Losing some hair every day is normal: most people shed around 50 to 100 hairs a day as old hairs make way for new ones. When more hair than usual comes out in the shower or on the brush, or the parting slowly becomes wider, hormones are often part of the story. Thyroid problems, low iron, polycystic ovary syndrome (PCOS), pregnancy and menopause can all change the hair growth cycle.
At Aura Medical Clinic in Tirana, hair loss linked to hormones is assessed by endocrinologist Dr. Sara Zavalani, the clinic’s founder. This article explains the most common hormonal causes, how they differ and which tests help to find the cause.
The main hormonal causes compared
| Cause | How the hair loss looks | Other possible signs | Useful tests |
|---|---|---|---|
| Underactive thyroid (hypothyroidism) | Thinning over the whole scalp; hair can become dry and brittle. | Tiredness, feeling cold, weight gain, dry skin, constipation. | TSH, free T4 |
| Overactive thyroid (hyperthyroidism) | Thinning over the whole scalp; hair can become fine and soft. | Fast heartbeat, weight loss, feeling hot, nervousness. | TSH, free T4 |
| Low iron | Increased shedding over the whole scalp, often gradual. | Tiredness, paleness, heavy periods, breathlessness on effort. | Ferritin, full blood count |
| PCOS (higher levels of male-type hormones) | Thinning on the top of the head and along the parting. | Irregular periods, acne, extra facial or body hair. | Hormone tests such as testosterone; sometimes a pelvic ultrasound |
| After pregnancy | Heavy shedding about 2 to 4 months after giving birth. | It usually settles within 6 to 12 months. | Usually none; thyroid and iron if it continues |
| Menopause | Gradual thinning and a wider parting. | Hot flushes, irregular or no periods, poor sleep. | Depending on symptoms |
Not every case is hormonal
- Genetic (pattern) hair loss is the most common cause in both men and women. In men it shows as a receding hairline and thinning crown; in women as thinning along the parting, usually with the hairline kept. It depends on how sensitive the hair follicles are to normal hormone levels, so blood tests are often normal.
- Shedding after a trigger: an illness with fever, an operation, a crash diet or major stress can cause heavy shedding 2 to 3 months later. It usually stops on its own once the trigger has passed.
- Scalp conditions and patchy hair loss, such as round bald patches, redness, scaling or pain, need an examination of the skin by a dermatologist.
Which tests help
There is no single “hair loss test”. The doctor chooses the tests based on your symptoms and history. The most common are:
- TSH and free T4, to check how the thyroid is working.
- Ferritin and a full blood count, to check iron stores and anaemia.
- Hormone tests such as testosterone, when there are signs of PCOS such as irregular periods or extra hair growth.
- Sometimes other tests, such as vitamin D, depending on your diet and history.
Normal ranges vary a little from one laboratory to another, so the results should be read by a doctor, together with the symptoms. If you take biotin (vitamin B7) or hair and nail supplements, mention it before the test, as they can change the result of some thyroid tests. Thyroid tests can be done at Aura’s laboratory.
What helps
Hair loss caused by hormones usually improves once the cause is treated: when thyroid function returns to normal, when low iron is corrected or when PCOS is managed. Hair grows slowly, about 1 cm a month, so it takes several months before the difference is visible. Avoid crash diets, which can cause shedding of their own.
While hair recovers, gentle care reduces breakage: avoid very tight hairstyles, frequent high heat and harsh chemical treatments. If thinning remains after medical causes have been ruled out, other options can be discussed, such as hair treatments and, for stable pattern hair loss, a hair transplant.
When to see a doctor
- Sudden or heavy shedding, or hair loss that lasts for more than a few months.
- Round bald patches, or redness, scaling, itching or pain on the scalp.
- Hair loss together with other symptoms, such as tiredness, weight change, a racing heart, irregular periods or extra facial hair.
- Thinning that starts after a new medication. Do not stop any medication on your own; discuss it with your doctor.
Questions for your consultation
- Could my hair loss be linked to my thyroid, my iron levels or my hormones?
- Which tests do I need, and when should I repeat them?
- Could my supplements or medications affect the results?
- How long will it take before I see an improvement?
- Should my scalp also be examined by a dermatologist?
- What can I do in the meantime to protect my hair?
Read more about endocrinology at Aura Medical Clinic, about an underactive or overactive thyroid and about dermatology consultations. A consultation with Dr. Sara Zavalani sets out your individual plan.
