In today’s episode, Dr. Lisa and Dr. Toni discuss: the different types of hair loss, causes, lab tests to consider and solutions that can work for women in perimenopause who are experiencing hair loss. It’s important to recognize that some hair loss is normal but unfortunately, abnormal hair loss is common. Up to 50% of women will experience significant amounts of hair loss in their lifetime.

What is Normal?

  • Loss of 50-100 hairs on average per day
  • No change in hairline/scalp you can see; pony tail still same size
  • 3-4 months postpartum: 
    • you don’t lose hair during pregnancy; make up for it at this time
    • normalizes at around 6-12 months postpartum

The Four Stages for Hair Follicles:

  1. Anagen – active growth phase lasting 2-7 years
  2. Catagen – brief transitional phase where fibre stops growing
  3. Telogen – rest phase lasting 3 months where old hair pushed up to skin surface then shed

What is Abnormal?

  • Losing more than 100 hairs per day when not postpartum
  • Change in your hairline with more scalp visible
  • Telogen effluvium: temporary hair loss after stress, shock or traumatic event

Type of Hair Loss:

  1. Genetic – progressive gradual reduction in your hair volume, can make your hair follicles more susceptible to reactive hair loss
  2. Reactive – also known as telogen effluvium, temporary hair loss

Causes of Hair Loss:

  • Nutrient deficiencies: low iron, vitamin b12, protein intake
  • Low thyroid function: Hypothyroidism or Hashimoto’s autoimmune thyroiditis
    • Your thyroid gland helps to regulate your body’s metabolism by controlling the production of proteins and your tissue use of oxygen. Any thyroid imbalance can therefore affect your hair follicles. 
    • If hypothyroidism is left untreated it may result in anemia or iron deficiency
  • Stress, shock or traumatic event
    • Can negatively impact your estrogen levels which can impact hair loss
    • Raises your androgen levels, disrupts your scalp health causing dandruff, negative impact on your digestion
    • Can negatively impact your thyroid function
  • Leaky gut, celiac disease and eating gluten – see Episode 8 for more info on gut health
  • Damaging hair dye or other hair care products that weigh your hair down
  • Traction alopecia: caused pulling hair back tightly (eg. ponytail, bun or braids) and weakening hair follicles
  • Hormone changes and imbalance
    • Perimenopause with lower estrogen
    • PCOS with high androgens and insulin resistance
  • Caloric restriction:
    • Excessive fasting
    • Cleanses with low protein intake
    • Eating disorders
    • No or low carb intake

Laboratory Testing You Can Consider To Determine The Cause of Your Hair Loss:

  • Nutrient testing
    • Iron panel – hemoglobin, ferritin, iron and transferrin saturation levels
    • Vitamin B12
  • Celiac screen
  • Food sensitivity testing
  • Thyroid panel (TSH, free T4 and T3 plus thyroid antibodies) – see Episode 42 for more info
  • Autoimmune testing
  • Hormone testing
    • adrenal/cortisol
    • hormone panel with estrogens and androgens
  • Blood sugar testing
    • Insulin and glucose levels when fasting
    • Hemoglobin A1C
    • Glucometer or continuous blood sugar testing at home

What you can do about it?

  • Biotin:  does it really work? 
    • Found in eggs, fish, meat, seeds, nuts, sweet potatoes, broccoli and cauliflower
    • Can impact accuracy on certain lab testing like thyroid hormone tests 
    • Too much can worsen cystic acne and affect your absorption of vitamin B5, which is needed for skin health
  • Your hair is made of protein, so adequate intake of protein rich foods is essential 
    • Palm sized portion with lunch and supper
    • Aim for a total intake of 1 gram per kilogram of body weight daily
  • Complex carbohydrates provide your hair with the energy it needs to grow
    • Carrots, sweet potatoes, squash, greens
  • Other minerals and vitamins: iron, copper, zinc, selenium, vitamin C, B12, D3, essential amino acids l-lysine and l-methionine 
  • Supporting scalp circulation 
    • Head/scalp massage
    • Exercise, yoga, headstands
  • Essential oils applied topically to scalp
    • Thyme, rosemary, lavender, cedarwood in carrier oil of jojoba and grapeseed has been shown to support hair growth in people with alopecia areata
  • Hair oils can make your hair stronger and protect hair follicles and strands to prevent breakage
    • Ayurvedic oils and herbs like amla, ashwagandha, brahmi and dashmool can be applied to dry hair for a pre-wash treatment
  • Work with naturopathic doctor or other medical professional to support hormone and blood sugar balance, improve digestion and leaky gut
  • Reduce stress: sleep, say no, rest, get help…

After you start a treatment plan, the more you can be calm and patient, the better. Due to the nature of your hair growth cycle, it takes at least 6 weeks to see an improvement. Do your best and give your body some time to regain balance.

Today’s Mama Must Have:

Dr. Toni has been using her bullet journal to get thoughts and to-do lists out of her head so she isn’t thinking about them in the middle of the night! See Episode 11 for more info.

Dr. Lisa loves Cheeks Ahoy unpaper napkins and reusable paper towels to reduce her use of single use products to clean up spills. 

Thank you for joining us today! 

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Stay safe everyone!