How I'm Reversing My Wife's Female Pattern Hair Loss Naturally: The Root Cause 8 Years of Clinics Missed

She was in front of the bathroom mirror, tying her hair back like every other morning. Then she stopped.

Right at her crown, beside her parting line, there was a gap.

She could see the scalp through it, and she was sure it had not been there last month. Or maybe it had, and she had simply never looked.

That was 2018, and she was 18 years old.

The story really starts two years earlier.

In 2016, she was in 11th standard, studying long hours with her hair tied back most of the day.

That is when she first noticed the strands on her pillow and in the bathroom drain. She picked one up and looked at the end of it, and there was a tiny white bulb sitting there.

She did not worry about it. Everyone loses hair, because that is how hair works.

It grows, it rests, it falls out, and a new one takes its place. She was not pulling out clumps of it.

What she saw looked nothing like the photo you find below, where a whole handful comes away in one go.

<hair shedding image of Hasi’s friend>

So she let it go, and two years passed.

Then came the mirror.

What she did not know in 2016 is the same thing that took her years to learn. Hair shedding and hair loss are two different problems.

Shedding is hair falling out while the root stays alive.

You find the strands in the shower or on your brush, and it happens because of the normal growth cycle, stress, or a shock to the body like an illness or due to the birth of a baby.

The root is still working, so the hair comes back.

Hair loss is different. The root itself, the follicle, is shrinking.

This is usually down to genes and hormones, mainly DHT.

Each new hair that grows out of that follicle comes in a little thinner than the one before it, and then thinner again, until one day nothing grows there at all.

The hard part is that you might never see extra hair falling, like shown in the above image.

Nothing looks wrong in the drain. You just look up one morning, and your part is wider, your scalp is visible in the crown area, or your ponytail feels thin between your fingers.

That is what happened to her. For two years, she kept checking how much hair was falling out. She should have been checking how much was still on her head.

She did not know any of that in 2018. All she had was the gap in the mirror and a growing fear that it would get bigger.

She panicked for a while, and then she started guessing.

Her first guess was food. She had been a vegetarian her whole life, so she decided she must be missing something in her diet.

She spent the next two years trying to fix that. It was also when she started eating eggs🥚🥚🥚.

It made no difference.

By 2021, it had pushed her into depression. The hair had not come back; she still had no idea why, and it had worn her down.

Her mum noticed this and took her to a popular hair care clinic here in the southern part of India.

The trichologist scanned her scalp in the very first sitting, using one of those hair analyser cameras.

Then came a hair pack for twenty to forty minutes, a serum massage, and derma rolling.

At the end, they handed her a kit with their own shampoo, a hair lotion, and sixty capsules.

<image of Vcare kit>

When I got to know about this after our wedding, I was really speechless. (btw, I knew about her condition even before our marriage. This deep conversation happened after our wedding).

So I asked her the obvious things. Did they run a blood test? Did they tell you what this condition is called? Did anyone explain what was causing it?

Her answer to all three was no.

That went on for six months, about six or seven sessions. She calls it a treatment. I would not.

She spent close to $1,000 and half a year on it, saw nothing change, and stopped going.

So she was back where she began, with no idea what was driving any of it. Another two years passed like that.

Then it got worse. By 2024, her scalp was clearly visible, so she went for a consultation at a different clinic.

<image: pavi before transplant image>

This time they started with a blood test.

Two things came back. Her vitamin D was deficient, and her hemoglobin was low.

<image: Vitamin D tablets>

You can see it in the report below. Hemoglobin slightly under range, HCT low, and an MCH reading that points to iron deficiency.

<image: Sri Sastha lab reports>

They put her on a balanced diet plan and recommended Growth Factor Concentrate (GFC) treatment. She went through with it, and four months later there was only a slight improvement.

<image: Pavi’s aug latest close-up photo>

Eight years, two clinics, and one blood test. Read like that, it sounds like something you cannot fix. It is not.

In this article I am going to show you exactly what was causing it, after eight years of nobody looking.

Here is what you will have by the end:

• Which type of hair loss you actually have. Three other conditions get mistaken for female pattern hair loss constantly. Two of them scar the follicle permanently if they are left alone, and one of those two moves fast.
• The eleven root causes, and the blood test that finds each one. My wife had never been tested for six of them.
• What minoxidil, finasteride and spironolactone really do. How they work, what they cost you, and why every one of them stops working the day you stop taking it.
• What two weeks of glucose data showed us. We put a continuous monitor on her arm and logged every meal, because almost all eleven causes turned out to run through the same place.

This is Part 1.

Her results, her repeated bloodwork and the progress of her hair growth after 100 days of following my protocol come in Part 2.

A note for you

This is not only my wife’s story. It is also everything we had to learn to get anywhere, written the way I first explained it to her. Plain words, no jargon left standing. That is on purpose. She could not act on any of this until she understood it, and neither will you.

Before you read on

I am not a doctor, and neither is my wife. I am her husband. What follows is a record of one person’s case: her labs, her photos, her food logs, her glucose data, and the things we tried that did and did not work.

She is doing this alongside a physician, not instead of one. Every prescription and every lab was ordered by a qualified doctor. Nothing here is a diagnosis or a treatment plan for you.

When I say we are reversing her hair loss, I mean something specific: measurable regrowth in the crown, tracked with monthly photos taken in the same light at the same angle, plus repeat bloodwork.

