Maybe it’s vanity or psychological, but our emotional relationship with our hair is an undeniably important one. Consider the myriad of life changes that prompt big hair moves like cutting a bob, getting a fringe or a whole new look, such as a big break up or new life phase like becoming a mother. It can be refreshing, and liberating and shifts energy and confidence. 

But anyone who has experienced hair loss for medical, emotional or hormonal reasons can attest, hair is much more than vanity. The power of hair to affect our self-confidence goes both ways.  Our hair relates to and displays our overall health and wellness. Healthy hair is associated with being shiny and full, but in illness, after surgery, or moments of traumatic life changes like when grieving, experiencing burnout, postpartum or menopause, hair loss can be its own kind of trauma. 

Normal Hair Loss 

You probably notice random strands of hair on the floors and surfaces of your home. We shed about 50-100 strands per day. This is normal hair shedding – when hair falls out, more grows back. If that shedding exceeds 125 strands or so per day with less growing back, you have hair loss which may include a visible widening in your hair part, hairline gaps or emerging bald spots. More than 50% of women will experience this during their lifetime. I am one of them.

My Story

In my early thirties, I hit a perfect storm of stress and difficult life events. I was dealing with divorce, starting a business and within a matter of months, lost my best friend and partner, 13-year-old dog and my lifelong mentor and Godmother who was like a mother to me to breast cancer. This mix of grief, anxiety and chronic stress caused me to steadily lose more and more hair. It was sneaky at first, I didn’t quite know if I was imagining it, but a trip to the hairdresser confirmed this stress was changing my hairline significantly. 

5 years later, I experienced hormonal hair loss after a miscarriage, and then almost a year later again,  due to surgery and anaesthesia after completing a round of IVF. The latter was a frightening experience that lasted for months, with increasing patches of scalp appearing and clumps of hair falling every time I washed or brushed my normally thick, healthy and full hair. 

As someone who has experienced significant hair loss due to hormonal, emotional and physical trauma. I dived into the topic to create this overview of what can trigger sudden or prolonged hair loss, when to be concerned and what can be done about it. 

What Triggers Hair Loss and Why 

Women are five to eight times more likely than men to have thyroid problems and subsequent hair loss related to their disorder

There are five different types of hair loss including four types of alopecia but in this article, we are focusing specifically on Telogen effluvium and Alopecia areata, which is often autoimmune or more commonly thyroid related, which affects women more than men. 

Alopecia Areata (AA)

AA are patches of hair loss anywhere on the body, but commonly on the head, caused by an autoimmune disease, often related to thyroid function. Conditions such as psoriasis may also trigger it, however more often for women, thyroid issues. Women are five to eight times more likely than men to have thyroid problems. One in eight will develop a thyroid disorder during her lifetime, such as hyper and hypo hypothyroidism, thyroiditis and Hashimoto’s thyroiditis. 

Traditional medicine often treats AA with corticosteroids, topical immunotherapy, and hair transplant surgery, but a holistic approach includes improving the underlying immune system and addressing possible roots of the autoimmune disease or thyroid problems, which may have to do with nutrient deficiencies. Both conventional and holistic medicine link healing and reducing thyroid symptoms can be supported by lifestyle changes. 

New studies show there is a relationship between AA and low vitamin D levels. Although more evidence is needed, early results also implicate low zinc and iron levels having an impact. If you suspect you may be dealing with this type of hair loss, it is important to seek medical help and if possible, have your thyroid tested. If T3 levels are irregular, which is what doctors test first, insist on testing T4 levels as well, which provides a more accurate picture. 

Telogen effluvium

This type of hair loss is temporary and can occur after a traumatic event, such as surgery, childbirth, or a stressful life event, the type I experienced multiple times. It can also be caused by hormonal changes, nutritional deficiencies, or medication side effects. Telogen effluvium typically causes hair to fall out in clumps or in excessive amounts, but it usually resolves on its own within a few months. Here are the common types of telogen effluvium (TE): 

Emotional and Physical Trauma

We all handle stress differently, and when something feels overwhelming, severe or consists of physical trauma like abuse, injury or surgery, our bodies will process it one way or another. Research has shown that emotional and physical stress can cause an increase in the levels of stress hormones in the body, such as cortisol, which can disrupt the normal hair growth cycle. Additionally, the emotional distress associated with trauma can lead to changes in eating habits, sleep patterns, and overall health, all of which can contribute to hair loss.

