Why Does Hypothyroidism Cause Hair Loss In Women?

Hypothyroidism hair loss

One of the most common complaints I hear from women with hypothyroidism and Hashimoto’s is hair loss. Thinning hair, bald patches and hair loss can be devastating because they not only affect how we look but also how we feel.

As many as two thirds of women can experience hair loss during their life time. According to American Academy of Dermatology, about 40% of women have noticeable hair loss when they reach the age of forty. For many, hair problems are not only a cosmetic issue that makes them feel unattractive and uncomfortable but is an emotionally stressful situation that can even cause depression.

Despite of widespread concerns among women about their hair problems, most doctors don’t take it seriously and often blame aging as a main cause. The truth is that which contributes to their hair issues.

Thyroid hair loss

Hypothyroidism causes hair loss because the slowing down of the metabolism affects scalp follicles and results in diminished hair strength and quality. At hypothyroidism, hair problems can start with thinning and changes in its structure when it becomes dry, brittle and coarse. In the advanced stages, hair falls out evenly or in large chunks that often can be noticed during brushing or hair wash.

Hair loss mostly occurs when hypothyroidism is undiagnosed or undertreated. Official normal TSH testing range is too broad and differs from lab to lab making the diagnosis of underlying thyroid condition more difficult. If a woman has subclinical hypothyroidism or her TSH is not in the optimal range which is around 1.0 it can result in low thyroid symptoms including loss of hair.

Low levels of metabolically active T3 hormone and thyroid hormone resistance can also cause hair loss in women. Adding a T3 medication and removing T3 thyroid conversion blockers can improve hypothyroid symptoms, quality of hair and stop hair loss. If hypothyroidism is properly treated the hair starts to regrow.

In addition, some drugs including thyroid replacement medication Synthroid states excessive hair loss as one of many possible side effects. Surprisingly, many patients and doctors are unaware of this fact.

However, optimal thyroid treatment doesn’t automatically guaranty that your hair problems will be solved. Main reason for that is other health conditions and imbalances that often come with thyroid disease. Below is a list of other contributing factors that also need to be considered and if necessary addressed:

Iron deficiency and thyroid hormone disorders are the two common conditions often associated with diffuse hair loss and most of the time there are no apparent clinical signs indicating it. Furthermore, sub-optimal and low iron levels are often in women with hypothyroidism and Hashimoto’s disease in particular.

There are 3 most common types of diffuse hair loss in women:

  1. Telogen effluvium which is sudden, rapid shedding of hair lasting for about 3 to 6 months.
  2. Chronic telogen effluvium occurs when the hair loss persists beyond six months and the condition becomes chronic.
  3. Female pattern hair loss which is a gradual diffuse hair loss with thinning of central scalp and widening of central parting line.

Besides iron deficiency anemia, hypo- and hyperthyroidism, malnutrition, vitamin and zinc deficiency has been most widely accepted as major causes of chronic diffuse hair loss.

Allopecia areataAlopecia areata is a non-scarring hair loss disorder with the highest incidence in patients under 30 years of age and a lifetime incidence risk of 2% among the general population. It is an autoimmune disorder that is characterized by patchy hair loss or bald spots on the scalp.

Besides hair loss on the scalp some patients have nails, eyebrows, eyelashes and body hair affected. Alopecia areata frequently occurs in association with Hashimoto’s thyroiditis, clinical and subclinical hypothyroidism, anemias and skin disorders of autoimmune etiology.

Estrogen dominance often coexists with hypothyroidism and autoimmune Hashimoto’s disease. In fact, they drive each other and both can cause hair loss in women. Both too much estrogen and too low progesterone create a state of estrogen dominance that promotes a decreased thyroid receptor sensitivity and as a result can cause hair loss.

Other hormonal changes due to ovarian cysts, high androgen levels, birth control pills, pregnancy and menopause cause hormonal shifts that can result in hair loss. Fluctuations in estrogen, progesterone and testosterone levels affect hair growth and any event that causes an imbalance of those hormones can trigger the fallout.

Using of synthetic hormones in contraceptives disrupts natural hormonal pathways. Loss of scalp hair is one of known side effects when a synthetic progestogen is combined with estrogen in the birth control pills. Furthermore, discontinuing of oral contraceptives can also result in hair loss in some women due to adjusting of hormones to their natural levels that can take up to 5 years.

Other women go off birth control pills to get pregnant and are able to restore their hormonal levels quickly. They often associate their hair loss issues with pregnancy, when in fact it has happened due to the discontinuation of birth control pills.

Up to 50% of women notice that they are shedding more hair than usual during the first 6 months after giving birth. Postpartum hair loss is a temporary event that is caused by abrupt drop in hormones that are returning to the normal pre-pregnancy levels.

Low progesterone in perimenopause and menopause as well as in young women with hormonal imbalances can trigger hair loss. In un-ovulating women progesterone levels fall causing the body to increase the production of the adrenal cortical steroid called androstenedione which is an alternative precursor of androgen testosterone.

This hormone promotes some androgenic male like properties including male pattern hair loss. By restoring the body’s progesterone levels androstenedione gradually decreases and re-growth of hair occurs usually within 6 to 12 months. Most women report improvement of hair thickness and texture while using the bio-identical progesterone.

Androgenic alopecia is caused by high levels of testosterone metabolite di-hydrotestosterone (DHT). This condition is very common in women with PCOS. About one third of women with PCOS have elevated thyroid antibodies. Furthermore, high levels of TSH and damage of the thyroid tissue were found in more than 40% of the PCOS women with Hashimoto’s disease. Both thyroid issues and high DHT in this group of patients can cause substantial hair loss.

