Have you been experiencing hair loss or thinning without a cause? For example, you’re not pregnant and didn’t just deliver. You’re not on a medication that causes hair loss (such as chemo, birth control pills, high blood pressure drugs) and you didn’t recently change shampoo, hairspray, or gel. Talk to your stylist first to see if he or she notices anything different in your scalp or hair, and ask if they have changed hair coloring. Next, look at your family and see if it’s genetic. Then, see your doctor and get yourself a work-up.

First, stress is absolutely number one! Whether it’s physical, mental, emotional, or environmental, stress can cause a type of hair loss called telogen effluvium where your hair lays dormant for a few months, falls out for a few months then re-grows a few months after that. This means you could be waiting for six to nine months for your hair. Another type is alopecia areata where the hair follicles are attacked by white blood cells and hair falls out in patches. In this type, hair may not always grow back like it used to.

Second, test for iron as there is a lot of research that shows low iron is closely associated with hair loss. Have your health care provider test a CBC, iron, and ferritin. Ferritin is another word for iron storage. Many labs have minimum values at 10ng/mL however functionally you should be above 50ng/mL. You can have too much iron so make sure you are tested first before starting iron supplements.

Third, get a full thyroid work-up. There is a lot of research that shows both hypothyroid and hyperthyroid can cause hair loss/hair thinning. Ask your health care provider for a TSH, Free T4, Free T3, and the thyroid antibodies. The American Association of Clinical Endocrinologists state a TSH above 3 is considered hypothyroid. Make sure you are on the correct dose if you’re on thyroid replacement as those on the medications may have hair loss simply because it’s a known potential side effect of that drug.

Fourth, check your hormones. Women who have too much testosterone or DHEA are at an increased risk for hair loss/hair thinning. Additionally, these women often have acne, hair growth in places they don’t want them (upper lip, nipples, belly button), irregular cycles, and other high testosterone symptoms.