But sometimes, it is not as surface-level as it seems, but rather a deeper, more concerning sign of health issues. The focus should be on broadening attention to consider underlying health factors that may result in hair shedding, rather than simply doubling down on oiling or hair treatments.
Dr Debraj Shome, Director & Co-Founder, The Esthetic Clinics (TEC) addressed this concern and told HT Lifestyle about the connection between hair health and systemic wellness.
He said, "Hair follicles are among the most metabolically active structures in the human body, requiring a steady supply of nutrients, hormones, and oxygen to maintain their rapid growth cycle. When the body faces physiological stress, hair follicles are sometimes the first to suffer, making hair loss a potential early warning system for various medical conditions, such as diabetes, hormonal problems, stress, depression, poor nutrition, vitamin deficiencies, and thyroid disorders, to name a few."
So this raises a very valid point that your hair loss is not always a cosmetic concern, but a very well body's first distress signals, reminding the need to search for deeper root causes to these otherwise common problems.
Dr Debraj Shome listed out the 4 possible health issues that may be the root causes of hairfall:
1. Iron deficiency
- One of the most common causes of chronic hair fall in Indian women is iron deficiency, often without anaemia.
- Even marginal drops in ferritin, a protein that stores iron, can push the follicles into dormancy.
- Studies have shown that low ferritin levels correlate with more severe telogen effluvium, particularly in menstruating women and those with restrictive diets.
2. Thyroid dysfunction
- Thyroid hormones control the growth, differentiation, metabolism, and thermogenesis of body cells, making the thyroid-hair connection particularly significant.
- Studies show that alopecia is a symptom in approximately 50% of people who experience hyperthyroidism and 33% of those with hypothyroidism.
- The pattern typically manifests as diffuse thinning across the scalp, affecting both men and women equally.
3. Autoimmune diseases
- Hair loss can also be the body's way of signalling autoimmune activity.
- Alopecia areata, an immune-mediated condition, presents as smooth, coin-shaped patches of hair loss and is often associated with conditions like vitiligo, lupus, or Hashimoto's thyroiditis.
4. Cardiovascular links
- In men, early-onset androgenetic alopecia has been linked to increased risk of metabolic syndrome and heart disease.
- A 2025 study published in the Journal of Medical Sciences and Health found that early onset androgenetic alopecia can be a clinical marker of cardiovascular issues such as metabolic syndrome, atheromatous plaques, hypertension, obesity and hyperlipidemia.
As you go for a doctor's checkup, it is important to identify the timeline of the hairfall, as it would act as a valuable clue for understanding the deeper root causes. Dr Debraj Shome emphasised the value of timing.
He said, " Hair's strength lies in its timing. Its reaction is often delayed by weeks or even months, which makes it an excellent retrospective clue. For example, when a patient presents with hair shedding in March, the trigger often occurred in January. This can be an illness, weight loss, a medication, or even emotional trauma. The follicles respond slowly, but visibly. This delayed feedback loop is why thorough history-taking matters so much. A scalp may tell us that something is wrong, but only a systemic lens reveals what that is and how we can work to fix it."
He also gave a heads-up that dermatologists ask not just about recent haircare but also about sleep patterns, stress levels, nutrition, menstrual history, thyroid symptoms, and gut health, which help them arrive at a comprehensive evaluation. The evaluation also includes tests like thyroid function tests, complete blood count, iron studies, vitamin D levels, and hormonal panels.
