Getting to the root of hair loss
Getting to the root of hair loss
The traditional medicine approach to curing hair loss is to treat the hair loss itself. A variety of treatments may be prescribed, from topical creams and shampoos to drugs to laser treatment to surgery.
But hair loss is a clue that something is wrong in the body, and it is worth investigating what may be causing it. If you have hair loss, your hair will not grow until the cause stops. For example, people who undergo chemotherapy or radiation treatments often lose a lot of hair. When the treatment stops, their hair will often regrow.
Once the cause of your hair loss is identified, a Functional Medicine health practitioner can work with you to curb it and enable healthy growth.
The four stages of hair growth
The normal hair growth cycle occurs in four different phases: the anagen, catagen, telogen, and exogen phases. If you’re experiencing excessive hair loss, this normal cycle will be interrupted.
Cycle 1: The Anagen Phase (Hair Growth)
The anagen phase is the longest and lasts about 2-7 years, depending on where your hair is located. Hair on your scalp takes much longer to grow than shorter hairs like hair on your legs and eyebrows.
About 80-90% of the hair on your scalp is in this growing phase. Your hair follicle, the sac where hair growth happens, forms a new hair shaft. Your hair follicles will push out the hair that continues to grow until the hair is cut or reaches the end of its lifespan and falls out.
Cycle 2: The Catagen Phase (Transition)
The catagen phase occurs when the anagen phase ends and lasts about three weeks. Your hair follicles shrink, hair growth slows, and hair separates from the bottom of the follicle. The hair remains in place until the next phase. Only 1-2% of your hair is in this phase at a time.
Cycle 3: The Telogen Phase (Resting Phase)
The telogen phase lasts about 3 to 4 months. Your hair is in this resting phase about 10-15% of the time.
Cycle 4: The Exogen Phase (Shedding Phase)
In a healthy individual, at the end of the telogen phase, the hair falls out (sheds), and new hair begins growing in the same hair follicle. 
What is normal hair loss?
Everyone loses hair on a daily basis, but how much is normal and when should you start worrying about it?
According to the American Academy of Dermatologists, it is normal to lose anywhere from 50 to 100 strands of hair per day. For people with longer hair strands, losing them may be more noticeable. Since there are around 100,000 hair follicles on each person’s scalp, the loss of 100 or so hair strands a day won’t make a big difference in appearance. 
When the body sheds significantly more hair every day, a person has excessive hair shedding. This is known as telogen effluvium.
Common causes of hair loss
There are a number of different causes of hair loss that a common throughout someone’s life.
Hair loss occurs when something stops the hair from growing. The medical term for this condition is anagen effluvium. The most common causes of hair loss include:
- Immune system overreaction
- Some drugs and treatments
- Hairstyles that pull on the hair
- Harsh hair-care products
- Compulsion to pull out one’s hair 
Genetics is the most common cause of hair loss. Inherited hair loss is known as androgenetic alopecia and means your hair growth cycle is shorter. Your hair may also be thinner than normal. Eventually, your hair follicles shrink and stop producing hair.
Excessive hair shedding is common in people who have experienced one the following stressors:
- Lost a significant amount of weight
- Given birth
- Experiencing high levels of stress
- Had high fever
- Undergone an operation
- Recovering from an illness, especially if it included high fever
- Stopped taking birth-control pills
Getting to the root of the problem
Uncovering the cause of excessive hair loss is key to finding the right treatment. There is a wide range of possible causes, including:
Vitamins and nutrients are essential to ensure all your organs and internal systems work well and for follicular development, hormone regulation, and immune function to occur. This means a balanced and nutritious diet. Poor nutrition or following a severely restrictive crash or fad diet can lead to all kinds of nutrient deficiencies, which in turn can result in hair loss, from thinning hair to patches of baldness. 
Certain nutrient deficiencies have been linked to hair loss, including zinc, riboflavin, biotin, folate, iron and vitamin B12. Micronutrients and macronutrients are both important for follicle development and the regulation of immune cell function, which play a major role in healthy hair growth. 
