Hair Loss And Your Thyroid Iron deficiency is the primary cause of hair loss in premenopausal women


Iron deficiency is the primary cause of hair loss in premenopausal women.

It's often the reason behind why women with Hashimoto’s continue to lose hair despite taking thyroid medications.

Your doctor may test for anemia by running a panel for red blood cells, hemoglobin, hematocrit, and iron levels, and all of them may come up normal. However, you may still be low in iron. If not enough iron is available, the body may pull the iron from less important physiological processes, such as hair growth, to keep enough iron circulating in the blood.

Ferritin is the name given to your body’s iron reserve protein. Ferritin is required for transport of T3 to cell nuclei and for the utilization of the T3 hormone.

Ferritin hair loss presents as increased hair loss during shampooing and brushing, as well as overall thinning of hair without specific pattern or bald spots. Rather, the woman may find that her hair feels thinner all over, and is less dense.

Ferritin levels can also be measured and will be a better predictor of how much iron you have stored in your body and available for use. Ferritin should be checked in all women with Hashimoto’s, and in anyone experiencing hair loss.

In addition to poor intake of dietary iron rich foods and lack of hydrochloric acid (see my Nutrient Depletions II Post), pregnancy (due to increased need for iron) and heavy menstruation increase the risk of iron/ferritin deficiency. During each menstruation, a woman will lose 10–15 mg of iron, while a pregnancy may cause a loss of 600–1000 mg of iron.

As iron needs an acid presence to be absorbed, antacids and calcium supplements taken around mealtimes may reduce the absorption of iron from foods and supplements.

Anyone with hair loss and taking PPI’s or acid suppressing medications should immediately get his/her ferritin levels checked.

Dietary factors can also impact iron levels. Tannins in tea and coffee can inhibit iron absorption and should be spaced out by an hour from iron-containing meals. Phytates found in nuts, legumes, and grains may also affect iron absorption, as well as egg whites.

Normal ferritin levels for women are between 12 and 150 ng/mL. According to some experts, Ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

Iron is present in the heme and nonheme version in foods. The heme version is the better absorbed version and is found primarily in animal products. The highest levels of iron are found in organ meats … yes, delicious liver. Beef, turkey, and chicken are the next best choices. (Sorry to all of my vegetarian friends.) In contrast, nonheme iron is found in nuts, beans, and spinach and is not usually absorbed as well. 

To restore your iron levels, you can eat cooked liver twice per week or eat beef a few times per week. Vitamin C increases the absorption of iron, so taking a vitamin C tablet or vitamin C rich food such as cooked broccoli along with an iron-rich food is the best way to increase iron and ferritin levels. Creating an acidic stomach environment by taking a Betaine and Pepsin supplement with meals can be helpful as well.

Most iron supplements are in the non-heme form and thus may not be absorbed as well. Additionally, many people find that they get terrible stomachaches from the supplements, and they find them extremely constipating! 

I struggled with supplements and trying to eat liver but was not able to get my ferritin levels up for years, until I did two things.

  1. Started high-dose probiotics
  2. Started taking Opti-Ferin C

If choosing to take iron supplements, do so with much caution as they are one of the leading causes of overdose for children and adults. An iron overdose can be deadly, so make sure you keep the iron out of reach of children. Be sure you speak to your physician or pharmacist about a dose appropriate for you. 

There may be other reasons for hair loss, including low T3 levels, fatty acid deficiency, hormonal imbalances and others. Check out my post "What's really going on in Hashimoto's". Subscribe to this blog for more information on how to deal with Hashimoto's. 

Your Thyroid Pharmacist,
Dr. Izabella Wentz, Pharm D.

PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free. . You will also receive occasional updates about new research, resources, giveaways and helpful information.  

