Postpartum Hair loss: What is normal and what is not?

Postpartum hair loss is quite common. For most, it is a temporary occurrence which, on average, starts at about 3 months postpartum and is related to hormonal fluctuation. During pregnancy because of hormonal influence there is an increase in the percentage of hair follicles in ‘growth phase’ which means thick, luscious hair. In the postpartum period, there is an increase in the percentage of hair follicles in ‘resting phase’ which is followed by shedding and thus (for some of us!) can lead to a LOT of hair loss. Usually hair growth will resume a more balanced growth/resting phase by 1 year postpartum.

If you are losing excessive amounts of hair and this starts or continues beyond 12 months postpartum, it might be advisable to talk to your healthcare provider about it. And generally speaking, there can be two things to assess when it comes to excessive hair loss - iron deficiency and thyroid concerns. 

Iron-deficiency related hair loss

Low iron can occur in women of child bearing age, especially if they have heavy menstrual bleeding which is one of many possible contributing factors. Measuring the Ferritin levels in your blood is one test that is sensitive enough to assess how much stored iron you have in your body. Normal levels are considered 10-15 ng/mL however some specialists believe this is too low when considering treating hair loss and will have patients shoot for levels around 50-70 ng/mL. So if you test low in iron (with or without anemia) it may still be worth considering increasing your iron-rich foods or iron supplementation with the guidance of your doc. NOTE: If you are just ‘guessing’ this is the reason for your hair loss and start supplementing and your iron is NOT actually low, this can be harmful!). Although the research is conflicting, many specialists concur that when the iron deficiency is treated, it stimulates the follicles to be in growth phase rather than resting/shedding and can help counter excess hair loss. 

Thyroid-related hair loss

Remember the hair follicles in the ‘resting phase’ discussion above? Well, thyroid hormones are directly involved with hair follicle function. So, if you have more ‘resting phase’ follicles, this will be followed by excessive shedding/hair loss. Getting a thyroid test might be helpful if you are having unusual postpartum hair loss AND other symptoms.

At 1-6 months postpartum, you could be experiencing the first phase of thyroid dysfunction- hyperthyroidism (high level of thyroid hormone circulating in the blood) although often we (and healthcare providers) don’t recognize the initial symptoms of hyperthyroid

• Anxiety

• Irritability

• Rapid heartbeat or palpitations

• Unexplained weight loss

• Increased sensitivity to heat

• Fatigue

• Tremor

• Insomnia

 4-8 months postpartum is when symptoms become more apparent due to being in the 2nd phase of thyroid dysfunction- Hypothyroidism (low level of thyroid level circulating in the blood):

• Lack of energy

• Increased sensitivity to cold

• Constipation

• Dry skin

• Weight gain

• Depression

 Here is something very important to note.The standard TSH test given at the doctor’s office might not tell the whole story! Your thyroid health is beyond just TSH. TSH indicates how well your pituitary gland functions rather than directly assessing thyroid function. If you aren’t getting answers and have some of the above symptoms, I would absolutely recommend seeing a functional medicine practitioner who will  look at ALL the key components of thyroid function and to work toward more optimal ranges. They may run a complete thyroid panel which would include TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies. This total thyroid panel will test for normal thyroid function as well as how well thyroid hormone is working in your body. It assesses the conversion of T4 to T3 (the active form of the hormone) and this is important because T3 drives metabolism function within our cells!  

So, sometimes hair loss is common. And considering how much hair loss is occurring and the timeline of when it is happening might be helpful for determining if you should talk further with your medical provider. 

Do you have experience to share on abnormal postpartum hair loss? Who did you seek guidance or support from? What tests or treatments were helpful for you?

All women’s bodies are unique. If you would like to know more about how the above relates to your specific condition, email me here. Please also follow us on Instagram or join our private Facebook Group for a ton of free support on common women’s health concerns.