I do not mean cured (It’s a work in progress. I will write a Part 2 blog if we have completed reversing it). Female pattern hair loss is a long-term condition, and holding the gains takes ongoing work. All photos are raw, unedited, and results vary enormously from person to person.

If your hairline is receding as a band, or you are losing your eyebrows, or your scalp looks smooth and shiny where the hair has gone, please stop reading and see a dermatologist. That pattern can indicate a scarring alopecia, which permanently destroys the follicle and needs urgent medical treatment.

Some links on this page are affiliate links, marked where they appear. If you buy through one, I may earn a commission at no extra cost to you. I only link to things she actually used.

Is this even female pattern hair loss (FPHL)?

How do you classify your hair loss as female pattern baldness?

In my wife’s case, she didn’t know her condition was female pattern baldness. Sadly, the hair care centers she went to for consultation didn’t find out she has FPHL.

To be clear, my wife had no idea this term exists! In fact, many of the women lack knowledge about their condition.

Without knowing the root cause of your condition, how do you fix yourself?

Unfortunately, many hair clinics skip the critical step of identifying the root cause altogether.

Their business model often prioritizes quick revenue over long-term solutions.

Given the high overhead costs of high-end infrastructure and staffing, these clinics are under constant pressure to generate immediate returns.

As a result, they quickly push high-ticket treatments like GFC, PRP, or even hair transplants right out of the gate.

Since identifying the root cause and fixing it naturally takes a long time, they are taking this route of immediately suggesting a treatment plan that gives a (temporary) result.

The actual decoding of the root cause takes a lot more time than you think. Because everything is connected in the human body.

For example, hair loss can be triggered by:

• Hormonal imbalance (High androgens and cortisol, Thyroid imbalance)
• Vitamin deficiencies
• Gut health (leaky gut)
• Poor Circadian rhythm
• Poor sunlight exposure
• Insulin resistance

There are already multiple factors that could be triggering your hair loss. If you start applying first-principles thinking to decode these factors one by one, you’ll get at least 5 to 10 reasons that trigger each one of the factors listed. We will be seeing that in the later section of this article.

Every human body is different in a certain way. You can have any one of these factors or a couple of these. For example, you can have hormonal imbalance alone or both hormonal imbalance and leaky gut that can be the cause of your hair loss.

So, now you’ve understood the complexity behind finding the root cause. This is why it’s difficult for hair care clinics to find your root cause. It’s actually very time-consuming, and they need your nuanced input too.

Beyond the time-consuming complexity of diagnosing its root cause, hair loss demands a quick solution because of its immediate impact on a person’s appearance and self-esteem.

This deep connection between hair and personal identity is nothing new. Even ancient Tamil poets devoted entire manuscripts (from as early as 300 BCE (the Sangam era)) to celebrating the beauty and cultural significance of a woman’s hair.

So it’s clear that clinics aren’t just chasing quick revenue. Women facing hair loss are equally desperate for immediate relief.

Now that we understand why finding the root cause matters so much, let’s break down the different types of hair loss.

We’ll revisit these underlying causes in more detail in an upcoming section.

Is it female pattern hair loss, or is it telogen effluvium?

Once you know that shedding and loss are two different problems, the next question is which one you have. Both have proper names.

Heavy shedding is usually telogen effluvium.

<image: Hasi’s friend hair fall>

Patterned thinning is female pattern hair loss.

Telling them apart is the most useful thing you can do early, because they behave in opposite ways.

Telogen effluvium is loud. Something happens to your body, and a few months later your hair falls out in handfuls.

You notice it in the shower, on your pillow, on the floor. It is frightening to look at, and it usually stops on its own.

<img: Telogen effluvium_reference>

Female pattern hair loss is quiet. There may be no extra shedding at all.

The hair simply comes back thinner every cycle until your part widens and your ponytail feels thin. It does not stop on its own.

<img: FPHL_reference

Here is something that confused my wife for two years. She kept checking the bulb at the end of the fallen strands.

That little white bulb only means the hair finished its cycle and let go, which is what healthy hair is supposed to do.

It shows up in telogen effluvium, it shows up in normal daily shedding, and it shows up when you have female pattern hair loss too.

The bulb at the end of the hair strand indicates the hair fell out. It tells you nothing about why.

The pattern tells you why.

	Telogen Effluvium	Female Pattern Hair Loss
How it starts	Suddenly, over a few weeks	Slowly, over years
What you notice first	Hair everywhere. Shower, pillow, brush, floor	A wider part, a thinner ponytail
How much falls per day	200 to 300 or more	Often normal, 50 to 100
Where it thins	Evenly, all over the scalp	Crown and part line, worst at the front
Your hairline	Stays put	Usually stays put, but the part behind it widens
Hair texture	Unchanged. Fallen hairs are full thickness	Mixed. Fine, short, wispy hairs beside normal ones
Usual cause	A shock to the body: birth, fever, surgery, crash diet, illness, a new medication, severe stress	Genes plus hormones, mainly DHT, often driven by insulin resistance, PCOS, thyroid or low iron
When the cause happened	Two to three months before the shedding started	No single event. It builds
Pull test	Positive. Six or more hairs come away	Usually negative
Does it stop by itself	Yes, usually within three to six months	No. It gets worse without treatment
Does the hair come back	Yes, once the trigger is gone	Only with treatment, and only the follicles still alive

The single most useful clue in that table is timing. Telogen effluvium does not start on the day of the trigger. It starts two to three months later.

