Hair loss from some form of hormonal disturbance has arguably become one of the most frequently seen complaints in pre and postmenopausal women. Diffuse ("all over") hair fall anecdotally seems equally as common, with this category subdivided as 'temporary & self-correcting' (termed Telogen Effluvium), and 'continuing until corrected' hair loss.
For the reader specifically seeking information on the subject, androgenic alopecia from hormonal origin has been detailed within other articles at this website. This item will instead concentrate on the causes and treatment of diffuse hair loss.
Diffuse hair loss is excessive hair loss from all over the entire scalp. Because the growing hair is very sensitive to nutritional, metabolic/hormonal or environmental disturbances, hair is often one of the first areas of the body to reflect disturbances in physiological functioning.
The continuously dividing cells of the hair follicle are one of the most metabolically active in the body, requiring high levels of available nutrients for optimal growth. However in terms of priority nutritional requirements the hair is paradoxically a non-essential tissue; expressing a diminished nutritional supply with changes in hair cycle phasing, leading to decreased hair growth, excessive hair fall, or a diminishing of hair shaft integrity.
High fevers, sudden shock or prolonged emotional stress, food poisoning, surgical/dental procedures, sudden weight loss/dietary changes, commencing/ceasing certain medication, or following childbirth are some of the events that may cause a percentage of hair in the growing (anagen) phase to prematurely pass into the falling (telogen) phase. Two-three months after any of these experiences, the hair will begin to shed abruptly and be lost in excessive amounts for about 2-3 months before settling. This type of diffuse hair loss is termed "temporary & self-correcting".
Although the above initiators are essentially self-correcting forms of undue hair shedding, a woman's iron and nutritional status should always be reviewed to limit the problem's continuance.
When hair loss is subtle, slowly thinning out over many months the underlying cause is apt to be a nutritional, metabolic and/or hormonal disturbance. It is important to remember here that your hair is essentially a reflection of what's happening within your body.
A nutritional disorder may occur from many causes such as protein, vitamin, mineral, or amino acid deficiency or excess. A nutritional deficiency causing excessive hair fall is usually the result of poor dietary habits and/or reduced digestion/absorption over a prolonged period. Iron deficiency in females is commonly caused from blood loss during menstruation and insufficient consumption of iron-rich foods (please refer to the article "Adequate Iron Levels in Women - an Interpretation").
Besides iron, other frequently seen mineral disturbances are zinc, chromium, and copper. A copper deficiency interferes with red blood cell iron utilisation, causing iron to be stored within body organs. This stored iron can't be utilised, & despite an actual body iron sufficiency - anaemia-like symptoms may result.
Oddly enough, Vitamin D (calcitriol) deficiency is regularly found within the Australian general population. Vitamin D is synthesised from sunlight exposure, but many fair-skinned people who shun the sun, or those folk confined to nursing homes/hostels etc risk an eventual deficiency. Vitamin D is essential for the absorption and utilisation of calcium and phosphorus from the gut. Loss of muscle tone and softening of the skeletal bones (osteomalacia) will eventually result from defective calcium utilisation.Glands, Hormones & Hair Loss:
Endocrine glands secrete hormones into our body's bloodstream, where, through complex negative feedback systems, they regulate body metabolism, the internal environment, and energy balance. The endocrine system consists of endocrine glands and several organs that contain endocrine tissue.
A metabolic disturbance might equally be defined as hormonal, for an under or overproduction of tropins (hormones that influence other endocrine glands) - or the hormones secreted by the glands themselves, is the primary cause of disruption to hair cycle phasing - resulting in a 'continuing until corrected' form of hair loss.
It is beyond the scope or intention of this article to detail all the conditions associated with endocrine dysfunction. Suffice to say that diffuse hair loss is a common sign, whilst good history-taking and medical referral for specific blood testing/management should confirm the diagnosis.
An astute trichology practitioner can assist by holistically reviewing the patient's diet, lifestyle, and stress levels to determine whether or not these issues are impacting on their hair.
There are many different reasons why an individual may experience severe or prolonged physiological or emotional stress. It may be the illness/death of a loved one, an abusive relationship or relationship failure, impending/threatened financial penury, chronic pain conditions, addictions etc. These types of severe stressors may activate a diffuse, androgenic, or autoimmune hair loss situation in a pre-disposed person.
Whilst our body's 'normal' stress response is a protective adaptation against harmful situations; the well-coined 'fight or flight' syndrome - excessive or protracted stress can pathologically influence our physiology to advance acute or chronic illness.
Reaction to stress is a complex cascade of hormones from one endocrine gland to another, with equally complex negative feedback mechanisms. This endocrine response occurs in conjunction with direct neural stimulation from the sympathetic nervous system.
Many important hormones are influenced by our response to stress including growth hormone (somatotropin), thyroxine, adrenaline and cortisol from the adrenal glands, and glucagon from the pancreas. All of these hormones have the capacity to raise blood sugar levels, whilst elevated blood cortisol can deplete or disorder a number of important steroid hormones.
Finally, it's well documented that stress directly influences many illnesses including ulcerative colitis, rheumatoid arthritis, asthma, migraine headaches, and depression. Stress as a cause for hair loss is sometimes prematurely diagnosed by some practitioners however, who are either unsure of what to look for or what to ask.
The person experiencing the problem should be the best judge of whether or not they are or have been under sufficient stress to initiate their presenting complaint.
About the Author: Tony Pearce RN is a specialist trichologist and a registered nurse. He is a founding member of the Society for Progressive Trichology. Tony has a clinical practice in Sutherland & Rozelle NSW. He is the Clinical Director for Trichology of Virginia/DC in the United States. In Australia he can be contacted on 02 9542 2700, or through his website at www.hairlossclinic.com.au
Copyright Anthony Pearce 2005.