I always had very thick curly hair. Around the age of 30 I started noticing my hair clogging the shower drain from time to time. However since I still had so much hair, it wasn’t high on my personal list of worst hypothyroidism symptoms.

Then all of a sudden one close look in the mirror last year at age 43 changed all that.

As I was brushing my hair something caught my eye in the mirror.

Wait…is that my scalp showing through?

A closer look.

My hair was noticeably thinner on both sides of my head above my ears, front, and at the temples.

My gut reaction was a scream, then tears.

What happened to my hair?

Then anger.

Hey Thyroid, Do NOT mess with me.

I went into deep research mode, searching for every article I could get my hands on related to thyroid hair loss.

I was determined to save my hair…

AND I DID IT.

Now my hair appears fuller, far less scalp shows through, baby hair has grown back at my temples, and the rate of hair loss has dramatically slowed down. I’m so thankful. Yes I know that may sound vain to be focused on my physical appearance but losing my hair was devastating to me. I have a feeling I’m not alone.

It took over one year of research, extensive lab testing, and trying various supplements to write this article (plus a fierce determination to get my hair back), so yes this article is lengthy.

Please note that I am not a doctor. I’m just sharing the ten things that worked for me in the hopes that you will discover what works for you too. As with all things in particular supplements mentioned at Hypothyroid Mom, consult with your doctor to be sure they are right for you and that you are taking the right dosage for your body. Our physiology is unique so what works for each of us will be unique too.

1. Optimal Thyroid Treatment

Every part of the body requires thyroid hormone for proper functioning, and that includes the hair follicles. In 2008, the Journal of Clinical Endocrinology and Metabolism presented the first evidence that human hair follicles are direct targets of thyroid hormones. This research demonstrated that the thyroid hormones T4 and T3 modulate multiple hair biology parameters from cycling to pigmentation.

You'll notice that I bolded the words thyroid hormones T4 and T3. Why is this so important for those of us with hair loss?

In mainstream medicine, Levothyroxine drugs are the gold standard for the treatment of hypothyroidism. While these drugs work for some people, they fail for others. Levothyroxine drugs contain T4 thyroid hormone only. Our bodies are supposed to convert that T4 thyroid hormone to the active T3 hormone our cells need. For some of us our bodies don’t convert T4 to T3 properly, leaving us symptomatic. This is why many of us do better on a combination of T4 and T3 thyroid hormone replacement treatment.

The noticeable hair loss was a red flag for me that I needed to get to my doctor for thyroid testing. I’m on the natural desiccated thyroid Nature-throid plus a compounded time-release T3. My doctor did comprehensive testing including the essential thyroid tests TSH, Free T4, Free T3, Reverse T3, and thyroid antibodies. Turned out my Free T3 was middle of the range. I personally feel terrible when my Free T3 is low or even middle of the range. Optimal Free T3 for my body is when it reaches top quarter of the normal range, so adjusting my thyroid medication dosage was an essential piece to my thyroid hair loss. What is optimal is individual and it’s about finding what’s right for you.

There are many different thyroid medication options. Finding a doctor open the treatment options to find what is right for you is key. Sadly not all doctors are open to the options and it can be a very frustrating journey. I’ve put together resources to help readers locate great thyroid doctors across the globe.

While optimal thyroid treatment was an essential piece of the puzzle, there were additional pieces critical to my hair loss solution.

2. Low Ferritin

Low ferritin (the stored form of iron) is one of the most common causes of hair loss in women. Given low ferritin is also a common problem for hypothyroid people, it is important to have iron testing including ferritin especially if you are experiencing hair loss. It is not enough to be told by your doctor that your iron levels are ‘normal’. Ferritin levels are not always tested. Get a copy of your lab results and be sure ferritin has been specifically tested. Even if ferritin is within the ‘normal’ range that doesn’t make it ‘optimal’.

Dr. Philip Kingsley is called the ‘Hair Guru’ by the New York Times. Why Is Ferritin Important? appears on his website:

Correct ferritin levels maximize your hair’s “anagen” or “growing” phase and encourage your hairs to grow to their full length. When you aren’t getting enough iron through your diet, your body takes ferritin stored in non-essential tissue, like your hair bulb, and gives it to essential tissue, such as your heart. Because your hair bulb is where all your hair cells are produced, this leeching of ferritin can cause your hair to shed before it reaches its maximum length.

