HeraSphere #18: Is your hair loss normal?

Hi friends,

I've always been what my husband calls a "prolific shedder." For years, he'd joke that it was a miracle I had any hair left on my head, because even in my twenties, I'd leave trails of dark strands everywhere—on the bathroom counter, wound around the vacuum cleaner, coating my pillowcases. It was just my normal.

So when I started hearing friend after friend complaining about hair loss in their forties and beyond, I got paranoid. Was my current shedding level still normal? Or should I be worried? That question sent me down a rabbit hole to understand what's actually happening to our hair as we age, how hair grows in the first place, and what we can do about it when things shift.

Turns out, I wasn't alone in my confusion—and you probably aren't either. This is a long one, so read the TL;DR below if you want a quick synoposis!

The TL;DR:

Up to 40% of women will experience noticeable hair loss by age 50, and at least 50% of women will experience hair thinning or loss at some point in their lifetime. Unlike men, who typically see receding hairlines or bald patches, women usually notice their part looking wider or their ponytail suddenly thinner.

Understand the biology. Follicles are metabolically active factories with cycles. Miniaturization causes permanent loss. Once follicles are gone, they're gone.

Rule out reversible causes first. Telogen effluvium, nutritional deficiencies, thyroid dysfunction, medications, scalp inflammation—all potentially reversible if caught early.

Stop doing damage. Tight hairstyles, excessive heat, harsh chemicals, scalp neglect, smoking, chronic stress—all actively harm follicles.

Intervene early. Don't wait until hair loss is obvious. By then you've lost 30-50% of density. Earlier action saves more follicles.

Work with a specialist. A dermatologist or hair restoration expert can systematically rule out causes, order proper tests, and develop targeted treatment.

Hair Biology 101: Understanding Your Follicle Factory

Before we can diagnose what's wrong, we need to understand what "right" looks like. Your hair follicle is essentially a tiny factory that goes through production cycles.

The three phases:

Anagen (Growth) — About 90% of your hair is actively growing for 2-8 years. Cells divide rapidly, pushing the hair shaft up at roughly half an inch per month.

Catagen (Transition) — A brief 2-3 weeks when the follicle shrinks and detaches from its blood supply. Growth stops.

Telogen (Rest) — The follicle is dormant for 2-4 months. At the end, the old hair falls out and the cycle restarts. Losing 50-100 hairs daily during this phase is completely normal.

A healthy follicle cycles through these phases for your entire lifetime. The problem isn't the cycle—it's when something disrupts it or damages the follicle itself.

What Actually Happens: The Miniaturization Process

The technical term for hair loss is follicular miniaturization—and understanding this process explains why timing matters so much.

Your follicles literally shrink. Terminal follicles (producing thick, pigmented hair) progressively become vellus follicles (producing fine, short, nearly invisible "peach fuzz").

The progression:

1. Anagen shortens — Hair grows for months instead of years, shedding before reaching full length

2. Follicle shrinks — Each cycle produces progressively finer hair

3. Miniaturization completes — Follicles produce only vellus hairs (essentially invisible)

4. Follicular deletion — The follicle may disappear entirely

The critical point: Research shows miniaturization can happen abruptly—sometimes in just one cycle. A follicle can go from producing thick hair to thin, miniaturized hair almost overnight. This is why hair loss can feel sudden even though the underlying process has been building.

Why prevention matters: Once a follicle is completely miniaturized or deleted, even the best treatments can't bring it back. You can only save follicles that are still functioning, even if they're producing thinner hair.

The Diagnostic Approach: Rule Out Causes Systematically

Most articles jump straight to "here's what causes hair loss." But that's not how good medicine works. You need to rule out reversible causes before assuming you have genetic pattern hair loss.

Step 1: Rule out temporary causes, like stress

Telogen effluvium is when stress shocks your system, causing excessive hair to enter the resting phase simultaneously. About 3 months later, it all sheds at once.

Common triggers: Major surgery, severe illness, high fever, significant weight loss, childbirth (affects up to 50% of women), severe emotional trauma, or stopping birth control.

How to tell: Increased shedding all over your scalp, not in a pattern. Usually temporary—hair regrows within 6-12 months once the stressor resolves.

