Hair Loss in Women: What Your Body Is Really Telling You

1. Iron and Ferritin Deficiency

Low ferritin is the single most common nutritional cause of hair loss I see in clinical practice. Ferritin is the storage form of iron, and the hair follicle is exquisitely sensitive to fluctuations in ferritin levels, often before other symptoms of iron deficiency become apparent.

The challenge is that standard iron panels frequently miss this. A serum iron or haemoglobin result can fall within the reference range while ferritin is critically low. For hair growth, ferritin ideally needs to sit above 70 to 80 micrograms per litre. Many women with significant shedding have ferritin levels in the teens or twenties, values that a GP might consider technically normal but that a naturopath recognises as inadequate for follicle function.

Causes include heavy menstrual bleeding, poor dietary intake, compromised absorption due to gut dysfunction, and long-term use of proton pump inhibitors. Addressing iron deficiency for hair loss requires more than supplementation. It requires identifying and resolving the reason iron is low or not being absorbed adequately.

2. Thyroid Imbalance

Both hypothyroidism and hyperthyroidism can cause diffuse hair loss, but hypothyroidism is significantly more prevalent in women and more frequently overlooked. Thyroid hormones are essential regulators of the hair growth cycle. When thyroid function is suboptimal, hair follicles spend more time in the telogen (resting and shedding) phase and less time in the anagen (active growth) phase.

Subclinical hypothyroidism, where TSH is elevated but within range, and Hashimoto's thyroiditis, an autoimmune thyroid condition, are both common presentations I see alongside hair complaints. Symptoms often include fatigue, cold intolerance, brain fog, sluggish digestion, and low mood, alongside the hair loss.

A comprehensive thyroid assessment, including TSH, free T3, free T4, and thyroid antibodies, is essential for an accurate picture. Naturopathic support for thyroid health involves addressing the autoimmune component, optimising nutrient cofactors like selenium, zinc, and iodine, and supporting the overall hormonal environment.

3. DHT, Hormones, and Androgenic Alopecia

Dihydrotestosterone, commonly known as DHT, is a potent androgen derived from testosterone via the enzyme 5-alpha reductase. In genetically susceptible individuals, DHT binds to receptors in the hair follicle and causes miniaturisation: the gradual shrinking of the follicle and shortening of the growth cycle, eventually producing finer, shorter hairs until the follicle ceases production altogether.

In women, androgenic alopecia often presents as diffuse thinning across the crown and top of the scalp rather than a receding hairline as seen in men. It frequently becomes more apparent around perimenopause as oestrogen levels decline and the ratio of androgens rises. Conditions like polycystic ovarian syndrome (PCOS) are also associated with elevated androgens and corresponding hair thinning.

Naturopathic approaches to DHT-driven hair loss focus on supporting hormonal clearance through the liver, reducing androgen excess, and providing follicle-supporting nutrients. Saw palmetto, zinc, and specific B vitamins have been studied for their role in modulating 5-alpha reductase activity. Suchi Bloom, our naturopathically formulated hair blend, is crafted to support follicle health and the internal environment in which healthy hair growth depends.

4. Chronic Stress and Cortisol

Significant physical or psychological stress can trigger a type of diffuse shedding called telogen effluvium. Under stress, the body deprioritises non-essential functions, and the hair follicle is one of the first to feel it. Elevated cortisol disrupts the hypothalamic-pituitary-adrenal (HPA) axis and interferes with the hair growth cycle, prematurely pushing follicles into the resting phase.

The typical pattern with telogen effluvium is a lag of two to four months between the stressful event and the onset of increased shedding, which makes it difficult to connect cause and effect. Common triggers include illness, surgery, rapid weight loss, emotional trauma, postpartum recovery, or a sustained period of high stress.

While telogen effluvium is often self-limiting once the stressor is removed, recovery can be delayed if the body remains nutrient-depleted or the stress response remains chronically activated. Supporting adrenal function with adaptogenic herbs, addressing sleep quality, and restoring nutritional reserves are all central to naturopathic recovery from stress-related hair loss.