💇‍♀️ Hair Loss and Hormones: A Deeper Look Beyond the Follicle

Hair loss is often dismissed as a cosmetic concern—something to cover up or treat with shampoos and pills. But in medicine, the surface often reflects something deeper.

A recent 2024 review in Biomedicines, "The Hormonal Background of Hair Loss in Non-Scarring Alopecias" by Owecka et al., comprehensively outlines the hormonal drivers behind common types of hair loss—particularly androgenetic alopecia, telogen effluvium, and alopecia areata. The review explores the effects of androgens (like testosterone and DHT), estrogens, thyroid hormones, cortisol, ACTH, and even growth hormone on hair follicle cycling.

Their conclusion is clinically sound: hormonal changes are central in many forms of hair loss, and hair loss can be a diagnostic clue pointing toward underlying endocrine imbalance.

But what if hormones themselves aren’t the root cause—but rather the messengers of something even deeper?

Hormones: Not the Villain, But the Voice of the Body

Hormones are not random actors. They are the command signals of adaptation—how the brain, endocrine organs, and immune system coordinate survival when the body is under threat. Whether that threat is inflammation, toxic exposure, chronic stress, or nutrient depletion, hormones mediate the body's internal resource allocation.

So rather than asking “Which hormone causes hair loss?”, a more productive question might be:

What unresolved stress or metabolic burden is triggering these hormonal adaptations—and why is the hair follicle one of the first systems to be sacrificed?

Hair Loss as a Sign of Energy Reallocation

Hair follicles are among the most metabolically active tissues in the body. They require amino acids, iron, zinc, ATP, and constant cellular turnover. But they are also non-essential for survival.

When the body senses threat—whether from oxidative stress, emotional trauma, gut dysbiosis, or heavy metals—it reallocates energy away from regenerative processes like hair growth and skin renewal. The result?• Hair thinning.• Brittle nails.• Fatigue.• Immune changes.

In this context, hair loss is not a disease—it’s a trade-off.

The ERM Framework: Seeing Hair Loss Through a Systems Lens

In the Exposure-Related Malnutrition (ERM) model that I and my team are developing, hair loss is an early signal of bioenergetic misallocation—often emerging during chronic adaptation to hidden stressors.

This framework shifts the question from:

"What hormone is out of balance?"to"What stress exposure has pushed the system to reroute energy from non-essential tissues like hair and skin?"

When we see hair loss as part of this broader adaptation-exhaustion cycle, it becomes:

• A clue to oxidative stress or mitochondrial dysfunction.

• A marker of nutrient triage, where limited zinc, biotin, iron, or cysteine are diverted to immune repair or detoxification.

• A consequence of persistent inflammation that alters cortisol, estrogen, thyroid, or DHEA signaling.

Beyond DHT Blockers: A Holistic View of Recovery

Conventional treatments like minoxidil or finasteride may help, especially when DHT excess is obvious. But when hair loss persists despite normal labs—or appears alongside fatigue, digestive issues, or mood shifts—it’s time to look deeper.

🔎 Ask:

• Is there a chronic stressor the body hasn’t resolved?

• Are key nutrients being depleted or misallocated?

• Is the HPA axis overactivated and stuck in catabolic mode?

Restoring hair is not just about blocking hormones—it’s about restoring safety, rebuilding reserves, and reclaiming resilience.

Conclusion

The review by Owecka et al. reminds us that hair loss is tightly connected to the body’s hormonal system. But within the ERM/stress-adaptation lens, those hormones are signals, not causes. They’re telling us that the body is adapting—sometimes wisely, sometimes at a cost.

When we listen to those signals with curiosity and care, we can shift from symptom suppression to systemic healing.

📚 Reference:

Owecka B, Tomaszewska A, Dobrzeniecki K, Owecki M. The Hormonal Background of Hair Loss in Non-Scarring Alopecias. Biomedicines. 2024;12(3):513. https://doi.org/10.3390/biomedicines12030513

#Hair Loss and Hormones, #Stress Adaptation Biology, #Exposure-Related Malnutrition (ERM), #Metabolic Trade-Offs, #Functional Medicine Approach to Alopecia