Iron and Hair Loss: What No One’s Telling You

Is your hair getting thinner, drier, or just not the same after 40?

Your thyroid is fine.

Your hormones look okay (ish).

And yet… you’re still shedding like crazy.

Have you checked your iron? Like, really checked it the right way?

Hair loss and low iron go hand in hand — and most women have no idea why.

Let’s fix that.

When “Normal” Labs Aren’t Normal

Here’s what’s wild: you can have “normal” labs — even a normal CBC (complete blood count) — and still be losing hair.

Why? Because your body might not have enough iron where it matters most: inside your hair follicles.

Iron isn’t just about energy. It’s literally what fuels new hair growth.

Without it, your follicles shift into “survival mode,” slowing growth and triggering more shedding.

Symptoms of Low Iron (Besides Hair Loss)

If you’re low in iron, you might also notice:

  • Fatigue or low energy

  • Shortness of breath

  • Rapid heart rate

  • Weakness

  • Pale skin (or pale lower eyelids when you pull them down)

  • Brittle nails

  • Restless legs

  • Easy bruising

How Low Iron Is Diagnosed

Your provider may start with a CBC, which looks at:

  • Red blood cells (RBC)

  • Hemoglobin (Hgb)

  • Hematocrit (Hct)

But here’s the catch — you can have a normal CBC and still have low iron stores.

That’s why ferritin (your iron storage protein) is critical to test.

Most labs list “normal” ferritin as 15–150 ng/mL, but that range is outdated.

The American Gastroenterological Association recently updated the lower limit to 45 ng/mL — a huge difference.

For years, I’ve argued that women feel awful (and shed hair like crazy) with ferritin below 50 ng/mL.

Many are told they’re “fine” at 17, 20, or 30 — but their hair, energy, and mood say otherwise.

Other helpful labs:

  • Serum Iron

  • TIBC (Total Iron Binding Capacity)

  • % Saturation

Why Iron Gets Low

Low iron isn’t always about diet. There are lots of reasons your levels could dip — and you can have more than one.

🥩 You’re not eating enough iron.

  • Vegan or vegetarian

  • Not a red meat fan

💥 You’re not absorbing it.

  • H. pylori infection

  • Medications that block absorption (antacids, PPIs)

  • Celiac disease or SIBO

  • Ulcerative colitis or Crohn’s disease

  • General gut inflammation or “leaky gut”

🩸 You’re losing it.

  • Heavy periods (hello, perimenopause!)

  • Ulcers, hemorrhoids, or GI bleeding

🩺 Chronic inflammation or disease.

  • Conditions that trap iron in storage — low serum iron but normal or high ferritin.

How to Treat It

Do you just take iron?

Maybe — but not before finding out why your iron is low in the first place.

Because if your gut’s not absorbing or you’re losing iron every month, supplements are just a band-aid.

Work with your provider to:

  1. Identify the cause (diet, gut, or bleeding).

  2. Choose the right form of iron (some are much easier on digestion).

  3. Re-test every 3–4 months.

Other Causes of Hair Loss

Iron isn’t the only reason your hair might be thinning. Other contributors include:

  • High androgens (testosterone or DHT)

  • PCOS

  • Low or fluctuating estrogens (especially in perimenopause)

  • High cortisol or stress — shedding often appears 2–3 months after a stressful event

  • Hair care products or water changes (hard vs. soft water, new shampoo, well water, etc.)

  • Low minerals (zinc, selenium, magnesium)

  • Medications (especially SSRIs like Prozac or Zoloft, birth control pills, steroids, and excess testosterone therapy)

  • Chemotherapy

Bottom Line

If your hair is falling out and your labs look “normal,” don’t stop there.

Ask for your ferritin — and make sure it’s above 45ng/mL for healthy hair growth.

Your body can’t grow lush, strong hair when it’s stuck in low-iron survival mode.

So before you buy another supplement or shampoo, check your labs first.

Your follicles will thank you later. 💁‍♀️

Carrie Jones

an educational website focusing on hormones

https://www.drcarriejones.com
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