Losing weight can be a rewarding journey, but it sometimes comes with unexpected side effects, such as hair loss. This article explores the connection between weight loss and hair loss, examining the causes, treatments, and preventative measures. Hair loss after weight loss is often a temporary condition that occurs when a person loses weight through restrictive dieting or weight loss surgery. Stress on the body or nutrient deficiencies may be the cause.
Types of Hair Loss
Hair loss, also known as alopecia, can manifest in various ways, affecting just the scalp or the entire body. It can be temporary or permanent, with causes ranging from heredity and hormonal changes to medical conditions and aging. Baldness typically refers to excessive hair loss from the scalp.
Common Types of Hair Loss:
- Gradual Thinning on Top of Head: This is the most common type, affecting people as they age. In men, hair often begins to recede at the hairline on the forehead. Women typically experience a broadening of the part in their hair.
- Circular or Patchy Bald Spots: Some people lose hair in circular or patchy bald spots on the scalp, beard, or eyebrows.
- Sudden Loosening of Hair: A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging.
- Full-Body Hair Loss: Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body.
- Patches of Scaling That Spread Over the Scalp: This is a sign of ringworm.
Telogen Effluvium: A Common Culprit
Hair loss after weight loss is often a temporary condition known as telogen effluvium (TE). This type of hair loss is generally known as telogen effluvium, and it is a common cause of hair loss. It typically occurs about 3-4 months after rapid weight loss and lasts for up to 6 months. TE is characterized by diffuse hair loss following stressful events such as childbirth, prolonged surgery or anesthesia, and severe febrile illnesses, as well as intentional or unintentional rapid weight loss.
Causes of Telogen Effluvium:
Some causes of telogen effluvium can include:
- Losing a significant amount of weight
- Giving birth
- Having high levels of stress
- Having high fever
- Undergoing surgery
- Experiencing illness, particularly with high fever
- Stopping birth control pills
Telogen effluvium generally subsides within 6-9 months as the body adjusts to the changes.
Read also: Is Your Diet Causing Hair Loss?
The Hair Growth Cycle and Telogen Effluvium
Hair shafts undergo several cycles during their lifetime. These are as follows:
- The anagen phase: This occurs when hair is growing and can last for several years.
- The catagen phase: This is a short transitional phase of a few weeks.
- The telogen phase: This is a rest phase of 3-4 months. At the end of this phase, the hair will fall out, and new hair will grow in the follicle.
Hair loss happens when stress on the body triggers the hairs to stop growing and enter the catagen phase too early. They will go on to the telogen phase and fall out prematurely. Telogen effluvium occurs when many of your hair follicles shift from the growth phase to the shedding phase. This typically happens several weeks to a few months after a major body stressor, like significant weight loss. Telogen effluvium can result in noticeable shedding across the scalp.
Weight Loss Surgery and Hair Loss
Although weight loss surgery can lead to reduced overall weight, it can also cause nutrient deficiencies that may lead to hair loss. Restrictive diets and weight loss surgeries can exacerbate nutrient deficiencies. For example, one 2018 study involving 50 people who underwent sleeve gastrectomy observed hair loss in more than half. Also, one 2021 study involving 112 women who underwent sleeve gastrectomy found that nearly 75% of them experienced hair loss. Of those who reported the condition, nearly 80% said that it started 3-4 months after surgery. Bariatric surgery is associated with rapid weight loss and commonly causes deficiencies in protein, vitamins, and/or minerals, which in turn can spark hair loss. In addition to reducing stomach capacity, some types of weight loss surgery allow food to bypass part of the intestines, leading to malabsorption of nutrients and increasing the risk for deficiencies.
The Role of Nutrition
Telogen effluvium following weight loss is sometimes the result of nutrient deficiencies in the diet and the cumulative effects of weight loss on the body. This is particularly the case if the weight loss is due to crash dieting, weight loss surgery, or restrictive dieting. Proper nutrition is vital to the formation of healthy hair shafts and the promotion of hair growth. Some studies suggest that diets low in iron and zinc may be more likely to induce hair loss. Other nutrients that may affect hair growth include fatty acids, selenium, and vitamin D.
Key Nutrients for Hair Growth:
- Iron: Essential for overall health and hair growth.
- Zinc: Plays a role in hair tissue growth and repair.
- Fatty Acids: Important for hair structure and shine.
- Selenium: An antioxidant that can help protect hair follicles.
- Vitamin D: Involved in hair follicle cycling.
- Protein: Amino acids, the building blocks of protein, are essential for hair growth. That’s because amino acids are necessary for the production of keratin, the main structural protein of hair.
Poorly planned diets, such as crash diets, can lead to deficiencies in essential fatty acids, zinc, protein, and overall calories, all of which can lead to hair loss.
