What Different Kinds of Hair Loss/Thinning Say About Your Health
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Dr. Siobhan Deshauer shows us different kinds of hair loss, what causes them, and what can be done about them:
Many different causes
Here’s how to tell them apart:
- Alopecia areata is an autoimmune condition where the immune system mistakenly attacks hair follicles, causing hair loss that can occur at any age and affects about 1 in 50 people. It often presents as smooth patches of hair loss and can be treated with steroid injections. Severe cases may require high-dose prednisone, which can restore hair growth over time.
- Discoid lupus is an autoimmune disease that affects the skin, leading to inflammation, scarring, and permanent hair loss. Unlike alopecia areata, it causes visible damage to the scalp and hair follicles. This type of lupus typically does not involve internal organs, unlike systemic lupus.
- Telogen effluvium occurs when a major systemic shock, such as an infection, surgery, or significant stress, triggers many hair follicles to enter the resting phase simultaneously, resulting in delayed hair shedding. The condition is diagnosed with a “hair pull test” and is typically temporary, as the resting phase is followed by normal hair growth phases.
- Allergic reactions to products, such as hair dye containing PPD, can cause hair loss due to scalp irritation and inflammation. An allergic response may trigger hair follicles to enter a resting phase, leading to hair loss by the same mechanism as telogen effluvium. Treatment with steroids can calm the reaction, and hair usually regrows after recovery.
- Syphilis, a sexually transmitted infection, can present with varied symptoms, including hair loss in a distinct moth-eaten pattern. Hair loss due to syphilis is reversible and curable with penicillin treatment, with hair regrowth typically occurring a few months after treatment.
- Biotin deficiency is rare due to its production by gut bacteria and presence in foods such as nuts, seeds, and beans such as soybeans. Deficiency can result from excessive consumption of raw egg whites, which block absorption. Severe deficiency causes hair loss and skin issues but can be treated effectively with biotin supplements.
- Iron deficiency anemia can cause hair thinning along with symptoms like fatigue and breathlessness. It often results from inadequate dietary intake, but can also occur after heavy menstrual bleeding. Treatment with iron supplements, or blood transfusions in severe cases, can restore both hair and energy levels, leading to significant improvements.
- Trichotillomania is a psychological condition marked by an uncontrollable urge to pull out one’s hair, often associated with anxiety or depression. Hair patches may show different stages of regrowth. While it can be challenging to manage, the condition can be treated with appropriate psychological and medical support.
- Traction alopecia results from hairstyles that exert prolonged tension on the hair, causing it to thin or fall out. This type of hair loss can be prevented by reducing the strain on the hair. Loosening hairstyles and giving the scalp a break can help hair regrow over time.
- Hypothyroidism causes symptoms like fatigue, dry skin, and hair thinning due to insufficient thyroid hormone production—however, it can be managed with diet, and if necessary, thyroid medications.
- Zinc deficiency may also cause hair loss and a characteristic rash. Treatment with zinc supplements can significantly improve hair growth and other symptoms.
- Medications, such as chemotherapy drugs, Accutane, and anti-seizure medications like valproic acid, are known to cause hair loss as a side effect. This type of hair loss is often reversible once the medication is stopped.
- Male pattern hair loss, or androgenic alopecia, is influenced by testosterone and genetic risk factors—which, contrary to popular belief, can come from either or both sides of the family. Early onset, especially before age 40, is linked to an increased risk of heart disease. However, effective treatments are available, and early intervention is beneficial.
- Female pattern hair loss is basically the same thing as male pattern hair loss (indeed, it is literally still androgenic alopecia), just a) almost always much less severe and b) with a gender-appropriate name. It affects up to 40% of women by age 50 and is characterized by thinning hair at the top of the head. It’s related to hormonal imbalances involving testosterone, such as those seen in PCOS and menopause, amongst other less common causes. Early treatment can be effective, and research is ongoing to develop more targeted therapies.
Dr. Siobhan Deshauer advises, if you’re experiencing hair loss, to monitor other symptoms too if applicable, take photos for tracking, and consult a doctor early for diagnosis and potential treatment.
For more on all of this plus visual illustrations, enjoy:
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Tasty Hot-Or-Cold Soup
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Full of fiber as well as vitamins and minerals, this versatile “serve it hot or cold” soup is great whatever the weather—give it a try!
You will need
- 1 quart low-sodium vegetable stock—ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough to boil in a big pan, but failing that, a large supermarket will generally be able to sell you low-sodium stock cubes.
