Anaemia is a very common condition, affecting 2 billion people worldwide [1]. It is known to cause a range of symptoms and produce a wide range of health complications. But could iron deficiency anaemia cause hair loss?
Certain forms of anaemia are caused by intense haemorrhaging or chronic disease. These events can easily trigger telogen effluvium, forcing an excessive proportion of your hair to stop growing and start temporarily falling out. However, the most common form of anaemia is caused by iron deficiency.
This article will tell you everything you need to know about how iron deficiency might affect your hair and what you can do to prevent that from happening. Keep reading it to discover more about:
At this time, there is insufficient evidence to show that iron deficiency anaemia produces or worsens hair loss [2]. The academic community has obtained mixed results when studying the relationship between this condition and alopecia.
Many studies [1][3][4 have found no correlation whatsoever between iron deficiency and hair loss. That means there were no significant differences between the proportion of people with alopecia experiencing anaemia and those without hair loss. However, some smaller studies [5][6] found a higher incidence of iron deficiency anaemia in women with alopecias, such as telogen effluvium and female pattern baldness.
This means the results are mixed and it is difficult to draw a final conclusion. It appears that iron deficiency likely plays a certain role in some forms of hair loss, such as telogen effluvium and female pattern baldness, but it is unclear exactly what role and to what extent [7].
Multiple issues need to be considered when assessing these studies, which conclude that the higher prevalence of iron deficiency anaemia in patients with hair loss makes it a determining factor for alopecia:
Anaemia is a common condition characterised by an abnormally low level of red blood cells and/or haemoglobin (an oxygen-carrying protein found in your blood). It can have several causes, such as profuse bleeding from an accident, chronic illness (e.g. kidney disease, gastrointestinal disease, autoimmune disorders, cancer, etc,) or certain vitamin deficiencies (B12, folate). However, its most common cause worldwide is iron deficiency [9].
In most people, the main signs and symptoms of anaemia include (but may not be limited to) the following [11][12]:
Your body uses iron to produce haemoglobin, as well as certain hormones (e.g. hepcidin). The average adult male needs 8 mg of iron per day, while the average premenopausal woman requires 18 mg, as they lose blood monthly through menstruation.
This mineral is absorbed from food such as meat, fortified cereal, beans and leafy greens. However, in developed countries, it is rare to develop a severe iron deficiency from poor dietary intake alone. This type of anaemia tends to be more frequently caused by heavy menstrual flows, pregnancy, conditions that cause iron malabsorption (e.g. bowel disease) or prolonged use of certain medication (e.g. non-steroidal anti-inflammatory drugs) [13].
Having very low levels of iron (under 11-12 g/dL of blood for pregnant and premenopausal women and under 13 g/ dL of blood in men) can impede the production of red cells and haemoglobin in your blood. This can lead to serious health conditions, as your body is being deprived of the oxygen and nutrients it needs to function properly.
Left untreated, anaemia can cause a significant amount of health complications, such as cardiovascular disease, kidney disease, metabolic and neurologic conditions, as well as cognitive impairment. It may also trigger or exacerbate the symptoms of diabetes and atherosclerosis.
When it occurs in pregnant women, this condition can lead to negative pregnancy outcomes and increase the risk for both mother and child. It can also impede foetal brain development, potentially resulting in intellectual disability or lowered IQ[1].
2 billion people around the world are believed to be anaemic, out of which 1.24 billion have iron deficiency anaemia [14]. However, the occurrence rates in different populations vary widely depending on factors such as age, gender, ethnicity and country. Thus, this condition is known to affect 30% of premenopausal women (539 million), 37% of pregnant women worldwide (32 million) and 43% of children under 5 [15][14].
However, since iron deficiency comes mainly from nutrition, these percentages are significantly smaller in developed countries and often much higher in developing ones. For example, in the UK, 3% of men, 6% of women, and 24% of adolescent girls had iron deficiency anaemia [14], compared to 89.5% of women and 89.9% of men in the Punjab province of India [1]. That is why it is important to keep the population of clinical studies in mind before drawing conclusions regarding the prevalence of anaemia in patients with hair loss.
