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Iron Deficiency Hair Loss

Also called: ferritin deficiency hair loss · anaemia hair loss

Iron deficiency - even without overt anaemia - is one of the most common and correctable causes of diffuse hair shedding, particularly in women of reproductive age. Ferritin (iron storage) below 30–70 ng/mL impairs the hair follicle's rapid cell division.

How it happens

Hair follicles are among the most metabolically active cells in the body. Iron is required for ribonucleotide reductase - the rate-limiting enzyme in DNA synthesis and cell proliferation. Suboptimal ferritin starves the follicle of iron, forcing more follicles into telogen. The effect is dose-dependent: the lower the ferritin, the greater the shedding.

In India

Iron deficiency is the most prevalent micronutrient deficiency in India, affecting an estimated 50–60% of women. Its role in hair loss is systematically underappreciated.

Key symptoms

  • Diffuse hair shedding (pattern mirrors telogen effluvium)
  • Fatigue, cold intolerance, brain fog (systemic iron deficiency symptoms)
  • Brittle nails with spooning (koilonychia)
  • Pallor (in anaemia)
  • Often no anaemia - ferritin may be low while Hb is normal

Common triggers

  • Heavy menstrual periods
  • Low dietary iron (vegetarian / vegan diet)
  • Pregnancy and lactation
  • GI blood loss (peptic ulcer, NSAID use)
  • Malabsorption (coeliac disease, post-bariatric surgery)

How it is diagnosed

  • Serum ferritin (target > 70 ng/mL for hair growth)
  • Full blood count - MCV, MCHC
  • Serum iron + TIBC
  • Peripheral blood smear
  • Consider coeliac antibodies if malabsorption suspected

Tests are performed by a qualified dermatologist or trichologist after clinical assessment.

Treatment options

Oral iron supplementationEvidence A

Ferrous sulphate / bisglycinate 150–200 mg elemental iron daily. Take with Vitamin C; avoid with tea, calcium.

Dietary iron optimisationEvidence A

Include haem iron (meat, poultry, fish) or plant iron with enhancers (lemon juice, bell pepper). Avoid iron inhibitors with meals.

Biotin Complex (adjunct)Evidence C

Supports hair matrix cell proliferation alongside iron repletion.

Timeline: Ferritin takes 3–6 months to replete with oral supplementation. Hair shedding reduction typically follows ferritin correction by 1–2 months.

When to see a doctor

Always consult a doctor before starting iron supplementation - excess iron is harmful. If ferritin is below 30 and hair loss is significant, haematological evaluation is warranted to find the underlying cause.

Dermatologist perspective
“I routinely check ferritin - not just haemoglobin - in every hair loss patient. A Hb of 12.5 g/dL with a ferritin of 12 ng/mL is a hair loss-contributing state even though it's not "anaemia" by textbook criteria. The ferritin threshold I use clinically for hair growth is ≥ 70 ng/mL.”
Dr. Abhishek Pilani · Gold Medalist Dermatologist · ISHRS Member · Co-Founder, Assure Clinic

Last reviewed March 2025. This page is clinical reference, not a diagnosis. Only an in-person assessment can tell you which condition you have.

Related conditions

Telogen Effluviumvitamin d deficiency hair

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