Low ferritin is a known, reversible cause of hair shedding. Ferritin is a protein that stores iron, acting as the body’s reserve supply of this necessary mineral. When iron reserves are low, ferritin levels drop, indicating iron deficiency. This deficiency can lead to telogen effluvium, where excessive hairs prematurely enter the shedding phase. Addressing this underlying iron storage issue is an important step in managing and reversing hair loss.
The Biological Mechanism Linking Ferritin and Hair Loss
Iron is an essential mineral, acting as a cofactor for enzymes involved in DNA synthesis and rapid cell division necessary for hair growth. The hair growth cycle consists of the anagen (growth), catagen (regression), and telogen (rest) phases.
Hair follicles require significant resources to sustain the lengthy anagen phase. When iron reserves are depleted (low ferritin), the body prioritizes the remaining iron for critical functions, such as red blood cell production. Hair production is considered a non-essential process and is deprioritized when iron stores are low.
This deficiency shortens the anagen phase, causing the hair follicle to prematurely shift into the telogen phase. The result is excessive hair shedding, often seen three to four months after the deficiency begins.
Defining Low Ferritin for Optimal Hair Health
The definition of low ferritin for hair health differs from the threshold used to diagnose iron deficiency anemia. Anemia is typically diagnosed when ferritin falls below 15 to 20 micrograms per liter (\(\mu\)g/L), but hair loss can begin much earlier. A higher target level is usually recommended for hair regrowth.
For optimal hair growth, serum ferritin levels should be above 50 \(\mu\)g/L, with some practitioners advocating for levels over 70 \(\mu\)g/L. Women with ferritin levels below 30 \(\mu\)g/L are more likely to experience telogen hair loss. Results must be interpreted with patient symptoms, as ferritin can be falsely elevated during inflammation or infection.
A serum ferritin test measures stored iron. Other important tests include Total Iron Binding Capacity (TIBC) and Transferrin Saturation. These tests help determine if the deficiency is caused by poor diet, absorption issues, or ongoing blood loss, such as heavy menstruation.
Treatment Approaches for Increasing Ferritin
The first step in treatment is to identify and address the root cause of the low ferritin, such as heavy menstrual bleeding, dietary intake, or underlying absorption issues. Increasing iron stores for hair regrowth requires a consistent, long-term strategy involving dietary adjustments and supplementation. Supplementation should always be managed under the guidance of a healthcare provider to prevent the risk of iron overload.
Dietary Adjustments
Dietary changes focus on incorporating iron-rich foods, distinguishing between heme and non-heme sources. Heme iron, found in animal products like red meat and poultry, is more easily absorbed. Non-heme iron, found in plant-based sources like lentils, beans, and fortified cereals, requires careful pairing for better uptake. Consuming foods rich in Vitamin C, such as citrus fruits or bell peppers, alongside non-heme iron sources enhances absorption.
Oral Supplementation
Oral iron supplements are the most common treatment, usually prescribed at 65 to 130 milligrams of elemental iron daily. Common types include ferrous sulfate or ferrous gluconate. A potential side effect is gastrointestinal upset, including constipation, which can sometimes be mitigated by adjusting the dosage or taking the supplement with food.
Monitoring and Results
Treatment is a slow process because hair follicles take time to respond to restored nutrient levels. Patients are advised to continue supplementation for six to twelve months, with repeat blood testing every three months to monitor ferritin and hemoglobin levels. Visible hair regrowth is noticeable once the serum ferritin level has been consistently maintained above the optimal threshold for several months.