While it is still unclear whether this form of anaemia can cause hair loss and under what circumstances, it is a known fact that iron is necessary for healthy hair growth. That is because your hair follicles need oxygen and nutrients to thrive and they are receiving them from your blood. If your blood is not transporting enough oxygen due to low levels of haemoglobin, it could disrupt your hair growth cycle and affect your strand qualities.
Moreover, iron also plays a part in DNA synthesis, which is needed to produce rapidly dividing hair cells. Insufficient levels of this mineral can directly impact hair production, as follicles are very sensitive to fluctuations in iron levels [16].
Finally, iron influences the production of certain enzymes and proteins necessary for healthy hair growth. Anaemia can inhibit this process and thus contribute to decreased hair production [17].
This means that even if it does not directly cause your hair to fall out, iron deficiency anaemia may affect your hair fullness and may reduce strand density and strength.
There are some indications that iron deficiency anaemia might contribute to your hair falling out. This condition has sometimes been associated in the scientific literature with diffuse hair loss, as you would encounter in telogen effluvium or female pattern baldness. However, there is insufficient evidence to establish a definite relationship between these conditions.
If your iron deficiency anaemia were to cause hair shedding, it would likely do so primarily by disrupting your natural hair growth cycle and triggering telogen effluvium (a condition that can often coexist with female pattern hair loss but is separate from it). The lack of iron would entail poorer nourishment for your hair follicles, which could shorten their growth phase and usher in their shedding phase faster.
Diffuse hair loss is the main and often the only symptom of telogen effluvium. This can be mild or sometimes make your hair so thin you can see your scalp. If you are only experiencing this type of alopecia, you should not normally see signs of scalp inflammation, well-defined bald spots or patterned hair loss. Your hair shedding should be uniform. However, some people with telogen effluvium also experience trichodynia – a burning or tingling sensation on their scalp.
Normally, telogen effluvium resolves itself 3-4 months after the physically or psychologically stressful event that caused it has been resolved. This means that whether it is caused by an iron deficiency, it should improve soon after you start taking iron supplementation. However, if your anaemia were not addressed, it would become chronic if left untreated.
While anaemia is quite common, it is far more frequently encountered in young children and women of childbearing age. However, other groups are vulnerable to this condition as well. The people most at risk of developing anaemia are as follows [18]:
If you are experiencing iron deficiency anaemia, your healthcare provider probably recommended iron supplementation and other treatments to address its cause. Should your hair loss have indeed been influenced by this deficiency, you should normally start seeing an improvement in hair growth 3-4 months after it has been corrected.
There have been some anecdotal reports in relevant literature about anaemic patients’ alopecia improving after taking iron supplements. However, not enough clinical trials have been conducted at this time to determine whether supplementation can curb hair loss in patients who are not anaemic, even if they have an iron deficiency [16].
It is also good to know that not all iron supplements are created equal. They come in many forms, some of which are better for treating iron deficiency than others. For example, chelated iron and heme iron are better absorbed in your digestive tract, making it easier to treat your anaemia.
It is difficult to establish a direct relationship between vitamin deficiencies and hair loss. However, there are indications that not getting enough of the following vitamins and nutrients may have a detrimental impact on your hair growth and may even cause hair shedding:
There are several conditions that can cause diffuse hair thinning. Here are some of the best ways to recognise and treat each of them:
This condition is normally triggered by severe physical or psychological stress, such as illness, being in an accident, undergoing surgery, or experiencing a traumatic event. It is normally temporary, but if its trigger remains unresolved, it can become chronic.
Signs and symptoms: diffuse hair loss, with no signs of inflammation; in some cases, burning scalp syndrome.
Treatment options: Treatment is usually not necessary for the acute form. Removing the stressor that triggered the telogen effluvium will normally resolve this condition. However, if this does not happen, Minoxidil and red light therapy for hair growth can help treat its chronic form.
