Can poor gut health cause hair loss?

We know that the skin is the interface between the body’s internal organs and the outside world. But did you know that the gastrointestinal tract (GIT) may affect this connection? Recent research has shown that poor gut health may cause hair loss.

The gut is more than just the alimentary canal that we all have drawn in science class. Beyond nutrient absorption and elimination, the GIT is home to a diverse and complex ecosystem of microorganisms: the gut microbiota or microbiome. It contains the enteric nervous system (ENS) and is also known as the ‘second brain’ tying nutrition, immunity, and hormones together.

Microbial organisms make up more than half of human body cells, up to five pounds of which are gut bacteria. The intricate relationship between the ENS, the neuroendocrine-hypothalamic-pituitary-adrenal (HPA) axis, the immune system of the gut known as gut-associated lymphoid tissue (GALT), and the gut mucosal barrier connects the gastrointestinal tract to different parts of the body, including hair. 

The Gut Microbiome And Hair Health

The gut contains beneficial (good) bacteria which help with digestion, and regulate immunity levels and brain health as well as disease-causing or pathogenic (bad) bacteria. An imbalance between the two types of bacteria is known as dysbiosis and can contribute to disease. 

Bad bacteria feed on highly processed foods, simple and refined sugars, artificial sweeteners, alcohol, and red meat, and tend to eliminate good bacteria. 

On the other hand, good bacteria boost microbial enzymes, which, break down food and release nutrients that our bodies can utilize, such as vitamin K, B3, B12, biotin, and folic acid which are critical to hair growth. 

In addition, the gut synthesizes vitamins that regulate the immune system, the proper functioning of which is important for hair growth and maintenance. The gut microbiota also regulates hormones such as estrogen, thyroid hormones and melatonin. These hormones control the transition between the phases of hair growth: anagen (growth/regeneration), catagen (degeneration), and telogen (rest). 

Poor gut health lowers estrogen levels. Estrogen increases the amount of time that hair spends in the anagen phase, so when estrogen levels fall, hair loses the protective benefits that it offers. An increase in stress leads to an increase in cortisol levels, which can push our hair follicles into the resting stage of hair growth.

If good bacteria are crowded out by the bad ones, nutrients essential for hair growth are not generated, hormonal imbalance may occur and immunity may be lowered, resulting in hair loss and thinning. The problem is aggravated if the gut microflora is not diverse enough.

Immune dysregulation by the lack of good bacteria and overload with bad ones can cause inflammation throughout the body, and scalp inflammation can kill off hair follicles.  Gut Inflammation increases the levels of pro-inflammatory cytokines that reach the hair follicles and influence the hair growth cycle and do not allow cells to recover completely, potentiating hair damage. Increased inflammation results in premature catagen phase induction, regression, and arrest of hair growth.

All of us have heard that stress leads to hair loss, but do you know why?  In addition to direct effects on gut health, stress sends signals to and from the nervous system through the vagus nerve, potentiating damage to the integrity of the gut microbiome. Overactivation of the vagus nerve can deplete good bacteria.  

Stress and other threats to gut health can also alter gut permeability, exposing hair follicles to greater immune damage. Micronutrients obtained from food have to pass through the intestinal wall and into the blood or the lymphatic system. The intestinal wall forms a barrier between bacteria and the rest of the body which has to be permeable to allow nutrients to pass.

Diet changes, gut microbial composition or inflammation in the intestines can alter intestinal wall permeability, disrupting digestive processes and impeding nutrient absorption. Without the proper nutrients, hair growth is slowed down or may stop entirely.

Gut disruptions may increase the permeability of lipopolysaccharides (LPS) produced from gram-negative bacteria. Once LPS enters into circulation (blood), it can cause low-grade inflammation throughout the body. Toxins generated from gut bacteria may also damage cells of the liver, which can increase hair loss.

Thus, a disordered gut may harm hair health due to intestinal malabsorption, gut inflammation, increased gut permeability, hormonal imbalance, and metabolic dysfunction.

Your hair is made out of protein, water, lipids, and a few trace elements. But the process of hair growth requires a lot of energy and involves other essential elements, such as vitamins, minerals, and hormones. If the body doesn’t have sufficient quantities of any element involved in this complex process of hair growth, then hair loss may result.

Can Improving Gut Health Enhance My Hair Quality?

Deficiencies of micronutrients (iron, zinc, iron, niacin, biotin or vitamin B7, copper, and vitamins A, C, D, and E) are linked to hair structural changes and/or hair loss and are, partially, associated with gut health status. 

The gut microbiome ferments carbohydrates to short-chain fatty acids (SCFAs) that provide energy to facilitate nutrient absorption. E.g., iron deficiency has been linked to lower lactobacillus bacterial counts in the gut. 

Malabsorption resulting from intolerance to particular foods, gut inflammation, overgrowth of bad bacteria, immune diseases, and parasitic infections has a strong correlation with hair loss. Individuals who undergo gastrectomy (surgical removal of a part or the entire stomach) may lower iron and zinc levels, both of which are important for hair growth.

In addition, in times of nutritional deficiencies, the body uses all its resources to maintain the functions of vital organs. Hair growth is not a priority, so your hair might take longer to grow or thin out.

