Few people are aware that thyroid hair loss can be extremely common. Studies show that alopecia is a symptom in approximately 50% of people who experience hyperthyroidism and 33% of those with hypothyroidism [2].
If your hair is falling out due to a thyroid disorder, you can expect to spot diffuse thinning all over your scalp. However, there are several other types of alopecia that share similar symptoms (e.g. telogen effluvium), so your hair shedding may be difficult to diagnose correctly without the help of a trichologist.
While treating your underlying thyroid condition will often curb your hair shedding, it does not guarantee complete regrowth [3]. A hair doctor can recommend the most effective medication and therapies to increase your hair density and thickness. They can also determine if you could benefit from a permanent hair transplant.
This article will tell you everything you need to know about:
Most commonly, people with thyroid-induced hair loss experience diffuse hair shedding all over their scalp due to disruptions in their hair growth cycle [3][4]. Their hair may grow slower, and depending on their type of thyroid disorder, it might become coarser or finer than usual.
In most cases, they show dry, brittle hair, often leading to breakage and split ends [3]. Moreover, studies have found a strong association between thyroid dysfunctions, premature greying, and common scalp problems, such as seborrheic dermatitis [5].
The relationship between autoimmune hair loss conditions such as alopecia areata and an autoimmune thyroid is still being investigated. However, studies reveal that conditions such as Graves’ Disease or Hashimoto’s thyroiditis increase the risk of developing this type of alopecia (although not necessarily by causing it) [7]. In this case, patients experience round patches of hair loss on their scalp or, in some cases, diffuse hair loss.
Finally, the hair on your head may not be the only one affected by thyroid disorders, you may also experience eyebrow hair loss [8], beard hair loss, or, very rarely, shedding of all your head and/or body hair (e.g. alopecia totalis or alopecia universalis)
People with hypothyroidism can develop partial eyebrow hair loss, known as Queen Anne’s Sign or Sign of Hertoghe [10]. This consists of complete hair shedding in the outer third of the eyebrow. However, this is not unique to thyroid disorders; it can also develop in patients with atopic dermatitis (eczema).
Men’s facial hair can also be affected by thyroid dysfunctions, which can cause it to develop a sparse, patchy beard and moustache.
It’s not always easy to tell whether your hair loss is caused by a thyroid disorder or by a different cause just by looking at your hair. Sometimes, a thyroid disorder can trigger certain types of alopecia or increase their symptoms. However, they can also develop completely independently of it.
Here are some questions to help guide you through this process and make the source of your hair shedding clear (although only a trichologist can give you an accurate diagnosis):
If you notice a receding hairline that has been slowly progressing and that the entire frontal area of your scalp is starting to thin, you may be experiencing male pattern baldness. This is a genetic condition that affects 85% of men during their lifetime [11].
While a thyroid condition could trigger androgenetic alopecia or worsen its symptoms, it can easily develop independently from it due to a combination of age, genes, and hormones.
What does male pattern baldness look like?
The main signs of male pattern baldness include a receded or M-shaped hairline and temple hair loss. In more advanced cases, you may also develop a bald spot on the crown.
Pro tip: If you want to see whether your hairline is receding, measure the distance between your eyebrows and the place where your hair starts. Always measure this for each eyebrow in a straight, upward line from its centre.
Take measurements every 2 weeks, writing down the results. Compare the notes at the end of each month – if your hairline is becoming higher or uneven between sides, it is a good idea to get assessed by a hair doctor. Male pattern baldness is treatable if diagnosed early but can progress if unaddressed.
While female pattern hair loss is the female version of androgenetic alopecia, it manifests differently than the male variety. Thus, you may not experience a receding hairline, but your increasing hair parting width will likely be the first sign of hair thinning and balding [12]
What does female pattern baldness look like?
This condition can be mistaken for thyroid hair loss more easily than its male counterpart because it often manifests with diffuse hair loss. However, it also has telltale signs, such as an ever-widening midline parting that may develop a Christmas tree pattern.
Pro tip: Part your hair in the middle and measure the width of your parting every 2 weeks, writing down the results. Always measure in the same 3 spots, one in the front, one in the centre and one towards the back of your scalp. Review your notes monthly and see a hair doctor if you notice a consistent widening, especially in the crown area.
Thyroid conditions tend to be associated with higher rates of autoimmune disorders, such as alopecia areata. But the two are not necessarily related. The most common form of alopecia areata manifests with patchy hair loss.
