What Causes Hair Loss & Thinning Hair?

Thinning Hair and Hair Loss is a very common problem facing women during Menopause and during times of hormonal imbalance. High stress, postpartum, surgery, and Perimenopause can also be contributing factors to why your hair is thinning. Hair loss happens when DHT (Dihydrotestosterone) is formed from your testosterone by an enzyme called 5a-reductase. Whenever 5a-reductase levels are high, DHT collects in your scalp tissues and can stop your hair follicles ability to grow. If this hair growth is stopped for a long period of time, the hair loss may become permanent. Genetics also play a role, as does aging. It is quite common for the elderly to experience significant hair loss and most men will thin as they age as their testosterone naturally dwindles. 

The hormonal process of DHT happens in both men and women. Although women obviously have much lower levels of testosterone to convert to DHT, even the smallest amount can trigger hair loss. What is confusing to many is DHT is necessary for hair growth all over the body, however when there is too much on the head it causes hair loss. Too much DHT can also cause Acne, Polycystic Ovary Syndrome, Hirsutism & Congenital Adrenal Hyperplasia. 

DHT related hair loss is usually reversible in most cases! Yay! By blocking the enzyme 5a-reductase from converting testosterone into DHT, you can reactivate your natural hair growth. There are a number of supplements, medications, and topical products that do just that. Keeps reading about how and what there is available.

How Hair Growth Works

It is important to know the basics of your hairs natural growth cycle in order to set any expectations for any supplement, medication or topical solution. No solution will work overnight and here is why:  Hair naturally has three stages within its growth cycle: Anagen Catagen and Telogen. Hair is made predominately of keratin and does not grow equally on the head. Each hair can be in any one of these 3 stages at different times. 

Anagen Stage

The active growing phase is called Anagen. During this sate the cells in the root are dividing and forming a new hair which grows pushing and existing hair that has stopped growing out of the way, causing it to shed as the new hair takes over. Hair in this stage grows approximately 1-1.5 cm (1/3 -2/3 of an inch) each month and stays in this state for 2-6 years. Fascinating, and the real reason some people can grow long hair and others cannot. If your genetics have your growth cycle set at 2 years for example your hair would only grow approximately 24 -36 cm (9 -14 inches) before shedding where as someone with a 6 years cycle could have 72-108 cms (28- 42 inches) of hair growth before shedding. 

Catagen Stage

is the transitional phase where 3% of all the hairs on your head have stopped their growth , the root sheath shrinks and attaches to the root of the hair. This stage only lasts for 2-3 weeks as the hair prepares to go into the Telogen stage. 

Telogen Stage

is the resting phase, usually accounting for 6-8% of all the hairs on your head. In this stage the hair is not growing. Lasting about 100 days, these are the hairs that are naturally shedding. Normal shedding can be anywhere between 25-100 hairs per day. 

Noticeable Hair Loss

Illness, surgery, changes in medication, childbirth, and poor nutrition can also cause hair loss. This hair loss is called telogen effluvium and is usually most noticeable months after the event when the patient is fully recovered. Telogen effluvium means that all the hair stops growing and goes into the resting phase. Once it resumes its natural cycle the hair will shed to make way for the new growth and a person will see a large amount of hair loss followed my lots of “baby” hairs that are the new growth. There are products that keep hair in the Anagen Stage or even trigger it early that you can use before hair loss is even an issue. 

Hair Loss & Thyroid Diseases

Both Hypothyroidism and hyperthyroidism can cause hair loss because the irregular function of your thyroid causes the testosterone in your scalp to convert more easily to DHT. It is usually easy to spot as the hair thins equally over the whole head. With proper thyroid treatment the hair usually goes back to normal and regrowth will occur but not always to full capacity.  If the thyroid condition is not diagnosed and left to progress the hair loss will continue. Because the hair cycle is so long however, thyroid medications many times get blamed for the hair loss as the timing can coincide with the shedding stage.

The following are autoimmune conditions that can cause hair loss due to Thyroid diseases: Hypo & Hyper thyroidism, alopecia areata, lupus &  polycystic ovarian syndrome. Most cause overall thinning however alopecia areata is associated with circular areas of hair loss causing significant baldness in the areas it affects. See your Doctor if you are experiencing hair loss. It can be a sign of thyroid disease, an iron deficiency or other illness. Hair loss is usually not the only symptom so it is important to discuss all your issues in order to get a proper diagnosis. 

Nutritional Support for Hair Growth

There are natural products that can help encourage hair growth and even regrowth. Biotin and collagen are both highly recommended if you are experiencing any hair loss. Please note that if you are in the process of getting a thyroid diagnosis, it is important to disclose to your doctor any supplements you are taking. Biotin in particular can impact test results and you might have to discontinue use until all your tests are completed. 

Biotin

Biotin is Vitamin B7, found naturally in foods like eggs, bananas, and milk. It’s primary role is to help the enzymes in your body break down carbohydrates and turn them into energy. The body also uses biotin to create Keratin protein which forms your hair skin and fingernails. Although an actual deficiency is rare, taking this key supplement in conjunction with zinc and Iron, studies have shown significant hair growth compared to no significant difference to those given a placebo. I have personally seen incredible results in clients who started taking Biotin. 