- 2 medium potatoes, peeled and diced
- 2 leeks, chopped
- 2 stalks celery, chopped
- 1 large onion, diced
- 1 large carrot, diced, or equivalent small carrots, sliced
- 1 zucchini, diced
- 1 red bell pepper, diced
- 1 tsp rosemary
- 1 tsp thyme
- ¼ bulb garlic, minced
- 1 small piece (equivalent of a teaspoon) ginger, minced
- 1 tsp red chili flakes
- 1 tsp black pepper, coarse ground
- ½ tsp turmeric
- Extra virgin olive oil, for frying
- Optional: ½ tsp MSG or 1 tsp low-sodium salt
About the MSG/salt: there should be enough sodium already from the stock and potatoes, but in case there’s not (since not all stock and potatoes are made equal), you might want to keep this on standby.
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a sauté pan, and add the diced onion, frying until it begins to soften.
2) Add the ginger, potato, carrot, and leek, and stir for about 5 minutes. The hard vegetables won’t be fully cooked yet; that’s fine.
3) Add the zucchini, red pepper, celery, and garlic, and stir for another 2–3 minutes.
4) Add the remaining ingredients; seasonings first, then vegetable stock, and let it simmer for about 15 minutes.
5) Check the potatoes are fully softened, and if they are, it’s ready to serve if you want it hot. Alternatively, let it cool, chill it in the fridge, and enjoy it cold:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Our Top 5 Spices: How Much Is Enough For Benefits? ← 5/5 in our recipe today!
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
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4 Critical Things Female Runners Should Know
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When it comes to keeping up performance in the face of menopause, Shona Hendricks has advice:
Don’t let menopause run you down
- Prioritize recovery! Overtraining without adequate recovery just leads to decreased performance in the long term, and remember, you may not recover as quickly as you used to. If you’re still achey from your previous run, give it another day, or at least make it a lighter run.
- Slow down in easy and long runs! This isn’t “taking the easy way out”; it will improve your overall performance, reducing muscle damage, allowing for quicker recovery and ultimately better fitness gains.
- Focus on nutrition! And that means carbs too. A lot of people fighting menopausal weight gain reduce their intake of food, but without sufficient energy availability, you will not be able to run well. In particular, carbohydrates are vital for energy. Consume them sensibly and with fiber and proteins and fats rather than alone, but do consume them.
- Incorporate strength training! Your run is not “leg day” by itself. Furthermore, do whole-body strength training, to prevent injuries and improve overall performance. A strong core is particularly important.
For more on each of these (and some bonus comments about mobility training for runners), enjoy:
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Master Your Core – by Dr. Bohdanna Zazulak
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In the category of “washboard abs”, this one isn’t particularly interested in how much or how little fat you have. What it’s more interested in is a strong, resilient, and stable core. Including your abs yes, but also glutes, hips, and back.
Nor is the focus on superhuman feats of strength, though certainly one could use these exercises to work towards that. Rather, here we see importance placed on functional performance, mobility, and stability.
Lest mobility and stability seem at odds with each other, understand:
- By mobility we mean the range of movement we are able to accomplish.
- By stability, we mean that any movement we make is intentional, and not because we lost our balance.
Functional performance, meanwhile, is a function of those two things, plus strength.
How does the book deliver on this?
There are exercises to do. Exercises of the athletic kind you might expect, and also exercises including breathing exercises, which gets quite a bit of attention too. Not just “do abdominal breathing”, but quite an in-depth examination of such. There are also habits to form, and lifestyle tweaks to make.
Of course, you don’t have to do all the things she suggests. The more you do, the better results you are likely to get, but if you adopt even some of the practices she recommends, you’re likely to see some benefits. And, perhaps most importantly, reduce age-related loss of mobility, stability, and strength.
Bottom line: a great all-rounder book of core strength, mobility, and stability.
Click here to check out Master Your Core and enjoy the more robust health that comes with it!
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What’s Your Ikigai?
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Ikigai: A Closer Look
We’ve mentioned ikigai from time to time, usually when discussing the characteristics associated with Blue Zone centenarians, for example as number 5 of…
It’s about finding one’s “purpose”. Not merely a function, but what actually drives you in life. And, if Japanese studies can be extrapolated to the rest of the world, it has a significant and large impact on mortality (other factors being controlled for); not having a sense of ikigai is associated with an approximately 47%* increase in 7-year mortality risk in the categories of cardiovascular disease and external cause mortality:
Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study
*we did a lot of averaging and fuzzy math to get this figure; the link will show you the full stats though!
