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Last updated July 20, 2020. 5 minute read

Anemia (iron deficiency) and hair loss: understanding the link

Research published in the Journal of Korean Medical Science suggests that iron deficiency may lead to hair loss that is similar to the pattern hair loss seen with androgenic alopecia. For men, this means a bald spot on the crown of the head or a receding hairline, and for women, it’s usually thinning hair along the part line followed by increasing diffuse hair loss.

Written by Alexandria Bachert
Reviewed by Mike Bohl, MD, MPH

Anemia is a condition in which the body doesn’t have enough healthy red blood cells to deliver oxygen to the rest of the body. There are multiple types of anemia, but one of the most common types is iron-deficiency anemia.

As the name suggests, iron-deficiency anemia occurs due to insufficient levels of the mineral iron in the body. More specifically, it’s when the bone marrow doesn’t have enough iron to create hemoglobin, which is the key to coloring your blood that shade of red and enabling the blood cells to transport oxygenated blood throughout your body.

Vitals

  • Iron-deficiency anemia occurs due to insufficient levels of the mineral iron in the body.
  • In the U.S., research shows that iron-deficiency anemia affects about 9–12% of non-Hispanic white women and nearly 20% of black and Mexican-American women, yet only 2% of adult men.
  • Recommended Dietary Allowance (RDA), a tool to help people consume a nutritionally adequate diet, can be a guide for daily iron intake.
  • Red meat, dark leafy greens, and iron-fortified cereals are approved sources of iron.

The body’s iron supply is mostly stored in the hemoglobin, but about one-third is also stored as ferritin (a blood protein that contains iron) and hemosiderin (an iron-storage complex) in the bone marrow, liver, and spleen (Ems, 2020). 

In some cases, it’s possible to not even realize that you’re living with iron-deficiency anemia until the condition progresses and signs start to manifest. People will experience symptoms differently, but some of the most common signs of iron-deficiency anemia include pale skin or yellow “sallow” skin, an increased heart rate, and a sore or swollen tongue. Irritability and fatigue are two additional hallmarks of the condition. A unique sign of iron deficiency is something called pica, which is an unexplainable craving for non-nutritive items like ice, clay, soil, or paper (Johns Hopkins, n.d.).

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When it comes to low iron levels and hair growth, the relationship has traditionally been a bit more tenuous and controversial (Trost, 2006). That said, more recent research has pointed to a potential link between low iron and telogen effluvium, a type of temporary hair loss that usually happens due to some type of stress and affects women around the hairline, leading to thinning hair.

Hair loss in women vs. men

One study examined more than 5,000 women aged 35–60 years to better understand the link between iron deficiency and excessive hair loss in women (Deloche, 2007). Among the women affected by excessive hair loss, the researchers found that a larger proportion of women (59%) had low iron stores (<40 mcg/L) compared to the remainder of the population (48%).

Another team conducted an analytical case-control study to assess if diffuse telogen hair loss in women of childbearing age (15 to 45 years old) is linked to iron deficiency (Moeinvaziri, 2009). After studying 30 women with and without diffuse telogen hair loss, the team found that mean ferritin level and transferrin saturation were significantly lower in patients with hair loss (16.3 vs. 60.3, respectively). In other words, the women with hair loss had fewer iron stores in their bodies.

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Additional research, published in the Journal of Korean Medical Science, even suggests that iron deficiency may lead to hair loss that is similar to the pattern hair loss seen with androgenic alopecia (Park, 2013). For men, this means a bald spot on the crown of the head or a receding hairline, and for women, it’s usually thinning hair along the part line followed by increasing diffuse hair loss.

Overall, alopecia due to anemia is something that largely affects women. In the United States, research shows that iron-deficiency anemia affects about 9–12% of non-Hispanic white women and nearly 20% of black and Mexican-American women, yet only 2% of adult men (Killip, 2007). 

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In premenopausal women, the most common causes of iron-deficiency anemia are menstrual blood loss and pregnancy. For men and postmenopausal women, gastrointestinal blood loss is a leading cause of low iron. People living with Crohn’s disease, celiac disease, kidney failure, or practicing a vegan diet may also be more prone to iron-deficiency anemia.

Diagnosis and treatment

If you believe that your hair loss is related to an iron deficiency, it’s important to consult your healthcare provider before taking matters into your own hands. While it may seem tempting to self-diagnose and treat with an iron supplement, they do have side effects, and your good health intentions may actually end up leading to more serious complications.

Instead, visit your healthcare provider to discuss your medication history and measure your iron levels. During a physical examination, your provider will keep an eye out—and an ear open—for some of the previously mentioned symptoms to understand how they relate to your levels of iron.

They also might run a few blood tests, including a serum ferritin concentration, which measures the amount of iron stored in the body and is regarded as the most efficient and cost-effective test for diagnosing iron deficiency (DeLoughery, 2017). It’s also important to measure hemoglobin and hematocrit levels; the first tracks the number of red blood cells, and the second looks at how much space red blood cells take up in your blood.

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Once iron-deficiency anemia is established as the cause of hair loss, best practice is to be more mindful of iron intake and to eat a balanced diet full of iron-rich foods in conjunction with supplements (if necessary) for hair regrowth and to prevent future hair loss.

Developed by the Food and Nutrition Board at the Institute of Medicine of the National Academies, Recommended Dietary Allowance (RDA) is a tool to help people consume a nutritionally adequate diet. RDA represents the average daily level of intake sufficient to meet the nutrient requirements of most (97–98%) healthy individuals; the iron suggestions are as follows. 

  • Females aged 9–13 years: 8 mg/d
  • Females aged 14–18 years: 15 mg/
  • Females aged 19–50 years: 18 mg/d 
  • Females aged 51+ years: 8 mg/d
  • Males aged 9–13 years: 8 mg/d
  • Males aged 14–18 years: 11mg/ d
  • Males aged 19+ years: 8 mg/d

Important to note, the daily amount increases to 27 mg/d for pregnant women of any age, and 10 mg/d for lactating women 14–18 years, and 9 mg/d for lactating women 19–50 years (NIH, n.d.).

Meats (beef, pork, lamb), poultry (chicken, duck, turkey), and fish (mussels, oysters, sardines, anchovies) are all rich in iron. For people who prefer to get their nutrients from plant-based sources, legumes and leafy greens like kale, broccoli, and collards are the way to get your iron fix. Grocery store shelves are also lined with iron-fortified foods—cereal, bread, and pasta—which are approved sources of iron.

To take the produce plan a step further, try consuming more foods with vitamin C. Broccoli, grapefruit, oranges, peppers, and other foods rich in vitamin C are known to help the body absorb more iron and may help lead to healthy hair.