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Thyroid Hormones and Female Hair Loss: What You Need to Know

    Quick Summary: Thyroid Hormones and Female Hair Loss

    • Thyroid Hormones: The thyroid gland produces crucial hormones, thyroxine (T4) and triiodothyronine (T3), which regulate metabolism and influence hair growth.
    • Thyroid Hormone Imbalance and Hair Loss: Imbalances, such as hypothyroidism (low hormone levels) and hyperthyroidism (high hormone levels), can disrupt the hair growth cycle, leading to hair thinning and loss.
    • Diagnosing Thyroid-Related Hair Loss: Diagnosis involves medical history, physical examination, and blood tests to measure thyroid hormone levels. Additional tests may identify autoimmune thyroid conditions like Hashimoto’s thyroiditis or Graves’ disease.
    • Treatment Options: Treatments include thyroid hormone replacement, antithyroid medications, radioactive iodine therapy, and surgery. Managing the underlying thyroid condition typically improves hair growth.

    Hair loss can be a distressing experience, especially for women. While there are many potential causes, thyroid hormones play a significant role in maintaining healthy hair. This article explores the relationship between thyroid hormones and female hair loss, offering insights into diagnosis, treatment, and management strategies.

    Understanding Thyroid Hormones

    The thyroid gland, located in the neck, produces hormones crucial for regulating metabolism, energy production, and overall bodily functions. The primary hormones produced by the thyroid are thyroxine (T4) and triiodothyronine (T3). These hormones influence various bodily processes, including hair growth1. Thyroid disorders affect nearly 14% of adult women and are among the most common endocrine disorders in reproductive-aged women2.

    Thyroid Hormone Imbalance and Hair Loss

    Thyroid hormone imbalances, particularly hypothyroidism (low thyroid hormone levels) and hyperthyroidism (high thyroid hormone levels), can significantly affect hair health. Both conditions can disrupt the normal hair growth cycle, leading to hair thinning and loss.

    • Hypothyroidism: Hypothyroidism occurs when the thyroid gland does not produce enough hormones. This condition slows down bodily processes, leading to symptoms such as fatigue, weight gain, and depression. Hypothyroidism is mostly seen in women between the ages of 40-50 and is seen in women ten times more often than men. It often occurs during the menopausal years. The prevalence of hypothyroidism is 1-2%3.

    In hypothyroidism, the reduced metabolic rate affects hair follicle cycling. The anagen (growth) phase of hair is shortened, and more hairs enter the telogen (resting) phase, leading to increased shedding and noticeable thinning4. Hair loss associated with hypothyroidism often presents as diffuse thinning as it affects hair across the entire scalp.

    • Hyperthyroidism: Hyperthyroidism is characterised by excessive production of thyroid hormones, accelerating bodily functions. Symptoms include weight loss, increased heart rate, and anxiety. It’s about 10 times more common in women than men, and typically happens between 20 and 40 years of age.

    The overactive thyroid accelerates the hair growth cycle, causing hair to shed prematurely. This can lead to noticeable thinning and loss5. Hair loss in hyperthyroidism often manifests as diffuse thinning, similar to hypothyroidism.

    The Role of Thyroid Hormones in Female Hair Loss

    Thyroid hormones influence hair growth by regulating the production of energy in hair follicle cells. An imbalance in these hormones disrupts this process, leading to hair thinning and loss. In women, the hormonal fluctuations associated with menstrual cycles, pregnancy, and menopause can exacerbate thyroid-related hair loss.

    • Menstrual Cycles: Hormonal changes during the menstrual cycle can affect thyroid function, potentially leading to temporary hair shedding.
    • Pregnancy: Pregnancy induces significant hormonal changes, impacting thyroid function. Postpartum thyroiditis, a condition where the thyroid becomes inflamed after childbirth, can lead to hair loss.
    • Menopause: Menopause brings a decline in oestrogen levels, which can unmask underlying thyroid issues, leading to increased hair loss2.

    Female hair loss differs from male pattern baldness, often presenting as diffuse thinning rather than localised patches of hair loss affecting the hairline, temples or crown. Women are also more likely to experience hair loss due to hormonal imbalances in addition to thyroid issues, making an accurate diagnosis crucial6.

    Diagnosing Thyroid-Related Hair Loss

    Accurate diagnosis of thyroid-related hair loss involves a combination of medical history, physical examination, and blood tests. It is essential to differentiate thyroid-related hair loss from other potential causes, such as nutritional deficiencies, stress, or genetic factors.

    • Medical History and Physical Examination: A thorough medical history and physical examination help identify symptoms consistent with thyroid dysfunction.
    • Laboratory Tests: Blood tests measuring Thyroid-Stimulating Hormone (TSH), T4, and T3 levels are crucial for diagnosing thyroid imbalances. Elevated TSH and low T4 levels indicate hypothyroidism. Blood tests revealing low TSH and high T4 levels confirm hyperthyroidism. Additional tests, such as thyroid antibodies, may be needed to identify autoimmune thyroid conditions like Hashimoto’s thyroiditis or Graves’ disease7.

    Treatment Options

    Treating thyroid-related hair loss involves addressing the underlying thyroid condition. Once thyroid hormone levels are normalised, hair growth typically improves.