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Archived Comments

Hashimotos patient. Unsuccessfully been ttc now for 24 months w/my husband.
Which high-dose probiotics did you use? Thank you!
Pure Encapsulations brand: S boulardii, Probiotic 50B (gluten and dairy free) VSL#3 (may contain traces of gluten/dairy; I have not had a problem but not recommended for celiac/anaphylactic reactions) VSL #3 can be ordered online, and Pure Encapsulations can be bought from your healthcare professional of from the E-store I set up with them
Doctor says my thyroid levels are level and I am still having hair loss!! It falls out really bad when I take a bath and brush it. I am taking Armour at 30 mg a day. I was on 60 but started with heart palps. Ferritin is normal, actually a little high from IV iron. I started taking Vit D 4000mg a day because my level was low and also Evening Primrose oil. Don't know what else to do. My iodine level was high via a urine test and blood test was 50 and normal levels are 40-92. Blood test says I do not have celiac. I also have periods of itching and get these fluid filled bumps on my head, face and body. I have been to so many different doctors and still no help!!!!! If anyone has any info PLEASE comment!!! I also have horrible constipation!!!
please post your question to the Hashimoto 411 site on Facebook. It is a wealth of support and expertise hugs, susie
Hi Tonia, Have you tried going gluten free, and using gluten free shampoo? I would say majority of people if not all have an issue with gluten. There is new research that suggests that gluten sensitivity is a spectrum, with Celiac being at the end of the spectrum and most severe. You can try excluding it from your diet and trying it again in 2-4 weeks to watch for a reaction. Google dermatitis herpetiformis, to see if your bumps look anything like that. This is a rash associated with gluten sensitivity.
Oi Tania, faça o exame genético para Doença celíaca. HLA-DQ2 e DQ8. Abçs.
Tonia, even if you do not have celiac, you are probably sensitive to gluten. Go GF, and see if your symptoms improve. You may feel worse before you feel better. My breakouts stopped once I was GF for three months. This weekend I ate a little, and guess who had a breakout?!? Me!!!
I am a 63 year-old woman with Hashimotos. I take Levoxyl 100 mcg M-F and 112 mcg on weekends. I also have Type 2 diabetes that is being controlled with diet and exercise. I have chronic hives and angioedema so must take 10 mg Zyrtec daily. I have had GI issues in the past...I have occasional bouts of severe nausea, diarrhea and vomiting (happens 1x per year or sometimes I go a couple of years) ...when that happens I also have uncontrollable shaking and I end up in the ER from the pain, nausea and dehydration. I have seen a GI specialist and an allergist and they have no clue as to why this happens. Now, I also have a low ferritin level 5.5 and because I have not been able to tolerate oral iron they want to infuse Iron 1x per week for 5 weeks to get my level up. I am reluctant to do this as I have always been anemic and have had an infusion in the past which caused so many side effects, My last T4 was 1.01. My TSH was 0.118. I just ordered your book, but would like your thoughts. Thank you!
Think you might be as well having a saliva cortisol test. x
Hi, Cindie iam 50 and at 23 had most of large bowel removed, they had just told me prior to this that i had Hashimoto's and if it would of been diagnosed sooner i might not have had all this troulbe. I was always anemic and shots,pills didn't do it. So i started iron transfusions. I have to tell u i went every 2 months for 2 years. Really helped and only side affect i had was tired for a few days. So after my ist bowel surgery i was in and out of hospital most of my 30's. Then we did iron and wow i had energy and all the other things that were wrong. Unfortunatly at 42 i had to have an ileostomy and the first 4 years were a nightmare. Then had to have my rectum removed and i just feel like some days i want to give up. I have been diagnosed with DIGITS by a surgeon who has 200 pattients 2 are men. Diffuse Irritable Gastronal Intestenal Disease and he had named this disease and has been trying to get it into the medical books as it is very rare. It's like your bowel is a snake and it pushes and pulls on the bowel so it works only when it wants. I hear your problems and i just thought i would tell u give the iron transfusions a try. Love to hear from u . Take care. Lisa
Hi. I was diagnosed with Hypothyroidism (normal TSH, low T3, low T4) about a year ago and am still struggling with Hairloss all over my head but worse at my temples. Despite supplementation with Iron, my ferritin is in the 30 range. Before supplementing it was 19. I originally tested negative for Hashimoto's and have never been tested again. Do you have any experience with Iron supplements not working to resolve the problem? Thanks!
Did you ever find anything to help with hair loss? It's mainly at my temples also and seems to be even getting worse!!
I saw that calcium is in the ingredients of the Opti-Ferin C. I thought that calcium was one of the things that inhibits the absorption of iron?? (how many Opti-Ferin C did you take a day to bring up your Ferritin?)