So if you are shedding hard this month, think back to what your body went through in the two or three months before, not last week.

A birth, a fever, an operation, a crash diet, a new medication.

In fact, while talking about the effluvium, there’s another type called Anagen effluvium.

Anagen effluvium attacks hair while it is still in the growing phase, called the anagen phase.

Something stops the cells in the root from dividing. The hair then breaks off or slips out in the middle of its growth phase, instead of finishing its cycle first.

The usual causes of anagen effluvium include chemotherapy, radiation to the head, and poisoning by certain metals.

The fallen strand looks different too, which brings us back to that bulb.

In telogen effluvium, the hair has the white club bulb on the end. It completed its cycle before letting go.

In anagen effluvium, there is no bulb at all. The strand is tapered to a point, or simply snapped off, because it never got to finish.

For telogen effluvium, look at what your body went through two or three months ago, not last week. A birth, a fever, an operation, a crash diet, a new medication.

For anagen effluvium, the cause is usually recent and obvious.

Types of Effluvium	Onset
Telogen effluvium	Delayed. Starts two to three months after the stressful event
Anagen effluvium	Rapid. Starts within days or weeks of the trigger

The hardest case is when you have both at once, and this is far more common than people realise.

A woman with early female pattern hair loss goes through a stressful year and picks up a telogen effluvium on top of it. The shedding is dramatic, so she treats that.

A few months later, the shedding stops, but her density never comes back to where it was because the underlying pattern loss was already there and nobody looked for it.

That is roughly what happened to us.

[IMAGE: Pavi’s before treatment image]

My wife’s condition may look like telogen effluvium at first glance. But I would say it could be a combination of both.

Let me tell you how.

Evidence for Telogen Effluvium (TE)

From the photos:

• The thinning appears relatively diffuse rather than strictly patterned
• Short baby hairs/regrowth visible in some areas, which suggests active cycling
• Sides are not dramatically spared the way pure FPHL typically presents

From her blood report:

• Critically low B12 (166 vs normal 211+)
• Low iron and ferritin (12.30, far too low for healthy hair)
• Vitamin D insufficiency (26.8)
• All three are classic triggers of telogen effluvium
• These deficiencies push hair follicles prematurely into the resting (telogen) phase, causing mass shedding

Evidence for Female Pattern Hair Loss (FPHL)

From her Photos:

• The “Christmas tree pattern” of widening along the central part is the hallmark sign of FPHL
• Thinning is clearly more concentrated at the crown and center, not random
• The frontal hairline is relatively preserved, which is characteristic of FPHL in women (unlike male pattern baldness)
• The sides being denser than the top is a classic FPHL distribution
• The pattern is consistent across all three photos
• My wife had not experienced any stressful events from the year 2016 to 2018. Hair loss first, and then comes the hair loss-induced stress
• My wife’s ponytail had not become thin
• She had not experienced sudden hair loss
• She had not encountered a bunch of hair strands in the shower drain

From her blood report:

• Testosterone elevated above female normal range (61.41 vs upper limit 53.35)
• LH at higher end suggesting possible androgenic hormonal imbalance
• PCOS not yet ruled out (yet to test this)
• All of these drive the androgenic miniaturization that causes FPHL

Confused about your condition? Take this quiz to find out for yourself.

Female pattern hair loss vs Frontal fibrosing alopecia

<img: FPHL vs Telogen effluvium vs frontal fibrosing alopecia vs fibrosing alopecia vs central centrifugal cicatricial alopecia>
<img caption: Source: https://www.nejm.org/doi/full/10.1056/NEJMcp2412146 >

Frontal fibrosing alopecia, or FFA, can look like female pattern hair loss in the early weeks. It is not the same thing, and the difference matters more than any other difference in this article.

Female pattern hair loss shrinks the follicle. FFA destroys it and puts scar tissue in its place. A shrunken follicle can be brought back. A scarred one cannot.

So if you are losing hair at the front or at the temples, read this part slowly.

Here is what FFA does. The hairline moves backwards in a band, evenly, across the front and around both temples. It does not thin.

It retreats, like a tide going out, and it takes the skin with it.

Female pattern hair loss does the opposite. It keeps your hairline and widens the part behind it.

Four signs are worth learning.

Your eyebrows. In many women, the eyebrows thin or vanish before anything happens on the scalp, sometimes years before.

Female pattern hair loss never touches your eyebrows. If your brows are going and your hairline is moving, that pairing on its own is a reason to see a dermatologist this month.

The skin. This is the check I would want you to do tonight. Stand under a bright light and look closely at the bare area. Then look at a healthy patch of scalp next to it. Healthy skin still has visible pores, and usually a few fine baby hairs, even where hair is thinning from FPHL.

Scarred skin has none. It looks pale, smooth, shiny, and slightly sunken, like the skin on the inside of your wrist. There is nothing on it. Blank skin at the hairline is the clearest warning sign you can catch at home.

Feeling. FFA often itches, burns, or feels tender along the edge of the hairline. Female pattern hair loss does not hurt at all.

The lonely hair sign. As the band moves back, one or two stubborn hairs are left standing on their own in the middle of the bare zone. Doctors look for this, and you can see it in a photo.

