Ferritin and Hair Loss in woman

Low serum ferritin hair loss?

Iron deficiency is defined as having a ferritin level of under 40ng/ml or iron saturation of Ferritin under 20%.

Iron deficiency is the most common cause of Chronic Telogen Effluvium ( CTE) in premenopausal women ('During one period, a woman will lose around 10-15 mg of iron, while throughout a pregnancy around 600-1000mg will be lost) . 72% of women in the premenopausal group were found to have iron deficiency as the cause of Chronic Telogen Effluvium (CTE).

In postmenopausal women; medications are the most common cause of telogen effluvium.

The loss of this ferritin from the follicle cells can affect the ability of the hair to grow. This leads to the development of vellus (non pigmented fine hairs), which can be an early indication of deficiency. The presence of vellus hairs is easily mistaken for miniaturized hair seen in androgenic alopecia. We should note here that Iron deficiency hair loss could therefore mimic the pattern of androgenic alopecia hair loss.

When low ferritin levels and female hair loss coexist, the patient is most likely diagnosed with Chronic Telogen Effluvium, or CTE. This hair loss condition usually occurs in women of childbearing age (18-50 years old), and results in evenly-distributed hair loss. Women with low serum ferritin hair loss usually notice one of two things:

• Increased loss of hair during shampooing or brushing.
• Less density of hair, as in a thinner feeling ponytail, or less hair to clip back.

If iron levels are insufficient to maintain blood health, the body "robs" iron from other cells. Since hair is not as essential to the body as is blood, the body often sacrifices the less important function of hair growth for the essential function of blood maintenance.

It is important to note that hemoglobin is the standard measure for iron in the blood, and while hemoglobin levels can diagnose anemia, they do not always correspond with low serum ferritin hair loss. A woman can have plenty of hemoglobin, yet still suffer from low serum ferritin levels

Rushton suggests that serum ferritin concentrations of 40 ng/mL or greater are required for maintaining good hair while 70ng/ml is required for regrowth

Iron metabolism

 

Total body iron averages approximately 3.8 g in men and 2.3 g in women.

Typically about 65% of the iron is in hemoglobin (in red blood cells) and about 4% in myoglobin (in skeletal muscle). About 30% of the iron in the body is stored (as ferritin or hemosiderin) in liver, bone marrow, and the spleen other tissues cells. A small percentage of the body's iron is in transport between various compartments of the body (in association with transferrin) or is a component of enzymes in cells throughout the body.

 Ferritin is a protein complex that contains about 23% iron. It's formed in the intestine when iron unites with a special protein called apoferritin. It is then stored in the body's tissues, especially the liver, spleen, and bone marrow.

Iron Deficiency and Ferritin:

Iron is stored mainly in the liver, within the iron storage proteins ferritin and hemosiderin. Iron stimulates the liver to make ferritin, and serum ferritin provides a reliable estimate of body iron stores. Ferritin is a protein found inside cells that stores iron so your body can use it later. Some Ferritin is released in the blood when the cell uses the iron. The amount of ferritin in your blood (serum ferritin level) is directly related to the amount of iron stored in your body.

Lower-than-normal levels may be due to:

• Heavy menstrual bleeding
• Intestinal conditions that cause poor absorption of iron
• Iron deficiency anemia

The fall of iron stores normally passes through several stages: lowered iron stores, iron depletion and iron deficiency anemia.

1) Lowered iron stores: This is indicated when the iron stores are reduced but not exhausted. No clinical effects are detected.
2) Iron depletion: Shows up in laboratory tests. Hemoglobin concentration may be well below ‘normal’ for that individual’s reference range. This can be detected by Ferittin Test.
3) Iron deficiency anemia: No iron is left remaining in the bone marrow. Hemoglobin production falls to the point where concentration is well below the reference range.

It is important to note, therefore, that iron deficiency (low iron stores, i.e. low ferritin) can occur even if the patient is not clinically anemic and has normal haemoglobin levels

The deleterious effects of iron deficiency are partly due to impaired delivery of oxygen to the tissues and to a deficiency of iron-containing compounds. Clinical features include restlessness and irritability lower IQ scores in adolescent girls fatigue in nonanaemic women, and abnormalities in response to infection and impaired T-cell proliferation.

It is believed that as people have reduced or do not have red meat intake

There may be a number of reasons why the amount of iron absorbed is not sufficient. Firstly, only about 10% of ingested iron is absorbed into the blood each day, and this is dependent on the type of food in the diet. Certain foods may inhibit the absorption of iron, such as tanins found in tea and coffee, also bran and egg albumin.

One can lose iron by: intestinal bleeding, excessive menstrual bleeding, poor digestion, long-term illness, ulcers, and heavy use of anti-acids. [Irritable bowel syndrome too]

Controlling iron deficiency

You can maximize your iron absorption by eating a combination of iron-rich foods such as red meat, green, leafy vegetables, shellfish, egg yolk, nuts and cereals with food or drinks that are high in vitamin C for example, a glass of freshly squeezed orange juice.  Avoid tea until at least an hour after eating as it contains tannin, which interferes with iron absorption.

One method of controlling iron deficiency in the body is to stimulate the liver to synthesize ferritin, the protein that stores iron in order to maintain the correct balance. Hair follicles are known to contain ferritin, and when the circulating stores of ferritin decline then these stores are called upon to ensure support for more essential cells, such as bone marrow.

Treatment:

1.     Eat a balanced diet that includes plenty of iron. Sources include red meat, spinach, broccoli, prune juice, kidney beans and chickpeas.

2.     Add Vitamin C-rich foods to your diet to help boost absorption of iron: Vitamin C sources are citrus fruits and juices, berries, green peppers, tomatoes, broccoli and spinach.

3.     Iron supplementation. The use of an iron supplement may help low ferritin hair loss by adding more iron to your system. The rationale for iron supplementation is that once the serum level is raised to the necessary threshold point, hair growth will resume. However, one of the biggest drawbacks to this type of treatment is that it takes a long time, because ferritin levels must be increased gradually. Allow 2-3 months for hair to stop shedding, and 6 - 12 months for new hairs to become long enough to make a visible impact. Woman usually needs between 18 and 30 mg daily
Excess iron can accumulate in the body. This increases the risk of heart disease, cancer, and some other conditions that are worse than hair loss.
Many people find that eating red meat is a better option than pills when serum ferritin levels are low. The iron in red meat is absorbed well.

"If you need to take iron supplements, do not take them at the same time as vitamin E, Antacids, tea or coffee. And choose an organic form of iron such as ferrous gluconate or ferrous fulmerate. Inorganic forms of iron, such as ferrous sulfate, can oxidize vitamin E.  Only about 10% of ingested iron is absorbed into the blood each day, and this is dependent on the type of food in the diet. Take after food to reduce GI side effects. Continue treatment for 3 months after the hemoglobin reruns to normal so as to ensure replenish the storage.

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