The first step if it’s not a singular event like an injury or surgery, is addressing the actual or perceived threat, stressor or loss. Can you reduce, eliminate the severity of what is stressing you or take steps toward doing so? Creating a plan of action and a few first steps in that plan can make you feel more in control of the situation and contain it. If you are dealing with grief or a more pervasive emotional trauma, it may not be so simple. However, acknowledging your loss and your feelings surrounding any of these types of traumas, stressors or losses is an important step. Time does not heal all wounds, but it may give you perspective, grace and allow for some space around it so it’s not taking up so much room in your head, heart and body. Finding someone qualified to support you in the process can be helpful, like a therapist, coach or support group. 

Dietary Changes

Observe your cycle, hormonal changes, hair, sleep patterns, gums and energy levels. Aberrations in these key areas of our health can indicate a diet that isn’t serving you well.

Nutrition plays a crucial role in the health of our hair. Nutritional deficiencies, such as iron, biotin, zinc, vitamins D and E, and under-eating protein can lead to hair loss in women. You may notice signs of deficiency if you have consistently been eating more processed foods, restricting calories or protein too much, too quickly, or eating less nutrient-rich foods. 

Alternatively, seemingly healthy switches like adopting a vegan or plant-based diet for the first time can cause hair loss. You may be unwittingly consuming more processed ingredients and seed oils in plant based spreads, sauces, and meat replacements. 

It’s also possible that if you are eating a whole foods vegan diet and having hair loss, your body doesn’t do as well absorbing plant-based sources of B-vitamins, omegas and vitamin D, for instance, or you are not consuming enough of these nutrients. This isn’t the case for everyone, many people feel great with these dietary changes, but some do not and notice issues like hair loss. 

Anytime you experience hair loss after a dietary change, don’t take it as a sign of “detox” or a “transition period”. Hair loss is something to take note of, your body is telling you it’s under stress or not getting enough of what it needs. Observe your cycle, hormonal changes, hair, sleep patterns, gum health and energy levels. 

Aberrations in these key areas of our health can indicate a diet that isn’t serving you well. Ensure you are maintaining a well-balanced diet and meeting your own needs, this is not a one-size fits all world. Determine what that means for YOU, not the latest fad or your favourite influencer’s “what I eat in a day”. 

As a Holistic Nutritionist, I feel strongly that it’s about whole, natural foods, grown in good soil, and consciously sourced. 

Hair loss and Hormonal Imbalances 

PCOS 

Hormonal imbalances can have a significant impact on our bodies and affect hair loss in women. Particularly the role of androgens, which are male hormones that are also present in smaller amounts in women and commonly imbalanced in women with PCOS and individuals with a genetic predisposition, androgens can bind to hair follicles in the scalp, causing them to miniaturise and shrink over time. This results in progressively thinner and shorter hair, eventually leading to hair loss. Luckily with improving PCOS (see our article here), this is possible to tackle head-on. 

Pregnancy, Miscarriage and Postpartum 

Pregnancy, miscarriage and postpartum can dramatically affect the hair growth cycle, as anyone who has experienced it knows. Many women have increased hair shedding and thinning after giving birth. During pregnancy, increased levels of oestrogen prolong the hair growth phase, resulting in thicker, fuller hair. 

However, after childbirth, oestrogen levels drop, causing the hair to enter the resting phase for longer and shed more than usual, leading to postpartum hair loss. Birth itself is a traumatic event on the body and you can experience similar effects as a new mum as in the section above on Emotional and Physical Trauma. Equally, for many women, miscarriage can induce the same type of hormonal fallout, grief and physical trauma with hair loss being one of the many side effects.  

Around one year postpartum, most women regain their normal hair growth. If your hair does not regain its normal fullness after one year, you may want to see a dermatologist or consult a functional medicine specialist, as birth and postpartum (especially combined with breastfeeding) take a toll on the body and can also result in deficiencies. Rest assured, if no bigger issues are at play, it will grow back! 

Menopause

Menopause can cause hormonal fluctuations contributing to hair loss due to a drop in oestrogen that leads to an imbalance in the male hormone, androgen, similar to during PCOS. Age, genetics, and lifestyle also play a role in menopausal hair loss. Ageing can lead to a decrease in the size and number of hair follicles, resulting in thinner and less dense hair. Genetic predisposition to hair loss can present during menopause, leading to increased hair shedding. Additionally, lifestyle factors such as poor nutrition, stress, and certain medications can contribute to menopausal hair loss.