Step 2: Check nutritional deficiencies

Hair follicles need specific nutrients to function. Deficiencies cause thin, brittle hair or stop growth entirely.

Essential nutrients:

• Iron/ferritin — Most common deficiency. Even if you're not anemic, low ferritin (under 70 ng/mL) affects follicle function

• Vitamin D — Plays a role in follicle cycling (aim for 40-60 ng/mL)

• Zinc — Necessary for protein synthesis and cell division

• B vitamins — Especially biotin and B12 for cell division

• Protein — Hair is 97% keratin protein. Inadequate intake directly impacts production

Action step: Get blood work before randomly supplementing. Know your baseline levels and work with a doctor to optimize them.

Step 3: Investigate hormonal disruptions

Thyroid dysfunction — Both hyper and hypothyroidism disrupt the hair cycle. Hyperthyroidism produces thin, fragile hair; hypothyroidism causes overall thinning and slow growth.

Testing needed: TSH, Free T3, Free T4, thyroid antibodies.

PCOS — Elevated androgens cause scalp hair loss and excess facial hair. Often involves insulin resistance that compounds the problem.

Perimenopause/menopause — As estrogen and progesterone decline, the relative increase in androgens (especially DHT) drives miniaturization. Estrogen and progesterone are your hair's protectors—without them, DHT has free rein to shrink follicles.

Step 4: Review medications

Many medications trigger hair loss: some antidepressants, beta blockers, ACE inhibitors, cholesterol medications, retinoids, and some NSAIDs.

Action step: Never stop medications without consulting your doctor, but ask if any could be contributing.

Step 5: Assess scalp health

Follicles can't function in an inflamed environment. Common culprits: seborrheic dermatitis, psoriasis, fungal infections, or allergic reactions to products.

Even microscopic inflammation you can't see can disrupt the hair cycle and accelerate miniaturization.

Step 6: Consider genetic pattern hair loss

If you've ruled out the above and are experiencing progressive thinning—especially in a pattern (widening part, crown thinning, overall density loss)—you likely have androgenic alopecia.

This affects 20-50% of women after 40. It's driven by genetic sensitivity to DHT (a potent androgen) and hormonal shifts. In genetically susceptible follicles, DHT binds to receptors and triggers miniaturization.

What NEVER to Do: Stop Damaging Your Follicles

While investigating causes, make sure you're not actively causing damage:

Tight hairstyles — Ponytails, braids, buns, and extensions that pull on follicles cause traction alopecia—mechanical damage that can permanently scar follicles. Notice thinning at hairline/temples? This could be why.

Excessive heat — Above 375°F weakens hair shafts and damages follicle openings. Miniaturized hairs are even more vulnerable.

Harsh chemicals — Bleach, perms, relaxers irritate the scalp and create follicle inflammation.

Improper washing frequency — Over-washing strips oils; under-washing allows buildup that clogs follicles. Most do well washing 2-4x weekly.

Rough handling when wet — Wet hair is most fragile. Aggressive towel-drying or brushing causes breakage.

Scalp neglect — Your scalp is skin. Product buildup, dead cells, excess sebum, and inflammation all impair follicle function.

Smoking — Nicotine reduces blood flow to follicles, cutting off oxygen and nutrients. Also increases oxidative stress and inflammation.

Chronic stress and poor sleep — Cortisol disrupts hair cycling. Poor sleep impairs follicle repair processes.

Prevention First: Protect Follicles Before They Shrink

Once you've stopped doing damage, shift to prevention. Create the optimal environment for follicles to stay healthy and delay miniaturization.