Unlike male pattern baldness, which manifests with a receding hairline accompanied by temple hair loss and a bald spot on the crown, the female variety is known for diffuse hair loss. This condition is normally inherited and influenced by age and hormones. It is progressive, which means it can advance if left untreated.
Signs and symptoms: a widening of the midline parting, a Christmas tree pattern around the hair parting, diffuse hair loss.
Treatment options: Minoxidil, Finasteride (not recommended to premenopausal women), PRP hair treatments, a hair transplant.
Alopecia areata is an autoimmune condition, which means your white blood cells are attacking your hair follicles. Its most common form causes round bald spots on the scalp. However, a less common form called diffuse alopecia areata (or alopecia areata incognita) can also manifest with diffuse hair loss.
This condition can sometimes resolve spontaneously within a year of onset (but may recur over the years). However, if it doesn’t, it will likely require treatment. Patients with alopecia areata are known to have higher chances of developing a variety of other health conditions, including iron deficiency anaemia [23].
Signs and symptoms: diffuse hair loss, scalp inflammation, yellow or black dots on the scalp, small, broken hairs in the shape of exclamation marks, pitted nails.
Treatment options: steroid creams, intralesional steroid injections, JAK inhibitors, topical Minoxidil
There are several things you can do to prevent the development of iron deficiency anaemia. The most important of them are as follows:
If you are worried that your anaemia may be making your hair fall out, it is a good idea to book a consultation with a trichologist. They will order all the necessary blood tests for hair loss and also use other diagnosis methods, such as a hair pull test, a dermoscopy or a scalp biopsy, to get a definitive cause for your alopecia.
Once you have your diagnosis, they will offer you a personalised treatment plan custom-tailored to your specific problem. If your hair loss is indeed caused by anaemia, treating it will be the first course of action.
However, if your alopecia turns out not to be anaemia-induced and you have an incipient form, they may recommend medications and therapies to help curb your hair shedding and achieve regrowth. If your baldness is more advanced, you might make a good candidate for a natural-looking hair transplant.
This simple, one-day outpatient procedure can permanently solve your hair thinning and balding because a hair transplant is permanent. That means you could regain your youthful looks and healthy locks without worrying about losing your hair.
Would you like to learn more about the impact iron deficiency anaemia can have on hair loss? Discover the answers to some frequently asked questions:
At this time, while there is some evidence that anaemia correlates with hair loss, it is mixed and not very consistent, so we don’t know much about its exact relationship to alopecia.
There are also insufficient studies to show how treating your anaemia can affect your hair loss. However, assuming that this condition was the only reason your hair was falling out, there is a good chance it will grow back once your iron deficiency is resolved.
Yes, a trichologist can order hair loss blood tests, which reveal if you have any nutrient inadequacy or deficiency that can affect your hair (iron included).
They can also perform specific diagnostic tests that reveal if you have any other type of alopecia unrelated to nutrients. In most cases, seeing a hair doctor will result in an accurate diagnosis of your hair loss.
Androgenetic alopecia (male or female pattern baldness) is caused by a combination of age, genetics and hormonal factors. It usually develops when your body produces too much of an androgen hormone called dihydrotestosterone (DHT). This hormone binds to androgen receptors in your hair follicles, shrinking them and preventing them from producing hair.
Studies show that iron deficiency anaemia may play some role in developing or exacerbating female pattern baldness symptoms. However, it is currently unclear exactly what that role is and the extent of its impact [7]. Thus, further research into this topic is needed.
If you are experiencing anaemia, following your healthcare provider’s treatment recommendations is best. That is because, in most cases, in developed countries, iron deficiency anaemia doesn’t have a dietary basis. It is more often caused by an underlying condition.
If your anaemia is dietary and you increase your iron intake, it could resolve without medical intervention. The same can be said if it was induced by a few months of heavy menstruation (which was resolved) or by accidental trauma involving blood loss. However, if it was caused by chronic illness, it will likely persist until treated.
If your anaemia is a result of pregnancy, it should normally improve once you have given birth. But it is very important to get it treated as soon as it is detected because it can place your health and pregnancy at risk.
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