Hair loss and feeling tired: are they linked?

Can feeling tired cause hair loss?

Feeling constantly tired can have a direct impact on hair health. When fatigue is intense and prolonged, it can trigger reactive hair loss, known as acute telogen effluvium. This type of hair loss generally occurs 2 to 4 months after a triggering factor, such as emotional shock, illness or intense stress. The hair cycle becomes disrupted (Park et al., 2023), leading to diffuse and simultaneous hair loss in the telogen phase. In these cases, one might lose up to 300 hairs per day, compared to the normal 50 to 100.

Chronic fatigue linked to prolonged stress, overwork or an unbalanced diet can also cause significant hair loss. This phenomenon is more common in women, particularly due to hormonal variations. When the cause of the fatigue is identified and addressed, the hair gradually resumes its normal cycle. Regrowth typically begins after 6 months and can return to its initial state after 12 to 18 months.

Conversely, a bit of temporary tiredness lasting just a few weeks won’t cause significant hair loss. However, it might temporarily slow down hair growth without causing long-term consequences.

What deficiencies cause hair loss?

Dietary deficiencies play a key role in hair health. When the body lacks certain essential nutrients, it can affect the vitality of the scalp and cause varying degrees of hair loss (Guo & Katta, 2017).

Iron

Iron is essential for the production of haemoglobin, which carries oxygen to the body’s cells, including those of the scalp. Iron deficiency can weaken hair follicles, leading to noticeable hair loss. This is particularly observed in women with heavy periods or those following a strict vegetarian diet. Clinical studies have confirmed that iron deficiency is one of the most common nutritional deficiencies associated with hair loss, although the exact level of deficiency required to trigger hair loss remains unclear (Guo & Katta, 2017).

Zinc

Zinc is a mineral essential for the synthesis of proteins that make up the structure of hair, including keratin. Zinc deficiency can make hair more fragile, slow hair growth, and promote hair loss. Zinc supplementation has been shown to be beneficial in patients with a proven deficiency, but excessive supplementation can be toxic and, rather ironically, worsen hair loss (Guo & Katta, 2017).

Vitamin B12

Vitamin B12 is crucial for the proper functioning of hair follicle cells. Since it isn’t synthesised by the body, it must be supplied through diet. A deficiency in B12 can cause anaemia, general fatigue, and diffuse hair loss. This vitamin is mainly found in animal products, which is why vegans are particularly at risk of developing this deficiency.

Vitamin D

Vitamin D plays a role in the regeneration of hair follicles. A lack of this vitamin can promote telogen effluvium, particularly in the autumn when sun exposure decreases. Recent research suggests that vitamin D is involved in the hair follicle growth cycle, and that its deficiency may be involved in various forms of alopecia (Guo & Katta, 2017). This is particularly relevant in the UK, where many of us are vitamin D deficient due to our rather limited sunshine!

Vitamin C

An antioxidant, vitamin C protects hair from free radicals and promotes iron absorption. A deficiency in vitamin C can make hair brittle, dull and accelerate hair loss. This vitamin also plays an important role in the synthesis of collagen, a structural protein essential for scalp health.

When to worry about hair loss?

Natural hair loss is part of a normal hair renewal cycle. On average, we lose between 50 and 100 hairs per day without cause for concern. This cycle consists of four distinct phases that follow one another throughout life, allowing approximately 20 to 30 complete renewals.

The anagen phase is the period of active growth, during which approximately 90% of hair is actively growing. It’s followed by the catagen phase, a short transition period of two to three weeks that affects approximately 2% of hair. Next comes the telogen phase, or resting phase, during which the hair stops growing but doesn’t fall out. Finally, the exogenous phase marks the natural shedding of the hair, allowing the start of a new cycle.

However, some situations deserve special attention: when daily loss becomes significantly higher than usual or when it continues beyond six to eight weeks. Another warning sign is the appearance of increasingly thin and short hair, indicating a disruption in the renewal cycle.

Research has shown that sleep disturbances can be an important indicator of underlying hair problems. One study found that patients with alopecia had significantly reduced sleep quality, with difficulty falling asleep and insufficient sleep duration (Park et al., 2023). These sleep disturbances were particularly marked in patients with moderate to severe forms of alopecia.

Good to know: Certain periods of life are more conducive to temporary hair loss, such as the postpartum period, the beginning of menopause or seasonal changes. In these cases, the situation is generally temporary and sorts itself out naturally.

Hair loss and feeling tired: what to do?

