Alopecia areata is a distinct form of hair loss, in which bald patches are easily noticeable. It can occur to the scalp, beard, eyebrow, and even arms and legs. Even though alopecia areata is a benign condition and often has no associated symptoms, it often causes significant emotional and psychosocial stress to the patient.
Much evidence supports the autoimmune etiology of alopecia areata. In other words, hair follicles are destroyed by the body’s own immune system and hair falls out as a consequence. Statistics show that regrowth of hair will occur within one year in most cases. However, regrowth is less likely if the hair loss is extensive and long-standing. The key is to treat it as soon as the hair loss occurs.
In my experience of treating alopecia areata, the three most important contributing factors are:
- Vitamin D deficiency
- Hypothyroidism and Hashimoto’s thyroiditis
I put diet as the number one factor because I just can’t overemphasize its importance. Diet is invariably underlying all autoimmune conditions, in my opinion, and in my clinical experience. Diet is a complex issue. There really isn’t a universal healthy diet for everybody. Diet has to be individualized. The foods that we eat can nourish our body, but can also cause inflammation, which then gives us all kinds of symptoms, such as heartburn, diarrhea, anxiety, migraine, joint pain, skin rash. And the list goes on. Alopecia is one of those conditions where the damaging effect of an improper diet is not immediately noticeable and therefore not obvious. Patients may never correlate certain foods with their hair loss, as the hair loss doesn’t occur overnight. In certain cases, dietary damage to the gut is long-standing and has led to leaky gut, which in turn has resulted in multiple food allergies/sensitivities. Careful analysis of diet and certain lab tests will be necessary to set the patient on a right path to health.
Vitamin D deficiency is another factor that underlies most autoimmune conditions. It is more common than most people think. Yes, even in our sunny state of Arizona! Vitamin D is actually a steroidal hormone that our body naturally produces. Vitamin D status directly reflects our health status. I often see on blood tests that vitamin D level drops if the patient has been stressed and suffers from lack of sleep. Unfortunately, stress and lack of sleep are all too familiar to most of us. A blood test of vitamin D is always included in the initial workup for a patient with alopecia areata.
Thyroid hormones directly affect hair growth. Clinical or subclinical hypothyroidism (low thyroid function) is often found in patients with alopecia areata. The most common cause of hypothyroidism in developed countries is an autoimmune condition called Hashimoto’s thyroiditis. In medical terminology, the suffix “-itis” means inflammation. In Hashimoto’s thyroiditis, the thyroid gland suffers from inflammation caused by the body’s own immune cells. In such cases, both low thyroid function itself and the autoimmune antibodies against thyroid contribute to the hair loss. I do need to emphasize that hypothyroidism caused by Hashimoto’s thyroiditis cannot be reversed by iodine supplement. In fact, a large dose of iodine supplement may be harmful to the thyroid gland. Thyroid function and thyroid auto-antibodies need to be evaluated through lab work and treatment with thyroid medication are often necessary to help patients to regrow hair.
Schedule a free 15-minute consultation with Dr. Song if you suffer from alopecia areata, by booking an appointment online, or calling us at 480-388-0099.