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Science & Research

When Hair Loss Is a Sign of an Underlying Health Issue

By Fifty 410 Medical Team|January 19, 2025|12 min read

> Quick Answer: Hair loss can be an early indicator of thyroid dysfunction, autoimmune conditions, iron deficiency anemia, hormonal disorders like PCOS, and other systemic health issues. If your hair loss is accompanied by other symptoms—fatigue, weight changes, irregular periods, or skin changes—seek medical evaluation. The hair follicle is a sensitive barometer of overall health.

Your Hair as a Health Indicator

Hair follicles are among the most metabolically active structures in your body. They require steady supplies of nutrients, hormones, and oxygen to function properly. When something is wrong systemically, hair is often one of the first places changes appear.

Research published in Clinical, Cosmetic and Investigational Dermatology found that up to 50% of patients presenting with hair loss had an underlying medical condition contributing to their symptoms1.

Thyroid Disorders: The Most Common Culprit

The Thyroid-Hair Connection

Your thyroid gland produces hormones that regulate metabolism throughout your body—including in your hair follicles. Both too much and too little thyroid hormone can cause hair loss.

Hypothyroidism (Underactive Thyroid)

Affects approximately 5% of women2. Hair-related symptoms include:

  • Diffuse hair thinning (not patchy)
  • Hair that's dry and coarse
  • Loss of outer third of eyebrows (classic sign)
  • Slow hair growth
  • Hair that breaks easily

Other hypothyroidism symptoms:

  • Fatigue and sluggishness
  • Weight gain despite normal eating
  • Cold intolerance
  • Constipation
  • Dry skin
  • Brain fog
  • Depression

Hyperthyroidism (Overactive Thyroid)

Hair-related symptoms:

  • Fine, thin hair that won't hold a style
  • Diffuse hair loss
  • Soft, silky texture (different from normal)

Other hyperthyroidism symptoms:

  • Unexplained weight loss
  • Rapid heartbeat, palpitations
  • Anxiety, nervousness
  • Heat intolerance
  • Increased sweating
  • Tremors

Getting Tested

A simple blood test can evaluate thyroid function:

  • TSH (Thyroid Stimulating Hormone): Primary screening test
  • Free T4 and Free T3: Actual thyroid hormone levels
  • Thyroid antibodies: Can detect autoimmune thyroid disease

If you have hair loss with any thyroid symptoms, request testing.

Iron Deficiency and Anemia

Why Iron Matters for Hair

Iron is essential for:

  • Oxygen delivery to hair follicles
  • Cell division in the hair bulb
  • Enzyme function required for hair growth

Iron deficiency is the most common nutritional deficiency worldwide, affecting up to 30% of women of reproductive age3.

Hair Loss Pattern

Iron-deficiency hair loss typically presents as:

  • Diffuse thinning (all over)
  • Increased shedding (telogen effluvium)
  • Hair that lacks luster
  • Slow regrowth

Research in the Journal of Korean Medical Science found that women with hair loss had significantly lower ferritin (iron storage) levels than those without, even when they weren't technically anemic4.

Other Iron Deficiency Symptoms

  • Fatigue and weakness
  • Pale skin, especially inner eyelids
  • Shortness of breath
  • Dizziness
  • Cold hands and feet
  • Brittle nails
  • Restless legs
  • Unusual cravings (ice, dirt—called pica)

Testing Iron Status

A complete iron panel includes:

  • Ferritin: Iron storage (aim for 70+ for optimal hair health)
  • Serum iron: Circulating iron
  • TIBC: Iron-binding capacity
  • Hemoglobin: For anemia diagnosis

Many dermatologists recommend ferritin levels of 70 ng/mL or higher for optimal hair growth—well above the "normal" threshold of 12 ng/mL5.

Autoimmune Conditions

Alopecia Areata

The most direct autoimmune cause of hair loss. The immune system attacks hair follicles, causing:

  • Patchy, round bald spots
  • "Exclamation point" hairs (short, broken hairs around patches)
  • Can affect scalp, eyebrows, eyelashes, or body hair
  • Nail changes (pitting, ridges) in some cases

Alopecia areata affects about 2% of the population6. It can:

  • Resolve spontaneously
  • Recur unpredictably
  • Progress to total scalp (alopecia totalis) or body hair loss (alopecia universalis)

Lupus (Systemic Lupus Erythematosus)

An autoimmune disease that can cause:

  • Patchy hair loss
  • Diffuse thinning
  • Hair loss along the hairline ("lupus hair")
  • Scarring alopecia (permanent in some cases)

Other lupus symptoms:

  • Butterfly-shaped facial rash
  • Joint pain
  • Fatigue
  • Sun sensitivity
  • Mouth ulcers
  • Kidney problems

Other Autoimmune Conditions

Hair loss can accompany:

  • Hashimoto's thyroiditis
  • Grave's disease
  • Celiac disease
  • Psoriasis
  • Dermatomyositis

If you have one autoimmune condition, you're at higher risk for others.

Hormonal Imbalances

Polycystic Ovary Syndrome (PCOS)

PCOS affects 5-10% of women and causes:

  • Elevated androgens (male hormones)
  • Hair thinning on the scalp (androgenetic pattern)
  • Excess hair growth on face and body (hirsutism)
  • Acne
  • Irregular or absent periods
  • Weight gain, especially around the midsection
  • Insulin resistance

The combination of scalp hair loss with facial/body hair growth is a classic PCOS pattern.

