Causes of Hair Loss in Women – Part 5: Too Much Stress

Our stress response describes the strain on our bodies caused by dealing with physical, emotional, mental, and hormonal adversity.

Stress affects us in many ways, some of which are necessary to survival. When facing a stressful event, your body receives the immediate energy and capacity to either run away, or stay and deal with the stressor (fight or flight).

During fight or flight, your digestion slows, blood flow is shunted toward your limbs, your blood pressure rises, blood sugar increases, and stored fats are released into the blood stream to give your body a jolt of energy so that you can make a stand or make your escape.

That’s basically the short-term “survival” type of stress.

But when you’re in this “survival state” on an ongoing basis, it doesn’t help you survive or thrive. Chronic stress suppresses metabolism, circulation, digestion, and your immune system. It also increases inflammation and insulin resistance, while disturbing your hormonal cycle.

Cortisol is a central hormone to the survival stress response. Cortisol, together with adrenaline, tells the body to shut down the less essential functions such as reproduction during a time of high stress, so you can focus purely on survival. It’s part of everyone’s natural fight-or-flight response, meant to help you escape danger, or survive through a famine state.

The changes that happen in your body when you face a direct threat to your life are useful on an “as needed,” short-term basis. But more often, the stress we experience is chronic. And it’s the chronic stress that leads to hair falling out.

Hans Selye, a preeminent researcher of stress during the 20th century, describe the “General Adaptation Syndrome” of chronic high stress.

The Signs of Too Much Stress

It’s helpful to look at hair loss as just one “star” in a constellation of symptoms caused by stress.

If you have more of these findings, you can perhaps view them as large, brightly-colored EXIT HERE! signs trying to point you off the dangerous and destructive superhighway of chronic stress.

Symptoms of excessive stress include hair loss, prematurely aging, dry and wrinkled skin, continuously forming stretch marks, low or absent sex drive, depression, fat gain on your upper back, trouble sleeping, feeling “wired” at night, digestive problems and constipation (although diarrhea can sometimes be a symptom), low body temperature, depression, low energy in general, and fatigue during the day.

Rather than simply causing you daily anxiety, chronic stress is a very serious problem for hair in many ways.

And it contributes to a feedback loop of health problems, which then contribute back to stress. It’s as if the chronic stress cycle feeds into itself – which it can do for a long time.

Here is how stress can contributes to hair loss.

How Stress Causes Inflammation & Autoimmune Disorders

We experience different types of stress – physical strain from declining health or lack of energy (a la the feedback loop), psychological stress including social strain, loneliness, work-related pressures, existential stress, etc.

There’s nothing safe from its reach – we can, and do, stress about just about anything and the effect is similar no matter what the target of our worry is.

Even when you perceive psychological stress, inflammation of your skin begins, starting with increased corticotropin-releasing hormone, adrenocorticotopic hormone, prolactin, substance P, calcitonin gene-related peptide, and glucocorticoids.[1] Your body understands all types of stress, and if it goes on too long, you get the inflammation that contribute to hair loss and autoimmune diseases.[2]

In a stressed out state, your digestion will be slowed, allowing for bacterial overgrowth in your digestive tract. This bacteria can multiply when bowels are stagnant, and sometimes it can escape the bowel and cause massive body-wide inflammation.[3] Since inflammation is an immune response, we can connect that stress can contribute to an overactive immune system response and autoimmunity.

Stress is powerful. Its accompanying hormones show their effect on mice when studied, causing hair loss, inhibiting hair growth, and causing hair-damaging pro-inflammatory effects.

Extreme emotional distress has been known to signal the onset of alopecia areata [4] which is a serious autoimmune inflammatory hair loss disorder. And Telogen effluvium (the term for hair loss due to stress) is connected to inflammation in those who suffer from it.

These hair loss disorders show the compound effects that stress and inflammation can have on female hair loss.

Stress Breaks Down Your Tissues

Stress increases your body’s need for energy. About the hormone cortisol, Dr. Ray Peat has said it causes the skin to become thin and fragile, whether it’s from starvation, medical treatment, or aging.