When faced with hair loss linked to feeling constantly tired, several solutions are available. Unlike androgenetic alopecia, occasional hair loss has the advantage of being reversible, provided that you act quickly and appropriately.

The first step is to pay particular attention to your diet. A balanced diet, rich in essential vitamins and minerals, not only helps combat fatigue but also provides hair with the nutrients necessary for optimal growth. Nutritional research has shown that hair follicles are among the most metabolically active cells in the body and are particularly sensitive to nutritional deficiencies (Guo & Katta, 2017).

Improving sleep quality is also rather effective. Studies have linked sleep disturbances to worsening of some forms of alopecia (Liamsombut et al., 2023). Establishing a regular sleep routine, limiting screen time before bed, and creating an environment conducive to rest can help improve hair health. The NHS recommends adults aim for 7-9 hours of quality sleep per night.

It’s also important to review your hair care habits. Overly aggressive products can weaken the scalp and make the situation worse. It’s best to opt for gentle care products that are suitable for your hair type.

Good to know: A medical consultation becomes essential when hair loss persists or intensifies unusually. Your GP a dermatologist or Dr Cinik’s Team can make an accurate diagnosis and identify the underlying causes of this hair loss.

Hair loss: what if it was androgenetic alopecia?

Unlike temporary hair loss related to feeling tired, androgenetic alopecia is a permanent condition that requires a different therapeutic approach.

In men, it’s generally characterised by a receding hairline and loss at the crown, while in women, it more often results in diffuse thinning on the top of the head.

Recent research has shown a significant correlation between sleep quality and the severity of androgenetic alopecia in men. One study showed that men with severe androgenetic alopecia had more frequent sleep disturbances, including reduced sleep duration (≤ 6 hours) and overall impaired sleep quality (Liamsombut et al., 2023). These results suggest that improving sleep quality could be a complementary aspect in the management of this condition.

In the case of androgenetic alopecia, hair transplantation has become an increasingly popular solution. This surgical technique consists of taking hair follicles from areas where hair is resistant to loss, at the back of the skull, to reimplant them in the areas affected by alopecia. Two methods, practised by Dr. Cinik in Turkey, stand out in particular: FUE (Follicular Unit Extraction) and DHI (Direct Hair Implantation).

The FUE technique consists of individually extracting follicular units from the donor area with a micro-punch less than 1 mm in diameter. The follicles are then sorted and reimplanted one by one in micro-incisions previously made in the recipient area.

The DHI method is distinguished by the use of a special instrument, the implanter or Choi pen, allowing the follicles to be extracted and reimplanted directly in a single step, without prior incisions. This technique ensures precise control of the angle, depth and direction of each implant, while minimising the time the grafts are exposed to the open air.

Hair loss and feeling tired: what you need to remember

• Intense fatigue, particularly when linked to stress or emotional shock, can trigger significant hair loss. Recent studies have linked sleep disorders to various forms of alopecia (Park et al., 2023).
• Nutritional deficiencies, particularly in iron, zinc, and vitamins B12, C, and D, can worsen hair loss and should be corrected with a balanced diet or appropriate supplementation (Guo & Katta, 2017).
• Daily hair loss of more than 100 hairs or that lasts beyond two months warrants a chat with your GP to identify the cause and implement appropriate treatment.
• Adopting appropriate hair care and a balanced diet is the first line of defence against fatigue-related hair loss.
• In the event of irreversible hair loss, hair transplantation is a sustainable and effective solution, restoring natural and dense hair using follicular transplantation techniques.
• Sleep quality plays an important role in hair health, and improving sleep quality can help reduce hair loss, particularly in people with androgenetic alopecia (Liamsombut et al., 2023).

Sources

Guo, E. L., & Katta, R. (2017). Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatology Practical & Conceptual, 7(1), 1-10. https://doi.org/10.5826/dpc.0701a01

Liamsombut, S., Pomsoong, C., Kositkuljorn, C., Leerunyakul, K., Tantrakul, V., & Suchonwanit, P. (2023). Sleep quality in men with androgenetic alopecia. Sleep and Breathing, 27(1), 183-189. https://doi.org/10.1007/s11325-022-02618-x

Park, S. H., Ji, K. H., Kim, J. U., Jang, S. H., Ahn, S. W., Hong, S. M., Jin, W. J., Seol, J. E., & Kim, H. (2023). Evaluation of Sleep Disturbance in Alopecia Areata through Questionnaire: Pittsburgh Sleep Quality Index as a Reasonable Tool. Annals of Dermatology, 35(3), 183-189. https://doi.org/10.5021/ad.22.136