Stress as a cause of hair loss? Truth or myth?

[Elissa]

I was just wondering if stress as a cause of hair loss is truth or just an "old wives tale". You always hear people saying "Oh-- you lose hair from stress"... Just wanted to know if there is any actual scientific documentation to back that up. Like HOW can stress cause hair loss?

I am asking because I am under a constant state of stress from chronic illness (CFIDS) and I want to know if just stress MAY be the cause of my hair loss. Then again I have been ill for 6 years now and my hair loss (on my head) is only the past year and a half. The hair loss on my body is the most recent and has only been happening a month or two.

I recently had an ACTH stimulation test done to test my adrenal function (results pending) and if my adrenal glands arent working sufficiently, that would again go back to a cause of stress (low cortisol would explain my body's inability to deal with stress).

So yeah.. the question of stress and it's relationship to hair loss has been on my mind lately with everything I have been going through lately. (Not to mention the stress and anxiety I have been experiencing FROM the hair loss itself.) Just not sure if there is science to back it up. Wanted your opinions. Thanks ladies! :>

[Women's Hair Loss Project]

I was just wondering if stress as a cause of hair loss is truth or just an "old wives tale". You always hear people saying "Oh-- you lose hair from stress"... Just wanted to know if there is any actual scientific documentation to back that up. Like HOW can stress cause hair loss?

I am asking because I am under a constant state of stress from chronic illness (CFIDS) and I want to know if just stress MAY be the cause of my hair loss. Then again I have been ill for 6 years now and my hair loss (on my head) is only the past year and a half. The hair loss on my body is the most recent and has only been happening a month or two.

I recently had an ACTH stimulation test done to test my adrenal function (results pending) and if my adrenal glands arent working sufficiently, that would again go back to a cause of stress (low cortisol would explain my body's inability to deal with stress).

So yeah.. the question of stress and it's relationship to hair loss has been on my mind lately with everything I have been going through lately. (Not to mention the stress and anxiety I have been experiencing FROM the hair loss itself.) Just not sure if there is science to back it up. Wanted your opinions. Thanks ladies! :>

Hi Elissa,

Stress can cause hair loss, however I think the type of stress that causes hair loss is *usually* extreme traumatic stress. The type of stress that may occur after the death of a loved one or after having surgery.

But there are other ways the body is put under stress, medications can cause stress on our bodies, not enough nutrition as usually evident in anorexics is a big stress on the body. We all handle things differently as well, so something I may not consider to be an extremely stressful situation may be a highly stressful situation for another person. Everyone is different.

I get highly irritated when doctors fluff hair loss off as stress without even making the slightest effort to get to the root (no pun intended) cause of the hair loss itself. I was personally "Diagnosed" with "stress" a number of times LOL. I think most every woman with hair loss has been told that at least once. I personally feel more often than not, plain ole stress isn't usually the culprit.

A good place to start is to figure out if your hair is actually exhibiting miniaturization. A doctor that frequently treats people with hair loss will most likely make use of a tool called a Densitometer, or something equivalent. If miniaturization is present androgenetic alopecia is the likely diagnosis. If no miniaturization is present, grab the girls and head to the bar to celebrate. At that point, I think you and your physician will have to be detectives in trying to figure out what is causing the excessive telogen effluvium. I have miniaturization present and I knew it very very early on, it took several doctors later to confirm what I already suspected, which is why I wandered down the path of using various treatments to combat it.

Boy, I just rambled on and on and on. Did I even answer your question? :D

[Angela]

Stress as a cause of hair loss is a hot button debate for me. LOL I HATE when doctors flippantly say its stress after finding out a little about our daily struggles.
I do believe that if adrenals are an issue, that cortisol could be the culprit, but that doesn't mean its stress.
If its true that stress causes hair loss, than every man, woman and child caught in the most horrific of circumstances, such as war torn countries, should ALL be bald. People in other countries working in sweatshops, prostitution, rotting in a jail where they are raped on a daily basis...all these things can cause a huge amount of stress.
Hot, hot debate for me, can you tell? AHAHAH! I really feel that the "stress" thing is a cop out or a way for many doctors to be lazy and not seek out the cause of hair loss.
We can make just about anything into a stressful situation, but without proof that stress is actually the cause (by blood work showing adrenal insufficiency) how can such people make that determination.

