The Thinning Girl's Guide to Female Hair Loss - Common Causes and Solutions:

In my previous article, "The Thinning Hair Girl's Haircare and Hairstyle Guide" I provided tips, tricks and product recommendations for women suffering from thinning hair. This article will focus on the common causes of female hair loss, and some of the more popular treatment options.

Although each woman is unique, and the factors behind each woman's hair loss can be just as unique, if my fellow hair loss sisters are anything like I was at the beginning of my own hairmare, the quest for answers results in bringing up more questions. Therefore and in short, the purpose of this article is to possibly help put things into perspective for my fellow female hair loss sufferers.

Before I delve into the meat and potatoes of my article, and in accordance with state and federal laws, please note that I am not, nor do I claim to be a licensed medical professional. Additionally, this article is not intended to be used for purposes of self diagnosis and/or treatment. Hair loss could be an indication of an underlying health condition. When in doubt, always seek the advice of a trained, medical professional. Now that we have that out of the way... let's get started.

Common Types/Causes of Female Hair Loss:

TE / CTE (Telogen Effluvium / Chronic Telogen Effluvium): From birth to death, hair follicles go through a series of life cycles, if you will. There are three phases within each life cycle of a hair follicle: Anagen - growing phase, Catagen - the intermediate or resting phase, and Telogen - the shedding phase. In a normal person, approximately 10-20% of the hair follicles are in the telogen phase at any given time. However in women suffering from TE or CTE, an underlying cause (aka insult / trigger) disrupts the normal hair cycles and can trigger as much as 50% of the hair follicles into the resting phase. The result is that more hair is being shed than usual. This usually results in diffuse (all over) thinning.

Classic TE which lasts anywhere from 3-9 months, is commonly seen in women following childbirth, crash dieting and/or significant weight loss, surgery, extreme emotional distress such as death or divorce, and the addition of or a change in birth control or medications. Once the body has sorted itself out and rebalanced, and the shedding stabilizes, the hair follicles begin to recover and go back to normal. However, please note that this recovery process can take several months depending on the severity of the loss. In other words, do not expect overnight results, patience is a virtue.

CTE is when the insult and/or trigger is not known, and / or there are several causal factors. In this type of hair loss, the TE process continues for a year or more. In my experience and through my research, CTE is a very common cause of female hair loss, and is most commonly the result of:

the use of certain daily medications
iron deficiency or anemia
nutritional deficiencies (e.g. protein)
thyroid disorders
autoimmune disorders which cause inflammation in the body
chronic illness such as diabetes
hormonal imbalance
chronic stress

In my own situation, my CTE stemmed from autoimmune thyroiditis, which in turn caused hormonal imbalance and nutritional deficiencies (although stress most definitely exacerbated my TE). It is important to note that my thyroid levels all tested normal. My thyroid antibody levels, however, were through the roof.

AGA (Androgenic / AndrogeneticAlopecia): In women suffering from AGA hair loss (also known as FPB or Female Pattern Baldness), there can be a genetic predisposition for hair loss. This type of loss is caused by a sensitivity to androgen hormones (testosterone, androsteinedione, and dihydrotestosterone (DHT), which disrupts the normal hair growth cycle. Although these hormones are dominant in males, they are most definitely present in females, as well, albeit in small amounts. In AGA / FPB hair loss, testosterone is converted to DHT in the hair follicle and then binds with receptors within the hair follicle. As the hair cylces through its normal life stages and over time, the hair follicles shrink. This type of loss is very common in women who suffer from PCOS (Polycystic Ovarian Syndrome) because they produce more androgen hormones than the average female and they have increased sensitivity to said androgens. However, if a woman does not suffer from PCOS and is simply at the mercy of her genetics and family history, then AGA loss will most likely be seen during either puberty, menopause or both. Usually the loss has a pattern to it, such as crown thinning and widening of the central part.

AA (Alopecia Areata): This type of hair loss is an autoimmune condition, where in laymen's terms, the body basically attacks the hair follicles. The result is usually one or more smooth, circular bald patches varying in size, but usually dime or quarter size. In some cases, the hair grows back within a few months with no treatment. In other cases, AA can result in Alopecia Totalis (complete loss of scalp hair and total baldness) or Alopecia Universalis (complete loss of scalp and body hair). Regardless of the severity of loss - spontaneous recovery is not unheard of. I have a friend who lost all of her hair to AA, and has completely recovered and regrown it. The downside is that there is no concrete cure and once you have AA, the future of your hair can be uncertain. The upside is that AA is not life threatening, and bald can be beautiful. I know of many, many beautiful women who are completely bald and lead very full and successful lives.

