Discover how low thyroid function can cause alopecia areata

Did you know that alopecia areata may be linked to your thyroid health?

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When I was dealing with alopecia, I found that my doctors often brushed off my slightly high TSH levels, despite my insurance specifically excluding thyroid issues because of their connection to alopecia.

That's when I decided to dig into the research myself to understand how thyroid problems and alopecia are related. What I discovered was eye-opening: by taking care of my thyroid health, I could potentially promote my hair growth and reverse alopecia.

In this article, I want to share what I've learned and explain how focusing on thyroid health could be the key to overcoming alopecia. Let's dive in.


The link between your thyroid and hair growth 

Several studies have explored the intricate connection between thyroid disorders and alopecia, which helps to shed light on the underlying mechanisms.

Time and again, research has demonstrated a correlation between thyroid dysfunction and various forms of alopecia, including alopecia areata and androgenetic alopecia. 

So what is the link?

The thyroid gland plays a pivotal role in regulating metabolism by producing hormones such as thyroxine (T4) and triiodothyronine (T3). When the thyroid is imbalanced, it can lead to an array of health issues, with hair loss being a common symptom.

A study published in the Journal of Investigative Dermatology found a strong association between thyroid autoimmunity and alopecia areata. One strong connection is that both thyroid issues and hair loss are autoimmune-related. 

Thyroid conditions, such as Hashimoto's thyroiditis and Graves' disease, involve the immune system mistakenly attacking the thyroid gland. Alopecia areata is caused by the immune system, attacking the hair follicles, which contributes to the development of alopecia. Furthermore, disruptions in thyroid hormone levels can influence the hair growth cycle. 

Thyroid hormones regulate the transition between the anagen (growth) and telogen (resting) phases of hair follicles. An imbalance in these hormones may lead to an increased number of hair follicles entering the telogen phase prematurely, resulting in hair shedding and thinning.

I often work with clients who are experiencing both alopecia areata and hair shedding, which is why one of the first areas I investigate is their thyroid health. 

Autoimmune responses can develop for many reasons, and understanding the underlying root cause of your autoimmune condition is vital for you. 


Cross-reactivity in thyroid health and alopecia areata

One theory about the link between alopecia areata and thyroid health relates to a concept called cross-reactivity. Cross-reactivity occurs when antibodies or other immune components recognise and bind to similar molecules that are not their intended target. 

Cross-reactivity can be likened to a detective searching for a suspect in a lineup. Imagine the detective is looking for a particular individual based on a description provided by a witness. However, due to similarities in appearance, the detective mistakenly identifies someone else in the lineup as the suspect. 

Similarly, in the immune system, antibodies may mistakenly recognise and bind to molecules that resemble the target they are meant to attack, leading to false identification and potential confusion in the body's immune response.

In alopecia areata, the immune system may react to components in a dairy molecule. Similar to the situation described above, ​​when antibodies are produced in response to dairy proteins, the immune system mistakenly targets and attacks proteins found in the hair follicle, leading to inflammation and potential hair loss.

The same may happen in autoimmune thyroid conditions. In autoimmune thyroid conditions, consuming dairy products can exacerbate inflammation and autoimmune responses in the thyroid gland due to cross-reactivity between dairy proteins and thyroid tissue, leading to worsening symptoms and thyroid dysfunction.

When I work with clients with alopecia or thyroid conditions, I often recommend a food sensitivity test. This test will help me understand whether their immune systems are reacting to certain foods and determine whether this is the mechanism at play. 


Gallbladder dysfunction in hypothyroidism

Hypothyroidism can contribute to gallbladder dysfunction by slowing down bile flow, which may increase the risk of gallstones and impair gallbladder function.

You may be wondering how this is linked to hair loss and alopecia.

The gallbladder has an extremely important role, as the bile it produces helps to break down fats from the food you eat. And not just that, there are vital vitamins and minerals that can only be digested in the presence of fat. 

Fat-soluble vitamins include vitamins A, D, E, and K, while fat-soluble minerals include calcium, magnesium, and phosphorus—all nutrients which are essential for hair growth. 

Vitamin A aids in sebum production, keeping the scalp moisturised and hair follicles healthy. Vitamin D is involved in hair follicle cycling and growth stimulation, while vitamin E acts as an antioxidant, protecting follicles from damage. Vitamin K supports healthy blood circulation to the scalp. Additionally, minerals like calcium, magnesium, and phosphorus promote the formation of keratin, contributing to the development of strong, resilient hair. 

So if you have alopecia and you are looking to put your body in the best place for healthy hair growth, you need to ensure that you are not deficient in these nutrients. And if you find yourself deficient in these nutrients even though your diet is nutrient-dense, it could be the result of a faulty gallbladder function. 

When I run stool tests for my clients with alopecia, often the results reveal an issue with fat digestion. On top of that, they may also have high cholesterol, which is another tale-tale factor that your gallbladder function might be off. 


Testing for thyroid dysfunction

Checking in with your body and symptoms is the first step in understanding whether your thyroid might be at the heart of your hair loss. 

Other symptoms of hypothyroidism include fatigue, weight gain, cold sensitivity, dry skin, and also include changes in toenails such as brittleness, slow growth, and a pale or yellowish discolouration.