This is all stressful, and yet stress exacerbates hair loss, and can accelerate menopausal symptoms and severity (ugh). This is definitely the time to adopt a new Zen philosophy, stress management techniques like meditation, breathing exercises, a new movement practice like yoga, weight lifting (especially critical for (peri)menopausal women) and laughter (yes, sounds mental, but it works). Laughter has been shown to reduce anxiety and cortisol immediately. Your hair and health may depend on it!

Dealing with hair loss 

Now that we know when this particular type of hair loss (Alopecia areata and Telogen effluvium) can occur and why, what can we do about it?

First, take a deep breath and let it out. Know that for most of the types of AA and TE hair loss, excluding genetic hair loss, your hair can and most likely will grow back. In the case of illness, deficiency or other underlying issues, it’s often the case that the issues must be addressed first in order for regrowth to occur.  That wider hairline, bald spots, funky hair line and the emotional impact is likely only temporary. From supplements to changing up your diet, experimenting with different scalp treatments and trying out new hairstyles – there are many ways to navigate hair loss. 

It’s not something that happened overnight and won’t be resolved with quick fixes or immediately either. Hair loss may take about 3 months to materialise and as long as 6-8 months to taper off as this is usually the normal cycle of hair growth so, think back to what you changed recently or as far as 3-8 months back. It may be combined with stress, life changes or hormonal changes as well, which can exacerbate hair loss or deficiencies that lead to hair loss by elevating your cortisol, and negatively impacting your sleep and eating patterns. 

Different Hairstyles

The first thing I did when I noticed my hair thinning was to switch up my hair part. 

It’s a quick fix and doesn’t change that you might still be losing hair or having weird, fuzzy baby hairs and re-growth but, I found a middle part was great for the M-pattern (traditional male hair loss pattern around the sides) hair loss, luckily both classic and very on trend at the moment. Paired with some chunky earrings, the new look covered the side loss and gave me more confidence. 

Wearing it up is good if you are experiencing top and middle hair loss. Sporting a fringe or going for a bob cut can do wonders to help even the difference between old and new growth. If a fringe or bob doesn’t suit you or sounds terrible (been there, a fringe is my enemy), a layered cut is good for hair that is bottom heavy from top thinning. Head scarves are another option if those patches are huge. My favourites of pure silk and fun patterns can often be found in vintage store bins and also goes well with the chunky earring look. 

Here is an article on top 10 hairstyles for women with thinning hair you can refer to. That first haircut post-loss is not one to skimp on. Go to someone you trust who has vision and understands your hair texture, considers your face shape and how you wear it daily. 

Supplements & Diet

Be sure your D(3) supplements include vitamin K2! These fat-soluble vitamins have a synergistic relationship. 

When hair loss is linked to nutritional deficiency, like restrictive eating, dietary changes or exacerbated by an autoimmune issue like thyroid or chronic stress issues, supporting the body with better nutrition can yield results.  As always, consult your doctor before making any dramatic diet change. I’ve dived into the key studies and advice outlining the key nutrients that can help and what doesn't and when it best applies to your situation: 

1. Protein: hair is primarily made up of protein, so ensuring an adequate intake of high-quality protein sources such as lean meats, eggs, beans, nuts, and seeds are believed to support hair health and important in TE and AA hair loss. 
   
   
2. Omega-3 fatty acids: found in fatty fish (such as salmon and mackerel), flaxseeds, chia seeds, and walnuts, omega-3 fatty acids have anti-inflammatory properties that has been found to reduce inflammation in the scalp and promote healthy hair growth and improved hair density, reducing the TE percentage and proportion of miniaturized anagen hair (applicable for PCOS, menopause and postpartum hair loss).
   
   
3. Biotin: also known as vitamin B7, biotin is essential for the production of keratin, a protein that makes up the structure of hair. Biotin-rich foods include eggs, nuts, seeds, and sweet potatoes. It's often in hair supplements and though it is important for hair health, it's not definitively shown in studies to improve hair loss through supplementation. 
   
   
4. Iron: anaemia, or deficiency has been associated with hair loss, so incorporating iron-rich foods such as red meat, but especially the fatty, connective tissue and organ meat from grass-fed animals (siginificantly, beef liver, the most bioavailable source of iron) spinach and lentils can help restore anaemic affected hair.
   