	Female pattern hair loss	Frontal fibrosing alopecia
Hairline	Stays. The part behind it widens	Retreats backwards as a band
Temples	Usually spared	Almost always involved
Eyebrows	Untouched	Often thin or gone, sometimes first
The skin	Pores and fine hairs still visible	Pale, shiny, smooth, no pores
Itch or pain	None	Common along the hairline edge
What is happening	The follicle shrinks	The follicle is destroyed and scarred
Can it regrow	Yes, where follicles are still alive	No. Treatment only stops it spreading
How urgent	Treat it properly, but you have time	See a dermatologist now

If any of that sounds like you, book a dermatologist now rather than in six months.

I am not saying that to frighten you. Treatment for FFA is a race. Nothing regrows the part that is already scarred.

The whole aim is to stop the scarring from spreading, and every month you wait is a hairline you will not get back.

Female pattern hair loss is different. A year of trial and error there costs you time, but it does not cost you the follicle.

Alopecia areata

Alopecia areata is your immune system attacking your own follicles.

It shows up as round or oval bald patches with clean edges, usually over a few weeks.

The skin inside them is smooth but still has its pores. Look at the edge of a patch, and you may find short broken hairs that are thinner at the bottom than the top.

It can hit eyebrows, lashes, and beards too, and it often comes with small dents in the fingernails.

Because the follicle is not scarred, the hair can come back, and often does on its own. The clue is the shape. Patches with edges point here. Even patterned thinning does not.

Traction alopecia

Traction alopecia is damage from pulling. Tight ponytails, tight buns, braids, weaves and extensions all put steady tension on the same follicles until they give up.

This one deserves real attention in India, where tight plaiting starts in childhood and carries on for decades.

It shows up exactly where the pull is hardest, so the hairline, the temples and behind the ears, rather than the crown.

Ask yourself whether the thinning matches the shape of the hairstyle you wear most days. Caught early, it reverses once you loosen your hair. Left for years, it scars, and then it is permanent.

The last point took us the longest to understand. These are not neat boxes, and you can have more than one at the same time.

Untreated thyroid trouble, or years of tight braiding, can sit on top of female pattern hair loss and make it look far worse than it is. That is exactly why you should take a test instead of guessing.

Confused about your condition? Take this quiz to find out for yourself.

The prevalence of FPHL and Telogen effluvium in Women

Before all of this happened, I knew nothing about these issues at all.

When I first learned about my wife’s hair loss, my heart completely broke. But I couldn’t just stand by.

I decided to use my background in online research to dig deeper and look for real answers.

I started by looking into search trends to see how many other people were facing this same struggle.

<img: FPHL_Google Trends>
<img: telogen effluvium_Google Trends>
<img: Hair loss_Google Trends>

I pulled these three charts from Google Trends in August 2026. All are worldwide and cover the last five years.

Hair loss is up 50 percent. Telogen effluvium is up 130 percent. Female pattern hair loss is up 350 percent.

Look at the order of those numbers. The more specific the search, the faster it has grown.

Women are no longer just typing hair fall into Google. They are typing the name of a condition, which means they already suspect what they have before they ever see a doctor.

The shapes are worth looking at too. All three lines sit almost flat from 2022 through most of 2025, lift together near the end of that year, and peak together in the middle of 2026.

When a broad term and a narrow medical term move in step like that, the cause is usually outside the condition itself.

More coverage, more open conversation, more women deciding to look it up. It does not mean hair loss became more common this year.

For me, the useful part is what those curves say about timing. In 2016, my wife had no vocabulary for this at all.

She had a strand with a white bulb on it and a guess about vegetables. Anyone starting today already has the words, and the words are what get you a real answer.

Note: One note on reading the charts. Google Trends shows relative interest, not the number of searches. A score of 100 is that term at its own busiest week, so the three graphs cannot be compared against each other. The dotted section at the right edge is incomplete data, which is why every line seems to drop off at the end.

Looking at those numbers helped me realize we weren’t alone, and it gave me the push I needed to keep searching for a real solution for my wife and women like you!

Since then, I saw these numbers, my subconscious mind was and is full of women who have been experiencing it. I can literally feel their pain of having it. Because I saw my wife’s inferiority complex and desperation.

Apart from this digital proof, I began to spot many women in the real world as well.

For example, I even saw one elderly woman in our wedding album.

<img: Elder woman in my marriage_Zoom>

She barely has any hair on her head! Pathetic 😞

Recently, I gave a talk at one of the best colleges in our city. During a break, I noticed a young woman who was probably only 19 or 20 years old showing early signs of hair loss.

<img: Me in one of the famous college in our city>
<img: Me delivering a speech in one of the famous college in our city>
Overall, I have seen more than 30 women (including women in their 20s) in our city dealing with conditions like female pattern hair loss or telogen effluvium.

Seeing all of this in person made me realize something important.

The online search trends I had been studying were not just numbers on a screen. They represented real people going through this every day.

And, FPHL prevalence is 3 to 12% among women of European descent in their 20s and 30s, 14 to 28% among those in their 50s, and up to 56% of women over age 70.

Hormones that Cause Hair Loss in Women

Before we get into the hormones that cause hair loss, it’s essential to understand the hair growth phases.

The Hair Growth Phases

Anagen
Anagen is the growth phase. This is when your hair actively grows.

Catagen
Catagen is a detachment phase. It is a short phase where the hair stops growing and detaches from the blood supply.

Telogen
Telogen is a fall-out phase. The hair falls out, and the follicle rests before starting the cycle afresh.

Let’s get into the hormones now.

The primary hormone responsible for pattern hair loss in women is dihydrotestosterone (DHT), a potent derivative of testosterone (an androgen).