Traction alopecia: Wearing you hair in tight hairstyles such as tight braids and ponytails puts a lot of stress on the hair and follicles causing the hair to be pulled on and pulled out. Caution - continuing to style your hair in this way can result in permanent damage.

Trichotillomania: The conscious or subconscious "habit" of pulling the hair or twisting it, sometimes without realizing it.

Mainstream and Alternative Treatments:

TE / CTE: In classic TE, treatment is usually not necessary as the trigger is usually a temporary situation that has already been resolved before the shedding even began. In CTE however, you will want to work with your doctor or doctors in figuring out the trigger and removing or resolving it. For instance, if your high blood pressure pills are the culprit, the resolution can be found in simply switching medications. If you have hypothyroidism, the introduction of thyroid medication such as synthroid or armour may help, but please be aware that it could take a series of adjustments in medications and/or dosage before you find what works best for you.

A word on iron deficiency - ongoing research indicates that iron deficiency, not necessarily anemia, can definitely result in CTE and can mimic AGA hair loss. If you are a woman who is menstruating normally, and whose diet is low in iron (red meats, green leafy veggies), then chances are you have some form of deficiency since iron is stored in the blood. Have your iron and saturation levels checked by your doctor and he/she can help you determine what type of supplementation you need as well as the dosage. Also and along those lines there are things you can do to enhance iron absorption such as getting your vitamin c and/or taking L-lysine.

Regardless of your trigger or triggers - there are certain steps that I will list below that CTE sufferers can use to assist in recovery. Just remember, our bodies are different and what works for one may or may not work for another:

Get on a good, whole food multivitamin such as New Chapter's Every Woman's Daily or Garden of Life's Living Multi. I advocate whole food supplementation by trusted brands, because (a) they are better assimilated by the body and (b) they do not contain artificial ingredients and fillers. Make sure your multivitamin contains all of the hair healthy vitamins which include, but are not limited to Biotin, the B vitamins, vitamins A, C, D & E, iodine, zinc and selenium. If you suffer from autoimmune thyroiditis however, be cautious in taking vitamins that contain high levels of iodine. Autoimmune thyroid sufferers are better off getting their iodine from food sources such as fish, kelp or algae (chlorella).

Make sure your diet is rich in lean, healthy proteins such as chicken, fish, seeds, nuts and legumes, as well as fibrous carbs such fresh fruits and veggies. Sidebar here - protein is hair food. Also and along those lines - don't skip meals. Food is energy and energy is needed by all of your bodily functions including hair growth. Also, starches aren't necessarily bad when eaten in moderation - just don't overdo it.

Drink plenty of water and skip the sugary drinks that have zero nutritional benefits.

Exercise smarter not harder - a combination of cardio and strength training 3-4 times per week for an hour in duration each session is exercising smarter. Two hours on the treadmill, seven days a week is exercising harder and will totally tax your system which can definitely exacerbate hair loss. Exercise increases circulation. Good circulation encourages hair follicle health.

Get on a good probiotic. Probiotics encourage healthy intestinal flora which will in turn aid you body in the digestion process. Good digestion is key to assimilating nutrients needed for a healthy body and healthy hair.

Get on some good essential fatty acids supplements. Fish oil is an Omega 3 fatty acid that has wonderful health benefits and helps supply your hair follicles with the EFA's they need to produce healthy hair. Nordic Naturals is a brand that is highly recommended by many holistic health practitioners (and some mainstream docs). Evening Primrose Oil is an Omega 6 fatty acid that is known for assisting in hormonally related hair loss, especially thyroid. Fatty acids also help reduce inflammation in the body which is key if your hair loss is related to autoimmune inflammation.

Bio-identical Hormone Replacement: If the hair loss is mild to moderate and related to hormonal imbalance, then an OTC natural, bio-identical progestrone cream may be very helpful in reversing hair loss (with phyto-estrogens if the loss is related to menopause). However, treating with a holistic practitioner such as a naturopathic doctor and using a compounded cream specifically created for your body would be the best route. BHRT is also available in other forms.