He states that “material from the skin is dissolved to provide nutrition for the more essential organs. Other organs, such as the muscles and bones, dissolve more slowly, but just as destructively, under the continued influence of cortisone.”[5]

Think about that: when we’re stressed, our body’s need for energy increases. This takes away from the cells of our skin, which also takes away from hair growth. Our muscles and bones can eventually dissolve under the chronic influence of stress, and one clear example of this can be seen when our teeth become translucent from their calcium being leeched away.

Stress Suppresses Thyroid Health and Metabolism

Cortisol, if overly abundant, can suppress the active thyroid hormone T3[6], rendering cellular metabolism inefficient. The thyroid hormones allow your cells to use oxygen and produce energy in the form of carbon dioxide, and T3 also helps synthesize your important sex hormones.[7]

If your body is trying to conserve energy due to chronic physical or psychological stressors such as fasting, injury, or emotional stress, the liver will tend to convert T4 to Reverse T3. Reverse T3 has the opposite effect of active T3, suppressing your metabolism and many bodily functions in order to keep you from wasting energy.

So being in a chronically stressed out state can create a condition like sub-clinical hypothyroidism. It isn’t necessarily a problem with the thyroid gland, it is simply due to inefficient T4 to T3 conversion in the liver. And we shouldn’t view this as the liver trying to “sabotage” us – it’s an ingrained function to help you survive longer in this stressed state.

In high stress, the thyroid’s function is suppressed, and the adrenal glands produce more cortisol and DHEA. This cortisol increase leads to metabolic adaptations the cause low thyroid function and decreased core temperature. If there is very low thyroid activity, the adrenal glands try to pick up the slack, and provide the energy in your body.

Eventually, the adrenals get overworked, leading to symptoms of “adrenal fatigue” aka burnout.

Stress Contributes to Insulin Resistance and Obesity

One of cortisol’s main functions is to suppress insulin’s effect on your cells, while also releasing stored fatty acids and sugars into the blood in case of a fight or flight need-energy-quick scenario.[8]

Chronically high levels of cortisol with its insulin-thwarting effects mean that the pancreas must secrete more and more insulin, just to try and get all of this sugar into your cells. And via the body’s feedback loop, this leads to insulin resistance.

In the case of metabolic syndrome or Cushing’s syndrome which are disorders hallmarked by stress hormones and insulin resistance, excessive cortisol becomes very dangerous. Obese people who are stressed have shown an enhanced negative response to any kind of stressor that stimulates cortisol release.

The hormone raises blood pressure, and frees sugars into the blood. Since cortisol tends to favor central obesity, these freed sugars can easily turn to dangerous abdominal fat.

Stress Causes Hormonal Imbalance

The stress that causes a disruption to your ovulation can be due to emotional turmoil, surgery, illness, restrictive diets, over-working, over-exercising, being sleep-deprived – and sometimes these all go together.

High stress leads to increased production of cortisol as we know. Chronic depression, emotional problems, and anxiety can multiply the effects of stress, and if you have a problem with one of these, you will be more susceptible to cortisol’s effects.

Elevated cortisol disrupts your body’s ability to receive your sex hormones (estrogen, progesterone, testosterone) which is one explanation for why you lose your sex drive when under stress.

And there are certain hormonal imbalances with clear links to excess stress.

Women who produce little or no sex hormones in conjunction with absent periods may have a condition called hypothalamic amenorrhea (HA). This is the loss of your menstrual period, but it can include a loss of ovulation as well, in which case it is called stress-induced anovulation (SIA). It can lead to ovarian insufficiency which mimics menopause. It is similar to a condition known as hypothalamic hypogonadism that is related to a problem in the pituitary gland.

These types of conditions tend to affect women who put themselves in an energy imbalance due to dieting, exercising, and investing emotional and mental effort into their stressors. Women with eating disorders are especially susceptible.

So you can see how your body shuts down production of its reproductive hormones, because of your ingrained perception that your environment (internal or external) isn’t “safe.” Your menstrual cycle’s delicate balance keeps your body supplied with the hormones of youth such as progesterone, pregnenolone, and the right amount of estrogen.