While DHT is commonly associated with male pattern baldness, it plays a key role in female hair loss as well. Specifically, in a condition known as androgenetic alopecia (female pattern hair loss).
The secondary hormones that are responsible for hair loss include estrogen and progesterone.

Dihydrotestosterone (DHT) & Androgens

There is an enzyme in the body known as Alpha-Reductase, which actively converts Testosterone to Dihydrotestosterone (DHT).

This DHT binds to the androgen receptors on your hair follicles. Hence, it shortens the Anagen phase of hair growth and extends the Telogen phase. It eventually leads to hair loss.

This is called hair follicle miniaturization.

The enzyme Alpha Reductase is actively found in the skin, prostate, and liver. It is actively responsible for prostate enlargement in men, hair loss on the scalp, and facial hair growth both in men and women.

So, it is clear that DHT is not a harmful metabolite of Testosterone, as projected by the social media influencers.

DHT is actually responsible for male genital growth in babies and the robust development of male secondary sex characteristics in teenagers.

The culprit is the enzyme called Alpha Reductase, which causes active breakdown of Testosterone to DHT.

The Protective Hormones: Estrogen & Progesterone

Estrogen helps keep hair in its anagen (growth) phase longer, promoting full, healthy hair.
Progesterone acts as a natural inhibitor of 5-alpha reductase, reducing DHT production.

Estrogen and progesterone usually act as a buffer against DHT. When these levels drop sharply, like after childbirth, during menopause, or after stopping birth control, that protection disappears. This leads to more hair shedding.

Why does the usual approach treat the symptom and misses the cause?

I want to say that our current healthcare system’s operating model is flawed. I’m not saying this from my knowledge blindly.

Dr. Russell Jaffe, a clinical pathologist and immunologist, argues that the modern healthcare system is disconnected because it focuses almost entirely on downstream “crisis care” rather than upstream, root-cause prevention.

He advocates for a shift toward personalized, proactive, whole-person healing that addresses biology, environment, and psychology.

The health care system is using the ‘divide and conquer’ method. Let me tell you the drawbacks of these with an example.

Here is a clear, real-world example that shows how the “divide and conquer” or “the downstream” approach fails a patient.

The Example: Downstream Approach vs Upstream Approach

Imagine a woman named Sarah. Over six months, she develops four separate symptoms:

1. Severe bloating and gut pain
2. Eczema and itchy skin rashes
3. Painful, stiff joints
4. Anxiety and constant fatigue

How the system handles it now

Instead of looking for a single underlying cause, the healthcare system divides her body into separate parts and sends her to four different specialists.

• The Gastroenterologist focuses only on her gut. He diagnoses IBS and gives her an acid blocker.
• The Dermatologist focuses only on her skin. She prescribed a steroid cream for eczema.
• The Rheumatologist focuses only on her joints. He gives her a strong anti-inflammatory painkiller.
• The Psychiatrist focuses only on her mood. He prescribes an anti-anxiety medication.

The drawbacks of this approach

1. No One Looks at the Big Picture: Each doctor treats one symptom in isolation. None of them ask why all these issues started happening at the same time.
2. Pill Stacking: Sarah ends up taking four different prescription drugs every day.
3. Medication Side Effects: The painkiller weakens her gut lining. The acid blocker lowers her stomach acid, making food harder to digest. The drugs end up worsening her initial problems.
4. The Root Cause Is Ignored: Her body continues to burn underneath because the real trigger was never found.

What looking upstream means instead (Dr. Russell Jaffe’s Model/ Functional health approach)

An upstream doctor looks at Sarah as one whole person rather than four separate body parts.
By looking at her biology, environment, and stress levels, the doctor finds one single root cause:

High chronic stress combined with an unmanaged food sensitivity broke down Sarah’s gut barrier (leaky gut). This allowed undigested particles to enter her bloodstream, triggering widespread inflammation that caused her joint pain, skin rash, gut distress, and anxiety all at once.

Instead of four drugs, Sarah receives a targeted plan:

• Remove the reactive food from her diet.
• Repair her gut lining with proper nutrition and sleep.
• Manage her daily stress response.

Within a few months, all four symptoms disappear together because the root fire was put out, rather than just fanning away the smoke.

That’s why I’m following functional health. I suggest you do too.

Conventional Treatments and their Drawback

Drugs called minoxidil, finasteride, and spironolactone are prescribed to treat baldness. You must be familiar with these.

What you don’t know is what exactly they do to your body. Let’s understand that.

Before we go through these: my wife was never offered any of them. Not minoxidil, not finasteride, not spironolactone.

Eight years, two clinics, roughly a thousand dollars, and not one prescription. She got a shampoo, a lotion, and sixty capsules.

Minoxidil is primarily a growth stimulator and vasodilator. It doesn’t fix the root cause.

What it changes is the conditions your follicles are working in.

Three things happen, roughly.

• Expands blood vessels (Vasodilation): Minoxidil relaxes smooth muscle in blood vessel walls. This increases microcirculation and blood flow to starved hair follicles. As a result, there will be more oxygen, nutrients, and growth factors.

• Extends the Anagen phase: As we have already seen, hair grows in cycles: Anagen, Catagen, and Telogen. Minoxidil pushes dormant hair follicles out of the resting phase and forces them into an extended growth phase.

