natural antithyroid agents such as bugleweed [4] and high doses of L-carnitine are also an option to lower the thyroid hormone levels, while herbs such as motherwort and hawthorn can act as natural beta blockers.
It’s worth mentioning that sometimes taking antithyroid medication or herbs will help to decrease the person’s hair loss, while other times the person will experience more hair loss upon taking these. I’ll talk more about this later in this post, but before we specifically discuss Graves’ disease and hair loss I want to make sure you have taken the necessary steps to start lowering your thyroid hormone levels. So if you have uncontrolled hyperthyroidism then this needs to be addressed first.
Why Do People With Graves’ Disease Commonly Experience Hair Loss?
The main reason why people with Graves’ disease experience hair loss is due to the thyroid hormone imbalance. While either high or low thyroid hormone levels can result in hair loss, as I mentioned earlier, it seems that high thyroid hormone levels more commonly result in hair loss. Based on what I just said here, it might seem obvious that in order to stop the hair loss you simply need to lower the thyroid hormone levels. While normalizing the thyroid hormone levels will usually cause the hair loss to stop, it frequently will take a good amount of time for this to happen.
The Impact of Antithyroid Medication and Herbs on Hair Loss
I’ll add that taking antithyroid medication such as methimazole or PTU can either improve or exacerbate the hair loss. I’ve worked with Graves’ disease patients who took methimazole and had an improvement in their hair loss, while others had their hair loss worsen upon taking antithyroid medication. Some people with Graves’ disease don’t experience any hair loss until they start taking antithyroid medication. Frequently what happens is that the person takes too high of a dosage of methimazole, which can make them hypothyroid, and this can also cause hair loss.
Bugleweed is an antithyroid herb that can also help to lower thyroid hormone levels. Because this herb isn’t as potent as antithyroid medication it’s less likely to cause a huge “swing” in thyroid hormone levels over a short period of time. As a result, taking bugleweed usually doesn’t cause hair loss as much as antithyroid medication does, although you also need to keep in mind that bugleweed isn’t effective in everyone with hyperthyroidism. In other words, taking bugleweed doesn’t always lower thyroid hormone levels. Antithyroid medication is more effective, but there is also a greater risk of side effects.
As I’m sure you know, antithyroid drugs and herbs don’t do anything to address the cause of the problem, and so while they might help with hair loss by lowering the thyroid hormone levels, it’s still important to address the underlying cause of the condition. In other words, if all you do is take antithyroid medication or herbs, this might temporarily help with hair loss associated with Graves’ disease, but once you stop taking these thyroid hormone-lowering agents the hyperthyroidism is likely to return, along with the hair loss.
What Are Other Causes of Hair Loss?
Although elevated thyroid hormone levels are the most common cause of hair loss in people with Graves’ disease, this doesn’t mean that there can’t be other causes as well. Let’s look at some of the other common causes of hair loss in people with Graves’ disease:
- Nutrient deficiencies. Nutrient deficiencies are common in those with Graves’ disease, and nutrient deficiencies can cause hair loss in general. In fact, many people who are suffering from hair loss will take nutritional supplements on their own to see if they will help. Some of the nutrient deficiencies that can cause or contribute to hair loss include zinc, iron, selenium [5], biotin, and gamma-linolenic acid (1) [6]. When looking to address nutrient deficiencies, it’s important to look into factors that can cause these deficiencies. Remember that Graves’ disease is an autoimmune condition, and since most of the immune system cells are located within the gastrointestinal tract, having a healthy gut is necessary for optimal immune system health. But many people with Graves’ disease have an unhealthy gut, which in turn can affect nutrient absorption. For example, H. pylori is a potential trigger of Graves’ disease, and numerous studies show that H. pylori can affect iron absorption (2) [7] (3) [8], which can result in hair loss. Other causes of malabsorption (i.e. Celiac disease [9], inflammatory bowel disease) can also affect the absorption of nutrients that play a role in hair loss. It’s also important to mention that overdosing with certain nutrients can cause hair loss. This includes selenium, vitamin E, and vitamin A (4) [10]. So while it’s important to correct nutrient deficiencies, you want to make sure not to take very high doses of certain nutrients, especially over a prolonged period of time, as this can lead to a toxicity that results in hair loss.