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The Impact of Rapid Weight Loss
Rapid weight loss places immense stress on the body, often leading to temporary hair loss. Sudden weight loss and restrictive diets have been linked to a condition known as acute telogen effluvium (TE), one of the most common causes of widespread hair loss on the scalp. Crash dieting The link between crash dieting and hair loss has been documented in research as far back as the 1970s . Your hair needs adequate calories and nutrients to grow properly. So, when your body doesn’t receive what it needs, side effects like hair loss can occur. Many studies have linked hair loss to rapid weight loss, calorie restriction, nutrient deficiencies, and psychological stress - all commonly in people who are following crash diets. Very low calorie diets have been shown to cause hair loss as well. Major stress, which sometimes comes along with restrictive dieting, has also been linked to hair loss.
Gradual Weight Loss
Losing weight slowly-1 to 2 pounds (0.5 to 1 kg) per week-helps your body adjust, reducing the likelihood of hair loss.
Health Risks Associated with Nutrient Deficiencies
However, the nutrient deficiencies of a restrictive weight loss regimen can be damaging. For example, reducing the amount of iron in the diet can lead to iron deficiency anemia, which has several serious health complications.
Complications of Iron Deficiency Anemia:
Iron deficiency anemia can lead to:
- Infections
- Heart problems
- Developmental delays in children
- Pregnancy problems
- Depression
Additionally, severe calorie restriction can lead to malnutrition and accompanying issues, such as decreased muscle function, cardiorespiratory problems, stomach issues, suppressed immunity, and depression and anxiety.
Read also: How digestive health affects weight loss
Prevention and Treatment Strategies
Telogen effluvium after weight loss can be the result of nutrient deficiencies or losing a lot of weight too quickly. Prevention and treatment of telogen effluvium focus on proper nutrition and diet. Maintaining a balanced diet while avoiding crash diets and quick fixes is important to long-term weight loss success as well as avoiding telogen effluvium. As such, it’s important that you aim to lose weight in a healthy, sustainable manner.
Dietary Recommendations:
- Balanced Diet: Choose a balanced diet that provides your body with the nutrients it needs to function optimally.
- Nutrient-Dense Foods: If you follow a dietary pattern that restricts many foods - such as a vegetarian or vegan diet, which may be low in hair loss-associated nutrients like iron and zinc - make sure to include nutrient-dense foods and supplement with nutrients your diet lacks.
- Foods to Include:
- Shellfish
- Seeds
- Nuts
- Eggs
- Dairy
- Legumes
- Spinach
- Quinoa
- Turkey
- Broccoli
- Fish
- Cashews
- Chicken
Supplementation:
If someone is already experiencing telogen effluvium but is no longer trying to lose weight, they will most likely find that the condition resolves in time once they address their nutrient deficiencies through diet and, if necessary, supplementation. If undergoing weight loss surgery, ensure that your levels of nutrients like zinc, iron, and vitamin B12 are optimal before the procedure, and supplement with nutrients recommended by your doctor or dietitian afterward. This can help prevent surgery-related hair loss. If you have a nutrient deficiency, food alone may not be enough to replenish your nutrient stores and a supplement may be necessary. However, research suggests that if you don’t have a nutrient deficiency, supplements might not benefit hair loss.
Other Treatment Options:
- Minoxidil (Rogaine®): A healthcare provider might recommend using minoxidil (Rogaine®). This is approved for treating FPHL. You can purchase the 2% or 5% solution over the counter (OTC). However, you have to follow directions exactly and use the product indefinitely.
- Light Therapy: A healthcare provider might recommend forms of light therapy like using the HairMax Lasercomb® FDA to treat FPHL. Another FDA-approved laser product is the Theradome LH80 PRO® helmet and low-light laser helmets and caps.
- Microneedling: Microneedling of the scalp with and without the application of minoxidil.
- PRP Injections: Injections of protein-rich plasma (PRP) to encourage hair growth.
- Hair Transplant Surgery: In extreme cases, hair transplant surgery may be considered.
Lifestyle Adjustments:
- Be Gentle with Your Hair: Use a detangler and avoid tugging when brushing and combing, especially when your hair is wet. A wide-toothed comb might help prevent pulling out hair.
- Avoid Harsh Treatments: Avoid harsh treatments such as hot rollers, curling irons, hot-oil treatments, and permanents.
- Reduce Stress: Reducing your stress, like talking with a mental health professional.
- Proper Scalp Care: Scalp massages improve blood circulation, delivering more nutrients to hair follicles and encouraging hair regrowth. To prevent hair fall after a workout, keep your scalp clean by washing away sweat and buildup. Use gentle hairstyles to avoid stressing your hair follicles, and stay hydrated to support scalp health.
- Quit Smoking: Stop smoking.
- Medications: Managing any underlying health conditions, changing your hairstyling routine to avoid damaging your hair follicles, taking medications.
