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Women, Hormones, and Hair Loss

April 18, 2018 | 16 Comments | Cheryl Wooster

Learn about often overlooked root causes of hair loss in women – especially in the perimenopausal years.  I’m happy to share what I’ve learned from my own life journey. Nothing is quite so potent as experiencing functional interconnectedness yourself (this one, from 2016).

Hair loss in women is a relatively common client complaint – and definitely clear evidence of an underlying imbalance that you can help them to explore and resolve if you’ve got the know-how.  Be sure to catch the most common causes I share in the video.

Realize that when I talk about hormone levels, I am talking about “free”, not “total” hormone levels.  This is a critical distinction in labwork.  At any given moment, 90+% of our body’s hormones are ‘locked down’ by binding globulins, in this case mostly SHBG (sex hormone binding globulin).  Bound hormones can’t have cellular effects; free ones can.  As women age, their SHBG decreases, and this allows more of their testosterone to be free.   While estrogen and progesterone production are falling off more dramatically, women continue to make testosterone in peri- and menopause.  And of course, we all have genetic variations in the levels of enzymes we have that convert one type of hormone to another.  As with all hormones, the key is in the balance of sex hormones (vs. overt levels of any one hormone).

Zinc is also a particularly key nutrient to help your clients (women and men) to avoid over-converting their testosterone to dihydrotestosterone (DHT), a common imbalance driver of hair loss.  Your clients can request their physician to check their “RBC Zinc” level and ensure it’s in the upper half of the reference range.

Whole licorice root is effective at reducing testosterone (which makes it a great choice for PCOS, by the way, but that’s another post for another day!).  It also is an adaptogenic herbs – usually geared toward boosting cortisol (by slowing its metabolism in the body).  Dosage needs vary; I personally have been using 500mg twice daily with great success.  Again, this is whole licorice root, not DGL.  And remember that uncontrolled hypertension is a contraindication for its use.  Whole licorice is also an effective phytoestrogen which can be helpful for stabilizing estrogen levels in late perimenopause and menopause as well.

I hope this is of service to you and your patients and clients!

Warmly,

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16 Questions for “Women, Hormones, and Hair Loss”

  1. 7
    Dina Assaad says:
    January 29, 2024 at 12:28 pm

    Hi Tracy, what are your top recommendations for navigating perimenopausal symptoms ?

    Reply
  2. 6
    Jennifer Moore says:
    December 16, 2019 at 11:56 pm

    Hi Tracy, I work with peri/postmenopausal women concerned with the loss of libido. Could this improve their hair loss but lower their libido?

    Reply
    • 6.1
      SAFM Team says:
      December 18, 2019 at 10:01 am

      Thank you for your question, Jennifer and for serving this specific type of women in need of support. With any hormone-modulating intervention, the first step is to asses your client’s hormone levels. Many of the AFMC certified practitioners use urine-based hormone testing (DUTCH Complete is one example) to this end and then choose the right action plan based on the results. Also, you may like to know that SAFM offers a Hormones Demistyfied Deep Dive Clinical Course for those who want to understand how to better support hormonal imbalances.

      Reply
  3. 5
    Elena Stanciu Elena says:
    December 10, 2019 at 9:27 am

    In someone who’s had thin hair since puberty and the last few months were particularly terrible, does it make sense to suspect that the thyroid might be involved: TSH 0.89 (uIU/ml), FT4 1.16 (ng/dl), FT3 2.54 (pg/ml). Could I be on the right track?

    Reply
    • 5.1
      SAFM Team says:
      December 16, 2019 at 9:50 am

      You’re onto something, Elena, suboptimal conversion of fT4 to fT3 can be a sign of suboptimal zinc – this can be confirmed with RBC zinc blood work. If this indeed comes back suboptimal then while supplementing you will want to ask a question what are the reasons for the zinc to be suboptimal – is it an issue with consumption or in the digestion and absorption.
      One could also choose to run a hormone test to explore the sex hormone balance that can be affecting the hair health, or a more advanced nutrient panel to ensure optimal levels of other hair-supporting nutrients.

      Reply
  4. 4
    sharon chud says:
    February 4, 2018 at 3:37 pm

    I have alot of hair loss also but just recently since I started with SAFM. I also have gone on many supplements which I was not on before. My testosterone has classically been low and I take an injection that I was told to increase to .15 every other week. I’m thinking the increase may be the cause or I’m wondering if I was taking too much Vit A. I was taking 25,000 IU’s.
    I just did a Dutch and I ordered a Spec. I am hashimoto’s and insulin resistanct but have been that for years with no hair loss.

    What is your opinion on Vit A as a culprit?