In case that huge (n=43,391) study didn’t convince you, here’s another comparably-sized (n=43,117) one that found similarly, albeit framing the numbers the other way around, i.e. a comparable decrease in mortality risk for having a sense of ikigai:
This study was even longer (12 years rather than 7), so the fact that it found pretty much the same results the 7-year study we cited just before is quite compelling evidence. Again, multivariate hazard ratios were adjusted for age, BMI, drinking and smoking status, physical activity, sleep duration, education, occupation, marital status, perceived mental stress, and medical history—so all these things were effectively controlled for statistically.
Three kinds of ikigai
There are three principal kinds of ikigai:
- Social ikigai: for example, a caring role in the family or community, volunteer work, teaching
- Asocial ikigai: for example, a solitary practice of self-discipline, spirituality, or study without any particular intent to teach others
- Antisocial ikigai: for example, a strong desire to outlive an enemy, or to harm a person or group that one hates
You may be thinking: wait, aren’t those last things bad?
And… Maybe! But ikigai is not a matter of morality or even about “warm fuzzy feelings”. The fact is, having a sense of purpose increases longevity regardless of moral implications or niceness.
Nevertheless, for obvious reasons there is a lot more focus on the first two categories (social and asocial), and of those, especially the first category (social), because on a social level, “we all do well when we all do well”.
We exemplified them above, but they can be defined:
- Social: working for the betterment of society
- Asocial: working for the betterment of oneself
Of course, for many people, the same ikigai may cover both of those—often somebody who excels at something for its own sake and/but shares it with others to enrich their lives also, for example a teacher, an artist, a scientist, etc.
For it to cover both, however, requires that both parts of it are genuinely part of their feeling of ikigai, and not merely unintended consequences.
For example, a piano teacher who loves music in general and the piano in particular, and would gladly spend every waking moment studying/practising/performing, but hates having to teach it, but needs to pay the bills so teaches it anyway, cannot be said to be living any kind of social ikigai there, just asocial. And in fact, if teaching the piano is causing them to not have the time or energy to pursue it for its own sake, they might not even be living any ikigai at all.
One other thing to watch out for
There is one last stumbling block, which is that while we can find ikigai, we can also lose it! Examples of this may include:
- A professional whose job is their ikigai, until they face mandatory retirement or are otherwise unable to continue their work (perhaps due to disability, for example)
- A parent whose full-time-parent role is their ikigai, until their children leave for school, university, life in general
- A married person whose “devoted spouse” role is their ikigai, until their partner dies
For this reason, people of any age can have a “crisis of identity” that’s actually more of a “crisis of purpose”.
There are two ways of handling this:
- Have a back-up ikigai ready! For example, if your profession is your ikigai, maybe you have a hobby waiting in the wings, that you can smoothly jump ship to upon retirement.
- Embrace the fluidity of life! Sometimes, things don’t happen the way we expect. Sometimes life’s surprises can trip us up; sometimes they can leave us a sobbing wreck. But so long as life continues, there is an opportunity to pick ourselves up and decide where to go from that point. Note that this is not fatalism, by the way, it doesn’t have to be “this bad thing happened so that we could find this good thing, so really it was a good thing all along”. Rather, it can equally readily be “well, we absolutely did not want that bad thing to happen, but since it did, now we shall take it this way from here”.
For more on developing/maintaining psychological resilience in the face of life’s less welcome adversities, see:
Psychological Resilience Training
…and:
Putting The Abs Into Absurdity ← do not underestimate the power of this one
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The Reason You’re Alone
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If you are feeling lonely, then there are likely reasons why, as Kurtzgesagt explains:
Why it happens and how to fix it
Many people feel lonely and disconnected, often not knowing how to make new friends. And yet, social connection strongly predicts happiness, while lack of it is linked to diseases and a shorter life.
One mistake that people make is thinking it has to be about shared interests; that can help, but proximity and shared time are much more important.
Another stumbling block for many is that adult responsibilities and distractions (work, kids, technology) often take priority over friendships—but loneliness is surprisingly highest among young people, worsened by the pandemic’s impact on social interactions.
And even when friendships are made, they fade without attention, often accidentally, impacting both people involved. Other friendships can be lost following big life changes such as moving house or the end of a relationship. And for people above a certain advanced age, friendship groups can shrink due to death, if one’s friends are all in the same age group.