Further, the pictures and illustrations that are made of someone under stress is usually of a person actually PULLING OUT THEIR HAIR! How is that the same as hair that is falling out on its own? That mental picture tells a thousand FALSE words. There is a disorder that affects men and women where they pull their hair out...but should that be confused with our types of hair loss?
I don't agree with the assertion that stress causes hair loss at all. I think its a bunch of hooey. Unfortunately, many men and women truly believe that stress has caused their hair loss, which in the end makes THEM feel like they can not cope or handle life or struggles in a productive and meaningful way. It points back to the hair loss sufferer and treats them like some sort or unstable person. Of course this is all unconscious.
Do you think the person with hair loss problems fails to get a job because of the way they look, or is it possible that the underlying reason is that the employer believes that stress is the primary reason for hair loss in the first place. Upon viewing a person with hair loss, unconsciously, isn't it possible that they pass that person over for a position because they think they won't be able to handle the high stress job they are applying for?

I think I should stop here, because I'll go on and on forever and bore everyone to death with my thoughts and rants. LOL

[Elissa]

Thank you both for answering so quickly! I realize it's a hot button issue.. I get pissed every time someone mentions that stress may be the cause (the doctors never said this, but family members have) because I have been under stress forever. Havent we all? And yeah.. now I see what you mean about people in war torn countries.. How come they arent all bald? Or maybe it's how we each individually COPE with stress? That's why I brought up the adrenals.. The theory is that someone with adrenal insufficiency can't cope with stressors because of the low cortisol. But I cant find any info anywhere online linking low adrenal function with hair loss specifically. I guess I was trying to link it myself. I just want an explanation for my hair loss already! And the recent body hair loss is just scary. And my internist and "hair loss expert" gave me NO answers on what medical conditions could cause that. I feel like I am left to play doctor/researcher!

I went to the "hair loss expert" about 5 times now. He looked at my scalp with a hand held microscope thingie... He said my hair looks thick.. He never mentioned anything about miniaturization and I never knew to ask him. I asked if he wanted to do a scalp biopsy and he said "no". he said it would not really tell him anything. (I know another woman who did get a scalp biopsy from this doc so I do know he perfroms them). I am just getting no real answers. First we thought my low copper levels were the culprit.. but then my internist did more extensive testing and doesnt think copper is the cause. Then I thought low iron based on everything i read here. My internist said that if he tested the ferririn levels of everyone in his office they would all come out in normal or low normal range, but we are all not walking around bald. He wasnt concerned about my low ferritin because it was in "normal" range. My hiar loss can not be from my thyroid because my thyroid levels have been PERFECT for a long time now (I have been treated for hypothyroidism for 5 years now but the hair loss is only the last year and a half) and I am constantly getting my levels checked. I am on Armour thyroid which is supposed to be the "better" thyroid medication. I am on my optimal dose. I am not on ANY other prescription meds.. so meds wouldnt be the cause of my hair loss. All the vitamins and supplements i started taking FOR hair loss (multivitamin with minerals, iron, copper, l-lysine, biotin). I have had ALL of my hormones tested. I do not have PCOS. My DHT is normal and my testosterone is low and all my other hormones are NORMAL. So I am truly left thinking "What is causing my hair loss?" I think I stumped my doctors. My last theory was the adrenals, but no one seems to know if that is even a cause of hair loss.. I am guessing because I can't find info and neither doctor really answered me :(

I am just so confused. Thank you all so much for your inout and info and understanding.

[Elissa]

Hi Elissa,

Stress can cause hair loss, however I think the type of stress that causes hair loss is *usually* extreme traumatic stress. The type of stress that may occur after the death of a loved one or after having surgery.