• Reverses Follicle Miniaturization: Over time, pattern hair loss shrinks follicles, causing hair strands to become fine and thin (“peach fuzz”). Minoxidil helps widen the physical size of the follicle, producing thicker, stronger hair shafts.

Now, let’s explore what Finasteride does.

Finasteride helps address the hormonal problem we have already talked about.
Finasteride blocks the enzyme (5-alpha-reductase) responsible for converting testosterone into DHT.
By lowering DHT levels on the scalp, Finasteride stops the root cause of the damage and prevents further hair loss.
Using Minoxidil without Finasteride is like trying to fill a leaking bucket with water: Minoxidil pushes new growth, but DHT continues to destroy the follicles.

Next, spironolactone. It was built as a water tablet for blood pressure and heart failure. It also blocks androgen receptors.

That is why skin doctors now use it for hair loss, acne and unwanted facial hair.

It works at the follicle end of the chain. It does not lower your androgens. It sits in the receptor so DHT cannot bind there.

It is prescription only, and it is not approved for hair loss anywhere. Every use here is off label.

Everything seems fine, right? Well, not quite.

The mainstream media and social media influencers previously misdiagnosed the problem by blaming DHT instead of 5-alpha-reductase.

Now, they’re making the exact same mistake by brushing off the side effects of minoxidil, finasteride, and spironolactone.

The Side Effects of Minoxidil

The level of misuse and abuse toward these drugs is shocking.

Minoxidil is an antihypertensive initially manufactured for treating severe hypertension.
But it was stopped due to its side effects.
Despite the results it brings for hair loss, it causes cardiovascular system failure and muscle loss. It also causes hypotension and heart failure.
Since it is anti-androgenetic / anti-testosterone, it also causes erectile dysfunction and low sperm count in men.

Cardiovascular failures

• Pericardial Effusion and Cardiac Tamponade: Oral minoxidil carries an FDA Black Box Warning. The reason is fluid collecting in the sac around the heart, a condition called pericardial effusion. It can compress the heart, which is cardiac tamponade, and that can be life-threatening.
• Reflex Tachycardia and Myocardial Strain: There’s also strain on the heart muscle. Minoxidil forces blood vessels wide open and blood pressure drops rapidly, so the body compensates by driving the heart to beat excessively fast. That’s reflex tachycardia. Over time, it causes ischemic heart disease, left ventricular hypertrophy meaning the heart muscle enlarges, and ECG abnormalities.
• Severe Fluid Retention and Pulmonary Edema: Minoxidil signals the kidneys to retain extreme amounts of water and sodium. That fluid can back up into the lungs as pulmonary edema, or show up as severe systemic swelling.

Connective tissue and facial changes

• Collagen Inhibition: Research shows minoxidil inhibits lysyl hydroxylase, an enzyme necessary for collagen synthesis. Long-term users frequently report structural changes in skin elasticity, premature aging, deep dark circles, and severe skin sagging.
• Pseudoacromegaly: Rare case reports in the medical literature document pseudoacromegaly: a coarsening of facial features, meaning the facial tissue and skin thicken, with systemic minoxidil exposure over extended periods.

![][image1]

The Side Effects of Finasteride

Finasteride causes other serious side effects, such as menstrual irregularities, muscle loss, anxiety, and depression.
It also causes erectile dysfunction in men.
As I told you before, Finasteride is a 5-alpha-reductase (5-AR) inhibitor.
It doesn’t just block scalp DHT; it crosses the blood-brain barrier and halts the synthesis of crucial neurosteroids in the brain (like allopregnanolone), which regulate mood, stress, and anxiety.

Severe neuropsychiatric risks

• Severe Depression & Anxiety: Meta-analyses show a significantly heightened risk of clinical depression and panic attacks in patients taking 5-AR inhibitors.

• Suicidal ideation and behavior: On suicidality, three regulators have acted. The FDA mandated a warning label update for finasteride, explicitly adding suicidal thoughts and behavior as potential adverse reactions.
  The European Medicines Agency (EMA) and French regulators (ANSM) have issued severe warnings. France requires signed informed consent forms because of the psychiatric risks.

• Cognitive Dysfunction (Brain Fog): Memory issues, difficulty concentrating, and cognitive slowing are widely reported in clinical reviews, attributed to depleted neurosteroids.

Post-finasteride syndrome (PFS)

PFS is perhaps the most alarming finding in the research.

• For a subset of patients, stopping the drug does not reverse the side effects. Symptoms can persist indefinitely after discontinuation: severe sexual dysfunction, including anhedonia and loss of sensitivity, plus profound emotional blunting, insomnia, and chronic fatigue.

• Clinical trials historically claimed side effects resolve after quitting. Persistent post-drug symptoms are now documented in the literature and actively investigated for epigenetic changes😮.

Persistent endocrine disruption in women

• Hormonal and Menstrual Crises: Severe disruptions to estrogen/progesterone balance cause heavy abnormal bleeding, extreme PMS/PMDD symptoms, breast tissue changes, and early onset menopausal symptoms.

• Teratogenicity: Exposure during pregnancy causes severe congenital malformations, specifically ambiguous genitalia in male fetuses.

The Side Effects of Spironolactone

Like minoxidil and finasteride, spironolactone also has some side effects.