But, all is not lost. We can make friends with people of any age, and old friendships can be revived by a simple invitation. We can also take a “build it and they will come” approach, by organizing events and being the one who invites others.
It’s easy to fear rejection—most people do—but it’s worth overcoming for the potential rewards. That said, building friendships requires time, patience, caring about others, and being open about yourself, which can involve a degree of vulnerability too.
In short: be laid-back while still prioritizing friendships, show genuine interest, and stay open to social opportunities.
For more on all of this, enjoy:
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You might also like to read:
How To Beat Loneliness & Isolation
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How gender-affirming care improves trans mental health
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In recent years, a growing number of states have passed laws restricting or banning gender-affirming care for transgender people, particularly minors. As conversations about gender-affirming care increase, so do false narratives about it, with some opponents falsely suggesting that it’s harmful to mental health.
Despite widespread attacks against gender-affirming care, research clearly shows that it improves mental health outcomes for transgender people.
Read on to learn more about what gender-affirming care is, how it benefits mental well-being, and how you can access it.
What is gender-affirming care?
Gender-affirming care describes a range of medical interventions that help align people’s bodies with their gender identities. While anyone can seek gender-affirming care in the form of laser hair removal, breast augmentation, erectile dysfunction medication, or hormone therapy, among other treatments, most conversations about gender-affirming care center around transgender people, whose gender identity or gender expression does not conform to their sex assigned at birth.
Gender-affirming care for trans people varies based on age. For example, some trans adults seek hormone replacement therapy (HRT) or gender-affirming surgeries that help their bodies match their internal sense of gender.
Trans kids entering adolescence might be prescribed puberty blockers, which temporarily delay the production of hormones that initiate puberty, to give them more time to figure out their gender identities before deciding on next steps. This is the same medication given to cisgender kids—whose gender identities match the sex they were assigned at birth—experiencing early puberty.
What is gender dysphoria?
Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity. This can lead to a range of mental health conditions that affect their quality of life
Some trans people may manage gender dysphoria by wearing gender-affirming clothing, opting for a gender-affirming hairstyle, or asking others to refer to them by a name and pronouns that authentically represent them. Others may need gender-affirming care to feel at home in their bodies.
Trans people who desire gender-affirming care and have not been able to access it experience psychological distress, including depression, anxiety, self-harm, and suicidal ideation. The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that roughly half of trans youth “seriously considered attempting suicide in the past year.”
How does gender-affirming care improve mental health?
For trans adults, gender-affirming care can alleviate gender dysphoria, which has been shown to improve both short-term and long-term mental health. A 2018 study found that trans adults who do not undergo HRT are four times more likely to experience depression than those who do, although not all trans people desire HRT.
Extensive research has shown that gender-affirming care also alleviates gender dysphoria and improves mental health outcomes in trans kids, teens, and young adults. A 2022 study found that access to HRT and puberty blockers lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the risk of self-harm and suicidal thoughts by 73 percent.
Both the Endocrine Society—which aims to advance hormone research—and the American Academy of Pediatrics recommend that trans kids and teens have access to developmentally appropriate gender-affirming care.
How can I access gender-affirming care?
If you’re a trans adult seeking gender-affirming care or a guardian of a trans kid or teen who’s seeking gender-affirming care, talk to your health care provider about your options. You can find a trans-affirming provider by searching the World Professional Association for Transgender Health directory or visiting your local LGBTQ+ health center or Planned Parenthood.
Some gender-affirming care may not be covered by insurance. Learn how to make the most of your coverage from the National Center for Transgender Equality. Find insurance plans available through the Marketplace that cover gender-affirming care in some states through Out2Enroll.
Some states restrict or ban gender-affirming care. Learn about the laws in your state by visiting the Trans Legislation Tracker.
Where can trans people and their families find mental health support?
In addition to working with a trans-affirming therapist, trans people and their families can find mental health support through these free services:
- PFLAG offers resources for families and friends of LGBTQ+ people. Find a PFLAG chapter near you.
- The Trevor Project’s hotline has trained counselors who help LGBTQ+ youth in crisis. Call the TrevorLifeline 1-866-488-7386 or text START to 678-678.
- The Trans Lifeline was created by and for the trans community to support trans people in crisis. You can reach the Trans Lifeline hotline at 1-877-565-8860.
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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