Further, the leaky gut syndrome may be linked to hair loss. With leaky gut syndrome-a side effect of poor gut health-the bad bacteria that are not supposed to get out, do get out and travel to other parts of your body and cause harm. Bad bacteria can harm your scalp and cause hair loss.

Gastrointestinal Conditions And Hair Loss

Irritable Bowel Syndrome and Hair Loss

Disruptions in vagal tone also occur in multiple gastrointestinal issues, such as inflammatory bowel syndrome (IBS), which has interlinked pathways with hair physiology and therefore, can cause hair thinning and loss.  A study has reported that IBS patients have faced hair loss, hair thinning, and brittle hair as part of the accompanying non-digestive symptoms.

IBS is an inflammation-related disorder of the large intestine, is related to poor gut health and research indicates that the inflammation may migrate to hair follicles and cause hair loss. IBS symptoms include bloating, pain, constipation, and diarrhea, and constipation.

Factors such as parasitic infections, alterations in serotonin levels, gut dysbiosis, and psychosocial factors are associated with the syndrome. IBS effects include food sensitivity, local inflammation, and malabsorption of carbohydrates.

IBD (Inflammatory Bowel Disease) and Hair Loss

Inflammatory Bowel Disease or IBD is an umbrella term including Ulcerative colitis, Crohn’s disease, and other non-infectious bowel inflammations. IBD is characterized by an overreaction of the immune system to gut microorganisms.

Symptoms vary, but most IBD patients report diarrhea, abdominal pain, weight loss, fatigue, and rectal bleeding. Hair loss in IBD patients is linked to nutritional deficiencies and adverse reactions to medications. Recent research has also revealed shared risk factors between IBD and Alopecia areata.

The Gut Workout For Healthy Hair

Disruptors of gut health include frequent antibiotic use, stress, poor diet, and other behaviours.  Studies have reported that improving gut health may stimulate hair growth among individuals with hair loss (Alopecia areata).

Fecal-matter transplantation (FMT) in refractory alopecia universalis patients for recurrent Clostridium difficile infection (CDI) results in subsequent hair regrowth, indicating that the gut microbial composition may be associated with immune conditions, including those associated with hair loss.

Gut correctors aim to optimize the gut microbiome and prevent inflammation, strengthen the gut mucosal barrier, and enhance nutrient absorption in the digestive tract. Prominent strains involved in stress responsiveness, immune control and dermatology are Lactobacillus reuteri, Lactobacillus rhamnosus GG, Lactobacillus helveticus, and Bacillus subtilus. 

• Consume a high-fibre, naturally grown or organic plant-based diet, comprising unprocessed whole grains (such as oats and barley), legumes, fruits, vegetables, seeds, and nuts. 

• Limit simple carbohydrates in your diet, while increasing your consumption of foods high in prebiotic fibre such as alums (including leeks, onions, and garlic), dandelion greens, bananas, apples, asparagus, Jerusalem artichokes, and chicory.
• Probiotic-rich fermented foods such as yogurt, sauerkraut, miso, kimchi, kombucha, tempeh, and kanji comprise live bacteria and yeasts that help to colonize the gut with healthy bacteria. A study has reported improved hair counts, hair thickness, and hair growth among androgenic alopecia patients.

• Biotin is a micronutrient commonly found in soybeans and mushrooms, and studies have shown that hair follicles rely on biotin to support the growth of new hair.
• Minimize sugar and sweeteners. Consuming high levels of sugar or artificial sweeteners (such as aspartame) may lead to gut dysbiosis.
• Avoid unnecessary consumption of antibiotics. Antibiotics work by wiping out the disease-causing bacteria, but in the process, they may damage the populations of good bacteria essential for optimum gut health. Make sure you only take antibiotics when prescribed by doctors, to avoid unnecessary changes in the composition of your gut microbiome. 
• Reduce chronic stress levels. Consider adopting a stress management routine to help lower your mental load. Exercise regularly, maintain a regular sleep routine, eat a balanced diet, practice mindful meditation, try aromatherapy, and practice deep breathing or yoga.

• Protein is the actual building block of hair and its sources include fish, meat, eggs, whole grains, dairy products, whole grains, and legumes like beans, lentils,  peas, peanuts, and soybeans.
• Iron and zinc iron and zinc are required for the chemical reactions that take place within cells that produce hair fibres. 
• Iron deficiencies are mainly caused due to insufficient dietary intake and blood loss. Sources of iron include liver, red meat, nuts, fortified cereals, beans, and dried fruits (apricots).
• Zinc is vital for immune function and hair growth and its sources include oysters and other types of seafood, meat, peas, dairy products, pumpkin seeds, oatmeal, and beans.

• Omega-3 fatty acids are considered essential fats because the body can’t produce them and they need to be acquired from food. They are important to maintain hormonal balance, and skin and hair health. Sources include fish and other seafood, nuts and seeds, and plant oils (flaxseed oil, soybean oil, and canola oil,).

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The Bottom Line

The gut truly is the body's second brain, and the right balance of good and bad bacteria can be a game-changer if you struggle with hair loss problems. Gut health and hair loss may not have been something you considered while meal planning, but probably you will moving forward!