AGA / FPB: Treatment should be aimed at (a) lowering the level of circulating androgens in the body, (b) decreasing sensitivity to said androgens and / or (c) inhibiting the conversion of androgens to DHT. Treatments for this type of loss are vast and varied. With that said, this article will set forth some of the most common treatments

Mainstream Treatments for AGA Hair Loss:

Rogaine (minoxidil): This is an over the counter, daily topical treatment which has been shown to slow or stop hair loss and encourage new growth. The effect minoxidil has on hair was actually discovered by accident. It was first introduced in a high blood pressure medication. It is theorized that it inhibits the conversion of androgens to DHT. It has been proven to work and it is FDA approved, but it may not work for everyone. Minoxidil is a key ingredient in many available topical treatment programs such as Scalp Med

Propecia / Finasteride: This is the only FDA approved once daily pill proven to reduce DHT. It is approved for male hairloss only, however, there are females who have had some success with this medication. Be aware that any medication, however, carries its risks.

Spironolactone: This prescription medication is a diuretic that is known for its anti-androgen effects. It is used to treat hair loss, acne and hirutism in women. It is commonly used by PCOS sufferers along with an oral contraceptive.

Oral Contraceptives / Birth Control Pills: some birth control pills are known for its anti-androgen effects. One very popular brand prescribed to and used by hair loss sufferers is Yasmin, but there are others. The problem is that oral contraceptives are also known for causing hair loss. It's sort of a catch 22.

Metformin: This is a diabetes medication that helps sensitize the cells to insulin and helps lower circulating blood sugars. It is often prescribed to women suffering from PCOS because it assists with insulin resistance which is common to PCOS sufferers. However, it is also known for having anti-androgen properties.

Alternative Therapies / Treatments for AGA Hair Loss:

Saw Palmetto: this is an herb which is believed to inhibit the conversion of androgens to DHT.

Pumpkin Seed Oil: this is a food based supplement believed to inhibit the conversion of androgens to DHT.

Bio-identical Hormone Replacement: creams, gels or pills prescribed by a doctor can have anti-androgen effects. What makes this different from traditional HRT is that the ingredients are natural and not synthetic.

Emu Oil: Applied topically and touted to reverse hair loss and encourage regrowth. There are no studies or scientific evidence that I'm aware of that demonstrates this as a proven treatment. However, I have read some stories of success from men and women who have used this in their hair loss arsenal.

Mainstream Treatments for AA Hair Loss:

Steroid injections:Monthly Injections of cortisone in the scalp can treat alopecia areata by reducing inflammation and shocking the follicles back into the anagen stage.

Oral Steroids: prescriptions for corticosteroid pills can be prescribed for extensive hair loss due to alopecia areata and will treat inflammation.

Topicals: prescription ointments, creams and shampoos also can be used, but they may be less effective than injections or pills.

Alternative Treatments for AA Hair Loss:

The only alternative treatment I am aware of for AA hair loss that has actually worked is a blend of specific essential oils, namely cedarwood, lavender, rosemary and thyme in a grapeseed and jojoba base (carrier oils).

I have heard of people applying white iodine or emu oil to bald patches with some success, but the above treatment is the only one backed by an actual study.

Hair Regrowth Supplements:

I can only offer my review on two specific hair regrowth supplements - Viviscal and Nu Hair.

Viviscal contains vitamin c, silica and a special blend of marine proteins aimed at feeding the hair follicles and combating the effects of stress. Viviscal is also known as Nourkin. There are many women out there who swear by this stuff, myself included.

Nu Hair is a blend of vitamins, herbs and fish collagen aimed at feeding the hair follicles, combating the effects of stress AND hormonal balancing.

I liked Viviscal in terms of regrowth, but it is very costly. Nu Hair is much more cost effective and I have noticed a major difference in the amount of hair I shed while using it. I was already shedding normally when I started taking Nu Hair - but the amount lessened even more.

Final Words - Tests, Diagnosis and Treatments:

Obviously, and to anyone who knows anything about female hair loss, this article barely scrapes the surface of the mysteries surrounding female hair loss, as well as the available treatment options. Therefore it is imperative that one works with one or more of her trusted medical professionals in testing, diagnosis and treatment. Usually, this professional will be a dermatologist or endocrinologist who specializes in hair loss conditions, but can be a sympathetic general practitioner or OBGYN.

For me, I find that the only reason I have been able to my own best advocate and figure out what was going on with my own hair loss, is because I carefully listened to my body and I have been an active participant in female hair loss forums, where sufferers share in their experiences - good, bad or indifferent, as well as their knowledge. These forums provide a wealth of information including, but not limited to, lists of medications that can cause hair loss, diagnostics and testing that should be performed, and treatments of all kinds. However and most importantly - these forums provide physical and emotional support while creating lasting friendships.

My favorite female hair loss forums can be found at:

http://www.herhairlosshelp.com
and
http://www.heralopecia.com

I hope to see you there.

To your health and hair,
Robin