Actually the tiny bit of calcium that is found in the supplement I recommend helps iron absorption!

What dose of Optiferrin-C do you recommend and how do you divide doses throughout the day? When I was tested, my ferritin level was only 4 ng/mL.
I had long frizzy and almost damaged hair, after I had my son I was constantly losing my hair! I was in tears and so upset! I couldn't take any vitamins since I was breastfeeding so I wanted something natural. I only used the Shielo Volumizing Shampoo 3 times and my hair completely stopped falling! Feels and looks so healthy, shinny and strong! It was so strong that I decided it was ready for some color so I dyed it and it looks awesome! The good thing is the Shielo products are known for also protecting hair color, while not having any harmful chemicals. It will solve all your pregnancy hair problems!
Where can I find this shampoo
Can you go in the heart of the matter with Hashimoto? being the immune system. When a person have Hashimoto for a long time it becomes a chronic issue therefore the immune system would be most likely suppress. The TH17 than come in place. Can you talk about this? You can take all the right supplements in the world but if you do not work on you immune system therefore on infection and inflammation nothing will happen as far as correcting for good the situation.
I was looking at the Optiferrin-C and noticed it has calcium in it as well. Since calcium inhibits the absorption of iron why would an iron supliment contain calcium? I'm pregnant and hashimotos/celiac and need to bring my iron levels up and am confused by the calcium/iron combination.
You may want to try Nutricology Vitamin C powder (camu-camu and acerola cherry - Pure formula's carries it). My Dr. put me on it when my iron level was 271! Now it's 436!!! Yikes! I have stopped taking it, but if you are LOW in iron, this could help. I took it with meals containing meat which may be my big mistake since Vitamin C increases iron levels!!!
I have Hashimoto's and eat a Paleo diet but not a lot of beef and no organ eats. My iron was 148 in December and Ferritin was 45. How do I raise my Ferritin without raising iron levels
The Thyroid Sessions Kelly Brogan suggested using Liver capsules from Radiant Life (she has a video on her website about using it). I started taking this for my low ferritin and my number DOUBLED in eight weeks. I was only taking one capsule a day! A great way to have liver, without smelling up your home. They also sell a liver powder that you can add to smoothies, or mix into soups. Here's the description from their website: "All natural grass fed cattle raised free from hormones, antibiotics, and pesticides. Made without introducing excessive heat, solvents, deodorizers, bleach, and refining. No supplemental iron added, just pure beef liver. Regularly tested for purity." Iron supplements always constipate me, so this is a great solution for those who can't tolerate it. can try going back to 60 mg of armour a day but take 30 mg twice a day...
Is there anything that can be done to improve hair texture. My hair is so frizzy and coarse since having this disease. Its really upsetting how hard it is to manage my hair now. I dread even so much as washing it everyday.
I have been diagnosed w/ Hashi's for 8 years. Recently, I had low iron. I started taking an iron supplement (again.) That is when my hair started thinning and my skin got dry. This has happened to me every time I restart an iron supplement after being told previously to stop taking it. Why do I lose my hair after I start taking the supplement?