Do you know if there is any scientific documentation out there that explains how a traumatic event or stress can cause hair loss? I searched, but I can't find any info. If you know of any such articles, please let me know. I can't seem to find a concrete explanation anywhere. Thank you so much !!! :>

[Angela]

Everything is based on "theory." It isn't the stress, but the stress hormones which can go into over drive. That is where the rubber hits the road. I believe that a person should have their hormones tested to see what those levels are before believing that it is contributing to hair loss. Here is an article about how stress works in the body and the theories that they have put to the test. This article is by the National Institute of Health:

http://www.nih.gov/news/nihback.gif NATIONAL INSTITUTES OF HEALTH

National Institute of Child
Health and Human Development (http://www.nichd.nih.gov/)
FOR IMMEDIATE RELEASE
Monday, September 9, 2002

NICHD Contact:
Robert Bock (rb96a@nih.gov)
(301) 496-5133 NIMH Contact:
Marilyn Weeks (nimhpress@nih.gov)
(301) 443-4536

Stress System Malfunction Could Lead to Serious, Life Threatening Disease
Whether from a charging lion, or a pending deadline, the body’s response to stress can be both helpful and harmful. The stress response gives us the strength and speed to ward off or flee from an impending threat. But when it persists, stress can put us at risk for obesity, heart disease, cancer, and a variety of other illnesses. Perhaps the greatest understanding of stress and its effects has resulted from a theory by George Chrousos, M.D., Chief of the Pediatric and Reproductive Endocrinology Branch at the National Institute of Child Health and Human Development (NICHD), and Philip Gold, MD, of the Clinical Neuroendocrinology Branch at the National Institute of Mental Health (NIMH).
Introduction
A threat to your life or safety triggers a primal physical response from the body, leaving you breathless, heart pounding, and mind racing. From deep within your brain, a chemical signal speeds stress hormones through the bloodstream, priming your body to be alert and ready to escape danger. Concentration becomes more focused, reaction time faster, and strength and agility increase. When the stressful situation ends, hormonal signals switch off the stress response and the body returns to normal.
But in our modern society, stress doesn’t always let up. Many of us now harbor anxiety and worry about daily events and relationships. Stress hormones continue to wash through the system in high levels, never leaving the blood and tissues. And so, the stress response that once gave ancient people the speed and endurance to escape life-threatening dangers runs constantly in many modern people and never shuts down.
Research now shows that such long-term activation of the stress system can have a hazardous, even lethal effect on the body, increasing risk of obesity, heart disease, depression, and a variety of other illnesses.
Much of the current understanding of stress and its effects has resulted from the theory by Drs. Chrousos and Gold. Their theory explains the complex interplay between the nervous system and stress hormones — the hormonal system known as the hypothalamic-pituitary-adrenal (HPA) axis. Over the past 20 years, Dr. Chrousos and his colleagues have employed the theory to understand a variety of stress-related conditions, including depression, Cushing’s syndrome, anorexia nervosa, and chronic fatigue syndrome.
The Stress Circuit
The HPA axis is a feedback loop by which signals from the brain trigger the release of hormones needed to respond to stress. Because of its function, the HPA axis is also sometimes called the “stress circuit.”
Briefly, in response to a stress, the brain region known as the hypothalamus releases corticotropin-releasing hormone (CRH). In turn, CRH acts on the pituitary gland, just beneath the brain, triggering the release of another hormone, adrenocorticotropin (ACTH) into the bloodstream. Next, ACTH signals the adrenal glands, which sit atop the kidneys, to release a number of hormonal compounds.
These compounds include epinephrine (formerly known as adrenaline), Norepinephrine (formerly known as noradrenaline) and cortisol. All three hormones enable the body to respond to a threat. Epinephrine increases blood pressure and heart rate, diverts blood to the muscles, and speeds reaction time. Cortisol, also known as glucocorticoid, releases sugar (in the form of glucose) from the body reserves so that this essential fuel can be used to power the muscles and the brain.