    Reply
    • 4.1
      SAFM Team says:
      February 14, 2018 at 9:42 am

      Indeed, this is a great example of the facts that (1) too much of any one nutrient is not “better” and can sometimes be detrimental and (2) our need for specific nutrients (esp. via supplement) can vary substantially. 25,000 IUs is a very high daily dose of fully-formed Vitamin A (assuming this is a retinoid and not beta carotene), and I highly recommend checking your serum levels after no more than two months of use to assess what you are absorbing. Vitamin A is also key for thyroid hormone conversion which plays an important role in hair growth/retention. Too little Vitamin A may contribute to hair loss (by affecting thyroid hormone action but also Vitamin D activity), but too much Vitamin A can cause hyperstimulation of hair follicles that leads to hair loss as well. This will be of interest to you: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315033/ . However, my instinct is that increased dosage of testosterone may be another (or the primary?) culprit as well. Your DUTCH test will give you insight as to how much of your testosterone is being converted downstream to dihydrotestosterone (DHT) – a particularly potent androgen implicated in hair loss (in both men and women). You don’t necessarily need to have high testosterone (or even free testosterone) levels to still have sufficient DHT to drive undesired androgenic effects. This is a great example of the “devil in the detail” that we cannot see with simple serum hormone labs *and* that hormone metabolites can have powerful hormonal effects. In fact, even if we quickly metabolize a hormone so that its initial form is not showing up in high amounts, we can still be experiencing dramatic hormone effects from various metabolite byproducts. Ferritin and RBC Zinc are also key blood markers. Also, given your autoimmune thyroid history, don’t lose sight of the fact that the level of autoimmune activity can shift dramatically (and suddenly) over time in response to our overall lifestyle and the collective set of potent exacerbators (e.g. stress, toxicity, low Vitamin D, low zinc, poor sleep, lower-quality food, poor air quality, medications).

      Reply
      • …
        sharon chud says:
        February 16, 2018 at 3:34 pm

        If the Dutch test comes back with the testosterone being converted to DHT should I cut back the dose or eliminate the testosterone injection completely?

        Reply
        • …
          SAFM Team says:
          February 28, 2018 at 8:21 am

          It depends. DHT is not inherently negative and is always going to be present to some degree, and each person’s tolerance of a certain level of DHT is going to vary. Some women struggle with strong symptoms of androgen dominance with only moderate levels of DHT while others with the same level may have no symptoms or concerns at all and benefit from having a strong but balanced androgenic response. What DUTCH shows is the relative conversion of testosterone down the 5a vs. the 5b pathway, so we can look at the *balance* between these two. A person can certainly have a genetic predispostion for more 5a metabolism, but there are also ways in which to address the root cause and help the body to shift to a better balance of 5a/5b metabolism of testostoner. Whether you stop using testosterone is going to depend on a person’s unique situation, in particular the intensity of androgenic symptoms and whether the body needs a break from the testosterone surge while the pathways are being adjusted through lifestyle choices (or whether these can be done concurrently). High levels of insulin increase the activity of the 5a enzyme (and thus often increase DHT) while actions such as ensuring ample zinc, taking saw palmetto, reducing body fat, and ensuring ample progesterone can reduce it. The DUTCH data report comes with a helpful hormone metabolism pathway diagram that identifies numerous actions that can shift the behavior of the enzymes that convert various hormones into downstream metabolites.

          Reply
  5. 3
    Kasia Hrecka says:
    November 3, 2016 at 1:40 pm

    Which is your supplement of choice for the whole licorice root?

    Reply
  6. 2
    Heather Green says:
    October 12, 2016 at 11:49 pm

    Would you recommend licorice or inositol for PCOS or both?

    Reply
    • 2.1
      SAFM Team says:
      October 13, 2016 at 4:05 pm

      For PCOS specifically, I would recommend inositol – and investigating and addressing both insulin resistance and over-exposure to xeno-estrogens (as well as optimizing estrogen metabolism). There is a Q&A post specifically about inositol in the membership area.

      Reply
  7. 1
    Louise Zamudio says:
    April 18, 2016 at 1:27 pm

    This is such a timely lesson thank you! I have been going thru a nasty divorce and lost a lot of weight so just figured it all came as a package but it stops then starts again so now I have another direction to check thanks. I have a daughter-in-law that suffers too to an extreme she is only in her late 20’s I have suggested she stop her birth control which is her only RX she takes as a start. You mentioned there is a stripe for testing testosterone?

    Thank you again

    Reply
    • 1.1
      SAFM Team says:
      April 19, 2016 at 10:26 pm

      You are welcome! Yes, one can check both Total and Free Testosterone in regular bloodwork labs from your doc. Keep in mind what I shared about insulin resistance (high glycemic diets) being a driver for high production of testosterone in the ovaries; this is a common challenge for young people who tend to consume a higher amount of refined, processed foods.

      Reply

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