Telogen effluvium is a form of temporary hair loss that usually happens after stress, a shock, or a traumatic event. In simple words, telogen effluvium is defined as increased hair shedding. Your hair loss occurs from the top of your scalp. It is a temporary condition and usually, your hair grows back once the causative factor is eliminated or managed well.

Hypothyroidism (underactive thyroid gland) is a fairly common condition and about 5% of Indians of all ages have this condition. Hypothyroidism gets more common with age. Women are more likely to have an underactive thyroid gland. 

The thyroid hormone plays a vital role in the development and maintenance of hair follicles as well. Follicles are the small pockets under the skin from which hairs grow. Severe or prolonged hypothyroidism may result in hair loss.

Telogen effluvium results in significant hair thinning which is noticeable and commonly occurs in women. Your hair does not start to fall immediately when periods of chronic stress begin; it is a result of stress over a long period of time and can start anywhere after weeks or months of continued stress. This condition is reversible and the earlier the cause is addressed, the better it is.

Other factors such as lack of nutrition, lack of exercise, and stress play a huge role in thyroid disorders. 

Hair roots usually rotate the work of making hair; such as hair roots on the head typically grow hair for a few years and then take a break.

How Hypothyroidism and Telogen Effluvium are Associated

The thyroid is a small, butterfly-shaped gland located at the front of your neck. It produces tetraiodothyronine (T4) and triiodothyronine (T3), which are two primary hormones that control how your cells use energy. Your thyroid gland regulates your metabolism through the release of these hormones.

Hair loss due to thyroid disease becomes apparent several months after the onset of thyroid disease. When the body does not have enough thyroid hormone, it can send the hair growth cycle into the state of telogen effluvium.

  • When hormone production is disrupted, specifically of hormones T3 and T4, it affects other processes in the body. This includes the development of hair at the root. Hair falls out and may not be replaced by new growth, resulting in thinning across your scalp and other areas such as your eyebrows. 

  • Severe and prolonged hypothyroidism can cause loss of hair. The loss is diffuse and involves the entire scalp rather than discrete areas. The hair appears uniformly sparse. 

Regrowth is usual with successful treatment of hypothyroidism, though it will take several months. It is unusual for mild hypothyroidism, or short-lived thyroid problems to cause hair loss.

Symptoms 

Losing 50–100 hairs per day from your head is normal and is a part of the normal hair growth cycle. If more than 100 hair strands are being lost per day, then it is called alopecia (hair loss) and is a cause of concern. 

However, if you have telogen effluvium then your hair comes out in handfuls. It is usually most noticeable on the scalp but can affect hair on any part of the body.

Hair loss is not the only symptom of hypothyroidism (underactive thyroid).

On the bright side, hair loss caused by thyroid conditions is usually temporary.

The symptoms of thyroid-related hair loss can be :

  • Diffuse loss of hair/thinning of hair covering your entire scalp

  • Hair loss occurs only in some areas of your scalp. This results in smooth, circular bald patches which can occur on the head or from any part of your body.

  • Loss of hair on the outer edge of your eyebrows. This is the most unique and characteristic symptom of hair loss associated with hypothyroidism.

  • Change in the texture of your hair. With hypothyroidism, your hair may lose its normal texture and become dry and coarse.

Treating The Cause

Mild forms of thyroid conditions do not generally lead to thinning hair. As a result, working with your doctor to keep your condition under control with medication may keep your hair thicker or regenerate growth. Results will likely not be immediate because hair takes some time to grow.

Treating thyroid-related hair loss requires treating the thyroid problem.

Your doctor will usually prescribe medications to treat an underactive thyroid. Consult your doctor for further management of your condition.

Your doctor will monitor your thyroid levels while you’re on medication.

Along with medication, there are different home remedies you may try to slow hair loss or regenerate hair growth.

Home Remedies

Maintaining a healthy diet is crucial for keeping telogen effluvium under control and eventually stimulating hair growth again. 

Eating a balanced diet can help to promote growth and improve the condition of hair. You should: 

  • Increase vitamin B supplements. The main vitamin responsible for hair growth is biotin that helps in producing protein keratin. Keratin is responsible for hair growth. Vitamin B6 is commonly found in liver, chicken, fish, and pork, while Vitamin B12 is in eggs, meat, poultry, shellfish, and milk. Dried beans, bananas, and potatoes are also great sources for B6. 

  • Add zinc to your diet. Zinc is believed to inhibit the creation of DHT (Dihydrotestosterone).  DHT is an androgen that is a sex hormone that contributes to the development of “male” sex characteristics, such as body hair which is present in excess causes male pattern baldness. Zinc supplementation helps in the treatment. 

  • Include lysine-rich food. It’s an essential amino acid that the body can’t produce on its own. Therefore, lysine has to be acquired through dietary sources like nuts, eggs, cheese, sardines, poultry, pork, and red meat. Lysine helps in the absorption of zinc and iron in the hair follicles hence helps in hair growth. 

  • Include iron-rich food. Iron helps red blood cells carry oxygen throughout the body to fuel your metabolism and aid growth and repair. Making changes in your diet with iron-rich foods may help with hair loss. These include red meat, liver, dark green leafy vegetables, beans, and lentils.

  • Vitamin C and D for hair growth. The deficiency of these vitamins increases your risk of telogen effluvium and makes it harder for hair to grow back fully. You can help yourself by adding certain foods to your diet. Vitamins C is available from citrus fruits such as grapefruit, orange, kiwi, lemon, etc. Vitamin D can be found in soy milk, almond milk, cod liver oil, salmon, etc.

  • Include spinach in your diet as it contains folic acid, iron, vitamins like A and C, which all promote hair growth. Vitamin A helps in producing sebum (a yellowish oily substance that is produced by the sebaceous glands in your skin)for your skin and hence moisturizes the scalp as well hence, aiding in better hair growth. 

  • Vitamin E protects areas of the skin, like the scalp, from stress and damage. Damaged skin on the scalp can result in poor hair quality and fewer hair follicles. Including vitamin E in your diet can restore the quality of hair. Vitamin E is available from avocados, almonds, hazelnuts, sunflower seeds, etc.

With treatment, hair growth may be noticeable within several months. However, in a few cases, the new hair growth may differ in color or texture from your original hair.

Speak to your doctor before initiating hair loss treatment at home as hypothyroidism does not lead to hair loss until the condition is more severe. Telogen effluvium can also be the symptom of another underlying issue. You may need home remedies along with medication to regrow your hair and to manage hypothyroidism.


References:

1. British Thyroid Foundation. 2021. Hair loss and thyroid disorders. [online] Available at: <https://www.btf-thyroid.org/hair-loss-and-thyroid-disorders> [Accessed 8 March 2021].

2. Keck Medicine of USC. 2021. Thyroid Problems: Fluctuating Weight, Hair Loss and More | | Keck Medicine of USC. [online] Available at: <https://www.keckmedicine.org/symptoms-of-thyroid-problems-fluctuating-weight-hair-loss-and-more/> [Accessed 8 March 2021].

3. Aad.org. 2021. Thyroid disease: A checklist of skin, hair, and nail changes. [online] Available at: <https://www.aad.org/public/diseases/a-z/thyroid-disease-skin-changes> [Accessed 8 March 2021].


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