Serum Ferritin Levels and Hair Loss
Here is the best article I've seen about relationship between low iron stores and hair loss. I hope I don't get into trouble copying and pasting most of this article from the informative website HairSite.com. I made a few comments which I inserted between brackets.
Iron Deficiency & Women's Hair Loss
One of the most common causes of hair loss in pre-menopausal women is not
hormones, but a nutritional deficiency, with depleted iron stores [serum
ferritin] being the most important factor.
In a study, one hundred and fifty three women who were diagnosed with telogen
effluvium from 1995-1998 were examined. Seventy two percent (n=75) of women in
the premenopausal group were found to have iron deficiency as the cause of
telogen effluvium. Iron deficiency is defined as having a ferritin level of
under 40ng/ml or iron percent saturation under 20%.
Iron deficiency is the most common cause of telogen effluvium in premenopausal
women. Although medications are the most common cause of telogen effluvium in
postmenopausal women, iron deficiency should not be ruled out.
Besides being a possible trigger for telogen effluvium where a lot of hair
shedding occurs, iron deficiency could also be the most likely underlying cause
when hair loss is subtle; slowly thinning out over many months or even years.
This is common among women of childbearing age due to menstruation and
pregnancy. Iron is found mainly in the blood, and according to Dr Michael
Sharon, author of Nutrients A-Z 'During one period, a woman will lose around
10-15 mg of iron, while throughout a pregnancy around 600-1000mg will be lost.'
Iron is the mineral that occurs in the greatest amount in the blood. The most
important function of Iron in the human body is helping the production of both
hemoglobin (the substance that carries oxygen within red blood cells) and
myoglobin. Myoglobin is a form of hemoglobin found in muscles. Iron is also
involved in the oxygenation of your body's red blood cells.
It is understood that levels of iron play a significant role in various body
functions, however, it is also essential for the normal growth and maintenance
of hair. If the amount of energy used up by the body is not replaced by food
intake, then other non-essential stores will be used up. Unfortunately, this
means the hair cells as they are not a vital part of living.
In order to maintain an adequate balance of iron in the body, the amount
excreted must be replaced by the amount ingested in the diet. When the amount of
dietary iron absorbed is insufficient, a negative iron imbalance occurs, and
consequently iron stores are called upon to make up the deficit.
The fall of iron stores normally passes through several stages: lowered iron
stores, iron depletion and iron deficiency anemia.
1) Lowered iron stores: This is indicated when the iron stores are reduced but
not exhausted. No clinical effects are detected.
2) Iron depletion: Shows up in laboratory tests. Hemoglobin concentration may be
well below ‘normal’ for that individual’s reference range. If the patient
increases their iron intake, the hemoglobin may respond by increasing.
3) Iron deficiency anemia: No iron is left remaining in the bone marrow.
Hemoglobin production falls to the point where concentration is well below the
reference range.
It is important to note, therefore, that iron deficiency (low iron stores, i.e.
low ferritin) can occur even if the patient is not clinically anemic and has
normal haemoglobin levels
There may be a number of reasons why the amount of iron absorbed is not
sufficient. Firstly, only about 10% of ingested iron is absorbed into the blood
each day, and this is dependent on the type of food in the diet. Certain foods
may inhibit the absorption of iron, such as tanins found in tea and coffee, also
bran and egg albumin. Whereas other foods may be enhance the absorption of iron,
i.e. vitamin C, alcohol, and flesh foods [red meat]. In general you can loose
iron by: intestinal bleeding, excessive menstrual bleeding, poor digestion,
long-term illness, ulcers, and heavy use of anti-acids. [Irritable bowel
syndrome too]
Nutritionist Angel Dowden advises 'You can maximize your iron absorption by
eating a combination of iron-rich foods such as red meat, green, leafy
vegetables, shellfish, egg yolk, nuts and cereals with food or drinks that are
high in vitamin C for example, a glass of freshly squeezed orange juice.
Avoid tea until at least an hour after eating as it contains tannin, which
interferes with iron absorption.
One method of controlling iron deficiency in the body is to stimulate the liver
to synthesize ferritin, the protein that stores iron in order to maintain the
correct balance. Hair follicles are known to contain ferritin, and when the
circulating stores of ferritin decline then these stores are called upon to
ensure support for more essential cells, such as bone marrow. [See my comment at
the end of this article.]
The loss of this ferritin from the follicle cells can effect the ability of the
hair to grow. This leads to the development of vellus (non pigmented fine hairs)
which can be an early indication of deficiency. The presence of vellus hairs is
easily mistaken for miniaturized hair seen in androgenic alopecia. We should
note here that Iron deficiency hair loss could therefore mimic the pattern of
androgenic alopecia hair loss.
A lot of dermatologists may not agree to the fact that iron deficiency could be
a major cause of hair loss, however most of them don't deny that it is an
important contributing factor, besides, a lot of hair loss treatments may not
work efficiently with low iron stores. Rushton suggests that serum ferritin
concentrations of 40 ng/mL or greater are required for maintaining good hair
while 70ng/ml is required for regrowth (Rushton DH. Management of hair loss in
women. Dermatol Clinic)
Comment
The writer of this article said, "One method of controlling iron deficiency in the body is to stimulate the liver to synthesize ferritin, the protein that stores iron in order to maintain the correct balance." I wish he would have elaborated on this. Ferritin is a protein complex that contains about 23% iron. It's formed in the intestine when iron unites with a special protein called apoferritin. It is then stored in the body's tissues, especially the liver, spleen, and bone marrow.
Saturation, which is mentioned in this article, is the amount of hemoglobin present in a volume of blood compared to the normal value.