Introduction

Hair is the first most noticeable part of beauty. A fine head of hair adds beauty to a good face, and terror to an ugly one. Despite being the center of interest, hair loss has affected 35 million men and 21 million women across the globe. Among many other causes, a deficiency of ferritin is one of the common, yet the reversible cause of hair loss.

 

What is ferritin?

When an excess of iron is taken in the diet, it enters the blood to raise serum iron levels. Higher levels of Iron can damage our body and this is where Ferritin comes into play. Ferritin is a protein synthesized by our body to store excess iron and provide a steady iron supply for the normal functioning of our body’s metabolic processes including synthesis of new cells.

 

So, serum iron and serum ferritin levels are two entirely different entities. Serum iron being the readily available form of iron to be used by cells whereas serum ferritin depicts the status of iron stores in the body. Both are important markers of hair growth. 

 

How Iron levels affect hair loss

Hemoglobin, an oxygen-carrying protein in red blood cells, is made up of an iron core and porphyrin rings. Deficiency of iron leads to less hemoglobin synthesis and ultimately a decreased supply of oxygen to the tissues - a condition called Iron deficiency anemia. To cope with this shortfall of oxygen, the body redirects the supply to essential organs, leaving hair follicles oxygen-deprived and contributing to hair loss.

 

Ferritin, on the other hand, compensates for this iron deficiency by releasing stored iron into the bloodstream but it doesn’t hold up for too long. Ultimately, the body compensates for low iron levels in circulation by borrowing ferritin from hair follicles and arresting the growth of hair. The iron levels in the blood are partially restored, which may lead us to believe that there is no iron deficiency.

 

The lifecycle of hair consists of a growing phase (anagen), transition phase (catagen), and resting phase (telogen). On average, the hair will grow for about 5 years before falling out and being replaced by a new strand of hair. If the ferritin levels are low, the anagen phase is reduced, hampering the full growth of hair and resulting in premature falls.

 

Causes of iron deficiency

Decreased dietary intake is one of the most common causes of iron deficiency. Iron obtained from plant sources (non-heme iron) has very low absorption (<10%) compared to iron obtained from animal sources (heme iron) which have higher absorption (30-50%). So, people who are strict vegetarians are more prone to develop iron deficiency. 

Other causes of iron deficiency include:

• Menstrual blood loss

• Gynecological disorders

• Celiac disease

• Crohn’s disease

• GI bleed

• Medications and Alcohol misuse

• Food that inhibits iron absorption

• Proton pump inhibitors (PPI)

• Less production of stomach acid

• Autoimmune disorders

• Hormonal disorders

 

Who is affected more?

Menstruating women are more prone to develop iron deficiency due to loss of blood in each cycle and not compensating it in daily diet. Their ferritin levels fall below the critical point. Such women present with the complaint of shedding too much hair, usually more than 100 strands per day. 

 

What level of ferritin is alarming?

Normal serum ferritin levels range from 15-150 ng/ml (µg/L). You’re most unlikely to suffer hair loss even if serum levels are in lower limits. But this doesn’t apply to everyone and some people still develop hair loss due to the scarcity of iron, even if ferritin levels are above 40ng/ml. 

 

Several studies have been done to find out a relation between serum ferritin levels and hair loss. Most of them concluded that serum ferritin level is an important marker of hair growth (3)(4)(5). Another study found no evidence of hair loss in a woman with a serum ferritin greater than 10ng/ml.

 

Treatment

Consult with a trichologist to know if your hair fall is due to low iron stores or not. If the former is the case, replenishing the iron stores with increased dietary iron intake can drastically reduce hair loss and improve the outcome. The food that is rich in iron include

• Liver and other organ meat

• Turkey

• Red meat

• Spinach

• Shellfish

• Legumes

• Pumpkin seeds

 

Vitamin C aids in the absorption of iron from the gastrointestinal tract. So, adding Vitamin C in the diet can also boost iron absorption.

 

Caffeine present in tea, coffee, and carbonated drinks can impede iron absorption. Avoiding such a drink is a good move if you’re suffering from iron deficiency already.

 

Iron deficiency developed in the background of certain intestinal diseases and gynecological disorders requires treating the primary cause first and then replenishing iron stores.

 

Iron supplements may cause a gastrointestinal disturbance in some people, consult your doctor before starting such supplements. 

 

A study published in “International Journal of Food and Nutrition Research” revealed that Intermittent iron plus intermittent antioxidants, vitamins, calcium, amino acids, and omega 3 had the best benefit showing reduction in hair fall after 4 weeks and 21% improvement in density over 6 months.    

 

Conclusion

Hair loss due to iron deficiency is a treatable and completely reversible condition. Supplementing with iron and other nutrients can not only prevent further hair loss but can also help regrow hair. If you’re experiencing hair loss despite making changes to your diet, it may be time to see your doctor for a diagnosis.

 

Ferritin levels lower than 15ng/ml are usually associated with hair loss. Consult your doctor if your labs show this much drop of ferritin. You’ll definitely need iron supplements.

 

Removing the element of stress and improving the quality of sleep might also benefit in reducing hair loss.

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