Increased insulin production due to a diet high in carbohydrates stimulates the hormone production by the ovaries causing high androgen levels. At PCOS, conversion of testosterone to estrogen in the ovaries is impaired and results in an excess of testosterone. Male pattern baldness and hair loss are common symptoms of PCOS due to over conversion of testosterone to its metabolite DHT.

Reversing PCOS by following a refined sugar reducing diet, using supplements and regular exercise to address the insulin resistance is critical for restoring hormonal balance and thyroid support in women with PCOS.

Thinning and loss of hair can be an indicator for coexistence of other health issues. Besides hair problems, majority of women have other accompanying symptoms such as fatigue and weight gain. Establishing and correcting the underlying disease such as hypothyroidism, anemia, estrogen dominance, nutritional deficiencies and PCOS not only improves the general well-being but also stops hair loss in most cases.

10 Tips To Stop Hair Loss In Women With Hypothyroidism

Hair loss in hypothyroidism

1. If you already have hypothyroidism and/or Hashimoto’s disease your first step is to optimize your thyroid treatment and then look into other imbalances that can be contributing factors for your hair loss.

2. Check mineral and vitamin deficiency. Deficiencies in vitamin B, zinc, iron, or calcium are the leading causes of hair loss. You can easily do a blood test to find out what are your deficiencies. Once you find out what they are, always consider altering your diet first before popping vitamins and supplements. Birth control pills, for example, deplete your body of vitamin B.

3. Test for heavy metal toxicity. It’s not uncommon to have elevated mercury levels from eating contaminated fish (like tuna, cat fish, tilapia) and seafood, having amalgam fillings in your teeth, having been given flue shots or drinking contaminated water. A urine and blood test will tell you how high are your levels and if it is a factor that affects your thyroid health.

4. Check your DHT levels. DHT stands for dihydrotestosterone which is a male hormone – the very hormone that makes men go bald. Women with elevated DHT levels often experience hair loss too. A simple blood test will reveal your levels.

Natural alternatives believed to help include green tea, stinging nettle, saw palmetto (the best-known natural DHT-blocker), pygeum extract, emu oil and pumpkin seed oil. Herbal treatments for hair loss such as evening primrose oil are one of natural treatments well known for its inhibiting properties of the production of DHT in hair follicles and can help to prevent hair falls and stimulate re-grow.

5. Look into the types and amount of fats in your diet. What has may be very effective is a generous introduction of saturated fat into the diet to increase the overall metabolism and body temperature.

We need good fats for balanced  hormones and good thyroid health. Fats help us produce hormones and I will tell you we have incredible results with my clients who dare to introduce a minimum of 3-4 tablespoons of saturated fats like coconut oil, lard, beef tallow, duck fat, butter or ghee (clarified butter) into their diets.

Do not be afraid of cholesterol going up – fat does not give us heart problems, this one of the biggest misconceptions of the decade – processed carbohydrates are to be blamed for our heart problems.

6. Control your blood sugar. The more insulin you have in your body, the more impact testosterone will make on your cells. To reduce the effects of high testosterone, minimize your processed carbohydrate intake, and balance your blood sugar with whole foods and good fats.

How do you know if you have unstable sugar levels? Here is a simple test: if you skip lunch, how would you feel by 4 pm? If you feel moody, spacey, shaky, unfocused or jittery it’s a clear sign of low blood sugar levels. A person with healthy blood sugar levels should just feel hungry.

7. Consider biotin. It’s crucial for nail and hair growth, and has no known side effects. Try five-to-eight milligrams a day.

8. Try spearmint tea. Research from the U. K. and Turkey suggest that drinking spearmint tea helped to reduce testosterone levels as well as improve the balance between follicle stimulating hormone and luteinizing hormone, which may help in retaining hair.

9. Onion juice! A study published in the Journal of Dermatology found that when onion juice was massaged directly into the scalp twice daily for two months, participants began to experience hair growth after just two weeks, while renewed hair was apparent in 20 of 23 people at six weeks.

10. Consider getting off  of contraceptives.  “The pill” suppresses the production of progesterone and adds more estrogen, which does a great job of preventing a woman from becoming pregnant, but also creates chaos in the endocrine system and diminishes thyroid health.

P.S. Do you like what you read and want to see more?  Do you want to know about holistic approach to your health? Subscribe to the Outsmart Disease thyroid blog updates and get your FREE e-mail course Nutritional guide for Hashimoto’s disease

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1. The truth about women’s hair loss by Spencer David Kobren, McGraw-Hill; 1st edition, 2001

2. Women’s hair loss: The hidden epidemic by Dr. Michael Lorin Reed, Lock & Mane, LLC; 1st edition, 2009

3. Thyroid guide to hair loss: Conventional and holistic help for people suffering thyroid-related hair loss by M.J.Shomon, CreateSpace, 2008

4. Diffuse hair loss in an adult female: approach to diagnosis and management. Indian J Dermatol Venereol Leprol. 2009 Jan-Feb; 75(1):20-7; quiz 27-8.

5. Alopecia areata and autoimmunity: a clinical study. Indian J Dermatol. 2008; 53(2):70-4.

6. Clinical profile and impact on quality of life: Seven years experience with patients of alopecia areata. Indian J Dermatol Venereol Leprol. 2011 Jul-Aug; 77(4):489-93.

About Marina Gutner, PhD

Marina Gutner, PhD, researcher, medical writer, thyroid blogger, founder and Admin of Outsmart Disease who writes about life-changing treatments for hypothyroidism, Hashimoto's thyroiditis and autoimmune disease and how to balance hormones in women