    The average reference ranges for ferritin are 14-170 micrograms per litre, but our research shows that ferritin should be at least 80 ug/L (micrograms per litre) in women for hair follicles to function at their best.

Treating low ferritin was another major piece of my hair loss solution. I tried various iron supplements and many of them gave me digestive issues including constipation. With a life-long history of constipation, that was the last thing I needed. I have personally found that iron in the form of liver concentrate such as the brand Carlson Labs Buffalo Liver works well for my body. My doctor regularly tests my ferritin to be sure I am taking the right dosage of iron supplements for my body and that I’m not taking too much because over-dosing on iron can be dangerous.

I’m careful to take iron supplements including multivitamins with iron at least 3 hours apart from my thyroid medication to ensure the iron doesn’t interfere with the absorption of my thyroid medication.

3. Low Stomach Acid 

I read a fascinating interview with Dr. Jonathan Wright by Suzanne Somers Honey, I Shrunk My Ponytail! Turns out this article would change the fate of my hair.

DR. WRIGHT: If stomach acid is low, protein isn’t efficiently digested – and hair and nails are made up of… protein! If we are deficient in protein, our bodies know that we can live without hair or nail proteins, but we can’t survive without heart muscle proteins or other important body proteins. So if we are short in supply of protein, the hair or nails are the first to go.

Turns out low stomach acid results in malabsorption of iron (which as you know is necessary for maintaining our hair) and many other essential nutrients. Thanks to this article I discovered my own issues with low stomach acid and now take this Betaine Hydrochloric Acid with Pepsin just before heavy meals containing protein. This has also helped me personally with heartburn, gas, acid reflux, and bloating.

There are two additional ways that I increase my low stomach acid.  Every morning before breakfast I drink warm water and lemon. Before the larger meals of the day I take 1 tablespoon of apple cider vinegar in water. I use Bragg’s Apple Cider Vinegar. This raw organic apple cider vinegar contains the ’mother‘ of the vinegar. The ’mother’ is made up of beneficial living nutrients and bacteria. Another option is to take digestive bitters.

4. Nutrient Deficiencies

Nutrient deficiencies are a common issue for those of us with hypothyroidism. Not only are nutrients essential for thyroid function, but they also play an important role in keeping the hair on our heads from falling. A good quality multi-vitamin is important and of course a healthy diet is essential, but still nutrient testing is important because many like me will require additional supplementation to bring us to optimal. Testing should include zinc, vitamin D, B12, and magnesium (for each nutrient listed I attached an article that explains its connection to hair loss).

Nutrient deficiencies are an issue for me personally. I supplement every day to maintain my nutrients at optimum. When I noticed a worsening of my hair loss last year, nutrient testing revealed that I was deficient in all those nutrients necessary for hair health.

5. Drug-Induced Hair Loss

There are many different types of drugs that can cause hair loss. Here is a list of  What Types of Drugs Cause Hair Loss by WebMD:

• Acne medications containing vitamin A (retinoids)

• Antibiotics and antifungal drugs

• Antidepressants

• Birth control pills

• Anticlotting drugs

• Cholesterol-lowering drugs

• Drugs that suppress the immune system

• Drugs that treat breast cancer

• Epilepsy drugs (anticonvulsants)

• High blood pressure medications (anti-hypertensives), such as beta-blockers, ACE inhibitors, and diuretics

• Hormone replacement therapy

• Mood stabilizers

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Parkinson’s disease drugs

• Steroids

• Thyroid medications

• Weight loss drugs

Did you notice that I highlighted thyroid medications on that list?

I’ve heard from many readers who had sudden worsening of their hair loss when they started one or another thyroid drug brand. Think back to the start of your hair loss, did it happen at the same time you started a specific thyroid medication?

6. Alopecia Areata

Alopecia Areata is a hair-loss condition that typically causes patchy bald spots on the scalp. It is an autoimmune disorder in which the immune system attacks the hair follicles.

What does this have to do with hypothyroidism? A lot.

It is estimated that 90% of people with hypothyroidism have the thyroid autoimmune condition known as Hashimoto’s Thyroiditis. Hashimoto’s is an autoimmune condition in which the body attacks its own thyroid gland. Despite the prevalence of Hashimoto’s, thyroid antibodies are often NOT tested. You may have Hashimoto’s and not even know it. There are two thyroid antibodies to test for Hashimoto’s: Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).

