Hair shedding can be frustrating, especially when you feel like you are doing everything right.
You may be eating well, taking supplements, using quality hair products, and still noticing more hair in your brush or shower drain.
One factor that is sometimes overlooked is iron status.
Iron plays an important role in many processes throughout the body, and low iron stores may be associated with certain types of hair loss, particularly diffuse shedding such as telogen effluvium. However, iron is only one potential contributor to hair loss, and not every case of hair thinning is related to iron.
What Does Iron Have to Do With Hair?
Hair follicles are metabolically active structures that require adequate nutrients to support normal growth.
When the body is dealing with iron deficiency or other nutritional deficiencies, hair growth may be affected. Some women with diffuse hair shedding have been found to have lower ferritin levels, although the relationship between ferritin and hair loss is not completely straightforward.
This is one reason iron status can be worth considering when evaluating unexplained hair shedding.
Ferritin vs. Hemoglobin: What’s the Difference?
When most people think about iron deficiency, they think about anemia.
But iron status is more complicated than simply looking at hemoglobin.
Hemoglobin is the protein in red blood cells that carries oxygen.
Ferritin is a marker of the body’s stored iron.
A person can have a normal hemoglobin level while still having depleted or lower iron stores. That means a normal CBC does not necessarily tell the entire story when evaluating symptoms that may be related to iron status.
This does not mean that every woman with hair loss needs iron supplementation. Instead, it means that iron status may be one piece of the larger clinical picture.
Who May Be at Greater Risk for Low Iron?
Certain women may be more likely to develop low iron stores, including those who:
Have heavy or prolonged menstrual periods
Are pregnant or recently postpartum
Have experienced significant blood loss
Follow restrictive diets
Have difficulty absorbing nutrients
Have certain gastrointestinal conditions
Have increased nutritional needs
For women experiencing hair shedding after pregnancy, for example, iron status may be particularly relevant if there was significant blood loss during delivery.
What Labs May Be Considered?
Depending on your symptoms and medical history, a provider may consider:
CBC
Ferritin
Serum iron
TIBC or transferrin
Transferrin saturation
Additional testing may be appropriate depending on the individual. Other contributors to hair loss may also need to be considered, including thyroid function, vitamin deficiencies, hormonal changes, stress, illness, medications, and rapid weight loss.
Should You Take an Iron Supplement?
Not necessarily.
Iron supplementation is not appropriate for everyone with hair loss, and taking iron when you do not need it is not harmless.
The goal is to understand why your iron stores may be low and determine whether supplementation is appropriate based on your laboratory results, symptoms, diet, medical history, and potential sources of blood loss.
If iron deficiency is identified, addressing the underlying cause is just as important as replacing the iron.
The Bigger Picture
Hair loss is rarely as simple as one lab value.
Iron status may be an important piece of the puzzle, but a complete evaluation should consider the broader factors that influence hair growth and overall health.
At Prestige Functional Medicine, we take a whole-person approach to hair restoration. Rather than focusing only on the hair itself, we look at potential nutritional, hormonal, metabolic, and lifestyle contributors that may be affecting hair health.
If you’re experiencing persistent or unexplained hair shedding, a personalized evaluation can help determine what may be contributing and whether additional testing is appropriate.