Addressing Hair Loss in CFS and Fibromyalgia

Published: October 1, 2012
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Hair loss or thinning is a common and important issue, especially in those who have CFS or fibromyalgia.

If you're experiencing hair loss in a generally thinning way (diffuse), then addressing:

  1. nutritional deficiencies and
  2. an underactive thyroid

... are especially important.

Low iron is a key nutrient for hair growth, and standard testing misses most cases of iron deficiency. In fact, despite the fact that most physicians consider a ferritin blood test (the best measure of iron deficiency or excess) over 12 to show adequate iron, a recent study in patients with chronic illness and even mild anemia (a description fitting most people with CFS) showed that a ferritin under 100 was diagnostic of iron deficiency!

In addition, for those with Restless Leg Syndrome (RLS) and a ferritin under 60, iron can be more effective than the medication Requip, and can eliminate RLS as well as your iron levels optimize.

In CFS and fibromyalgia patients, as in any chronic illness, a very common cause of unusual hair loss is a condition called "Telogen Effluvium." This is when the normal cycles of natural growing and falling out of the hair follicles become jolted out of their usual random phase due to illness. In this condition, a severe physical stress — such as pneumonia or a CFS flare up — can produce unusual hair loss which doesn't begin until 3-9 months later. This type of hair loss is reversible, although it can take 3-9 months. It often grows in more quickly than this, but it's better to be pleasantly surprised than to feel disappointment and abandon the needed Rx too quickly.

To address hair thinning:

  1. Optimize overall nutritional support. A good multivitamin powder is excellent for this, plus take a 29 mg iron tablet for 6-12 months (until the ferritin is over 100). Do not take iron if the ferritin is over 200 (and have your doctor check for iron excess called hemochromatosis, which is easy to address but life threatening if missed).
  2. Optimize thyroid function — even if your thyroid labs are "normal."

Addressing with the SHINE Protocol overall will also help hair growth as well as dramatically improve the quality of life in CFS and fibromyalgia.

Please note that the above applies only to stress-induced hair loss, which is evidenced by widespread thinning. Other patterns have a different cause. For example:

  1. Autoimmune issues. In this condition, hair loss appears as multiple coin-shaped bald spots called alopecia areata.
  2. Male pattern baldness. If present in a woman, this suggests elevated testosterone and DHEA . If these are present, and a fasting morning insulin blood test is over 10 (showing insulin resistance), this would suggest the presence of PCOS (polycystic ovarian syndrome). This improves by addressing the insulin resistance with the medication metformin (very safe and helpful in PCOS) and eliminating excess sugar.
Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. His newest book (June 10, 2024) is You Can Heal From Long COVID. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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