From the Guidelines
Hair loss associated with fatigue is typically caused by several underlying conditions, including vitamin D deficiency, thyroid disorders, iron deficiency anemia, chronic stress, autoimmune conditions like alopecia areata, certain medications, and nutritional deficiencies beyond iron, particularly low levels of B vitamins and zinc. According to a study published in the American Journal of Clinical Dermatology 1, vitamin D plays a crucial role in the normal hair follicle, and its deficiency has been associated with alopecia areata. The study found that lower serum vitamin D levels were associated with alopecia areata, and that vitamin D supplementation may be beneficial in the prevention and treatment of the condition.
Some key points to consider include:
- Vitamin D deficiency is a common condition that can cause hair loss and fatigue, and its prevalence is high in patients with alopecia areata 1
- Thyroid disorders, particularly hypothyroidism, can cause both fatigue and hair thinning due to hormonal imbalances that affect hair follicle function
- Iron deficiency anemia is another common cause of hair loss and fatigue, as low iron levels lead to fatigue while depriving hair follicles of essential nutrients
- Chronic stress triggers elevated cortisol levels, causing both exhaustion and telogen effluvium, a condition where hair prematurely enters the shedding phase
- Autoimmune conditions like alopecia areata can cause patchy hair loss and fatigue from systemic inflammation
- Certain medications, including some antidepressants, blood pressure medications, and chemotherapy drugs, may list both fatigue and hair loss as side effects
- Nutritional deficiencies beyond iron, particularly low levels of B vitamins and zinc, can contribute to both symptoms
- Hormonal changes during pregnancy, menopause, or from conditions like PCOS can simultaneously affect energy levels and hair growth cycles
Treatment should address the underlying cause through:
- Blood tests to identify deficiencies or hormonal imbalances
- Stress management techniques
- Proper nutrition
- Potentially medication adjustments under medical supervision As noted in the British Association of Dermatologists' guidelines for the management of alopecia areata 2012 1, counseling and psychological support are also essential for patients with alopecia areata, particularly those who are profoundly upset by their condition.
From the Research
Causes of Alopecia Associated with Fatigue
- Fatigue is not directly mentioned as a cause of alopecia in the provided studies, however, some studies mention that alopecia can be associated with systemic diseases, autoimmune diseases, and psychological stress, which can also cause fatigue 2, 3, 4, 5, 6
- Iron deficiency (ID) is a common cause of alopecia, and it can also cause fatigue, as it can lead to anemia 3
- Autoimmune diseases, such as alopecia areata, can also cause fatigue, as they can lead to inflammation and immune system dysfunction 4, 5
- Psychological stress can also contribute to alopecia, and it can cause fatigue, as it can lead to anxiety, depression, and other mental health issues 2, 3, 6
- Some studies suggest that alopecia can be caused by a combination of factors, including genetic, environmental, and hormonal factors, which can also contribute to fatigue 2, 3, 4, 5, 6
Systemic Diseases and Alopecia
- Systemic diseases, such as malnutrition, autoimmune diseases, and endocrine diseases, can cause alopecia, and they can also cause fatigue 2
- A comprehensive history and physical examination, with targeted laboratory testing, may elucidate the underlying cause of alopecia and fatigue 2
Treatment and Management
- Treatment of alopecia and fatigue depends on the underlying cause, and it may involve addressing the underlying systemic disease, autoimmune disease, or psychological stress 2, 3, 4, 5, 6
- Iron supplementation may be beneficial for patients with iron deficiency-related alopecia, and it can also help alleviate fatigue 3
- Physician support and education are important for patients with alopecia and fatigue, as they can help patients cope with the psychological and emotional impact of the condition 2, 6