If you've noticed more hair in the shower drain or on your pillow lately, you're not imagining it, and you're not alone. Anywhere from 6–38% of women will experience some form of hair loss in their lifetime. As a naturopath, hair changes are one of the most common things people bring to me, usually with the same question: is this normal, or is something actually wrong?
The honest answer is that it depends entirely on which kind of hair loss you're dealing with, because the causes, and the fixes, are genuinely different.
Two Very Different Kinds of Hair Loss
Most hair loss falls into one of two categories:
- Androgenic alopecia: a hereditary, progressive pattern of thinning, a receding hairline and bald spots in men, thinning along the centre part in women. This develops gradually over years and is driven by genetics and hormone sensitivity in the follicle itself.
- Telogen effluvium: a diffuse, temporary shedding that happens when a stressor pushes an unusually large number of hairs into their resting phase at once. It's sudden, it's alarming, and importantly, it's usually reversible once the underlying trigger is addressed.
If your hair loss came on suddenly, months after a stressful event, illness, birth, or major diet change, you're almost certainly dealing with telogen effluvium, not a permanent pattern. That distinction matters, because it changes what's actually worth doing about it.
What Triggers Telogen Effluvium
Pregnancy and postpartum: this is one of the most common triggers. Elevated oestrogen during pregnancy keeps hair in its growth phase for longer than usual, which is why hair often feels thicker during pregnancy. After birth, oestrogen drops sharply and all of that hair shifts into shedding phase at once. Postpartum telogen effluvium affects roughly 1 in 5 women, typically starting 2–4 months after birth and lasting around 2 months before it resolves on its own (Rebora, 2019).
Thyroid function: thyroid hormones are directly involved in the hair growth cycle, and both an underactive and overactive thyroid can trigger diffuse shedding. In autoimmune-related telogen effluvium specifically, thyroid antibodies show up in a large proportion of cases, which is part of why a thyroid panel is one of the first things worth checking if shedding doesn't have an obvious cause.
Menopause: the same mechanism shows up again here. Falling oestrogen relative to androgens changes the hair growth cycle, which is why thinning often becomes noticeable through perimenopause and menopause, not just from "getting older."
Illness, surgery, crash dieting, and major stress can all do the same thing: push hair into shedding phase 2–3 months after the event, which is often what makes the connection so easy to miss. People rarely connect hair falling out in June with a stressful event in March.
The Iron Connection
This is the piece most people, and plenty of practitioners, miss. A 2022 systematic review and meta-analysis pooling 20 studies and over 3,600 participants found that people with telogen effluvium had significantly lower serum iron and ferritin than people without it, and identified serum ferritin below roughly 20–30 µg/L as a meaningful threshold associated with the condition (Almohanna et al., 2022).
This is exactly why iron deficiency and hair shedding show up together so often, particularly in menstruating women, postpartum, and anyone who's recently changed their diet. If you want the fuller picture on iron absorption and why standard iron tablets don't always fix it, we covered that in depth in Heme Iron vs Non-Heme Iron. The main takeaway here: if you're shedding and you haven't had ferritin tested (not just "iron" on a standard panel, ferritin specifically), that's the single most useful test to ask for.
The Sulphur and Keratin Connection
Hair is close to 90% keratin, a structural protein that depends heavily on sulphur-containing amino acids to form and hold its shape. This is the same mechanism we cover in our piece on MSM and joint health: adequate sulphur intake supports the physical building blocks of keratin, not just for joints and skin but for hair strength as well. It's not a fix for telogen effluvium on its own, but it's a genuinely relevant piece of the nutritional picture.
What Actually Helps
- Get ferritin and a full thyroid panel tested before trying anything else. Guessing wastes months; a blood test takes days.
- If it's postpartum, give it time. Postpartum telogen effluvium almost always resolves on its own within 6–12 months as the hair cycle resets. It's distressing, but it's rarely permanent.
- Address the nutrient gaps that show up on testing, rather than supplementing broadly and hoping. If ferritin is low, a whole-food heme iron source like The Beef or The Multi is a gentler, better-absorbed option than synthetic ferrous sulfate. If sulphur and keratin support is the gap, Pure MSM is worth considering alongside your diet.
- See a dermatologist if shedding is patterned rather than diffuse, or if it's been going on for more than 6 months without improvement. Telogen effluvium is temporary by definition; if it isn't resolving, it's worth ruling out something else.
Hair shedding can feel like it's happening for no reason, but there's almost always a reason, and in most cases it's identifiable with a couple of simple blood tests rather than trial and error with a dozen different serums.
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