- Sex hormone imbalances. Imbalances of the sex hormones (estrogen, progesterone, testosterone) can cause hair loss. Elevated thyroid hormone levels will commonly cause sex hormone imbalances. Frequently correcting the hyperthyroidism will resolve the sex hormone imbalance, although sometimes additional action will be required to balance the hormones.
- Alopecia areata [11]. Alopecia areata is an autoimmune condition that causes hair loss on the scalp, face, and sometimes on other areas of the body. A 2018 study showed that alopecia areata is significantly associated with Graves’ disease and Hashimoto’s thyroiditis (5) [12]. However, it’s important to mention that frequently alopecia areata will develop first, many times in childhood, although it’s also possible for thyroid autoimmunity to precede alopecia areata.
Please keep in mind that it’s very possible for those with Graves’ disease to have more than one factor causing hair loss. For example, while hyperthyroidism is the most likely cause, the person might also have nutrient deficiencies that are a factor. In this situation not only will the thyroid hormone levels need to be balanced, but the nutrient deficiencies need to be addressed as well. As I mentioned earlier, if someone has hyperthyroidism that leads to sex hormone imbalances, lowering the thyroid hormone levels may resolve the sex hormone imbalances, although this isn’t always the case.
Can Diet Alone Help With Hair Loss?
I mentioned how nutrient deficiencies are a potential cause of hair loss. Because of this you may wonder if eating a nutrient dense diet can correct such nutrient deficiencies, and thus resolve the hair loss problem. Although it’s important to eat nutrient dense foods, many times supplementation is necessary to correct nutritional deficiencies, and then once this has been accomplished the goal should be to maintain healthy nutritional levels through diet (although I’ll add that sometimes supplementation is still necessary). Just remember that having a healthy gut is necessary for the optimal absorption of nutrients.
How Long Does It Take To Reverse Hair Loss?
As for how long it takes to reverse hair loss, this of course depends on the person, as well as the cause of the hair loss. If hyperthyroidism is the sole cause of the person’s hair loss it can take a few weeks to a few months before the hair loss stops. The same thing applies to sex hormone imbalances. Moderate to severe nutrient deficiencies will take time to correct, and so if this is responsible for the hair loss then it will usually take longer for the hair loss to stop and grow back. Based on what I’ve said here, while some people start noticing their hair loss improving within a few weeks of taking measures to correct their hyperthyroidism, for some people it will take a few months before they notice a significant improvement.
What Can You Do To Help With Graves’ Disease Hair Loss?
After reading this post you probably have a pretty good idea what you can do to help with your hair loss, but I’ll list them below in bullet point format:
- Correct the hyperthyroidism. This is the most common cause of hair loss in those with Graves’ disease, but of course even if someone isn’t experiencing hair loss it’s important to lower the thyroid hormone levels.
- Balance the sex hormones. Once again, correcting the hyperthyroidism many times will help to balance the sex hormones. But when this isn’t the case you might need to do other things. One thing I didn’t mention earlier when discussing sex hormones is that having healthy adrenals is important in order to have healthy sex hormones. And many people with Graves’ disease have adrenal problems. So while many doctors will resort to giving bioidentical hormones to their patients with sex hormone imbalances, evaluating the adrenals is a good first step before doing this.
- Correct nutrient deficiencies. I’ve also discussed how many people with Graves’ disease have nutrient deficiencies, and certain nutrient deficiencies can cause hair loss. I also explained how it’s important to address the cause of the nutrient deficiencies, and how overdosing with selenium, vitamin A, and/or vitamin E can cause hair loss.
What’s Your Experience With Hair Loss?
If you have Graves’ disease and have dealt with hair loss please feel free to share your experience in the comments section below. Are you still experiencing hair loss, and if not, how long did it take for your hair loss to stop and grow back? If you took antithyroid medication, did this improve or worsen your hair loss? Did you take any nutritional supplements, or do anything else naturally that helped? Thank you so much for sharing your experience with everyone.