Anemia and Hair Loss: Understanding the Connection and Finding Solutions

We’re not all “Popeye,” eating cans of spinach each day to stay strong, but making sure we have a healthy amount of iron in our diet is important. Iron is a mineral crucial to our health. Its most important function in our bodies is to aid in the production of red blood cells. The mineral can help prevent anemia and boost resistance to infection. And when it comes to our hair, iron plays a vital role.

“Iron is really important for hair growth and hair health,” says dermatologist Melissa Piliang, MD. “When we see patients who are experiencing hair loss, we often perform labs to screen for iron deficiency. It’s not uncommon for us to find iron to be low in women.”

This article explores the intricate relationship between anemia, particularly iron deficiency, and hair loss. It delves into the causes, symptoms, and treatments for both conditions, offering practical advice for maintaining healthy iron levels and promoting hair regrowth.

The Crucial Role of Iron in Hair Health

Iron helps your body produce hemoglobin, a protein in your red blood cells. Hemoglobin carries oxygen around the body via our bloodstream to all our tissues and organs - including our hair follicles. By supporting-oxygenation of hair follicles, iron promotes cell turnover. Iron also optimises energy levels, nourishes your muscles (including your heart), and helps your immune system function. In other words, it is a great all-rounder for your general fitness and wellbeing.

When your body is short of oxygen, it channels its available supply to your vital organs to keep them alive, rather than to your hair follicles. Without oxygen, your hair follicles cease to function properly, and your hair may fall out. In fact, a large proportion of people who come into our Trichological Clinics for hair loss treatment, have some degree of anaemia.

Read also: Treating Hair Loss Related to Anemia

Can Iron Deficiency Cause Hair Loss?

Yes. If you do not have enough iron in your body, you may develop a condition called iron deficiency anaemia - which can cause your hair to shed. Many women are low in iron,” notes Dr. Piliang. “Hair shedding may be the first sign that patients notice.” You may experience excessive hair shedding (Telogen Effluvium). You may also find that your hair will not grow past a certain length.

Hair loss due to iron deficiency can look like traditional hair loss in both men and women. If you have hair loss, you will notice more hair falling out than usual when you brush or wash your hair. In severe cases, you may see bald spots on your scalp. A study published in the Journal of Korean Medical Science found that iron may not only play a role in hair loss, but it may cause hair to fall out in a fashion similar to that of genetic male- and female-pattern baldness.

Understanding Iron Deficiency Anemia

Iron deficiency anaemia is a condition wherein your body lacks iron to make enough red blood cells. Red blood cells contain haemoglobin, which carries oxygen around your body to your tissues, allowing them to function. Anemia means that a person’s body does not produce enough red blood cells. Anemia, particularly iron-deficiency Anemia, disrupts the body’s ability to produce hemoglobin. It leads to decreased oxygenation of hair follicle tissues. Anemia is usually characterized by pale discoloration of skin and eyes. It happens when there is a shortage of hemoglobin in the blood. Hemoglobin carries oxygen to tissues in our body. A decreased amount of red blood cells or hemoglobin can lead to a decreased oxygen supply.

Who is at Risk for Iron-Related Hair Loss?

Certain individuals are more likely to experience iron-related hair loss.

• Women: Iron is especially vital for women of child-bearing age who have monthly periods and who may or may not get a lot of iron in their diet. “Many women avoid red meat, which is our best source of iron,” says Dr. Piliang. “If you’re a meat eater, the best way to address this problem is to get two 4-ounce portions of red meat per week. This small amount should be enough to maintain healthy levels of iron for most women.” In premenopausal women, the most common causes of iron deficiency anemia are menstrual blood loss and pregnancy.
• People who follow a vegetarian/vegan diet: Those who are vegetarian or vegan may want to focus on including foods that are good sources of iron. “If you’re a vegetarian or vegan, you can eat beans, spinach and other dark leafy green vegetables as sources of iron,” suggests Dr. Piliang. “However, plant-derived iron is not absorbed as completely.” Dr. Piliang recommends making sure your diet includes foods high in vitamin C, as they can help your body absorb iron completely. Low iron levels can often occur with vegetarian and vegan diets, if care is not taken to include non-animal sources of iron.
• People who exercise heavily: Heavy exercise like running or high-impact aerobic exercise can cause small tears in your joints or the lining of your stomach. “These small tears leak a little blood,” says Dr. Piliang. “Over time and with regular exercise, this can lead to loss of iron and eventually anemia.” Some iron is also lost in sweat, so high levels of exercise can lead to low iron levels, if not replaced enough through the diet.
• Men and Postmenopausal Women: In men and postmenopausal women, the most common causes of iron deficiency anemia are gastrointestinal blood loss and malabsorption.

Symptoms of Iron Deficiency Anemia

The symptoms of iron deficiency anaemia include:

Read also: Does Ozempic Cause Hair Loss?

