Hair Loss: Underlying Causes of Hair Loss in Women

One of the more common complaints in my office is that of women suffering hair loss, also called alopecia. Women often report they notice more hair in the drain after showering or in the hair brush and while there is a normal amount of hair that can be expected to be lost in a day, an increase beyond the norm, warrants deeper investigation.

Our hair, skin and nails are often the first clue to health issues that might be stemming from a deeper level. Naturally as we age, the rate of new hair growth slows, while the rate of hair loss stays the same or can be accelerated by nutritional deficiencies, hormone imbalances, toxicities, other underlying pathologies or medications. Hair follicles on the scalp range in number between 100,00-350,000 and are continually undergoing phases of growth and rest. When hair follicles stop producing new hair we investigate the 2 main subsets for the cause of hair loss, focal hair loss and diffuse hair loss.

Diffuse Hair Loss

This type of hair loss is usually due to an acute change in hormones, medication or hormonal stress as this causes all of the hair follicles to cease to regenerate new hair at the same time. Diffuse hair loss can also be associated with extreme stress on the body. Individuals can lose hair from their scalp and body (alopecia totalis.) Post-chemotherapy hair loss is a classic example of diffuse hair loss due to a medication. Diffuse hair loss usually resolves after the offending medication or stress has been resolved.

Focal Hair Loss

This type of hair loss often occurs secondarily to an underlying pathology that can cause hair to fall out in patches or in specific areas on the scalp like on the sides or top of the scalp. Causes of this type of hair loss range from hormonal imbalances, traction (from having hair pulled back too tightly with an elastic) to a topical fungal infection of the scalp disrupting the ability for the hair to grow. Focal hair loss can also be due to an autoimmune condition, thyroid disorder or nutritional deficiency.


Hair loss or thinning hair is a common sign of hypothyroidism, or tired thyroid. The thyroid gland manages metabolism and sets the pace at which hair is regenerated. When thyroid hormone is not adequate, changes in hair health can be one of the indicating signs there could be an imbalance. With rates of hypothyroidism among women in the United States are estimated as high as 20%, it should be something you ask your doctor to test at least at each annual physical examination.


Our hair requires specific nutrients to grow strong. We are what we eat, or in some cases, what we don’t eat. From lack of specific vitamins and minerals to inability to absorb nutrients in the digestive tract, there are several reasons why nutrition could be the cause of hair loss. Specific nutrients know to support hair strength and quality include zinc, omega 3-fatty acids, Vitamin A and iron. It is recommended you speak with your health care provider about having these nutrients tested to assess baseline and to determine the amount to supplement. While conditions like hair loss often require supplementation, you can always increase your food intake of these hair supporting nutrients. Pumpkin seeds contain high concentrations of zinc, omega 3-fatty acids are notably in fatty fish like salmon but also in flax and chia seeds, vitamin A can be found in vegetables like sweet potatoes, carrots and kale and iron foods include red meat and dark leafy greens. While waiting for labs and other assessments to come back, increasing these hair supportive nutrients it is a good place to start!

Androgen related hair-loss

Similar to male pattern hair loss, women can suffer from hormonal hair loss too. Genetic factors often play a role in ones susceptibility to this type of hair loss. Women who have other hormonal conditions like PCOS or Poly Cystic Ovarian Syndrome, already have a higher amount of testosterone hormone in circulation which increases the risk of androgen related hair loss. There are steps you can take to reduce the amount of excess testosterone in the body by enhancing the detoxification of testosterone. This can be done by increasing liver detoxification supportive foods high in Sulphur like brussels sprouts, cabbage, cauliflower, and broccoli. There are also specific vitamins and herbs that can be supplemented to increase the detoxification of higher testosterone levels.


Celiac disease, an autoimmune condition driven by eating gluten containing foods causing an inflammatory attack of the hair follicles, thereby causing hair loss. Testing for celiac disease is recommended if you have been eating gluten in your diet to see if this could be the cause of hair loss. Reducing grains in the diet and focusing on a more vegetable filled diet is recommended for general health and can improve hair in the process. It should be noted that not all celiac patients have hair loss, but can be a contributing cause.


Your digestive tract is the window to health in the rest of the body, including your hair health. If you often feel bloated and gassy or have changeable bowel habits, there could be an underlying imbalance in your ability to breakdown and absorb nutrients. Beyond celiac disease, food intolerances, history of antibiotic use and stress can also lead to an imbalanced digestive tract. Digestive analysis, food intolerance testing and diet modifications can be helpful in pinpointing malabsorption issues.

While it might seem vein to be concerned about your hair health, it can tell us about deeper health issues that may be below the surface. Additionally, studies have shown that women who suffer from hair loss have increased anxiety and depression and psychological stress. Increasing the health of your hair improves your overall health inside out, so make your hair a priority!

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