   
5. Vitamin D: this plays a role in hair follicle cycling and can be obtained from sun exposure, fatty fish, fortified dairy products, and supplements. Be sure your D(3) supplements include vitamin K2! It’s an essential vehicle to get the vitamin D where it needs to go. I was supplementing for years with D, and was still woefully deficient until I changed to a D3 + K2 supplement (applicable for trauma and stress TE, PCOS, menopause and postpartum hair loss).
   
   
6. Antioxidants: topical antioxidants including piroctone olamine, zinc pyrithione, zinc carbonate, niacinamide, panthenol, and caffeine were applied to the scalp in a recent study and showed promising results. This may be helpful for AA hair loss, or hair loss that isn't improved after the 8 to maximum 12 months of hair cycle recovery. See your dermatologist about this! Dietary antioxidants like vitamin C are important in the case of anaemia hair loss, it’s essential for iron absorption if using supplemental iron or relying on plant-based iron sources! 

Be careful about buying vitamins and other supplements that claim that they can regrow hair because many are overpromising. The American Academy of Dermatology Association also warns that taking a supplement to regrow hair may seem like an easy solution, however, they won’t help if your hair loss isn’t due to a nutrient deficiency. 

Back to the bioavailability component of nutrients, opt for what your body absorbs best: a whole food, natural diet-based version whenever possible. Always check with a healthcare provider to know how much and what you actually need. Vitamin D, B and iron tests are a quick, easy blood test away (easily done at home now, and cheaply) to understand a lot more about the state of our health. If your levels are “normal” but you are not convinced, we find cross-checking the results with what functional medicine specialists suggest as ideal values is helpful as they tend to focus more on the root causes of issues more than symptom alleviation. 

Medication

It may not be effective for everyone but there is a medication that a dermatologist can administer. 

In Minoxidil users, researchers noticed that hair grows back in places where they lost it. The solution that is applied to the scalp has a few negative side-effects such as possible skin irritation, different colour and texture of hair, and excessive hair growth on the cheeks or forehead (yikes), so consider consulting a health care provider before trying these types of medications.

What Worked For Me

In my case, hair loss had emotional, lifestyle and hormonal components at play. This may be the case for many other women as well. These are issues that touch not only our hair brush, but our confidence, identity and physical health. Though defeating at times, I found ways of navigating it, first by understanding my hair loss, the health issues related to it, adapting my diet and taking a new perspective with improved stress management helped. 

I found that a combination of clever styling, a “this is all temporary” mentality shift and moving away from my plant-based diet in favour of ethically sourced animal products was essential. I began to include things like raw goat’s milk (straight the farm and I get to pet the goats while doing it!), grass fed beef liver (also available in supplement form, I like Nordic Kings in Europe), omega-3 supplements and more fatty fish consumption all helped my hair back its old lustrous self and went from being very deficient in D and B vitamins to healthy nutrient levels. 

I know how frustrating hair loss can be. Fairly new studies show that some people even go to the extent of 3D printing, hair farming, and reawakening dormant follicles to regrow their hair back! But as with most things in life, I suggest you start simple – find out the cause of your hair loss and take the necessary steps to treat it. 

HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life, the SABI aims to change the narrative around our hormones from one of taboo, embarrassment and loneliness, to awareness and even pride. Much more than a wellness brand, SABI offers a carefully crafted line of products to carry you through your hormonal journey; a set of rituals, supportive tools, and ancient herbal remedies that have been tested time and again by women and now, backed by medicine. SABI is a blend of science and nature conceived by women who have experienced the joys and deep implications of bringing a child into the world, the pains of a heavy and difficult period, miscarriage and difficulty conceiving

Here is an invitation to get to know your body and its cycles better and to really understand what is going on inside. Learn to use your hormonal cycle to your advantage no matter your stage of life, and know that you can always support and balance your hormone levels. Look for the right sources of information, know that there is help, and know that you’re supported.

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation. 

ABOUT HILARY 

Hilary is the Co-Founder of the SABI, a Holistic Nutritionist, natural, whole foods Chef, product developer and advocate for women getting to know their bodies, cycles and selves better. Born in Los Angeles, California and raised in Baja California, Mexico, she now lives in Amsterdam, The Netherlands with her partner and her dog, Flint.  

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