Hair loss or hair shedding is often reported several months after transitioning to a whole food plant-based (WFPB) diet. The medical term for the condition is telogen effluvium, a temporary scalp disorder characterized by increased shedding of hair resulting from the premature conversion of hair follicles from the growing (anagen) phase to the resting (telogen) phase. In the normal scalp hair cycle about 85% of your hair is in the growing phase (for up to 4 years each follicle). At the end of its growing phase the follicle enters the resting phase for approximately 4 months after which the hair sheds and a new 4-year cycle of growth begins. A “trigger event” can cause a larger than usual number of hair follicles to stop growing and enter the resting phase, which you will only notice as the daily hair shedding increases 3-4 months later. Regrowth of hair usually begins once the hair is shed but at the rate of 1cm per month it can take many months to show and up to a year to return to normal. Telogen effluvium is a self-limiting condition that can be triggered by illness, emotional stress, drug therapies, rapid weight loss, nutrient deficiencies or hormonal changes. It should be differentiated from other conditions such as alopecia areata, an autoimmune condition that most often causes distinct bald patches, and androgenetic alopecia, the gradual, testosterone driven hair loss that most often affects males.
Changing to a WFPB diet often involves a significant and unintended reduction in energy intake due to the lower energy density of whole plant foods, which can result in a period of rapid weight loss, i.e. a “triggering event” for hair loss. Although this weight loss is often welcome, not everyone needs to lose weight and it’s not sustainable in the long term. We put a lot of effort into educating WFPB newcomers on how to source adequate calories from high carbohydrate starchy whole plant foods (see our Energy Density page).
Hair shedding may also be triggered by a rapid reduction in estrogen, a hormone that has a positive effect on scalp hair growth. The standard Australian diet (SAD) causes unnaturally high levels of estrogen (a factor in many women’s health problems). Transition to WFPB brings estrogen (and other growth hormones like IGF-1 and insulin) back down to normal levels (improving many women’s health problems). The hair follicles initially go into a withdrawal state, resulting in increased hair shedding, but gradually adapt to the reduced (normal) hormone levels and hair growth returns to normal.
Medical investigation should be considered when hair shedding is severe, prolonged or not explained by recent lifestyle changes or stress. Potential causes include thyroid hormone deficiency, any chronic disease and nutrient deficiency, particularly iron and zinc. Please note that serum zinc is not a reliable indicator of zinc status and that most people’s results are often just above or just below the bottom of the reference range. Of course many health professionals will point the finger at a plant-based diet as causing nutrient deficiencies, but if you are eating a diet of mostly whole plant foods then deficiency is unlikely to be the cause.
If you have been losing hair at an unusual rate a few months into your dietary change then you can be reassured by the fact that baldness and hair thinning does not seem to be a characteristic of women who have followed a WFPB lifestyle for many years, in fact many report their hair has never been healthier.
- Telogen effluvium – DermNet NZ
- Is telogen effluvium reversible?
- Bergfeld, W. F., & Mulinari-Brenner, F. (2001). Shedding: how to manage a common cause of hair loss. Cleveland Clinic Journal of Medicine, 68(3), 256-261.
- Goette, D. K., & Odom, R. B. (1976). Alopecia in crash dieters. JAMA: Journal of the American Medical Association, 235(24), 2622-2623.
- Malkud, S. (2015). Telogen Effluvium: A Review. Journal of Clinical and Diagnostic Research, 9(9), WE01-03.
Page created 11 June 2018
Page last updated 12 June 2018