If you have thyroid-related hair loss, you may have to settle in and be a bit patient. It's likely that for most, the hair loss will slow down, and eventually stop, once hormone levels are stabilized and in the normal range. This may take a few months, however. But rest assured, I've had many thousands of words from people, and have yet to hear from anyone who lost most of his or her hair, or became bald, due to thyroid disease.
Dr Wentz, What do you know about liver desiccated pills? Are they safer than iron supplements? Will they help increase ferritin levels? Thank you
Is Ferritin called Ferremia in spanish? Because I am having this issue and my Ferremia lvls are at 39. I have coffe after every meat meal.
i take Biotin 5000mg twice a day and after a few months hair is regrowing
Why do most of these articles that I read say that the labs such as t3 or t4 or tsh and now an iron lab sometimes come back as normal and symptoms are still present? Why do different labs have different normal levels. Are these test not sensitive enough?
The problem with the ranges that say what is "normal" is that unhealthy people are included in the range. As my doctor explained it, to get a range for "normal" ferritin levels, scientists survey all kinds of people, some of whom many have excess iron and some of whom may have low iron. Yes, sick people are factored into the range! In Dr Wentz's Root Cause book she lists the ideal range for iron. You can also search for this information on other thyroid sites. Hope that makes sense!
Do you need iron post-menapausally? Do we take calcium & magnesium together or separately? Thank you!
I had a gastric bypass and I have hypothyroid any suggestions for us? My hair is so much thinner and my energy levels are awful
For constipation I find that Prune Juice with Pulp is very helpful. Prune Juice w/o pulp does nothing to help me. I drink a 4 oz glass at bedtime. Another 4 oz in the morning if no good result. I dont think it has ever taken more then 3 glasses. Sometimes I heat it a little. Then drink 1 glass a day. You will need to listen to uour body.
Dr. I'm on levothyroxin 125mcg,can I swich to armour since everybody says they feel better coz I feel sicky sometimes,why I feel my muscles feel tingling when I wake up
I was just diagnosed with hereditary hemochromatosis. My iron is high and my ferritin was at 1390 prior to my most recent phlebotomy. I have been on thyroid meds and have all my levels checked regularly yet my hair still falls out in handfuls and has changed from very thick to thin and whispy. I was told it was due to my low thyroid. Should I be looking for another cause?
I have my thyroid removed three years ago. Since than start loosing lots of hair and is getting thinner every day. I am taking sythroid I wonder if the medication making my hair thiner?
How do you know if your supplement is non-heme? What should I be looking for on the label? Thanks!
I have hypo, on 137mcgs of synthroid, major hair loss! I take 10.000 biotin, 1000mg evening primrose, and collagen6000mgs. it really helps!!
Ive been losing hair on an off......have had to have iv iron.....and about to change thyroid meds.......the drs. No matter what they do my body dont hold iron so nothing works.......and when its does its 6 months at a time then hoes tired...been through tjis since I was ready to throw in towel......
I have taken lots of different brands of Iron supplementation and I would like to recommend Spatone Liquid Iron Supplement sachets. I buy it over the counter at my local pharmacy. It is so gentle on the stomach, no more nasty gastric upsets!