The common side effects include:

• Irregular periods, spotting, or missed periods. This is the most frequent complaint at 100 mg and above, which is why a combined pill is often prescribed alongside.
• Breast tenderness or swelling
• Needing to urinate more, particularly in the first few weeks. It is a diuretic.
• Dizziness when you stand up, from lower blood pressure
• Tiredness and headaches

Less common side effects include:

• Nausea
• Lower sex drive
• Mood changes
• Dry skin

Rare but worth knowing:

• High potassium. Spironolactone makes your body hold on to potassium, and too much potassium is dangerous.
• Uncommon in healthy young women, more likely if you are over 45, have kidney problems, or take ACE inhibitors, ARBs or regular anti-inflammatory painkillers.

Why it’s happening to my wife and you: the root-cause map

This is my wife’s crown after we started fixing a few of the causes listed below.

<img: My wife Transition>

So read the whole list, including the ones that sound like they have nothing to do with you. Six of these had never been tested on my wife in eight years, and hers was one of the six.

Your genes decide which follicles are sensitive to DHT. They do not decide how much DHT reaches those follicles.

They do not decide how fast the damage adds up either.

That part is driven by things you can measure and change, and it is the part every clinic my wife visited ignored for eight years.

In the previous section of this article, the “Hormones that Cause Hair Loss in Women”, I have talked about DHT, estrogen, and progesterone.

As seen before, your body makes DHT from testosterone, using an enzyme called 5 alpha reductase. All women make both. That is normal.

The trouble starts at the follicle. On the top and front of your scalp, some follicles carry receptors that react to DHT.

When DHT binds to one, it cuts short the hair’s growing phase. The follicle gets less time to work on every cycle.

So each new hair is finer and shorter than the last one. That is miniaturisation, and it is the whole disease in one sentence.

The follicles at the back and sides of your head do not react the same way. That is why your part thins while the hair above your neck stays thick. It is also why hair transplants work.

Two things set the speed. How touchy your follicles are, which is down to your genes. And how much free androgen is in your blood, which is not.

The rest of this section is about that second number.

So here is the map. Eleven drivers, what each one does, and the test that finds it.

<Img: handwritten primary causes for hair loss>

Image caption: This is the first copy of primary causes that trigger FPHL and telogen effluvium, written by me for my wife after completing my 2 months of research.

Now, I’ll give you a more fine-tuned version of the root causes for our hair loss.

Insulin resistance

Most doctors never test for this one. In our case, it turned out to be the centre of the whole problem.

Now, let’s come to the problem of it.

Most of the testosterone in your blood is bound to a carrier protein called SHBG.

Bound testosterone stays locked in your bloodstream.

It cannot enter a follicle, so it cannot cause any hair loss there. Only the free part can.

So SHBG is on your side. The more of it you have, the less testosterone reaches your hair.

Your liver makes SHBG, and insulin tells it to make less. So when insulin runs high, SHBG drops. Free testosterone then rises, even though your total testosterone has not moved at all.

Insulin resistance is the main culprit for your hormonal imbalance.

That point matters more than anything else in this article.

Your total testosterone can look perfectly normal on paper. Meanwhile, the amount reaching your follicles has gone up.

If your doctor checks total testosterone and stops there, the problem stays hidden.

Insulin runs high in response to what you eat and how your body deals with it. That is why we put a glucose monitor on my wife. That experiment gets its own section below.

If you have higher insulin than normal, this condition is known as hyperinsulinemia. It is not diabetes itself, but it often happens before type 2 diabetes. It occurs when your body does not respond well to insulin. Your pancreas then makes extra insulin to manage your blood sugar.
In my ebook, you can find protocols to keep your insulin level optimal naturally.

Ask for: fasting insulin, fasting glucose, HbA1c, SHBG, total testosterone, and free testosterone. Fasting insulin is the one that matters, and it is almost never included by default. You have to name it. With fasting insulin and fasting glucose, you can also work out HOMA IR, the standard score for insulin resistance.

Let’s look at my wife’s case.

My wife had blood drawn twice in eight years. Surprisingly, her HOMA-IR level (0.78 in 2025) and HbA1c (5.98% in 2024 and 5.1% in 2025) were normal.

You can see those values in the below report.

<img: old and new reports>

But, CGM data shows multiple peak insulin levels per day!

<Img: Insulin peak levels in a day_CGM data>

HOMA-IR is a fasting snapshot. What it means is my wife has excellent fasting metabolism, but specific meals or triggers might still produce short-term glucose volatility.

This glucose volatility can affect hormones through a secondary pathway: adrenal stress, which contributes to adrenal hyperandrogenism.

Leaky Gut

Leaky gut is common in this century due to junk foods and overeating. You need to fix this before you supplement your body with proper nutrition.

“Leaky gut” (medically referred to as increased intestinal permeability) occurs when the tight junctions holding your intestinal lining together loosen.
<img: leaky gut>
<img caption: Source: Gastro Savannah>

This allows undigested food particles, toxins, and bacteria to pass through the gut barrier directly into the bloodstream, triggering immune reactions and systemic inflammation.

Primary triggers include:

• Dietary factors: High refined sugars & ultra-processed foods, gluten and zonulin trigger, alcohol, and industrial seed oil and trans fat.
• Medications:
  • Non-steroidal anti-inflammatory drugs (NSAIDs): Regular use of drugs like ibuprofen, naproxen, or aspirin directly degrades the protective gastric and intestinal mucosal barrier by inhibiting protective prostaglandins
  • Frequent antibiotic use
  • Proton pump inhibitors (PPIs)
• Chronic stress and circadian disruption:

This is my wife’s. She works rotating shifts, so for half of every month she is awake all night and asleep in daylight.
Her gut has been trying to run its repair cycle on a schedule that changes every two weeks, for years.