The Mediterranean Diet and Hair Loss
The Mediterranean diet is characterized by low amounts of saturated fat, animal protein, and high amounts of unsaturated fat, fiber, polyphenols, and antioxidants. The main nutrients found in the Mediterranean Diet are rich in antioxidant, anti-inflammatory components. It also has an important place in hair loss treatment, since recently treatment strategies have included polyphenols and unsaturated oils more and more frequently. It has been found that plant-rich diets - such as the Mediterranean Diet (MD), whose main nutrients are rich in antioxidants, anti-inflammatory, and estrogenic components - include chemicals that stimulate hair growth and reduce hair loss. This is why dietary practices characterized by a large intake of anti-inflammatory, antioxidant and estrogenic activities are emphasized as additional treatments for alopecia.
Thyroid Disorders and Hair Loss
The thyroid gland is a small, squishy, butterfly-shaped gland located in the front of your neck above your collarbone. Your thyroid produces two main hormones: thyroxine (T4) and triiodothyronine (T3). Together, these hormones influence the regulation of cellular activity for everything from digestion and heart function to muscle control, metabolism and body temperature. There are many types of thyroid conditions, but the two most common are hypothyroidism and hyperthyroidism. Both conditions can affect various bodily systems, including brain function, heart rate, metabolism, menstrual cycle and fertility.
Hypothyroidism:
Hypothyroidism is having an underactive thyroid and not having enough thyroid hormone.
- Dry skin and hair loss: Hair follicles naturally go through phases of growing, shedding and resting, but with hypothyroidism new hair grows more slowly and normal shedding continues, resulting in overall thinning.
- Weight gain and constipation: You haven’t been eating more or exercising less yet find yourself gaining weight due to your underactive thyroid suppressing your metabolism.
Hypothyroidism has several causes. Hashimoto’s disease: An autoimmune disorder where your immune system attacks your thyroid.
Hyperthyroidism:
- Constant hunger and/or weight loss: Hyperthyroidism increases your metabolic rate, causing weight loss and constant hunger even if you’re eating as you always have. This type of weight loss is not healthy, Dr. Angell says, because it involves the loss of muscle mass and not just fat.
- Rapid or irregular heartbeat: Your heart may feel like it is pounding, and you may have trembling in your hands and fingers.
Hyperthyroidism has several causes. Graves’ disease, an autoimmune disorder in which your immune system makes antibodies to your thyroid that cause it to make too much hormone. Thyroid nodules, which are growths on your thyroid. They are usually benign (not cancerous). But they may become overactive and make too much thyroid hormone. Thyroiditis, or inflammation of the thyroid. Too much iodine. Iodine is found in some medicines, cough syrups, seaweed and seaweed-based supplements. Too much thyroid medicine.
Risk Factors and Diagnosis:
Women are significantly more likely than men to develop thyroid disorders, with rates about four times higher in women overall, Dr. Angell explains. The disparity is even more pronounced for hypothyroidism, which affects nearly 5 out of 100 Americans ages 12 years and up but affects women as much as nine times more frequently than men. These risks increase particularly after pregnancy and during menopause.
All the symptoms mentioned above are rather nonspecific, even when taken together, Dr. Angell cautions. This means that a mild thyroid condition can be difficult to diagnose based on symptoms alone. If you suspect you may have thyroid problems - especially if someone in your family has previously been diagnosed with thyroid or other autoimmune conditions - your primary care physician can use a simple blood test to diagnose thyroid function. The TSH test provides a highly accurate measurement.
Treatment:
Fortunately, many of the effects of thyroid dysfunction are often treatable by properly addressing the underlying thyroid imbalance. Dr. Angell notes that recent advances have changed treatment approaches. “What’s particularly new is the recognition that some patients who don’t feel well on T4 alone might benefit from adding T3 supplementation, an approach that wasn’t recommended in the past,” he says. Experts at Keck Medicine, including Dr. Angell, are continually researching new treatments and therapies for thyroid conditions. Unlike today, where T3 pills must be taken daily on an empty stomach, extended-release forms of T3 and subcutaneous delivery of T4 are in development, Dr. Angell says.
When to See a Doctor
Hair loss due to weight loss is neither dangerous nor permanent. Generally, the body adjusts within a few months, and hair production resumes. See your doctor if you are distressed by persistent hair loss in you or your child and want to pursue treatment. Also talk to your doctor if you notice sudden or patchy hair loss or more than usual hair loss when combing or washing your or your child's hair. If shedding continues for more than 3-6 months, or is concerning, don’t wait to call an expert. Some shedding is normal, but you shouldn’t ignore prolonged, patchy, or emotionally distressing hair loss. The earlier you seek support, the more options you’ll have to slow shedding, stimulate growth, and restore your confidence. A healthcare provider can identify the cause of your hair loss and help you come up with a plan to get your hair growing again.