Why is my hair falling out?

Recently, I’ve heard lots of people tell me that their hair is falling out, out of the blue, not really knowing why. This includes me. So I’ve been reading lots, refreshing my knowledge - to better understand the possible causes of sudden hair loss, and what I can do to help prevent any further hair loss.

Firstly - when should you be concerned? Brushing your hair and seeing a few strands on the brush head is normal. However, when you start losing a noticeable amount - for example every time you run your hand through your hair - then it can be a cause for concern.

So the first thing to do, in conjunction with your doctor, is to find out why. Here is a summary of my research into the most common causes and solutions for sudden hair loss:

Nutritional Deficiencies

Eating a balanced diet is key for hair health, and in the first instance I would make sure that my diet is abundant in the foods listed below.

Firstly, eating an adequate amount of protein is vital for hair growth - hair is effectively a protein filament and grows from follicles in the skin. You don’t need to go overboard, but just make sure you are eating the recommended daily allowance which is 0.8g per Kg. Protein can be found in lean meat, poultry, fish, eggs, yogurt, chickpeas, tofu and yogurt. I would also recommend making sure that your diet has lots of foods that contain omega-3 fatty acids such as oily fish, chia seeds and flaxseeds.

Generally, having a zinc and iron deficiency are the most common nutritional links to hair loss. Therefore, it will be beneficial to make sure you eat enough of the foods that contain these important minerals:

• Zinc - oats, pumpkin seeds, cashews, salmon, turkey, oysters, chickpeas, and lentils;

• Iron - spinach, legumes, red meat, pumpkin seeds, shellfish and red meat.

Furthermore, there is some evidence that suggests that a lack of the following vitamins and nutrients can also be attributed to hair loss - selenium, vitamin D, and vitamin A.

• Vitamin A - Oily fish, eggs, red, green and yellow fruit and vegetables containing beta carotene which we can convert into vitamin A, such as spinach, carrots, sweet potatoes, bell peppers, mango, papaya and apricots;

• Vitamin D - direct sunlight, oily fish, red meat and egg yolks

• Selenium - brazil nuts, fish, meat, eggs

Are You Stressed?

Stress is something that we have probably all experienced, to varying degrees, over the last few months. Stress can be physical - for example if you have suffered from COVID-19 or a sudden trauma to the body. Other physical stressors may include severe flu and surgery. Stress can also be psychological - for example experiencing anxiety from sudden redundancy, money worries, worry about our families, a sudden breakdown in your relationship etc. And stress can contribute to hair loss.

A common type of hair loss triggered by stress is called Telogen Effluvium. The main symptom is an increased shedding of hair, which you can see when doing very simple things like washing your hair or combing it. How does this happen? Well, there are three phases in any typical hair cycle: (1) Anagen or growth phase (2) Catagen or transitional phase (3) Telogen or resting phase. Significant stress can result in the anagen phase slowing down, meaning that fewer hairs enter the next two stages, and as a result there are a greater number of hair follicles in the resting phase. Within a few months, affected hairs might fall out suddenly and increased hair shedding occurs.

The good news is that where hair loss is caused by stress, it is usually reversible, through stress management techniques. All you need to do is to find an effective way of relaxing that works for you. Here are some examples of stress-relieving activity that you can try:

1. Get active - exercise is a great way of reducing some of that emotional stress that you are harbouring and for clearing your thoughts. Walking, pilates, yoga and going for a quick jog around the block are all easy activities that you can build into your everyday routine.

2. Connect with people - lockdown has shown us that wherever we are in the world, we are able to stay connected with our family and friends. Having a good support network of people can help to ease your worries or work troubles and help you see things in a different way. Whether you speak to people via zoom, meet with friends for a walk in the park or meet up with a family member for a coffee - it will help relax and feel better.

3. Meditation and mindfulness - there are so many apps such as Calm or Headspace that can help you chill out. Take the time to have some ‘me time’ each day, even if it's five minutes, you will feel better for it.

Hormonal Fluctuations

It’s worth noting that there are a few hormonal-related causes that can lead to hair loss. These include:

• Menopause - women naturally produce a small amount of testosterone, which prior to the menopause is balanced by the larger amount of oestrogen. Once menopause occurs, the oestrogen levels drop, and the effect of testosterone (androgen) increases. A sensitivity to androgens can cause the inactivation of hair follicles, leading to hair loss.

• Pregnancy - during pregnancy, women may actually find that their hair is thicker and more luxurious. It’s not actually thicker, but the increased levels of oestrogen during pregnancy and in particular the first trimester, results in decreased levels of male hormones and therefore causes your follicles to produce less sebum, making your hair feel bouncier and more voluminous. After you have given birth, it is not unusual to lose hair at a noticeable rate in the first six months after giving birth. This is simply because your body no longer has increased levels of oestrogen and progesterone, and your body is slowly getting back to normal. After a few months, you should see regrowth typically in the form of ‘baby-hair’ along the hairline. So don’t worry, the best advice I can give, is to wait it out and ensure that you are having a well-rounded, healthy diet, incorporating the foods listed above.

• Thyroid Function - thyroid hormones regulate the body’s metabolic rate controlling heart, muscle and digestive function, brain development and bone maintenance. If your thyroid is under or overactive, it can impact hair follicles and cause issues such as hair loss, dry hair or reduced growth. Your thyroid function can only be revealed by blood tests, and I would suggest that if your thyroid function is the case, work with your GP and endocrinologist to provide you with a treatment plan, hopefully helping you with the hair loss.

• Polycystic Ovary Syndrome (PCOS) - this is a common condition that affects how a woman’s ovaries work, where symptoms usually include irregular periods, excess androgens (male hormones) and polycystic ovaries (where fluid-filled sacs will form on the ovaries). Higher than normal levels of androgens can result in thinning hair, commonly referred to as female pattern baldness. If you think you might be suffering from PCOS, speak to your GP and nutritionist who can discuss with you the ways in which you can manage your symptoms.

I hope the above goes some way to help you understand why you may be suffering from hair loss, and why hair loss doesn’t have to be a permanent cause for concern for you. More often than not, you can take simple steps to help improve hair loss, hopefully resulting the restoration of your crowning glory!