They say that your hair is a sensitive barometer of your overall health – so it's not surprising that when your iron levels are low, your hair can be affected. If you've noticed that you seem to be losing more hair than you should, read on and see how iron and hair loss are connected.
NOTE: this information should not be seen as medical advice. Please speak to your doctor if you are experiencing hair loss and before taking any supplements.
There is quite a bit of published research into the relationship between low iron and thinning hair, with references all the way back to 1963.
Although it's still a contentious issue, there are many medical professionals who support the view that there is a direct link between iron and hair loss and that iron supplements can help reduce or reverse the problem.
Do remember that, whilst some of these studies listed here do demonstrate a relationship between low iron and hair loss, that doesn't necessarily mean that the low iron CAUSED the hair loss (that has yet to be scientifically proven).
Nonetheless, it's certainly something to bear in mind when you are trying to establish what might be causing YOUR hair loss issues!
This research, published in 2007, studied 5110 women aged 35 to 60.
Each woman filled in a questionnaire about the extent of her hair loss and had her iron level (serum ferritin) tested.
Among the women who described their hair loss as excessive, 59% had low iron stores compared to the remainder of the population.
This research, published in the Journal of Investigative Dermatology in 2003, studied only a small number of women but gave some interesting results.
The subjects of the study – women with telogen effluvium, androgenetic alopecia, alopecia areata and alopecia universalis/totalis - were compared to a group of 11 women who did not suffer from hair loss.
Iron levels for the women with androgenetic alopecia and alopecia areata were SIGNIFICANTLY lower than in women without hair loss.
The iron levels of the women suffering from alopecia universalis and telogen effluvium, however, were not lower than those of the women without hair loss.
This article was published in the Journal of the American Academy of Dermatology in 2006. Its authors – Cleveland Clinic dermatologists Leonid Trost MD and Wilma Bergfeld MD - wrote that they "… believe that treatment for hair loss is enhanced when iron deficiency – with or without anemia – is treated".
Whilst acknowledging that there may not yet be enough hard evidence to fully confirm a direct relationship between iron and hair loss, the report concludes:
"It is our practice at the Cleveland Clinic Foundation to screen male and female patients presenting with hair loss, both cicatricial and noncicatricial, for iron deficiency by obtaining a complete blood cell count, red blood cell indices, and serum ferritin concentration. We treat iron deficiency, with or without anemia, through dietary modification and, when necessary, oral iron supplementation. Although this practice is not evidence based per se, in our experience we believe that treatment for hair loss is enhanced when patients maintain a serum ferritin concentration greater than 70 ng/mL."
This approach is shared by George Cotsarelis, director of the University of Pennsylvania, who told the health site Web MD:
"From our clinic's experience, it is clear to me that if you replenish hair loss patients' iron stores with iron supplements, they are more likely to regrow hair, or at least stop hair shedding. And they don't have to be anemic. That is the biggest mistake doctors make".
He also believes that if you have a tendency towards hair loss (perhaps a family history, for example), then the process will be accelerated by a lack of iron in the body.
Iron is an essential mineral. It is needed for many important functions, but primarily to make red blood cells to carry oxygen around the body. If your levels are too low and your body is not getting enough oxygen, then you will feel tired and your immune system will be weakened.
We absorb iron from the food we eat. It moves around the body via the blood, bound to a molecule called 'transferrin', which delivers it to everywhere it's needed.
Most of the iron in the body is in the hemoglobin, a protein in red blood cells. Some iron is stored in the liver or other organs of the body.
The main storage form of iron is called ferritin. Ferritin levels give a good indication of how much iron is stored in your tissues. Small amounts of ferritin are secreted into the blood's serum. So doctors are able to look for iron deficiency by giving a blood test to check serum ferritin levels.
There are various reasons that you could be low in iron…
Women are particularly at risk of iron deficiency, thanks to menstruation and childbirth, both of which are significant causes of heavy blood loss and subsequent loss of iron.
