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Hair loss and digestive discomfort, how are they related?

November 03, 2021

Caída de pelo y malestar digestivo, ¿Cómo están relacionados?

Hair loss is associated with acute and chronic disease, protein-energy malnutrition (PEM), mineral and vitamin deficiencies, and adverse effects to medications.

Within IBD (Inflammatory Bowel Disease) we find Chron's Disease, Ulcerative Colitis and IBS (Irritable Bowel Syndrome), but as we know these names are the consequences and not the causes of digestive discomfort: it is a mixed bag for intestinal dysbiosis. You can read more information about the causes of IBS here to expand information.

Let's get to it! Hair growth is divided into 4 phases, anagen, catagen, telogen and exogenous, but 85% of the hair is in the anagen phase of growth, which lasts approximately 8 years, until the hair falls off.

Most people have between 100,000 and 150,000 hairs on their scalp and shedding 25 to 100 telogen hairs per day is normal; However, anagen hair loss (growing, the first phase) It is never normal.

These follicles are metabolically very active and, as a result, very sensitive to nutritional changes, inflammation, and medication intake. In IBD patients notice increased hair loss when washing and brushing their hair and may be aware of hair loss around the house, on the pillow or on the carpets when vacuuming.

Unlike other types of alopecia, hair loss occurs diffusely, not "patchy" as would other types of autoimmune alopecia) or androgenic alopecia, very typical of PCOS (hair loss on the crown with preservation of the frontal hairline). , as we see in the image)

Androgenic alopecia

It is known that both acute and chronic diseases such as IBD can result from diffuse alopecia, but there is little literature that addresses this area beyond the association.

Systemic inflammation

Cytokines are inflammatory messengers produced by the immune system that are synthesized in situations of inflammation. We know that in IBD, despite having a notable genetic component, intestinal dysbiosis plays a relevant role. The lack of diversity of intestinal bacteria or the pathogenic proliferation of some of them produces an activation of the IS (Immune System), intestinal permeability and low production of SCFA fatty acids (anti-inflammatory), with which it is common to find a high amount of cytokines circulating in blood.

Elevated levels of cytokines IFN-γ, TNF-α deprive the dermal papilla cells of their ability to maintain anagen hair growth, and with it, exacerbated hair loss.

Telogen effluvium, hair loss in IBS


Iron: Deficiency of this mineral is common in IBD, affecting approximately 40% of patients. Causes of iron deficiencies include decreased intake, chronic blood loss, and decreased absorption. Hair follicle matrix cells divide rapidly, and decreased iron levels can reduce ribonucleotide function that depends on iron as a cofactor. Suffering from Helicobacter Pylori, gastritis or hypochlorhydria (feeling reflux and heartburn) it is common to observe iron deficiency.

Zinc : Zinc deficiency is known to be present in 15% to 65% of IBD patients, particularly in fistulizing CD and as a result of reduced dietary intake, impaired absorption, increased excretion, hypoalbuminemia. Zinc is involved with important functional activities in the hair follicle: it is a potent inhibitor of hair follicle regression, accelerates follicle recovery, and maintains the secretion of sebaceous oil glands.

Protein energy malnutrition: Severe PEM can precipitate telogen hair loss. The scalp is a protein-rich tissue, and during dietary protein deprivation, blood protein levels are maintained at the expense of tissue protein. In diffuse alopecia the diameter of the hair bulb is significantly reduced when there is PEM and subsequently, the hair falls out easily.

The low levels of Vitamin D either Biotin They can also cause diffuse alopecia. It should also be taken into consideration that hypothyroidism, taking hormonal contraceptives and antidepressants can also cause hair loss.

If you suffer from hair loss and also symptoms of digestive discomfort, investigating your lifestyle habits and analyzing the state of your digestive system will be key to solving it, because by solving the cause, hair loss can be reversed in a few months. The solution is not in supplementation but in finding the root to solve the problem from the base.

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