Normally, cortisol also exerts a feedback effect to shut down the stress response after the threat has passed, acting upon the hypothalamus and causing it to stop producing CRH.
This stress circuit affects systems throughout the body. The hormones of the HPA axis exert their effect on the autonomic nervous system, which controls such vital functions as heart rate, blood pressure, and digestion.
The HPA axis also communicates with several regions of the brain, including the limbic system, which controls motivation and mood, with the amygdala, which generates fear in response to danger, and with the hippocampus, which plays an important part in memory formation as well as in mood and motivation. In addition, the HPA axis is also connected with brain regions that control body temperature, suppress appetite, and control pain.
Similarly, the HPA axis also interacts with various other glandular systems, among them those producing reproductive hormones, growth hormones, and thyroid hormones. Once activated, the stress response switches off the hormonal systems regulating growth, reproduction, metabolism, and immunity. Short term, the response is helpful, allowing us to divert biochemical resources to dealing with the threat.
Stress, heredity, and the environment
According to Dr. Chrousos, this stress response varies from person to person. Presumably, it is partially influenced by heredity. For example, in most people the HPA axis probably functions appropriately enough, allowing the body to respond to a threat, and switching off when the threat has passed. Due to differences in the genes that control the HPA axis, however, other people may fail to have a strong enough response to a threat, while still others may over respond to even minor threats.
Beyond biological differences, the HPA axis also can alter its functioning in response to environmental influences. The HPA axis may permanently be altered as a result of extreme stress at any time during the life cycle — during adulthood, adolescence, early childhood, or even in the womb.
If there are major stresses in early childhood, the HPA feedback loop becomes stronger and stronger with each new stressful experience. This results in an individual who, by adulthood, has an extremely sensitive stress circuit in place. In life threatening situations — such as life in an area torn by war — this exaggerated response would help an individual to survive. In contemporary society, however, it usually causes the individual to overreact hormonally to comparatively minor situations.
Effects on the body
Stress and the Reproductive system
Stress suppresses the reproductive system at various levels, says Dr. Chrousos. First, CRH prevents the release of gonadotropin releasing hormone (GnRH), the “master” hormone that signals a cascade of hormones that direct reproduction and sexual behavior. Similarly, cortisol and related glucocorticoid hormones not only inhibit the release of GnRH, but also the release of luteinizing hormone, which prompts ovulation and sperm release. Glucocorticoids also inhibit the testes and ovaries directly, hindering production of the male and female sex hormones testosterone, estrogen, and progesterone.
The HPA overactivity that results from chronic stress has been shown to inhibit reproductive functioning in anorexia nervosa and in starvation, as well as in highly trained ballet dancers and runners. For example, in one study, Chrousos found that men who ran more than 45 miles per week produced high levels of ACTH and cortisol in response to the stress of extreme exercise. These male runners had low LH and testosterone levels. Other studies have shown that women undertaking extreme exercise regimens had ceased ovulating and menstruating.
However, the interaction between the HPA axis and the reproductive system is also a two way street. The female hormone estrogen exerts partial control of the gene that stimulates CRH production. This may explain, why, on average, women have slightly elevated cortisol levels. In turn, higher cortisol levels, in combination with other, as yet unknown, factors, may be the reason why women are more vulnerable than men to depression, anorexia nervosa, panic disorder, obsessive compulsive disorder, and autoimmune diseases like lupus and rheumatoid arthritis.