If the amount of iron you are consuming is less than the amount you need, the iron stored in your ferritin will be used up to meet your needs. This means your ferritin levels will be low but you won't yet have anemia. Left untreated, though, anemia could eventually develop.
Your levels are checked using a blood test. There are a few different kinds of tests.
CBC (complete blood count) – this checks your red blood cell and hemoglobin levels
Serum iron – this checks the amount of iron in the blood
Serum ferritin – this checks the amount of iron stored in the body
Total Iron Binding Capacity – this tests how much iron could/should be in the body, by determining how much transferrin (the molecule that transports iron) is NOT carrying any iron.
Having normal iron levels is important, but having enough STORED iron is important too!
Your doctor will either recommend that you modify your diet, or - if necessary - prescribe an iron supplement.
He/she would probably recommend taking the supplement on an empty stomach, to avoid other things (like caffeine) blocking its absorption.
Some people find that iron supplements cause an upset stomach, so you might want to ask your doctor if you can have liquid iron, which many find easier to tolerate.
The problem with tests for low iron and hair loss is that your doctor may not order quite the right test to diagnose the cause.
As described above, there is more than one test that can be done.
There is a difference between the iron levels in hemoglobin (measured by the CBC test) and your levels of ferritin (measured with the serum ferritin test).
Research suggests that low ferritin levels may be one of the most common causes of hair loss. And it's possible to be low in ferritin, without having an actual iron deficiency.
Yet many doctors only order the CBC test, leaving ferritin levels unchecked.
So you could be told that blood tests have shown your iron levels to be 'normal'... and you may not discover that your ferritin levels are low, potentially causing your hair loss.
For this reason, it's important to ASK your ferritin levels to be checked.
Another issue is that your doctor may tell you your ferritin levels are in the 'normal' range, when they are actually at a level some experts would consider too low for optimum hair growth.
The Mayo Clinic puts the normal range for blood ferritin at 11 to 307 ng/ml (nanograms per millileter).
But even if your level falls into this 'normal' range, some experts say it could still be too low.
Doctor Cotsarelis suggests that a level of at least 50 ng/ml is needed to replenish their hair. Dermatologists Trost and Bergfeld put that figure even higher, at 70 ng/ml.
If your ferritin levels fall below the levels recommended by these experts, then do discuss this with your doctor.
If he/she does not prescribe supplements, then you will certainly want to look at your diet and ensure you're consuming enough iron-rich foods (see below).
Because this can be VERY dangerous – too much iron is as bad as not enough.
The body can't easily excrete excess iron, so if you take too much, it builds up. This can have many negative effects on the body, including an increased risk of liver and heart disease, plus the acceleration of other conditions like Alzheimer's and Parkinson.
Iron overload can also cause hair loss.
Iron overload is not only caused by consuming too much iron – there can be other reasons.
It can be acquired after receiving numerous blood transfusions or iron shots. It can also be inherited.
Only your doctor can diagnose iron overload, which is treated with iron reduction therapy.
Another reason you should not try to 'self-diagnose' if you suspect your iron levels to be low...
...is that your low iron may be caused by ANOTHER medical condition. It's important that your doctor establishes the cause of any iron deficiency.
If your doctor feels that supplementation is not required, then you need to look to your diet to make sure you are consuming enough iron.
This is particularly important if you are dieting and/or doing a lot of exercise.
Good sources of iron include:
'Heme iron' comes from animals. 'Non-heme iron' comes from plant sources. Heme iron is better absorbed by the body than non-heme, so if you are vegetarian, make sure that you are consuming plenty of iron-rich vegetables and pulses.
The setting aside of special 'meatless' days of the week has recently become popular, but some sources suggest this may have triggered a rise in iron deficiency. So make sure you are replacing iron-rich meat with another good source!
Once your iron levels get back to normal, it can take up to a year to fully regrow your locks.
Yes, it's frustrating having to wait that long. But you should notice that the shedding stops far sooner, giving you some encouragement and a good sign that things are heading in the right direction!
I would love to hear about YOUR experience with no iron and hair loss.
If you have anything to share – or any comments you would like to make – please contact me here.