High DHT levels, more than likely.
Believe it or not, what is believed to cause Male Pattern Baldness is often a cause for hirsutism, or facial hair growth, in women. DHT is a sex steroid and an androgen hormone that is formed from the conversion of testosterone into a more potent form instead of converting into estrogen. An enzyme, 5α-reductase, synthesizes DHT in the adrenal glands, hair follicles, testes and prostate in men and in the ovaries in women. It is responsible for growth of the prostate in males and the beginning of puberty in females. Excess levels can cause balding (androgenic alopecia) and in women it is likely to cause thinning of the hair on the head and excess hair growth in the pubic region, breast area, or on the face. Excess amounts can also lower libido and cause acne.
The role of hormones
DHEA is the precursor to testosterone and is often high in conjunction with high testosterone or high estrogen, but in some cases neither testosterone nor estrogens are high while DHEA may be elevated. This could indicate that there is an imbalance in the ratio of the two and the body is attempting to correct it. How does it often do that? By upregulating the 5-alpha reductase, thereby causing elevated DHT. In women, hair loss has actually been linked to higher testosterone:estrogen ratios ratios than non-thinning women. In younger balding men, elevated estrogen levels are also common. Typically in both males and females, an imbalance of the testosterone:estrogen ratio is associated with hair loss when the estrogen is higher. In females, when the testosterone is higher, you typically see facial hair growth, amenorrhea, and acne although this is not always the case. I have seen high levels of DHEA and DHT and normal levels of both testosterone and estrogen. In this case, I often look at the thyroid. For many men, an underactive thyroid also coincides with a lower-than-desired testosterone:estrogen ratio (the inverse is true for women usually). These levels lead to higher DHT conversion, which then leads to hair loss in men and hirsutism and/or alopecia in women.
Check your hormone levels and thyroid function
The endocrine system, and specifically your adrenals and thyroid, are the body’s center for hormone production and regulation due to the top down signaling cascade. If you have an underperforming thyroid, you probably often have cold hands/feet, poor circulation, nagging fatigue, irritability, a low body temperature, and imbalanced hormone levels. Another external symptom of a suppressed thyroid gland (or hypothyroidism) is a decrease in eyebrow hair thickness on the outside of your eyebrows.
It is important to get your hormones checked if you have any of the aforementioned symptoms. Some other factors to take into consideration are endocrine disruptors such as herbicides, pesticides, plastics, chemicals from the halide family (fluoride, chloride, and bromide), electromagnetic pollution, and stress. Adrenal, pituitary, and sex organ tumors are less prevalent causes but should be ruled out as well. That being said: Below are a few suggestions for those with thinning hair and those with hirsutism.
Help for hirsutism (facial hair growth in women)
- Drink Spearmint tea. Generally people find that three cups per day is the magic number. Don’t expect immediate results, but over the course of a few months, there should be noticeable improvement.
- Balance your hormones with herbs. Schizandra and Vitex agnus-castus are two of my favorite herbs because of their ability to tonify organs as well as modulate hormone signaling.
- De-stress. Deep breathing exercises, meditation, not overextending yourself, and yoga are all great techniques for decreasing stress.
Androgenic alopecia (hair loss) and thinning hair
- Essential oil blends of ylang ylang, lavender, and rosemary carried in coconut oil can be applied topically daily to areas of reduced hair growth on the scalp. The combination awakens the follicles and can strengthen hair that may be weakened due to poor nutrient absorption caused by high DHT.
- Get labs done to measure ferritin, iron saturation levels, total iron binding capacity, and thyroid hormone levels. Low iron can contribute to hair loss and can cause low thyroid function as well.
- Digestive enzymes are helpful for safeguarding against poor nutrient absorption. Remember, hair growth requires cellular energy, which requires a certain recipe of nutrients. A biotin and vitamin E supplement may not be the end all and be all of hair and nail treatments.
- Again, de-stress. And examine the meds you are taking. Accutane, anti-depressants, birth control pills, and blood thinners often have an effect.
- Ashwaganda is a great herb to help nourish the adrenals and modestly increase testosterone. For those with a low testosterone: estrogen ratio, this would be very beneficial.
- Essential fatty acids are extremely important in nearly all aspects of health. If the hair loss is due to an inflammatory process, one should consume more of the EPA component of fish oils or EFA’s.
Testing for an imbalance in hormones often requires more than just examining the estrogen, testosterone, and progesterone levels in the body. A thorough look at the hormones from the pituitary to the sex organ output is often necessary. Heavy metal levels in the body should also be considered as high levels of mercury can contribute to hair loss. Those with mercury amalgam fillings should consider a safer alternative.
Autumn Frandsen N.D. is a Naturopathic Physician at National Integrated Health Associates, NIHA, serving Washington D.C., Maryland and Virginia. As a naturopath, her philosophy is to use the least invasive and effective method to bring balance to the body and restore health. Her areas of focus include Allergies, Environmental Medicine and Chemical Sensitivities, Homeopathy and Herbal Medicine, Heavy Metal Detoxification, Anti-Aging and Weight Loss.