For the rest of the article here is the a link to the page...I couldn't fit the whole article in this post:

http://www.nih.gov/news/pr/sep2002/nichd-09.htm

[Elissa]

Thank you so much for sharing this article.. I skimmed through it and I'll read it later when I have time to read it more thoroughly...

So far it looks like a LOT of what i have been reading. I have been researching/reading about the HPA axis and it's connection to CFIDS for awhile now. I am hoping the ACTH stimulation test i had done wednesday will show whether or not I have some form of Addisons or adrenal dysfunction like my internist believes. I just couldnt find anywhere whither or not there the hair loss is caused by this. (and he couldnt tell me either.. between teh internist and the hair loss doc neither of them know if adrenal dysfunction causes hair loss?) But I guess if hair loss can be caused by hormones which are out of whack under stress, that makes sense ( i have to read through that article more thorouhgly later when my brain turns on.. I am not sure if i am interpreting it correctly.)

Gah-- I am pretty brain fogged right now.. But thank you SO much for posting the article.. i am printing it out right now *HUGS*

[Elissa]

Angela-

Thank you SO much for posting that article.. I printed it out and read it last night and toward the end of it it does mention body hair loss! The is is the first time I am seeing anything about hair loss mentioned with adrenal dysfunction! Check out this quote from the article.. it even mentions Chronic Fatigue Syndrome (CFIDS) which I have!

"Although many disorders result from an overactive stress system, some result from an under active stress system. For example, in the case of Addison’s disease, lack of cortisol causes an increase of pigment in the skin, making the patient appear to have a tan. Other symptoms include fatigue, loss of appetite, weight loss, weakness, loss of body hair, nausea, vomiting, and an intense craving for salt. Lack of the hormone CRH also results in the feelings of extreme tiredness common to people suffering from chronic fatigue syndrome."

I cant wait to get back theh results from the ACTH stimulation test I had done Wednesday. I still dont understand why the hair loss expert doc and teh internist couldnt answer me when I asked both of them if adrenal dysfunction causes hair loss and if this was possibly the cause of my hair loss. I feel like doctors are so clueless when it comes to hair loss. Also-- neither of them seemed too alarmed with my SUDDEN loss of body hair. You would think that would seem strange, no?

Thanks again... You and everyone else have been so helpful to me.
*HUGS* :>

[Angela]

You're welcome hon. I think the main thing to remember is that "stress" in and of itself doesn't cause hair loss. It is the hormones that regulate our ability to handle stress that are really the culprit. That's why I feel it is so important to challenge any doctor that assumes that stress is the cause of a person's hair loss. How could he possibly know it is stress unless he can quantify it with measurable results? I think that any man or woman that is thrown that diagnosis..."its just stress", should ask the doctor to back that up with real evidence. If he is saying that it is stress than he won't mind running the tests to check for adrenal insufficiency. Not just that, but hair loss is not the only symptom, and by him just brushing it off as "stress" he is also neglecting the possibility that other body systems may be at risk for serious complications.
They should be held accountable for their flippant diagnosis without having verifiable proof! Maybe then they will be less inclined to say stupid things.
I can't wait till the day comes when a doctor is sued for saying such things, neglecting the real problem, causing a person extreme physical and emotional duress and winning a large settlement of money. That seems to be the only thing that makes people perk up and listen. Maybe doctors will learn from such things and be more careful and less lazy or apathetic in how they treat their patience.

[janetknight]

It's quite annoying when someone gives a quick or offhand comment about hair loss. Stress can be a cause, but life is stress! Seriously, the causes of hair loss are many and cannot be quickly dismissed by some flippant comment. Each of us knows the personal pain of managing and trying desperately to solve this issue - JK

[divinem]

I don't know about emotional stress, but I've had physical stress cause hair loss (major surgeries, losing 165 lbs. in a year, and the physical stress of autoimmune disease).

Emotional stress? Hmmm... In one year, I went through a divorce, became the singe mother of an 18 mos. old child, learned my mother was terminally ill, went through major departmental changes at work where I effectively committed corporate political suicide, was hospitalized with pneumonia and then my grandmother (who raised me) died. I didn't lose any hair then.

So personally, no, I am not a believer that emotional stress causes hair loss.

Hope this helps.

~Melissa

[Angela]

Wow, you said a mouthful! :eek:

[divinem]

Wow, you said a mouthful! :eek:

Kinda succinct with key argument points, eh? LOL

[Angela]

Yes it is, although extreme emotional stress over a period of years can actually breakdown a person's physical health. That doesn't necessarily point to hair loss however. Digestive problems, fertility problems, blood pressure and stuff like that are usually affected by extreme emotional stress. I think it also depends on a person's constitution.
I was watching a show on Discovery Channel about this woman who had a tumor growing on her adrenals. This woman went through 16 years of extreme anger and fits of rage, was horrible to her family, suffered with physical problems as a result of the tumor (neither her nor the doctors knew she had a tumor growing) and in the long 16 years she was afflicted she didn't lose any of her hair.

When I was a child, I suffered some major life stresses with my mother and where we lived...I should have been skin bald by the time I was nine years old.