Another potential sign of hypothyroidism is wrinkly fingertips (or pruney fingers), like when you have stayed too long in the bath. Your fingers wrinkle because not enough oxygen is getting to the tips, but this may also be a sign of dehydration. 

If you are experiencing several of the symptoms above, it might be worth testing to understand what is going on with your thyroid function and hormones. Testing your thyroid function involves several vital markers that provide valuable insights into your thyroid health. 

Let’s look at the elements of thyroid testing so you can evaluate what this means for you:

Thyroid Stimulating Hormone 

The primary test is the measurement of Thyroid Stimulating Hormone (TSH) levels, which is produced by the pituitary gland and regulates thyroid hormone production. Elevated TSH levels typically indicate an underactive thyroid (hypothyroidism), while low TSH levels suggest an overactive thyroid (hyperthyroidism). 

Think of TSH as the thermostat in your body's metabolic system. Similar to how a thermostat regulates the temperature in a room, TSH helps regulate thyroid hormone levels to maintain metabolic equilibrium. 

When thyroid hormone levels dip, TSH acts like a thermostat, sensing the drop in temperature and signalling the thyroid gland to increase hormone production, akin to turning up the heat to maintain a comfortable room temperature. 

Conversely, when thyroid hormone levels are sufficient, TSH decreases its signal, like a thermostat maintaining a steady temperature without the need for adjustment. 

This dynamic feedback mechanism ensures that your body's metabolic "temperature" stays within the optimal range for overall health and function. And when it is out of range, you know that your thyroid isn’t working optimally, which is why it is then worth checking your thyroid hormones to understand the cause. 

Triiodothyronine (T3) and thyroxine (T4)

Additionally, assessing levels of triiodothyronine (T3) and thyroxine (T4) hormones provides further information about thyroid function. T3 is the active form of thyroid hormone, while T4 serves as a precursor that is converted into T3 as needed. 

Reverse T3 (rT3) is a less active form of T3 and may indicate thyroid dysfunction or stress. 

Your free T3 levels are the most important as this is the hormone which is most active in your body, and when it is low, you will likely have symptoms of hypothyroism. 

I worked with a client recently, who had hair loss and symptoms of hypothyroidism, and she had normal levels of TSH and most of her thyroid hormone levels, however, her T3 was low. 

In conventional medicine, your doctors will normally only test for TSH, even though TSH can be in range, and you can still have low free T3 which is why is it important to do a full thyroid panel if you want to know all your levels. 

Thyroid antibodies 

Testing for thyroid antibodies, such as anti-thyroid peroxidase (TPO) and anti-thyroglobulin antibodies, can help diagnose autoimmune thyroid conditions like Hashimoto's thyroiditis and Graves' disease. 

I find that many of my clients have been diagnosed with hypothyroidism in the past, but are unsure whether it is autoimmune related. It is vital to know this, as the way you approach your recovery will be different depending on the cause. 

In my clinical practice, I offer thyroid testing which includes all of the above markers so that you can truly understand what is at the heart of your thyroid condition, and from that, know the best way to recover from it. 


Natural therapies to support thyroid function

Identifying the root cause of thyroid health and hair loss is the first step to recovery. 

However, there are some simple ways to adopt a diet and lifestyle that support thyroid function and put your body (and scalp) in the best position for hair growth. 

Ensuring an adequate intake of essential nutrients such as iron, zinc, selenium, and vitamins A, E, and D is crucial for optimal thyroid function and hair health. Nutrient-dense foods include organic red meat, organ meat, seaweed, seafood, and oily fish, as these ensure that your body gets the most beneficial form of vitamins and minerals. 

You can eat a nutrient-rich diet on a vegetarian diet, but you need to be mindful of the vitamins that are less available in this diet, including vitamin B12, vitamin D, iron, omega-3 essential fatty acids, zinc, and iodine. You can work with a health practitioner to decide if supplementing these nutrients might be worthwhile for you. 

Certain herbs, known as adaptogens, may help the body adapt to stress and support thyroid function. Adaptogens like Rhodiola rosea, l-theanine and holy basil have been studied for their potential role in balancing hormones and reducing stress, which can be beneficial for individuals with thyroid-related alopecia. However, as these types of herbs are suitable for everyone, please consult your health practitioner before taking any new supplements. 

Stress management techniques, such as yoga and meditation, can be valuable in supporting overall well-being and potentially reducing the impact of stress-related hair loss. Chronic stress is known to contribute to thyroid imbalances and exacerbate alopecia symptoms, so finding strategies to calm down your nervous system, especially at night, will help to regrow hair faster and more robustly. 

Understanding the link between thyroid health and hair loss helps to determine whether this might be a factor in your own hair loss and what action you can take to support your hair growth. 

If you would like to know more about how my nutritional therapy services might help your symptoms, please visit my profile to book a free initial consultation with me. 

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The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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London W1G & Harrogate HG1
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Written by V. J. Hamilton
Autoimmune Disease Expert | BSc (Immunology), DipION, mBANT
location_on London W1G & Harrogate HG1
After 25 years of suffering from multiple autoimmune conditions including alopecia, psoriasis and CFS, VJ discovered she could uncover the root cause of her issues to transform her health & live without symptoms. VJ now uses these same principles...
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