The Most Common Causes of Alopecia: A Functional Medicine Guide
Experiencing hair loss, or alopecia, can be an extremely stressful experience. And it makes sense — no one wants to lose their hair! We often think of “balding” as a men’s health issue, but the truth is that alopecia can happen to anyone, at any age, for a wide range of reasons. In fact, more than half of all men and women will experience hair loss of some kind by the time they turn 50!
This can be the result of genetics, medical conditions, certain medications, hormonal changes, or just a result of normal aging. The good news is that by taking a closer look at the underlying causes of hair loss, there’s a chance that you may be able to slow it or even reverse it.
If you’re worried about hair loss, don’t panic. Keep reading!
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How Much Hair Loss is Normal?
The average human loses about 100 hairs a day. And normally, we don’t even notice! That’s because new hair is constantly growing in its place, maintaining the thickness of the hair on our head. When alopecia — which is a general term of hair loss — occurs, hair isn’t growing as much as it's being lost and that can lead to balding and thinning of the hair.
There are a lot of different types of alopecia and they can all cause a different form of hair loss. For example, it can occur in patches, as a general thinning of the hair in certain areas or all over the head, and it can even mean full-body hair loss. Some experience a rapid loss of hair and others experience a gradual thinning of the hair over many years.
Regardless of the type of hair loss, the question I often get from my patients is “Why is this happening, and is there anything I can do about it?”
What Are the Common Causes of Alopecia?
The causes of alopecia range depending on the individual. And it doesn’t have to be just one factor, either. Sometimes it’s a combination of a few of the factors below! Here is a list of the most common causes of hair loss I see among my patients:
1. Major hormonal fluctuations
In women, hair loss is often the result of a large hormonal event or imbalance. This can include pregnancy, giving birth, and entering menopause. The good news is that this is often temporary and not true hair loss; typically, the hair loss subsides once your hormones return to normal.
What you can do: Focus on stress relief, proper nutrition, and consider hormonal testing with a functional medicine provider.
2. Your DNA
Unfortunately, hereditary hair loss is the most common cause of hair loss and the one that is the most difficult to treat. This type of hair loss is typically gradual and involves a receding hairline and bald spots in men and a thinning of hair along the crown of the head in women.
What you can do: There are a couple of FDA approved medications (1) that will slow or even reverse hereditary hair loss. Deciding whether or not to take medication involves weighing the pros and cons of slowing hair loss with the potential side effects of the medications.
3. Certain medical conditions
Thyroid conditions, lupus, and PCOS are just a few of the many conditions that have been connected to hair loss. Alopecia areata is an autoimmune condition that causes sudden patchy hair loss that occurs quickly. The good news is that for the vast majority of people, hair grows back within a year.
What you can do: The good news here is that there’s typically a LOT you can do to improve these underlying health conditions. I recommend taking a look at my book The Inflammation Spectrum for nutrition and lifestyle tips.
Many common medications and over-the-counter drugs can contribute to hair loss. These include birth control pills, NSAIDS, and acne medications. If you take a medication or receive treatment for cancer, arthritis, depression, high blood pressure, or cardiovascular conditions, your medication could be the underlying cause of your hair loss. (Here’s a full list to check out.) (2)
What you can do: Never stop a medication without talking to your doctor first. That said, it may be possible to switch medications or reduce your dosage to help with hair loss. I also recommend working with a functional medicine expert on lifestyle interventions that may treat the underlying cause of your illness, which may reduce your need for medications entirely!
Stress with a capital “S” is one of the most common causes of hair loss. I see this type of hair loss frequently among my patients who are grieving or have experienced a traumatic event. The good news is that this type of hair loss is temporary and will resolve on its own.
What you can do: First, be kind to yourself. Hair loss is your body’s way of telling you that you’ve been through a lot. Try to find ways to show yourself some TLC — like a bath, a long walk, talk to a therapist, or a yoga class — and rest assured that this type of hair loss happens to a lot of people.
6. Hairstyles and chemicals
There are certain hairstyles that pull on hair and can cause something called traction alopecia, including braids and pigtails. The use of harsh chemicals can also damage hair and cause thinning and breakage. These factors can cause permanent damage so it’s important to keep an eye out for hair loss and take steps to mitigate it right away.
What you can do: Look for non-toxic hair care products and salons that try to reduce their use of chemicals and damaging products.
7. Vitamin deficiencies
Certain nutrient deficiencies have been linked to hair loss (3), including riboflavin, biotin, folate, and vitamin B12. Micronutrients and macronutrients are both important for follicle development and the regulation of immune cell function, which play a major role in healthy hair growth.
What you can do: Take a high-quality multivitamin daily and get checked regularly for nutrient deficiencies. You can also take a B vitamin complex to make sure you’re not deficient in any of the B vitamins above that are linked to hair loss.
One of the top kinds of alopecia that I see in patients is alopecia areata, which is an autoimmune disease. This means that your immune system is triggered and attacks a part of your body, a phenomenon called molecular mimicry. When you have alopecia areata, the immune system tags and attacks the hair follicles, causing them to fall out.
What you can do: As with any autoimmune condition, there is no one solution. Every case is different, with different factors to consider. Comprehensive labs and a multi-pronged approach should be implemented. This is something that I consult with patients around the world about.
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- FDA Approved Hair Loss Treatment (Medications). Hair Transplant Clinic Ireland. https://www.hrbr.ie/fda-approved-hair-loss-treatment/. Published June 18, 2012. Accessed November 25, 2020.
- Watson S. Medications That Can Cause Hair Loss. WebMD. https://www.webmd.com/skin-problems-and-treatments/hair-loss/drug-induced-hair-loss-2#1. Published January 11, 2010. Accessed November 25, 2020.
- Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019;9(1):51-70. doi:10.1007/s13555-018-0278-6
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BY DR. WILL COLE
Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.