I'm on 60 armour two months and my hair is falling out in handfuls too! I was on raw thyroid bought online at Walmart. No hair loss. My daughter was freaking out that I was not under dr care so I got on armour through my dr. I have had thyroectomy and RAI pill for thyroid cancer. Now that that is over my hair is my main concern. I think I'll go back to raw thyroid fron Walmart online store recommended by many bloggers. Hope this helps you.

I'm on 60 amour and take biotin and evening of primrose oil as well as b-15. My hair stopped falling out three days ago when I began these supplements to my armour. It's been three months since my RAI treatment for thyroid cancer. I think THAT RAI pill is the reason for my hair falling or it could be the thyroidectomy pre-RAI pill. I am still mourning the loss of my thyroid. When I think about it , it makes me mad that the medical profession removes organs instead of supplying supplements. ok that was a rant but I AM glad my hair has stopped falling out now. I bought the B-15 on Amazon because it's not available anywhere else. Read up on it - it provides buco energy.

I was on 60 Armour. I've switched to raw thyroid bought online at Walmart pharmacy. No itching hair is much better too. No heart palpatations.

Sally, what is the amount (dose) of raw thyroid that you take? I have Hashimoto's my TSH is normal at the moment 3.5 but, my doc went ahead and put me on 25mcg of Synthroid. Unfortunately all it has done is make my hair fall out worse than it already was. I feel lost!

Are you still consuming dairy?

Where can I get this shampoo please

Interesting enough, I had phases this year my hair fall out in bunch, I was scared to brush how bad it was. I have started with iron supplements, but also with AMLA OIL applications at the same time, and got good results pretty quickly. My doctor then discouraged me to continue with iron suppl, but I somehow stopped with amla as well (I would oil it up like crazy though, it was hard to wash off with no-poo method). So I found myself in same situation soon later. (my ferritin 18, and just discovered I have Hashimoto) So now I am on iron supplements for one month, and just for the sake of feeling better about hair, I applied AMLA OIL once few days ago - I have already noticed a difference. You just need to take a little bit, oil scalp, and also ends, it has done miracle for my dry/split ends. Bought it in indian store in Little India (Toronto, Canada).

Its best not to take calcium and magnesium together as they are antagonistic....leave two hours between and take magnesium just prior to bedtime, calcium at least 2 hours before that. Hashimotos commonly causes raised calcium levels to circulate around the body and soft tissues; this is an abnormal situation, calcium should be in the bones. Taking supplemented calcium will just add to the problem but if your calcium is prescribed discuss this with your Doc. Low thyroid function is likely to see low thyroid hormone including calcitonin. Calcitonin encourages calcium into the bones. Parathyroid glands produce parathyroid hormone; these glands are within the thyroid gland; parathyroid hormone encourage calcium out of the bones and into circulation. This hormone output is usually unaffected by Hashimoto's therefore, the normal balance between calcitonin and parathyroid hormone is disrupted leaving parathyroid hormone and its effects dominant. Porcine thyroid hormone such as Armour includes calcitonin whereas other thyroid hormone supplement such as synthetic T4 or synthetic T3, does not include calcitonin.

I have been diagnosed with hypothyroidism for about 17 years. I was cold all the time,weight gain,and most obvious was the exhaustion and the hair loss. I found out only because I thought I had carpal tunnel syndrome. The doctor said he better check my thyroid. It had just been tested 2 months before and was found normal. This time, I was diagnosed with hypothyroidism. Recently, I have been suffering from severe exhaustion and just constant fog and forgetfulness. I read an article about Hashimotos disease. I went to my doctor and asked for a test specifically for Hashimotos. He told me that the test was negative,but that the antibodies would have been long gone because I've suffered from hypothyroidism for over 23 years. (I had sudden weight gain and hair loss during my pregnancy). I take iron supplements for iron because I am unable to eat meat. He said all my levels were fine. I started taking hair skin and nail vitamins as well because my eyebrows are so sparse. What can I do or get tested for to figure out what is truly my problem? I currently am on .125 mg of Levothyroxine.

Please try switching to Armour. It took me years to find a doctor that would prescribe Amour. My hair did grow back after being on Armour. I'm now on NP Thyroid (Armour equivalent) the doctor also prescribed several supplements: iodine, prengenolone and DHEA to boost energy level. I also take Siberian (ginseng) Eleuthero for energy, and homemade tumeric tea for iron deficiency. Hope this is helpful.

I forgot to mention that I was able to loose weight, only after being on Armour. I eat normally now, and do not diet. I use coconut oil, which I read that eating coconut oil promotes healthy thyroid, and weight loss. Of course, I do exercise when I can. Hope you find this helpful.