Recovery, of hormonal balance can happen, with a reduction in stressors and cortisol. Women with these conditions who were treated with cognitive behaviorial therapy showed the return of normal ovarian function and also a partial thyroid recovery.[9]

Stress Causes Cushing’s Syndrome

Cushing’s syndrome is the result of prolonged exposure to very high amounts of the stress hormone cortisol. Cortisol is produced in the adrenal glands when the pituitary gland secretes adrenocorticotropic hormone (ACTH). Chronically high and imbalanced cortisol levels interrupt the balance of sex hormones in the human body.

Symptoms of Cushing’s syndrome, which will be similar to high stress symptoms mentioned earlier, can include fat gain on the trunk (stomach and back), insulin resistance, more fat on the back of the neck and in the face, thicker neck, thinning skin, rapidly growing stretch marks, alopecia, hirsutism, skin tags, darkened skin, reduced libido, menstrual irregularities, infertility, memory loss, and depression.

External causes of Cushing’s syndrome include using cortisol-like drugs or steroids over a long period of time to treat another condition such as asthma, arthritis, or an organ transplant.

Cushing’s syndrome, like many other diseases, isn’t a terminal illness, and can likely be reversed or well managed.

And the same is true for those of us suffering from any other stress-related illnesses and symptoms.

It is possible to reverse the imbalances caused by stress, but success is dependent upon your ability to convince your brain and body that you are safe.

How to convince your brain and body that you are safe, so you can bring stress down overall?

Thankfully, there are some great ways to balance stress hormones, which in addition to improving your life overall, will free up some energy that your body can put back into healing your tissues, including hair and skin.

I’ll be posting about stress reduction methods in an upcoming blog post, and am excited to share them with you.

Before you go, I want to leave you with a helpful quote from the Roman poet, Ovid – and I think it applies well to stress and hair loss:

“Take rest; a field that has rested gives a bountiful crop.”

Thanks so much for reading and have a blessed day.

1. Journal of Investigative Dermatology (2004) 123, 455–457; doi:10.1111/j.0022-202X.2004.23237.x Burden of Hair Loss: Stress and the Underestimated Psychosocial Impact of Telogen Effluvium and Androgenetic Alopecia Ina M Hadshiew*, Kerstin Foitzik*, Petra Arck† and Ralf Paus Department of Dermatology, University Hospital Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany Department of Internal Medicine, Charité, Berlin, Germany Correspondence: MD Ralf Paus, Department of Dermatology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany Email: Received 31 May 2003; Revised 25. November 2003; Accepted 4 February 2004; Published online 6 August 2004.

2. 13. Social stress up-regulates inflammatory gene expression in the leukocyte transcriptome via β-adrenergic induction of myelopoiesis Nicole D. Powella, Erica K. Sloanb,c, Michael T. Baileya,d,Jesusa M. G. Arevaloe, Gregory E. Millerf,Edith Chenf, Michael S. Koborg, Brenda F. Readerd, John F. Sheridana,d,h,1, and Steven W. Coleb,e,i,1

3. Bacterial Endotoxin © Kenneth Todar, PhD

4. Alopecia areata and Affected Skin CRH Receptor Upregulation Induced by Acute Emotional StressKatsarou-Katsari A. · Singh L.K. · Theoharides T.C. Dermatology 2001;203:157–161 (DOI: 10.1159/000051732)

5. 29. Progesterone Pregnenolone & DHEA – Three Youth-Associated Hormones PROGESTERONE INFORMATION Raymond Peat, MA, PhD (Univ. of Oregon)

6. Aviat Space Environ Med. 1995 Apr;66(4):325-9. Effects of high altitude and cold exposure on resting thyroid hormone concentrations. Hackney AC, Feith S, Pozos R, Seale J.

7. Becoming Stress Proof Part IV: Ray Peats Generative Energy, Pulse & Body Temperature

8. November 2009 Issue Cortisol — Its Role in Stress, Inflammation, and Indications for Diet Therapy By Dina Aronson, MS, RD Today’s Dietitian Vol. 11 No. 11 P. 38

9. Stress Induced Anovulation S L Berga and T L Loucks Emory University School of Medicine, Atlanta, GA, USA

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