• Extreme tiredness
• Lack of energy
• Pale skin
• Breathlessness
• Heart palpitations
• Diffuse hair loss from the scalp
• Fatigue: Fatigue is one of the hallmark symptoms of anemia. It is also very easy to miss due to its generality. You might feel exhausted. Even light work may make you more exhausted than usual.
• Weakness: You may feel weaker than usual. It may take more strength for you to complete simple tasks.
• Headaches and Dizziness: Iron deficiency makes it harder for oxygen transportation through blood vessels. It can cause headaches or dizziness.
• Cold Hands and Feet: Anemia can cause poor circulation. It can lead to cold hands and feet, as there is not enough oxygen-rich blood reaching these areas.
• Brittle nails
• Sore tongue

The Connection Between Ferritin and Hair Loss

The term “Ferritin” may be quite new to many people. Ferritin is actually a protein in the blood that stores iron for the body. If you have low Ferritin levels, it means that you are iron deficient and prone to hair loss. Some Ferritin is stored in the hair follicles. Many people think that when you lose a lot of hair, you lose a large amount of this iron-storing protein. However, in fact, the process of losing Ferritin can occur before you have hair loss problems.

Whenever your body is low in iron, it will “borrow” Ferritin from your hair follicles and other sources that are less important to the body when you are sick. Low Ferritin levels interfere with your body's ability to produce red blood cells. These blood cells are vital for carrying oxygen throughout the body. Without enough red blood cells, your body's major organs and systems will not function as efficiently as they should.

Symptoms of Low Ferritin Levels

The symptoms of a Ferritin (iron storage protein) deficiency are similar to those of an iron deficiency. The most common sign of low Ferritin levels is excessive hair loss. Other common symptoms include:

• Extreme fatigue
• Dizziness
• Shortness of breath
• Pounding in the ears
• Headaches
• Restless legs syndrome
• Prone to brittle nails
• Difficulty concentrating

Ferritin Levels and the Thyroid

Excessive hair loss is often one of the first signs of hypothyroidism, a condition in which your body doesn’t produce enough thyroid hormone. In addition, a lack of thyroid hormone can also lead to symptoms such as weight gain, lethargy, dry skin, and poor cold tolerance. In some cases of hypothyroidism, excessive hair loss may not be directly related to a lack of thyroid hormone, but instead to a lack of iron. This can cause low Ferritin levels and hypothyroidism to occur at the same time.

When there is not enough Ferritin (an iron-storing protein) in your body, your thyroid has trouble producing enough thyroid hormone. If you notice symptoms of hypothyroidism, you should see your doctor and have your Ferritin levels checked.

Read also: Hair Loss Side Effect of Eliquis

Diagnosing Iron Deficiency and Hair Loss

If you are losing your hair, or notice it is not growing as long or as fast as it used to, we suggest asking your doctor to test your iron levels. If a person suspects their iron levels may be low, they should visit a doctor who can perform blood tests to determine if they are anemic. If you think your hair loss is related to an iron deficiency, consult a doctor to measure your iron levels.

Iron levels should be analysed by checking the following blood levels:

• Serum Iron
• TIBC (Total Iron Binding Capacity)
• Transferrin Saturation
• Ferritin
• Full blood count

Your doctor will most likely order a ferritin level blood test, which measures the levels of a protein called ferritin that helps store iron. Hemoglobin concentration can be used to screen for iron deficiency, whereas serum ferritin concentration can be used to confirm iron deficiency. However, the serum ferritin concentration may be elevated in patients with infectious, inflammatory, and neoplastic conditions. Other tests may be needed, such as erythrocyte zinc protoporphyrin concentration, transferrin concentration, serum iron concentration, and transferrin saturation.

It is our practice at the Cleveland Clinic Foundation to screen male and female patients with both cicatricial and noncicatricial hair loss for iron deficiency. Although this practice is not evidence based per se, we believe that treatment for hair loss is enhanced when iron deficiency, with or without anemia, is treated.

Treating Iron Deficiency Anemia and Hair Loss

If you discover you are anaemic, try not to worry - hair loss due to anaemia is reversible. Addressing the underlying cause is crucial for hair regrowth.

Medical Treatments

• Iron Supplements: Your GP can prescribe you an iron supplement. It is important to follow the dosage you are given, because high iron levels can also be dangerous, and taking more than prescribed will not lead to a faster result. A doctor may recommend a person take iron supplements daily to help their body restore iron over time. A person should always talk to their doctor before taking iron supplements because they can cause severe side effects. A person may have to take iron supplements for 3 to 6 months before their iron stores reach normal levels. Iron supplements commonly cause constipation, so slow-release supplements are preferred. It’s important to talk to your doctor first, before taking iron supplements, though.
• Iron Injections: A doctor may recommend iron injections to raise iron levels faster. People who are severely anemic may also require intravenous iron or iron injections. People who cannot absorb iron properly, such as those with Crohn’s disease, may also benefit from injections.
• Minoxidil (Rogaine): In addition to taking supplements and changing your diet, you may want to use a product like minoxidil that helps hair grow back. You use this popular over-the-counter liquid like shampoo. You rub it into your scalp twice a day to promote hair growth and avoid further loss of hair. The effects of Rogaine last about 16 weeks, after which time the rate of growth should slow down. However, you can keep applying it after 16 weeks to reap any additional benefits. Rogaine is available to both men and women. For severe hair loss, your doctor may prescribe minoxidil (Rogaine) - a medication that helps treat hair loss.
• Finasteride (Propecia): It’s available only to men in pill form. It slows hair loss, and for some men it stimulates hair regrowth.
• Surgery: Although surgery doesn’t promote regrowth, it is an option available to those experiencing permanent hair loss. Hair transplant and restoration surgery involves removing small plugs of skin that contain hairs and implanting them to the bald areas of your head.
• Platelet-Rich Plasma (PRP) Treatment: This involves separating the platelets from a sample of a person’s blood using a specialized machine and then injecting these platelets into areas of the scalp affected by hair loss. Reviews suggest that PRP treatment may be effective in treating hair loss, but the mechanisms of action are not fully understood.

