How to Fix Hair Thinning at the Root Cause (for women)

I could spend quite a bit of time talking about how maddening it is to be going about your business and realize that your hair is falling out - for seemingly no reason. One of the reasons this symptom is so frustrating is that it’s often considered a vanity issue - and therefore not taken seriously by healthcare providers. But hair loss and thinning - especially in women - has significant cultural and social ramifications (for better or for worse). And, more importantly, it always points to deeper health concerns like chronic stress, nutrient deficiency, and hormone imbalances.

So instead of spending our precious time discussing all the reasons that hair thinning drives women nuts, we’re going to dive right into the top three root causes of hair loss in females, and I’m going to share some actionable, science-based solutions for each - let’s do this!

The first root cause of hair thinning that I see in my practice is sub-optimal ferritin.

Notice that I didn’t say “low” ferritin, ok? Because even ferritin levels that are within a normal range according to the lab might not be high enough to combat or resolve hair loss. In Functional Medicine, we aren’t content with “normal” when it comes to our nutrient status - we want to be in an optimal range so that we function and feel the best we possibly can.

Now, what is ferritin, exactly? That’s a good question - because a lot of people have never seen their ferritin levels on bloodwork. It’s more common to test iron in the blood instead - but ferritin is a more helpful measurement when it comes to chronic or longstanding conditions because it tells us about our long-term iron status. Specifically, it’s a protein that stores iron and releases it into the blood when needed. Iron levels in the blood may fluctuate, giving us a false sense of security around how much iron we have in reserve - where ferritin gives us the bigger picture.

Why is having optimal ferritin levels important? Well, it’s what makes our red blood cells able to carry oxygen to the rest of the body, fueling our function on the most basic levels. When iron reserves are low, it can result in fatigue, dizziness, shortness of breath, weakness, and a bunch of other symptoms that overlap with other root causes.

So, how do we fix this root cause?

We do a blood test to determine ferritin levels, and then we optimize them - for reference, research has found that anything less than 50 micrograms per liter is insufficient to regrow hair. I typically aim for 70 micrograms per liter with my clients. I help my 1:1 clients access this kind of testing all the time - in case your practitioner won’t draw it for you - just FYI.

Ok, so how do you improve your ferritin if it’s below that magic 70 micrograms per liter?

If you tolerate it, you could incorporate more grass-fed, red meat into your diet. Nuts and seeds have some iron in them, as do green leafy veggies like spinach and kale. Taking Vitamin C with meals can improve iron absorption, as can digestive enzymes. I’ve found that the quickest route to improved ferritin (and therefore improved hair growth) is iron supplements - but quality really matters with this one because iron can be very hard on digestion. To avoid the constipation and gut irritation that comes with low-quality iron supplements, I recommend a product that contains ferrous bis-glycinate in combination with other compounds that are necessary for forming healthy red blood cells - you can grab my favorite HERE - and I’ll even pass along my 20% practitioner discount so you can save some cash.

There are other reasons why you might not be absorbing or utilizing iron effectively including microbiome imbalances or overgrowth, heavy menstruation, and low progesterone - if you know your ferritin is low despite intake, it may be worth a deeper investigation into underlying causes - feel free to apply for a 1:1 consultation if you’d like some help coming up with an action plan.

The second root cause of hair loss and thinning that I find in my female clients is thyroid hormone imbalance.

And again, we’re looking to optimize thyroid function, so we’re not content with “normal” lab results.

The most common way to assess thyroid function is by measuring thyroid stimulating hormone, or TSH, but unfortunately this doesn’t tell us the whole story. It’s possible - and even common - to have thyroid imbalances even if your TSH falls within a “normal” lab range.

Research shows that thyroid antibodies, a hallmark of a specific type of hypothyroid disease called Hashimoto’s, can be found up to a decade before TSH signals hypothyroidism. But most doctors don’t perform a full thyroid panel, including these antibodies as well as T3 and T4…more on that in a minute.

Symptoms of this subclinical, early low thyroid function include hair loss and thinning, fatigue, weight gain, brain fog, always feeling cold, puffy face and eyes, loss of eyebrow hair, constipation, depression…the list actually does go on, but the point is that these symptoms are what we call non-specific, meaning that they could have any number of overlapping root causes.

SO, if the symptoms of early thyroid dysfunction are fuzzy, and early testing isn’t the norm, that means many, MANY women with hair loss or thinning are falling through the cracks and missing out on years opportunity to resolve the issue at the root cause. And that’s a real bummer!

Here’s what you can do instead:

Get a full thyroid panel including TSH, Free T3, Free T4, and thyroid antibodies. You can ask your primary care provider or gynecologist to order this for you - and some will! If yours won’t, you can order your own at-home thyroid testing kit HERE. I’ll even help you interpret it!

Once you know if your thyroid is playing a role in your hair loss, you can take steps to rebalance it! Treating thyroid dysfunction could be as simple as taking thyroid medication to raise your hormone levels or as complicated as treating leaky gut, rebalancing micronutrients, calming an overactive immune system…it can get pretty complex. But the point is, you’ll know if it’s contributing to your hair loss because you’ll have complete data - and from there you can investigate further steps. Again, if this turns out to be a factor for you, I’d be happy to help you come up with a plan of action that fits your specific situation.

The third root cause of hair loss and thinning I’ve seen in my Functional Medicine practice is malnutrition.

And I don’t mean a lack of calories. A person can be over-fat and still malnourished because they are lacking the essential micronutrients needed for the body to function at it’s best - this situation is actually alarmingly common in the United States because the Standard American Diet is so nutrient-poor.

Here are a few micronutrient gaps that can cause or contribute to hair loss or thinning in women:

Essential fatty acids from foods like anchovies, herring, flax seeds, and olive oil can’t be made from scratch by the body, so if you’re not eating them (or supplementing with them), you could be deficient. Selenium is a micronutrient found in seafood, organ meats, and Brazil nuts and also helps balance blood sugar as well as prevent hair loss.

When it comes to re-growing hair, you need optimal levels of collagen, zinc, and biotin (as well as iron, which we already talked about). Collagen comes from animal products, specifically cartilage, bones, and joints. Bone broth is a great source of collagen, and there are many products on the market containing this skin, hair, and joint supporting micronutrient. But not all collagen is created equal - some sources can be very irritating to the gut or cause constipation, so quality does count. Top sources of zinc include oysters, lamb, pumpkin seed, hemp seeds, and cocoa powder. Biotin is a B vitamin, and one of the micronutrients most commonly associated with hair growth. High amounts can be found in egg yolks, soybeans, peanuts, and chicken liver.

I don’t know about you, but herring, organ meats, and oysters don’t regularly make it onto my plate (though I do love oysters!) - so if you’re experiencing hair loss or thinning, you may need to get these micronutrients in supplement form. And, not to sound like a broken record about this, but you need to know that, unfortunately, not all supplements are created equal. For the highest-standard, best-quality supplements for hair loss and thinning, check out my vetted products HERE.

If you’re struggling with the frustration of hair loss or thinning, I want you to know that you’re not alone, you’re not selfish or vain for wanting a solution, and that Functional Medicine has options for you!

Check out the links in this article or get more personalized help by applying for a 1:1 Functional Medicine Consultation with me, Dr. Kate, HERE.