What does alopecia areata look like?
If you have this condition, you will most likely experience smooth, rounded bald spots on your scalp and sometimes in your facial hair. You may also develop yellow or black dots on your scalp or see broken hair strands that look like exclamation marks. However, rare forms of this condition can also look different.
You may experience diffuse hair loss (alopecia incognita), bald swathes of scalp in the back or sides of your head (ophiasis alopecia), total hair loss on your scalp (alopecia totalis), or complete balding all over your body (alopecia universalis).
Pro tip: A considerable proportion of alopecia areata cases are diagnosed in childhood and resolve on their own within a year but often flare again throughout life. If you have experienced bald patches before, which have gone away without treatment, it is a sign you may have alopecia areata (but only a dermatologist or trichologist can confirm this).
Thyroid hair loss is frequently a form of telogen effluvium, as the disorder that causes it often disrupts your hair growth cycle [2][8]. However, telogen effluvium is rather common and can also be caused by significant physical or psychological stress. So an illness (e.g. a COVID-19 infection) or trauma (e.g. important examinations, divorce, bereavement) can be enough to trigger it.
What does telogen effluvium look like?
This condition manifests with diffuse hair loss all over your scalp (and possibly your facial hair). The amount of hair shedding could be troubling, and in some cases, you may develop hair so thin you can see your scalp. However, you should not see inflammation, rashes, or bald spots, but you may experience trichodynia (a burning or tingling sensation)
Pro tip: Telogen effluvium normally resolves itself in approximately 3 months after the stressful event has subsided. If you reduce the amount of stress in your life but see no hair loss improvement in 4-6 months, seeing a hair specialist is a good idea.
A restrictive or imbalanced diet can deprive your hair of the nutrients it needs to grow and thrive. So, your strands may start falling out, as vitamin deficiencies can cause hair loss. If you have started a strict diet in the past few months or have been eating less balanced meals, it could be the source of your hair shedding. Moreover, popular weight loss medications such as Wegovy can cause hair loss in some patients as well.
What does hair loss caused by weight loss look like?
Significant weight loss can cause hair loss, specifically diffuse hair thinning all over your scalp. You should not see localised bald spots, temple or hairline recession, or a widening of the midline parting.
Pro tip: Hair loss blood tests can tell you if you have any significant nutritional deficiencies that can cause your hair to fall out. They can also help you determine if you have a thyroid condition that can lead to hair thinning.
Supplementing vitamins or minerals without having a deficiency will not help improve your hair loss, and in some cases, they won’t lead to full regrowth even if you do have one. So try eating a balanced diet for healthy hair, even if you are trying to lose weight.
Sometimes, the cause of your diffuse or localised hair loss can be as simple as a scalp problem. Seborrheic dermatitis can lead to inflammation that can make your hair fall out more across your entire scalp. And scalp psoriasis, eczema or scalp folliculitis can lead to hair loss in the affected areas of your head.
What do common scalp problems look like?
Each scalp condition has its own symptoms. However, if you are experiencing a kind that causes hair loss, you can expect to see inflammation, redness, or irritation on your scalp. You may also see silver, white, or yellow and greasy flakes in your hair.
Pustules, pimples, or small, oozing lesions are not uncommon. In most cases, you will experience some discomfort, such as scalp itching, burning, tingling, pain, or tenderness.
Pro tip: If you notice flaking, irritation or inflammation on your scalp, try medicated hair products, such as Nizoral shampoo. Also, hair growth oils such as peppermint oil for hair or tea tree oil may also help soothe your symptoms. However, if you don’t see any improvement in a few days of home treatment, it is best to see a dermatologist, as you may need prescription medications.
Prolonged wearing of tight hairstyles such as top knots or ponytails can cause hair loss, as they pull on your hair roots, damaging your follicles. This leads to a condition called traction alopecia, which prevents your hair from growing in the areas where the most tension is applied.
What does traction alopecia look like?
Traction alopecia usually occurs in the frontal area of the scalp, manifesting as balding around the hairline, temples, or fringe line. Your skin may also look bumpy or irritated in those areas, and you may experience tenderness or tingling.
Pro tip: This condition normally resolves itself after you stop pulling on your hair roots, giving your follicles a chance to heal. So, if you have been wearing tight hairstyles for prolonged amounts of time, try avoiding them for a few months and see if your hair loss improves.