Dietary Changes and Lifestyle Adjustments

• Dietary Changes: You may also want to ask your doctor to suggest changes to your diet. The most beneficial treatment for anaemia is making sure you’re getting enough iron through good nutrition as well as a suitable supplement. Consuming more dietary iron can also help increase levels.

  • Eat a well-balanced diet. Be sure to fill up on iron-rich foods like spinach, peas, lean proteins - like pork and salmon - and dried fruit. You should also look for the phrase “iron-fortified” on labels of packaged foods like cereals. Good Sources of Iron includes Meat (including liver), Shellfish, Whole grains (e.g. brown rice), Nuts, Beans, Leafy green vegetables (e.g. curly kale, spinach), Dried fruit (e.g. apricots), and Fortified cereals.
  • Add foods high in vitamin C to your diet. These foods allow your body to absorb iron in a more efficient manner. Be sure to eat more oranges, strawberries, melons, broccoli, and tomatoes. “Vitamin C helps your body absorb the iron you consume in food or supplements,” says Dr. Piliang. “To get the most bang for your buck, eat vitamin C-rich foods with your iron-rich foods or supplement.” Taking iron with vitamin C, as is found in citrus fruits (like lemons and limes) or some combination of supplements, increases the stomach’s absorption of iron.
  • Although animal meats contain much higher levels of iron than plant-based foods, you can still ensure that you get enough iron by eating whole grains, beans, and nuts. You should also add some iron-rich foods and vitamin C at the same time to increase your body's ability to absorb iron.

• Lifestyle Adjustments:

  • Avoid smoking and excessive alcohol consumption and engage in regular, moderate exercise to improve overall health and circulation.
  • Wear your hair down. Wearing it tight in a headband can lead to breakage and hair loss.
  • Protect your hair from the elements with scarves and hats. On exceptionally sunny and windy days, keep your hair covered.
  • Brush and wash your hair gently. Being gentle can help you avoid pulling out any excess hair during routine maintenance.
  • Avoid using chemicals and hair dyes. If you do use chemicals and hair, seek help or guidance from a trained professional.
  • Avoid heat-based equipment like blow dryers and curling irons.

• Address Potential Food Sensitivities: Your doctor may recommend a blood test or an elimination diet if he or she suspects that you have a food sensitivity. Gluten intolerance is considered one of the main causes of poor iron absorption. This also leads to reduced Ferritin stores and excessive hair loss.

• Vitamin D and Zinc Supplementation: Vitamin D deficiency is another factor that leads to hair loss. Therefore, you should try to supplement your vitamin D intake through sun exposure or incorporate other vitamin D-rich foods into your diet, such as cheese, fatty fish, and eggs. Additionally, zinc deficiency is common in people with excessive hair loss. To prevent hair loss due to zinc deficiency, you should add more zinc-rich foods to your diet, including dairy products, meat, and whole grains.

Ferritin Levels and Hair Loss Recovery Rates

For hair loss related to low Ferritin (iron storage protein) levels, your hair will likely grow back once the underlying iron deficiency is effectively treated. However, it can take several months for your hair to grow back, so patience is key to the success rate of hair loss recovery.

Risks of Excessive Iron Supplementation

While iron supplementation is important for your overall health, too much iron can be counterproductive. Health care professionals say that normal Ferritin levels are 20-200 nanograms per milliliter for women, and 20-500 nanograms per milliliter for men. Even if your Ferritin levels are low, taking too much iron can cause health problems, including:

• Abdominal pain
• Irritability
• Black or bloody stools
• Increased heart rate
• Vomiting
• Lower blood pressure

Even iron overdose can lead to liver failure and death. Therefore, you should not use any iron supplements to increase your Ferritin levels without a doctor's prescription. A blood test is the only way for your doctor to diagnose low Ferritin levels. Therefore, to prevent and detect hair loss due to low Ferritin, you should see a doctor as soon as possible.

Is Hair Loss from Anemia Permanent?

Anemia-related hair loss is usually reversible. If you treat your anemia effectively, your hair will grow over time. However, you have to address the underlying cause first.

Prevention Strategies

To prevent future hair loss, you should:

• Eat a healthy, balanced diet.
• Add foods high in vitamin C to your diet.
• Be gentle with your hair.
• Protect your hair from the elements.

tags: #anemia #and #hair #loss #causes

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