    • Thyroid Hormone Replacement: Levothyroxine, a synthetic form of T4, is the standard treatment for hypothyroidism. It helps restore normal thyroid hormone levels, reducing symptoms, including hair loss. Regular monitoring of TSH and T4 levels ensures the correct dosage of levothyroxine, as over- or under-treatment can impact hair growth.
    • Antithyroid Medications: Medications such as methimazole or propylthiouracil reduce thyroid hormone production, helping to manage hyperthyroidism and its associated symptoms, including hair loss8.
    • Radioactive Iodine Therapy: This treatment involves taking radioactive iodine orally, which selectively destroys overactive thyroid cells, reducing hormone production9.
    • Surgery: In severe cases or when other treatments are ineffective, surgical removal of the thyroid gland may be necessary8.

    If you notice significant hair thinning, or if shedding is excessive and persistent, it’s advisable to consult with a hair loss specialist, such as our clinic.

    • Hair transplant surgery: For more severe cases of hair loss and where patients have managed their thyroid hormone dysfunction, surgical options can be considered to restore hair. The procedure involves taking hair follicles from a donor area (usually the back of the scalp) and transplanting them to thin areas. This procedure can provide results that are both natural-looking and long-lasting, effectively restoring hair growth and improving appearance and self-confidence10.

    Practical Advice for Managing Hair Loss

    While treating the underlying thyroid condition is crucial, additional strategies can help manage and improve hair health.

    • Nutritional Support: Adequate nutrition is vital for healthy hair growth. Ensuring a balanced diet rich in vitamins and minerals can support hair health.

    Iron: Iron deficiency can exacerbate hair loss. Foods rich in iron, such as lean meats, spinach, and legumes, are beneficial .

    Biotin and Zinc: These nutrients support hair growth and can be found in eggs, nuts, and whole grains11.

    • Hair Care Practices: Gentle hair care practices can minimize hair damage and loss.

    Avoid Heat Styling: Excessive use of heat styling tools can damage hair, leading to breakage and loss. When heat styling is necessary, use a heat protectant spray beforehand to minimise damage. Interestingly, research reveals that although using a hair dryer causes more surface damage than natural drying but, using a hair dryer at a distance of 15 cm with continuous motion causes less damage than air drying12

    • Use Gentle Hair Products: Shampoos and conditioners free of harsh chemicals can reduce scalp irritation and hair damage. Consider using sulfate free shampoos as they can prevent the removal of hair’s natural oils.
    • Stress Management: Stress can exacerbate hair loss. Implementing stress management techniques, such as yoga, meditation, and regular exercise, can support overall health and hair growth13.

    Conclusion

    Understanding the link between thyroid hormones and female hair loss is crucial for effective diagnosis and treatment. By addressing thyroid imbalances and adopting supportive hair care practices, women can manage hair loss and promote healthy hair growth. Regular medical consultations and a holistic approach to health can help achieve the best outcomes for those affected by thyroid-related hair loss.

    References

    1. Brent, G. A. (2012) ‘Mechanisms of thyroid hormone action’, J Clin Invest, 122(9), pp. 3035-3043. Available at: https://www.jci.org/articles/view/60047
    2. Brown, E. D. L., Obeng-Gyasi, B., Hall, J. E. and Shekhar, S. (2023) ‘The thyroid hormone axis and female reproduction’, Int J Mol Sci, 24(12), pp. 9815. Available from: https://doi.org/10.3390/ijms24129815
    3. Thyroid UK. Hypothyroidism. Available from: https://thyroiduk.org/if-you-are-hypothyroid/about-hypothyroidism/overview-of-hypothyroidism/
    4. NHS. Hypothyroidism (underactive thyroid). Available from: https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/
    5. NHS. Hyperthyroidism (overactive thyroid). Available from: https://www.nhs.uk/conditions/overactive-thyroid-hyperthyroidism/
    6. Hussein, R. S., Atia, T. and Bin Dayel, S. (2023) ‘Impact of thyroid dysfunction on hair disorders’, Cureus, 15(8), pp. e43266. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492440/
    7. Yazdaan, H. E., Jaya F., Sanjna, F., Junaid, M., Rasool, S., Baig, A., Natt, M. Z., Maurya, N., Iqbal, S., Yeldo, B. A., Khan, A. S., Varrassi, G., Kumar, S., Khatri, M. and Awan, S. K. (2023) ‘Advances in thyroid function tests: precision diagnostics and clinical implications’, Cureus, 15(11), pp. e48961. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726078/
    8. Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21(10):1081-1125. Available from: 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum (liebertpub.com)
    9. Mansourian AR. A review on the metabolic disorders of iodine deficiency. Pak J Biol Sci. 2011;14(6):412-424. Available from: A review on the metabolic disorders of iodine deficiency – PubMed (nih.gov)
    10. Rassman, W. R., Bernstein, R. M., McClellan, R., Jones, R., Worton, E. and Uyttendaele, H. (2002) ‘Follicular unit extraction: minimally invasive surgery for hair transplantation’, Dermatol Surg, 28(8), pp. 720-8. Available at:  https://pubmed.ncbi.nlm.nih.gov/12174065/
    11. Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. (2019) ‘The role of vitamins and minerals in hair loss: A review’, Dermatol Ther, 32(5), pp. e12964. Available from: The Role of Vitamins and Minerals in Hair Loss: A Review – PubMed (nih.gov)
    12. Lee, Y., Kim, Y. D., Hyun, H. J., Pi, L. Q., Jin, X. and Lee, W. S. (2011) ‘Hair shaft damage from heat and drying time of hair dryer’, Annals of dermatology, 23(4), pp. 455–462. Available at: https://doi.org/10.5021/ad.2011.23.4.455
    13. Thom, E. (2016) ‘Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption’, J Drugs Dermatol, 15(8), pp. 1001-4. Available from: Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption – PubMed (nih.gov)

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