When you have one autoimmune disease, you are at high risk of developing other autoimmune diseases. In her guest post for Hypothyroid Mom Autoimmune Diseases Brew In Your Body FOR YEARS Before Diagnosis Functional Medicine nutritionist Tracy Konoske wrote:

Dr. Gerald Mullin from Johns Hopkins says statistically somebody with an autoimmune disease is at risk of a total of 7 autoimmune diseases in his or her lifetime.

I hear from readers all the time with multiple autoimmune diseases including Hashimoto’s and Alopecia. If this turns out to be the cause for your hair loss, it is important to address the underlying autoimmune issue.

7. Sex Hormone Imbalances

Perimenopause…are you kidding me?!

The signs were there. My menstrual cycles changed very suddenly and became much shorter in length. At that exact same time my hair loss accelerated. Coincidence? I don’t think so.

I went to my doctor and had my sex hormones tested.

For me it turned out I was in perimenopause. What is perimenopause? It’s that rocky road of hormonal shifts leading to menopause. When perimenopause starts varies for each woman, but it can start 10 years before menopause.

In my case I had estrogen dominance, too much estrogen relative to progesterone. Sex hormone issues are common in women with hypothyroidism and even more reason why they should be part of thyroid testing for every person presenting with thyroid issues. Bioidentical progesterone has been a major help in saving my hair.

Don’t forget testosterone testing…yes testosterone. Harvard-trained MD and author of the New York Times Best Seller The Hormone Cure Dr. Sara Gottfried had this to say about testosterone in her article The Horrors of Hair Loss for The Huffington Post:

 Another possible reason for hair loss? Too much testosterone. That’s right: Women also produce the hormone testosterone. In fact, testosterone is what gets us in the mood, gives us self-confidence, and keeps us vital and sassy.

 But if testosterone levels are too high in women — whether because of menopause, excess weight, or other causes — we see symptoms of male-pattern baldness and rogue hair growth on the face. The hairs on your head are falling out, but you’re finding new ones on your chin? Totally unfair!

High testosterone can cause hair loss but so can low testosterone. Be sure to have yours tested.

Dr. Josh Axe has a very helpful video on his website called 6 Secrets for Reversing Hair Loss. According to Dr. Axe, hair loss is also linked to an increase in an androgen hormone called DHT (DiHydroxy Testosterone).

I’m fortunate to have a great doctor who did extensive testing including DHT when I went in tears to her office about my thinning hair. I wonder though how many doctors know to test DHT? Hmmm…It means being an advocate for yourself and insisting on the right tests, or finding a good doctor who will do them.

8. Blood Sugar Imbalance

Author of the book ‘Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause’, Dr. Izabella Wentz wrote the following information in her article ‘Hashimoto’s And Getting Your Hair Back’…

Balance your blood sugar! Blood sugar swings brought on by eating too many carbohydrates and not enough quality proteins and fats can wreak havoc on your health and hair! Blood sugar swings encourage the conversion of T4 to reverse T3. Reverse T3 is a inactive hormone that blocks the body’s utilization of T3, resulting in increased hair shedding.

In an interview with Dr. Datis Kharrazian Gluten: Why hypothyroidism patients often fail to get better he said,

There’s just no question that many people that have Hashimoto’s and hypothyroidism have gluten sensitivity. For some patients, it’s life-changing when they go gluten-free.

I find these two sources very interesting because I’ve been on a gluten-free journey now for 1 year and I’ve been working on stabilizing my blood sugar levels. I was a white flour and sugar addict and I remember too well the swings up and down and crashes in my blood sugar throughout the day. Since going gluten-free I’ve been more mindful of my blood sugar levels and I don’t experience the sharp crashes in energy that I used to. I have to be honest and tell you that I find it hard to go 100% gluten-free but when I do I feel better and it motivates me to continue. What I’ve noticed is that when I do cheat and eat a heavy gluten meal my hair comes out in handfuls. Is it a coincidence? I don’t think so.

 9. Hair Loss Supplements

Here are supplements that I take on a daily basis that have made an obvious difference in my hair.

Omega-3 Fatty Acids

Dr. Andrew Weil is a world-renowned leader and pioneer in the field of integrative medicine. In his article ‘Two Supplements for Thinning Hair’, he wrote:

Make sure you’re getting enough omega-3 fatty acids. Eat wild Alaskan salmon, sardines, herring or mackerel two or three times a week, or sprinkle two tablespoons of freshly ground flaxseeds per day on cereal or salads. You can also supplement with a high-quality fish oil.