Collagen 

Collagen is another important supplement to take is you are experiencing significant hair loss. Collagen also promotes beautiful healthy skin. Collagen is made up of 3 nonessential amino acids, one of which is Proline the main component of keratin. Collagen also improves the skin and helps reduce the signs of aging., it is found in the layer of the skin that holds the hair root and has shown to significantly help those with thinning hair. Collagen is a must have for anyone over the age of 40 IMO. Plump youthful skin begins with good collagen & hydration.

Saw Palmetto

Saw Palmetto is a natural supplement used to treat hair loss, bladder infections, prostate cancer & low libido. It has been used as a natural medicine by Native Americans for hundreds of years. An extract found in the berries of this plant may block 5a-reductase, the enzyme that converts Testosterone to DHT. This supplement thins the blood so should not be taken prior to surgery or with prescription blood thinners such as warfarin. As with all supplements please discuss with your doctor to avoid any adverse reactions to your other medications.

Topical Solutions & How They Work

Minoxidil

Minoxidil is the name of the active ingredient approved by the FDA in Canada available in products without a prescription as an effective topical hair growth solution. Minoxidil works by keeping more hair in the Anagen phase longer. It helps hair that is currently in the Telogen phase to shed more quickly, start the Anagen stage and keep it there. In laymen’s terms as hair goes into the growing phase it remains there longer and shortens the other two phases so that more of your hair is growing on your head at all times. This produces a thicker head of hair and helps reduce shedding. This only lasts for as long as you are actively using the product. 

Minoxidil comes in different strengths from 2-5%, best results were reported with the 5% solution. There are a number of brands that have Minoxidil as the main ingredient: Nioxin®️, Rogaine®️, Equate®️, Shapiro®️, Kirkland®️. Many come with a full range on complimentary products from shampoo, conditioner, hair thickeners, etc. Some of these products help prepare the scalp for better penetration of the product, however it is the scalp treatment itself that does the work. It can be used in conjunction with your favourite shampoo and styling brands with similar if not same results. However if you have excess sebum (that thick coating on your scalp or clogged pores) then a full kit with the exfoliating shampoos may be your best option. 

Prescription Medication for Hair Loss

Dutasteride 

Approved in Canada to treat enlarged prostate, under the brand name Avodart. It is typically only prescribed for hair loss in advanced cases.  Although it is considered the most effective medication for hair loss, It is not formally approved for women but that does not mean your doctor cannot prescribe it for you.  Although this product has the best results  i may take a few months before you see results. This medication is taken orally and can be effective taken 1-3x a week vs daily. This medication can worsen preexisting depression and can take up to 6 months to leave the system fully, so very careful consideration and options should be explored first. 

Dustasteride is also used as part of hormone therapy in transgender women  Common side effects in men include: impotence, decreased ability to maintain and erection, decreased sexual desire, decreased semen production, increased breast size, and breast tenderness, testicle pain and swelling.  In women: mood changes, depression, fatigue, weight gain, decreased sex drive, breast tenderness, breast enlargement, muscle soreness. 

Finasteride

is the 2nd most effective medication for hair loss, slightly more effective than Minoxidil as a hair loss treatment according to studies. Finasteride is available as both a topical solution and oral medication in a class medications called 5-alpha reductase inhibitors. By blocking testosterone conversion to DHT (thought to be the hormone involved in male and female hair loss) is Finasteride can help slow down, stop and reverse hair loss. Important: Finasteride as oral medication is usually only prescribed to women post menopause or who cannot get pregnant due to its association with birth defects, even if handled. As a oral medication some women reported side effects such as headache, irregular menstruation and dizziness, however the topical solution only reported irritation and localized pruritus. 

INFO FOR MEN: Finasteride (brand name Propecia) is a medication used to shrink an enlarged prostate (BPH- benign prostatic hyperplasia) in adult men. This medication works by decreasing the hormone DHT, which is responsible for prostate growth and is also the hormone thought to be responsible for hair loss. Side effects include: inability to have or maintain an erection, decrease in sexual desire, decreased semen production, pain in the testes and depression along with severe allergic reactions. But you’ll have hair, so up to you what matters.  

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Best Products to Stop Hair Loss

HERBAL SUPPLEMENTS & TOPICAL SOLUTIONS – To See Real Results You Must Be Willing to Take Consistently for 6-12 months. Trying for a month will not do much that’s not how hair growth naturally works. Best Results can be found by using a topical solution and taking a supplement.

Best Supplements to Reverse Hair Loss

BiotinClick here for Biotin Supplements

Collagen Click here for Collagen Supplements

Saw PalmettoClick here for Saw Palmetto Supplements

Combination Formulas

Biotin, Collagen & Saw Palmetto Combined for Hair

DHT Blocker with Biotin, Iron, Zinc, Saw Palmetto Powder for both Men & Women

Viviscal With Biotin Apple Extract and Vitamin C – see attached research on this product

Blind Test Study of Viviscal®️ (main ingredient is Biotin) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509882/

Best Topical Products with Minoxidil 5%

Nioxin Systems – the leave in treatment is the most important product, can be used daily

Shapiro MD Hair Loss Foam – Shampoos & Conditioners also available in this system

Rogaine Women’s 5% Minoxidil Foam (Once a day)

Other Products with Minoxidil 5%

My Favorite Hair Products for Fine Thinning Hair