The thyroid is an endocrine (hormone-producing) gland located at the lower front of your neck. Its role is to produce specific hormones called thyroxine (T4) and triiodothyronine (T3).
These hormones are extremely important to the functioning of your body, as they are involved in the function and metabolism of most types of cells. Some of the processes they support are [16][17]:
There are two main kinds of thyroid disorders: the ones that make your thyroid hyperactive (producing too many hormones) and those that make it underactive (producing too few hormones). The first case is called hyperthyroidism, while the second is known as hypothyroidism.
In most cases, these conditions are caused by autoimmune thyroid disorders, such as Graves Disease (also known as Basedow Disease) [18], or Hashimoto thyroiditis, where your body’s own immune system attacks your thyroid [19][20][21]. But they can also be caused by thyroid nodules (lumps), excessive levels of iodine, treatment with certain kinds of medications (e.g. lithium, interferons, amiodarone), thyroid inflammation, hormonal changes caused by pregnancy and childbirth or, rarely, thyroid cancer [22][23].
Here are the main symptoms to look out for in thyroid disorders:
Thyroid hormones play an important role in hair follicle growth and health. Here are the mechanisms through which thyroid dysfunction can make your hair fall out [2]:
In a healthy person, hair undergoes a natural growth cycle, resting and shedding. However, if this cycle is disrupted, excessive hair loss can occur. Both hypothyroidism (in most cases) and hyperthyroidism can cause telogen effluvium by shortening the growth phase and making a greater proportion of hair than normal enter the shedding phase.
Prolonged low levels of thyroid hormones can affect blood circulation, including to the capillaries in your scalp. Moreover, they can also decrease your metabolic activity [16]. Both these processes can lead to a lower amount of oxygen and nutrients reaching your hair follicles, slowing down your hair growth and decreasing strand strength and thickness.
Hypothyroidism can have a negative effect on the production of the natural oil (sebum) your scalp and hair need to stay hydrated. Thus, it can lead to dry, brittle, coarse, and dull strands, which break off easily.
On the other hand, hyperthyroidism can make your strands finer than normal, reducing their mechanical strength and increasing hair breakage [2]. So, a thyroid condition may be the reason your hair feels thinner and more fragile.
Alopecia areata is an autoimmune type of hair loss where your white blood cells are attacking your hair follicles.
While further research is needed to determine the exact nature of the relationship between alopecia areata and other autoimmune conditions, studies have shown an association between this kind of hair loss and autoimmune thyroid disorders, such as Hashimoto’s thyroiditis or Graves’ disease [2][7][8].
Diffuse alopecia areata has been found in up to 50% of patients with hyperthyroidism, while approximately 5% of patients with this condition experience hypothyroidism related to Hashimoto’s disorder [25][2].
Thyroid hormones play a role in the production of the male hormone dihydrotestosterone (DHT) [15]. When excessive amounts of DHT are produced, you can develop androgenetic alopecia. Moreover, thyroid dysfunctions can influence estrogen metabolism and availability, impeding its protective and hair-growth-stimulating functions on your hair follicles.
Finally, pregnant women are more predisposed to developing Graves’ disease. The many hormonal changes in their bodies (including an increase in thyroid hormone production to help with foetal growth and development) can mask its symptoms, making it more difficult to diagnose in a timely fashion. This is why a thyroid condition may cause hair loss during pregnancy [26].
One study shows that 31.25% of women with female pattern baldness also experience hypothyroidism [2]. A different study, performed on both men and women with androgenetic alopecia, revealed a 50% rate of thyroid dysfunctions in patients older than 40 [8]. While there are theories saying that thyroid disorders can trigger or worsen symptoms in people who are genetically predisposed to developing androgenetic alopecia, further research is needed to confirm this effect and to better understand its circumstances [8].
While hair loss is more common in men than in women, thyroid-induced hair loss is more frequently seen in the female population. That is because women are up to 500% more likely to experience thyroid dysfunctions that can lead to hair shedding than men [27]. Studies have revealed that hyperthyroidism is present in 1.5% of women and 0.5% of men, while hypothyroidism affects 3% of the male and 10.5% of the female population [27].
Thyroid disorders are also more likely to affect people as they advance in age (especially after the age of 60) [18], but also pregnant and postpartum women [20]. People who have congenital thyroid dysfunctions are, of course, at increased risk of developing hair shedding, depending on the severity of their condition. As are those with a family history of thyroid dysfunction or people who experience certain predisposing illnesses, such as type 1 diabetes, Turner syndrome, or an autoimmune disorder [28][7][17].