Optimize nutrition:

• Protein: 0.7-1g per pound of ideal body weight daily

• Omega-3s: From fatty fish, walnuts, flaxseeds (this reduces inflammation)

• Antioxidants: Colorful fruits and vegetables combat oxidative stress

• Adequate calories: Chronic restriction triggers hair loss

Support scalp blood flow:

• Daily scalp massage (4-5 minutes) increases blood flow

• Regular cardiovascular exercise improves circulation

• Avoid nicotine and excessive alcohol

Minimize inflammation:

• Anti-inflammatory diet (Mediterranean-style)

• Manage stress effectively

• Treat scalp conditions promptly

Protect from oxidative damage:

• Sun protection for scalp (hats or scalp sunscreen)

• Antioxidant-rich diet (vitamins C and E, green tea, berries)

• Consider targeted supplements after optimizing diet

Maintain stable hormones:

• Regular sleep schedule

• Avoid extreme dieting or excessive exercise

• Manage insulin resistance if present

When to Intervene: Why Timing Changes Everything

Here's the hard truth: Once follicles are completely miniaturized, you can't save them. Even powerful treatments only work on follicles still producing hair, however thin.

Signs it's time to see a specialist:

• Visibly wider part

• Noticeably thinner ponytail

• More scalp visible when hair is pulled back

• Significantly more shedding (beyond your normal)

• Hair loss persisting over 6 months after ruling out temporary causes

Don't wait "to see if it gets worse." By the time hair loss is obvious, you've lost 30-50% of your density. Gone follicles are gone. The goal is catching miniaturization while follicles are still producing hair—even if it's thinner.

Some treatment options when prevention isn't enough:

Minoxidil — Increases blood flow, prolongs growth phase. Available OTC in 2% and 5% strengths. Requires daily use indefinitely. Can reverse miniaturization in follicles that aren't too far gone.

Finasteride/dutasteride — Blocks DHT production. Off-label for women, contraindicated in pregnancy, but prescribed for postmenopausal women.

Spironolactone — Anti-androgen that blocks DHT receptors. Often prescribed for women with PCOS or androgenic alopecia.

Low-level laser therapy — FDA-cleared laser caps use red light to stimulate follicles. Expensive, requires consistent use, shows modest improvements.

PRP (Platelet-Rich Plasma) — Injections of concentrated growth factors stimulate follicle regeneration. Emerging science with promising results.

Hormone replacement therapy — Restoring estrogen and progesterone in perimenopause/menopause significantly improves hair health for many women.

My Personal Experiment: Understanding Root Causes

At the same that that I was doing this research, I also got my blood work. Turns out my ferritin (iron) was low and I was copper deficient—both were too low for optimal hair growth. Those were reversible causes I could actually fix.

So now I'm supplementing with Cooper Complete Basic One Multivitamin & Mineral Support with Iron plus Nutrafol for Women 45+, the most-recommended hair growth vitamin I kept hearing about. I'm also trying to get adequate sleep, which is always a challenge with 3 kids and a busy consulting practice!

Full transparency: it hasn't been long enough to see results (hair needs 3-6 months minimum). But the bigger win has been understanding the biology, finding actual deficiencies through testing rather than guessing, and catching potential problems early.

I'll report back on Nutrafol, but the bigger win has been understanding the biology and catching potential problems early.

The Bottom Line: Think Like a Detective, Not a Consumer

Hair loss after 40 affects up to 50% of women. But "common" doesn't mean "inevitable" or "untreatable."

The mistake most of us make is jumping to products without understanding what's broken. We're trying to fix the car without diagnosing the problem.

For me, this investigation shifted my mindset from anxiety to agency. I can't control genetics, but I can control how I care for my scalp, what I eat, how I manage stress, and when I intervene.

That's not nothing. That's actually everything.

What about you? Have you noticed hair changes? Gotten blood work? Seen a specialist? Hit reply and tell me—your experience could help other women know what to ask for.

xo,

Lilly

PS. Please share this with a friend or family member who may benefit from learning about the science of hair loss and preserving his/her follicles before its too late!

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Note: While I love diving deep into research and sharing what I've learned about women's health and wellness, I want to be crystal clear: I'm a passionate health advocate and researcher, not a medical professional. Think of me as your well-informed friend who does extensive homework – but not your doctor.

Everything I share in HeraSphere comes from careful research and personal experience, but it's meant to inform and inspire, not to diagnose or treat any medical conditions. Your body is uniquely yours, and what works for one person might not work for another. Always consult your healthcare provider before making significant changes to your diet, exercise routine, or wellness practices, especially if you have underlying health conditions or take medications.

ICYMI: Here are a few prior issues related to sleep, skin health and immunity - all factors for hair loss