Menopause and Perimenopause

Declining estrogen affects hair:

  • Thinner, finer strands
  • Slower growth
  • More visible scalp
  • Changes in texture

These changes can be addressed—explore our hair support options.

Postpartum Hormonal Shift

The dramatic hormone drop after pregnancy causes:

  • Significant shedding 2-4 months after delivery
  • Can lose up to 30-40% of hair
  • Typically resolves by 12 months postpartum

While normal, excessive or prolonged postpartum loss warrants evaluation.

Nutritional Deficiencies

Beyond iron, other deficiencies affect hair:

Vitamin D

  • Regulates hair follicle cycling
  • Deficiency linked to telogen effluvium and alopecia areata7
  • Very common (40% of adults are deficient)
  • Get levels tested and supplement if low

Zinc

  • Essential for hair tissue growth and repair
  • Deficiency causes hair loss and slow regrowth
  • Common in vegetarians, those with GI issues, and heavy alcohol users

Biotin (Vitamin B7)

  • Severe deficiency causes hair loss
  • Rare with normal diet
  • Can be depleted by certain medications or GI conditions

Protein

  • Hair is 95% protein (keratin)
  • Inadequate intake leads to thin, brittle hair
  • Common with restrictive diets

Other Systemic Conditions

Diabetes and Blood Sugar Issues

Poorly controlled blood sugar affects circulation and healing:

  • Diffuse hair thinning
  • Slow hair growth
  • Associated with other complications

Kidney Disease

  • Can cause diffuse hair loss
  • Hair texture changes
  • Usually accompanied by other symptoms

Liver Disease

  • Hair thinning and loss
  • Changes in hair texture
  • Usually with other signs (jaundice, fatigue)

Red Flags: When to Seek Medical Evaluation

Seek evaluation promptly if hair loss is accompanied by:

Systemic symptoms:

  • Unexplained fatigue
  • Unintentional weight changes
  • Fever
  • Night sweats

Skin changes:

  • Rashes anywhere on body
  • Scalp redness, scaling, or pain
  • Nail changes

Hormonal signs:

  • Irregular or absent periods
  • Excess facial/body hair
  • Acne that started or worsened in adulthood

Other concerning signs:

  • Sudden or patchy hair loss
  • Hair loss after starting new medication
  • Family history of autoimmune disease
  • Hair loss with joint pain

Getting Proper Evaluation

What to Expect

A thorough evaluation may include:

Medical history:

  • Family history of hair loss and autoimmune conditions
  • Menstrual history
  • Dietary habits
  • Medications and supplements
  • Stress levels
  • Recent illnesses or surgeries

Physical exam:

  • Scalp examination
  • Hair pull test
  • Examination for signs of systemic disease
  • Thyroid palpation

Laboratory tests:

  • Complete blood count
  • Comprehensive metabolic panel
  • Thyroid panel (TSH, Free T4, thyroid antibodies)
  • Iron studies (ferritin, serum iron, TIBC)
  • Vitamin D level
  • Hormone panel if indicated (testosterone, DHEA-S, prolactin)
  • ANA if autoimmune suspected

Specialists Who Can Help

  • Dermatologist: For hair-specific diagnosis and treatment
  • Endocrinologist: For hormonal causes
  • Rheumatologist: For autoimmune conditions
  • Primary care provider: For initial workup and referrals

Treatment: Addressing the Root Cause

When hair loss signals an underlying condition:

The priority is treating the underlying cause:

  • Thyroid medication normalizes hormone levels
  • Iron supplementation restores stores
  • Autoimmune treatments reduce inflammation
  • Hormonal treatments address imbalances

Supporting hair recovery:

While treating the underlying condition, hair-supportive treatments can help:

  • Minoxidil stimulates growth and may help while addressing the cause
  • Nutritional support ensures follicles have what they need
  • Gentle hair care minimizes additional loss

Our hair support formulas combine minoxidil with key nutrients like biotin, vitamin D3, and vitamin K2 to support follicle health while you address underlying causes.

The Bottom Line

Hair loss isn't just a cosmetic concern—it can be your body's way of signaling that something needs attention. If your hair loss is accompanied by other symptoms, don't dismiss it. A proper medical evaluation can identify treatable conditions early, when intervention is most effective.

Your hair deserves attention. So does the rest of your health.

Explore hair support options | Contact our care team


References:

  • Almohanna HM, et al. Clin Cosmet Investig Dermatol. 2019;12:443-461
  • American Thyroid Association. "General Information/Press Room." 2024
  • World Health Organization. "Iron Deficiency Anaemia: Assessment, Prevention, and Control." 2001
  • Park SY, et al. J Korean Med Sci. 2013;28(6):934-938
  • Rushton DH. Clin Exp Dermatol. 2002;27(5):396-404
  • Pratt CH, et al. Nat Rev Dis Primers. 2017;3:17011
  • Rasheed H, et al. Skin Pharmacol Physiol. 2013;26(5):249-255
  • This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare provider for diagnosis and treatment of any health condition. Compounded medications are not FDA-approved finished drug products.

    Topics:hair losshealth signsthyroidautoimmunedeficiencieswomen

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