Moreover, research suggests that thyroid dysfunctions may play a role in triggering early onset androgenetic alopecia or worsening its symptoms in people who are already genetically predisposed to developing this condition (although further evidence is needed to understand the nature of their correlation) [2][5].
Some people can expect to see hair regrowth a few months after starting treatment to manage the thyroid condition which caused their hair shedding [3]. However, this regrowth may sometimes be incomplete and in some patients, it may not happen at all [25]. That is why early diagnosis is important in thyroid disorders, as it can not only help you get your condition under control faster and with a lower toll on your body, but it can also help you limit the extent of your hair shedding early on.
Since hair loss caused by thyroid disorders represents a systemic type of alopecia, the best thing you can do is to address the underlying cause. That means getting your thyroid condition under control significantly increases your chances of achieving hair regrowth. However, this does not happen in all patients with thyroid dysfunctions.
The treatment needed to balance your thyroid hormones and curb symptoms such as hair loss depends on the exact condition that you are experiencing. To get the most appropriate care, you need to see an endocrinologist. They will run all the necessary tests, provide you with a diagnosis, and may recommend one of the following treatment options [29] [30]:
Levothyroxine is considered the standard of care in this condition. This oral medication is taken daily, and it replaces thyroxine, This is a hormone normally produced by your thyroid but which is insufficient in people with hypothyroidism. Levothyroxine is safe and can be taken long-term without significant side effects as long as the recommended dosage is not exceeded [29].
If your thyroid is hyperactive, you may be recommended a type of medication called thionamides to stop it from producing excessive amounts of hormones. Should your condition be more advanced, you may require radioactive iodine treatment, a type of radiotherapy that destroys some of the cells in your thyroid, to lower hormonal production.
For severe hyperthyroidism, which does not respond well to non-surgical treatment, you may also be offered surgery to remove part or all of your thyroid. If you have this operation, you may need to take levothyroxine for the rest of your life to compensate for the fact you will no longer be producing thyroid hormones.
If your hair loss does not improve after a few months of thyroid treatment, it is important to see a trichologist. They will check if your thinning is indeed caused by your thyroid condition or by a different type of alopecia. Once they have the correct diagnosis, they may recommend:
If you have tried everything and you still haven’t found a way to curb your hair loss, book a hair transplantation consultation at the most convenient of our central London clinic locations. Our brilliant surgeons will be happy to explain the entire process to you in detail and to determine whether you can benefit from this procedure.
Do you think a thyroid disorder may be the root of your hair shedding? Find out more about the relationship between your thyroid function and hair loss by reading the answers to these common questions:
In general, it is only a good idea to take vitamin supplements if you have a deficiency otherwise, they are unlikely to help your hair loss. If you have a clinical deficiency, your healthcare provider can provide the best guidance.
Otherwise, eating a well-balanced diet rich in vitamins C, D, and E, iron, zinc, magnesium, and selenium should provide all the nutrients your hair needs and no vitamin supplementation should be needed.
While thyroid hair loss normally occurs independently of your lifestyle choices, you can avoid additional hair shedding by making some changes. Avoid heat-styling your tresses and exposing them to the hot sun, as it can be difficult to fix heat-damaged hair.
Choose gentle hair products and reduce the frequency of bleaching or dyeing your hair. Eating healthily, getting plenty of rest and exercise, cutting back on smoking, and reducing stress can also be very important for improving your hair health.
There is only anecdotal evidence regarding the effectiveness of biotin for hair loss. Moreover, the British Thyroid Foundation raises the alarm that many commercially available supplements contain far higher doses than the daily recommended intake (30 mcg).
Some can reach as high as 5000-10000 mcg, which may cause false readings for free T4 (FT4), free T3 (FT3) and TSH (a thyroid-stimulating hormone regulating the level of T3 and T4) [31]. These tests measure the levels of thyroid hormones in your body, which helps diagnose hyper- or hypothyroidism.
No commercially available shampoo can be stand-alone effective against hair loss produced by a thyroid disorder. However, some of the best shampoos for thinning hair may help achieve regrowth once you have your thyroid condition under control.
You can also try a Minoxidil shampoo, but it is unlikely to be as effective in shampoo form as it is as a topical solution.
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