It is good you are taking hose supplements but it is not appropriate to take both Pregnenolone AND DHEA together, take one or the other but not both together. Best wishes.

Susan, I have been on the Levothyroxin for almost three months now. Like you, I also suffer from the exhaustion, hair loss and weight gain. YOU are the first one to mention "sparce" eyebrows! I suffer from that also and have for quite a long time. For over 10 years I tested negative for thyroid issues. This past summer my test came back positive and thus, here I am. I just had to reply to your posting because all this time I thought my eyebrows were just hereditary through my Mother. Now, it may be from this disease. I just have to wonder about the medication(s) really working because it doesn't seem that many have been successful at finding the proper dosage. It is very discouraging. I wish you (and everyone else) the best on this journey to finding their way back to "normal" from this illness.

Thank you, this was incredibly timely for me.

I have had hashimoto over 30 years. And I did loose all my hair. It always fell out after I had children. After the first child it came back after 6 yrs.....then after 2nd child it all fell out ahain and has not come back. I have really read alot lately about it...but when I finally went to a specialists. He blew me off loke it was nothing. He gave me no hope. And he seems impartial to how this has affected over the years. Can anyone send me info that I can give him maybe help me? Very frustrated.

I was on synthetic thyroid (synthroid, levothyroxin) for years, and my hair falling out. When I finally switched to Armour, my hair actually grew back. I was always anemic, but once I started drinking homemade tumeric tea, my iron levels were tested normal range for the very first time. Turmeric has many minerals, and iron being one of them.

Is Amour a new thyroid medication.

Tanya, how long did it take for your hair to start growing back when you switched to Armor? I started on it just this week after being on 50 mcg Synthroid for about 18 months, and my hair has thinned probably since last winter.

I'm 31, Diagnosed with PCOS 6 years ago and have been battling hair loss for almost 5 years now. My thyroid tests are normal every time it gets checked. My Iron is just fine. Since all I've seen are lousy endocrinologists, I continue on with hair loss and thinning. No doctor can find out whats going on or if its the PCOS or fails to see it as an issue. I'm at a complete loss for help as my Insecurity about hair keeps growing. I have found that using Nioxin hair products help it to look thicker but does not stop it from falling out. Any suggestions would be appreciated.... wasting my money on seeing more doctors would be my last resort.

Very interested in this "Turmeric Tea"! Anyone have a special one for us HASH/Hair Loss Folks. I have been Gluten and Dairy Free for years--but even with additional B Vits., nothing is helping with the Hair. At age 62 -- taking Iron is scary. My range is always 40 to 70 and I keep my D-3 up as well. On Natural Thyroid. Thank you!

Hi Izabella. I just saw this on Mercola - he states that ferritin over 80 is overload. What do you think about this?

My doctor recently put me on Ferrous Sulfate 324 MGEC Tabs. After reading your thoughts on the OptiFerin-C I ordered a bottle. I am now wondering what would be the equal dose to the Ferrous Sulfate I was prescribed? Right now I am only taking one OptiFerin a day because I'm not sure.

Yes it is true that if we have thyroid we would surely lose hair.

Has anyone heard of high doses of wheatgrass for hair loss due to low ferritin? This is what my NP prescribed for me. I only started 12 days ago, and now have run into constipation. Gave myself a fleet enema, and stopped for a couple of days until my bowels started back themselves. I started back again, but cut the dose in thirds. Just wondered if anyone else has heard or tried this themselves.

Hi, I've had my thyroid removed due to "the good cancer" followed by radioactive iodine treatment on synthetic medication for thyroid all blood work is normal however I have lost eyebrows and hair has thinned out so much that I look bald! Also going through menopause doing gel hormone cream. Desperate please help if anybody has some information

I had Graves D., so my thyroid was killed. I now take a high dosage of synthroid. I feel like crap all the time. I tell tell the doctor & he keeps increasing dosage. I have a huge problem with sleep. Can you help me? Cindy