Have you noticed more strands of hair on your pillow, in the shower, or collecting in your brush? While it’s normal to shed between 50 to 100 scalp hairs per day, losing more than that consistently may signal an underlying imbalance that needs attention.
Hair loss is a common concern that affects both men and women, often causing distress and frustration. But like many conditions, hair loss is multifactorial meaning it may stem from a combination of internal and external factors. By understanding the root causes and the hair growth cycle, you can begin to address hair loss in a more individualized and effective way.
The Hair Growth Cycle: More Than Just Growing and Falling Out
Hair doesn’t just grow endlessly, it goes through a natural cycle with four distinct phases:
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Anagen (Growth Phase): This is the active growth phase that can last several years. About 80–90% of your scalp hairs are in this phase at any given time.
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Catagen (Transitional Phase): A short 2–3 weeks phase where the hair follicle shrinks and detaches from the blood supply.
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Telogen (Resting Phase): Lasts around 3 months. Hair doesn't grow during this time, and new hairs begin forming underneath.
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Exogen (Shedding Phase): The final phase when old hairs fall out to make room for new growth.
Disruptions in this cycle, especially when hairs enter the telogen or exogen phase prematurely, can result in excessive shedding.
Signs and Symptoms of Unhealthy Hair Loss
Hair loss can present in different ways, and recognizing the pattern may help identify the cause:
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Gradual thinning on the crown or top of the head
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Sudden loosening of hair, especially after physical or emotional stress
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Circular or patchy bald spots on the scalp or other areas
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Widespread body hair loss (can be linked to autoimmune or systemic conditions)
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Increased shedding in the shower or while brushing
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Itchy or inflamed scalp
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Painful or tender areas on the scalp
Root Causes of Hair Loss Beyond Genetics
1. Thyroid Imbalance (Hypothyroidism or Hyperthyroidism)
The thyroid plays a major role in regulating metabolism, including hair follicle function.
Low thyroid hormone (often marked by high TSH) can slow the hair growth cycle, leading to thinning and shedding.
Tests to request:
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TSH (Thyroid Stimulating Hormone)
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Free T3 and Free T4
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Reverse T3 (to assess thyroid conversion issues)
2. Nutrient Deficiencies
Healthy hair follicles require a constant supply of nutrients for cell turnover and structural integrity.
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Iron: Iron deficiency is one of the most common reversible causes of hair loss in women. It’s essential for oxygen transport and follicle metabolism.
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Zinc: Supports cellular replication and tissue growth, both critical for hair repair and regrowth.
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Vitamin D: Involved in the stimulation of hair follicles. Deficiency may lead to telogen effluvium (temporary shedding).
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B-complex Vitamins (especially Biotin, B12, and Folate): Support cellular energy and keratin structure. Low levels are linked to weak, brittle hair.
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Vitamin E: Acts as an antioxidant, protecting hair follicles from oxidative stress.
How to assess:
You can request bloodwork through your healthcare provider or do comprehensive nutrient panels available through functional medicine labs or some at-home kits.
3. Stress and Cortisol Imbalance
Elevated stress hormones, particularly cortisol, are closely linked to a type of hair loss called telogen effluvium, where large numbers of hairs prematurely enter the resting phase.
In more chronic cases, stress can also contribute to Trichotillomania, a condition where individuals feel compelled to pull out their own hair.
Rather than testing just serum cortisol, consider salivary or urine cortisol, which reflect free, bioavailable cortisol throughout the day.
4. Sex Hormone Imbalance
Hormonal shifts can significantly impact hair health, especially in women.
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Female Pattern Hair Loss (FPHL) often appears as gradual thinning on the crown, and is influenced by androgens (like testosterone) and sensitivity of the follicles.
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Pregnancy and Postpartum Hair Loss: During pregnancy, higher estrogen levels prolong the anagen phase, making hair appear thicker. After childbirth, estrogen drops sharply, causing a synchronized shift into the shedding phase (postpartum telogen effluvium).
Tests to consider:
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Estradiol
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LH (Luteinizing Hormone)
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FSH (Follicle Stimulating Hormone)
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Total and Free Testosterone
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DHEA-S
5. Medications That Can Contribute to Hair Loss
Several common medications are known to interfere with the hair growth cycle:
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Isotretinoin (Accutane): Can push hair follicles into the telogen phase early, increasing shedding.
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Antidepressants (SSRIs, SNRIs, tricyclics): May alter hair texture and reduce growth via nutrient depletion or hormonal pathways.
If you suspect a medication is contributing to hair loss, always consult with your healthcare provider before making changes.
Supplements that can assist with hair loss
1. Saw Palmetto: This plant extract is well-studied for its ability to inhibit DHT (dihydrotestosterone), a hormone linked to hair loss, particularly androgenic alopecia. Clinical trials show both oral and topical saw palmetto can significantly reduce hair shedding and increase hair density, with oral supplementation also lowering DHT levels. Supplements containing saw palmetto have demonstrated improvements in hair count, density, and quality in both men and women with androgenetic alopecia and telogen effluvium.
2. Omega-3 and Omega-6 Fatty Acids: Deficiencies in these fatty acids can lead to a higher proportion of follicles in the telogen (resting/shedding) phase. Supplementation has been shown to increase the anagen-to-telogen ratio, reduce shedding, and promote hair shaft elongation in both animal and human studies. A 6-month RCT in women found omega-3/6 supplementation significantly reduced telogen hairs and promoted anagen phase.
3. Ashwagandha: This adaptogenic herb helps balance cortisol, a stress hormone that can damage hair follicle proteoglycans and push follicles into the shedding phase. Clinical studies indicate ashwagandha supplementation improves hair density, thickness, and growth, likely by reducing stress-induced hair loss.
Lifestyle Approaches to Support Healthy Hair Growth
While addressing underlying causes is essential, incorporating these strategies can also make a noticeable difference:
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Manage stress: Incorporate mindfulness, meditation, journaling, or breathing techniques like box breathing to lower cortisol levels.
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Nourish from within: Prioritize a nutrient-dense diet rich in lean protein, leafy greens, seeds, nuts, and colourful vegetables.
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Ensure adequate protein intake: Hair is primarily made of keratin, a protein, and protein deficiencies can weaken the hair structure.
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Pre-shower brushing: Gently brushing your hair before washing helps reduce tangles and minimizes breakage during shampooing.
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Use gentle hair care products: Avoid products with sulfates, parabens, formaldehyde-releasing preservatives, and harsh alcohols. These can strip the scalp's natural oils and irritate the follicles.
Final Thoughts: Treating Hair Loss from the Inside Out
Hair loss isn’t just a cosmetic issue, it’s often a sign of a deeper imbalance. Instead of chasing temporary solutions, consider a root-cause approach. With proper testing, nutritional support, hormone balancing, and targeted lifestyle shifts, hair growth can often be restored naturally over time.
If you’re experiencing hair loss and are unsure where to begin, consulting with a naturopathic doctor or a functional medicine practitioner can help you identify your unique triggers and design a personalized care plan.
About the author:
Hi, I’m Abinaa, a fourth-year naturopathic medical student at the Canadian College of Naturopathic Medicine with a deep-rooted passion for natural healing, inspired by my South Asian upbringing. Through this blog, I hope to share my journey, explore topics in holistic health and wellness, and offer simple, thoughtful insights that support a more balanced and mindful way of living.