 Supplement your diet with GLA (gamma-linolenic acid) in the form of black currant oil or evening primrose oil. Take 500 mg of either twice a day for six to eight weeks to see if it helps.

I take this brand of Cod Liver Oil free of detectable levels of mercury every day and I take evening primrose oil as I'll describe next.

Evening Primrose Oil

Author of the book ‘Thyroid Guide To Hair Loss’, Mary Shomon wrote this in her article at About.com Thyroid ’Hair Loss Solutions For Thyroid Patients’:

According to endocrinologist Dr. Kenneth Blanchard:

“For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it — if a woman is losing hair in partly a male pattern – -then, the problem is there is excessive conversion of testosterone to dihydrotestosterone (DHT) at the level of the hair follicle. Evening primrose oil is an inhibitor of that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.”

I use this brand of Evening Primrose Oil.

Biotin

Biotin is available at many local stores. I’ve read mixed reviews about biotin with some users loving biotin and others complaining about acne breakout. This particular brand of Biotin not only has great online reviews but also works well for me. Again we’re all different.

Silicon

I read this study on the benefits of a bioavailable form of silicon called choline-stabilized orthosilicic acid (ch-OSA) on skin, nails, and hair. Sure enough this silicon (ch-OSA) supplement called BIOSIL has made a difference not only in my hair but also my skin and nails.

10. Adrenal Fatigue

The body relies on the adrenal glands located on top of each kidney to manage stressful situations. Given our busy stressful lives it’s not surprising that many of us suffer from issues of adrenal dysfunction.

How would you know if you have adrenal fatigue?

Check out these symptoms…

fatigue, insomnia, chronic pain, headaches, migraines, anxiety, depression, weight gain, joint inflammation, gastrointestinal issues (constipation or diarrhea), tendonitis, bursitis, low libido, fibromyalgia, irritability, anger, fidgety, nervous, addictions, obsessive, frequent urination, heart disease, blood pressure problems, light-headedness, and dizziness upon rising from a bed or chair

Don’t many of these symptoms sound a lot like the symptoms of hypothyroidism? Hmmm…

I’ve read that many hypothyroid people also have adrenal fatigue (whether they realize it or not). From this very list of symptom that’s not surprising really.

At that time when my hair loss noticeably worsened, I was going through an extremely stressful time in my life. At that very same time my menstrual cycles dramatically changed and my progesterone levels plummeted. The thyroid, adrenals, and sex hormones are all so intricately connected, and my experience showed that loud and clear.

The problem is that the adrenals are often NOT tested. In fact adrenal fatigue is not even a recognized diagnosis in mainstream medicine yet the problem is a serious issue for thyroid patients.

An essential part of my hair loss solution was the testing and treatment of my adrenal fatigue. I’m fortunate to have an open-minded doctor who understands the importance of the adrenals in thyroid health.

I took a saliva test (where I took samples of my saliva at 4 different times over the course of one day) that tested my cortisol. Cortisol production varies throughout the day with levels normally highest in the morning and declining by late evening. The advantage of saliva testing is that it takes cortisol levels at different times of the day and lets you know how your cortisol levels vary during the day.

My results showed that my cortisol levels were below normal throughout the day. I was obviously struggling with adrenal fatigue and I’m so fortunate to have discovered this.

There are different ways to treat adrenal issues and what’s right for a person is individual too. I personally do well on adaptogenic herbs including Ashwaghanda, Rhodiola, Holy Basil, and Schisandra. I take adaptogenic herbs in this supplement Gaia Herbs Adrenal Health.

Last year when I was losing so much hair I was under too much stress.

I’m not always good at being good to myself.

I put other people’s needs before my own and let myself fall to the bottom way too often.

I take on far more than I should because I feel guilty to say NO.

NO

I’m not sure why that word is so hard for me to say.

I try to be everything to everyone, but me.

The particularly stressful events in my life at that time along with an unhealthy way of putting myself last wreaked havoc on my hair. I knew at that moment that I had to take better care of myself otherwise I would lose all my hair.

While all the testing, treatments, and supplements mentioned in this article were essential in stopping my hair loss, there was an even bigger thing that saved my hair above all else:

SELF-LOVE

This article was originally published on hypothyroidmom.com

*Image of “hair loss“ via Shutterstock