Other contributors like low vitamin D, and a low protein diet may be factors as well.
A functional medicine health practitioner can determine which blood tests and nutrients are required to uncover any deficiencies. You may also have gut problems that are preventing the absorption of nutrients.
Hormone imbalances often lead to hair loss. There could be a problem with male/female hormones, thyroid hormones, adrenal hormones or a combination of all three hormones.
Another common hormone issue is with the thyroid. Both excessive and deficient amounts of thyroid hormones can cause hair loss. Again, if there is a thyroid problem the key is finding and fixing the cause.
Hair loss is one of the most common signs of an underactive thyroid (hypothyroidism). This may appear as brittle, dry and thinning hair Sometimes, the outer third of your eyebrow also sheds.
When your hormone production is disrupted, specifically the output of hormones T3 and T4 (the primary and secondary hormones produced by your thyroid), it affects the life cycle of each strand of hair. This includes the development of hair at the root, how long it grows before falling out, and its replacement by new growth. 
Your functional medicine practitioner will test you for thyroid-stimulating hormone, free T3, free T4, total T4, total T3, reverse T3 and thyroid antibody tests. Your body needs T4 because it converts it to T3 (active thyroid hormone). Low T4 levels can lead to low T3 which manifests in symptoms like hair loss. There are of course several factors that can slow down proper conversion from T4 to T3, like nutrient deficiencies, dietary changes, inflammation, stress, and toxins for example. 
Your functional medicine health practitioner will help you determine which treatment is best for you if you have an underactive thyroid.
Sex hormone dysfunction
Male pattern balding, (androgenic alopecia), is one of the most common reasons that men lose hair as they get older. Women can also experience this type of hair loss, but it is much less common.
Dihydrotestosterone (DHT) is an androgen. An androgen is a sex hormone that contributes to the development of what are thought of as “male” sex characteristics, such as body hair. But it can also make you lose your hair faster and earlier. 
Estrogen also contributes to hair loss as well. After pregnancy and in menopause, there is a drop in estrogen which causes thinning hair.
Adrenal fatigue may cause hair loss due to problems with the production of the two hormones linked to hair loss, testosterone and dehydroepiandrosterone (DHEA). Adrenal fatigue can lead to problems with processing DHEA and testosterone, which may lead to hair loss in men and women. 
There are several environmental toxins that your body needs to get rid itself of. If you aren’t eliminating them, they can accumulate and lead to changes in your gut microbiome, insulin resistance, hormone disruptions – all of which can lead to hair loss.
Toxic levels of thallium and colchicine have long been established to cause alopecia. Lithium and selenium toxicity is known to cause hair loss, but lead, cadmium, mercury, iron, aluminium, copper, and other heavy metals can also affect hair growth. The toxins have a negative interfere with hormones, strip the body of nutrients, and can even damage the actual hair follicle, resulting in excessive hair shedding and impaired hair growth. 
Lupus and PCOS are just a few of the many conditions that have been connected to hair loss. Alopecia areata is an autoimmune condition in which your immune system can mistakenly attack your hair follicles, can cause sudden patchy hair loss that occurs quickly.
Intestinal issues can contribute to toxicity and hormonal imbalances. Everything you eat ends up in your digestive tract. Once there, your enzymes and gut bacteria break it down into simple elements that are absorbed and transported for further processing or immediate use. This is why any digestive problems may indirectly lead to hair loss. 
Uncovering gut issues will enable your functional medicine health practitioner to start to work on healing your gut to slow and eliminate hair loss.
People may experience hair loss during or after a chronic viral, fungal or bacterial infection. New research has revealed that COVID-19 can cause hair loss. As infections produce toxins, destroy cells and consume nutrients, it’s important to get rid of the infection as a priority and then build the immune system. This may be with supplements of dietary changes.
Treating hair loss naturally
Hair loss can be caused by a number of different underlying issues and there isn’t a one-size-fits-all approach to treatment. At Advanced Functional Medicine, our expert practitioners will work with you to uncover the root cause of your hair loss and provide natural solutions to help it to grow back stronger and healthier.