• Cortisol & HPA Axis Activation: Persistent emotional or physical stress elevates cortisol, which weakens gut immunity (IgA production) and destabilizes intestinal tight junction proteins.
  • Circadian misalignment: Poor sleep or irregular sleep patterns disrupt the daily repair cycle of the gut epithelium. My wife has this too; she has been working multiple shifts. So, half of the month she would be on night shifts.
• Microscopic infections & dysbiosis:
  • SIBO (Small Intestinal Bacterial Overgrowth): Excess bacteria in the small intestine produce lipopolysaccharides (LPS), endotoxins that trigger local immune cells and damage the lining.
  • Candida or Parasitic Overgrowth: Pathogens can physically attach to and disrupt epithelial cells.
• Nutrient deficiencies:
  • Lack of Zinc, Vitamin D, & L-Glutamine: These key nutrients are necessary for cell turnover and the maintenance of tight junction protein complexes.
  • Low Dietary Fiber: Soluble fiber feeds good bacteria to produce short-chain fatty acids like butyrate, which serves as the primary fuel source for repairing gut lining cells.

The gut is the first brain. (Yes, many evolutionary biologists actually consider it the first!)

Therefore, it should be taken care of.

The gut is the library of beneficial microorganisms called the microbiome.

This microbiome not only plays a role in digestion, but it also plays a role in:

• Sleep
• Mental health
• Brain health
• Metabolism
• Hormonal health
• ETC

To fix your gut, do the following:

• Do not eat the 3 demons of the gut: lactose, gluten, and fructose
• Start fasting. Begin with one meal a day (OMAD), then graduate to 48 hours weekly. This autophagy marathon promotes the regeneration of gut cells and general gut health.
• Eat sauerkraut
• Eat salt
• Eat less dietary fiber. When you eat fiber all the time, you overwhelm the microbiome.
• Raise your stomach HCL. It should be as strong as possible: 1-3 on the pH scale
• Meat and eggs are important
• Essential fatty acids are also important. They aid in the digestion of vitamins A, D, E, and K
• Stay away from seed oil. Instead, use olive oil and pure ghee
• No alcohol and no smoking
• Resistance training and 5,000 steps daily are a must
• Avoid unnecessary use of antibiotics, antacids, and anti-ulcer medicines

Fix your gut through your own efforts because hospitals will not.

PCOS

PCOS is the most common hormone problem in younger women. Thinning hair is one of its known signs.

PCOS has been officially renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS).

Doctors use the Rotterdam criteria, which require two of three findings.
Irregular or missing ovulation. Signs of high androgens, either on a blood test or visible as acne, unwanted facial hair, or thinning scalp hair. Polycystic ovaries on a scan.

You do not need all three. You also do not need to be overweight.

Lean PCOS is real, and it gets missed all the time because the woman in front of the doctor does not match the textbook picture.

My wife has never been screened for it, despite eight years of hair loss. Since she didn’t experience any symptoms, I skipped in this part 1 of recovery.

If your periods are irregular, do not let this one go untested the way we did.

Insulin resistance sits under a large share of PCOS cases, whatever your size.

Let’s see how insulin resistance drives PCOS.

When your cells stop responding well to insulin, your pancreas makes more of it to compensate. Insulin levels in your blood go up.

Your ovaries do not resist insulin the same way.

So while your muscle and fat cells are ignoring the signal, your ovaries are receiving a much stronger one than normal.

High insulin tells theca cells in the ovary to make more androgen. It also makes those cells more responsive to LH, a hormone that already runs high in many women with PCOS.

At the same time, high insulin lowers SHBG in your liver, exactly as described above.

So you get hit from two directions. Your ovaries make more androgen, and less of what they make stays bound. Free androgen rises on both counts.

That extra androgen then stops egg follicles from maturing properly, which is what produces the irregular cycles and the appearance on a scan.

Ask for: the fasting insulin panel, plus LH, FSH, prolactin, DHEA-S, and an androgen panel. Ask for a pelvic scan too if your cycles are irregular.

Irregular Thyroid hormones

A slow or overactive thyroid causes shedding, not pattern loss. But it does two kinds of damage at once.

It thins your hair on its own, and it makes any pattern loss underneath look worse.

One TSH result is not a thyroid check. TSH can sit inside the normal range while free T4 and free T3 tell a different story.

Thyroid antibodies can turn positive years before anything else shifts.

Let me simplify the thyroid gland and its work.

The thyroid is a small butterfly-shaped gland located at the front of the neck, just below Adam’s apple.

It weighs 20-30 grams, and it influences nearly every cell in the body.

It has two lobes connected by a bridge called the isthmus.

Its basic functional unit is called the thyroid follicle, a microscopic structure responsible for producing thyroid hormones.

The thyroid uses iodine from food to manufacture two hormones:

• T4 (Thyroxine)
• T3 (Triiodothyronine)

T4 is the storage form.

T3 is the active form that exerts effects on cells.

So, the thyroid produces an inactive hormone called T4.

The body must therefore convert T4 into T3.

Selenium is needed for this conversion. Without it, you may have normal T4 levels but still experience symptoms of hypothyroidism.

Some people swallow thyroid medication, and their blood tests improve, but they still remain tired, cold, or mentally foggy.

This is because there is poor conversion of T4 into T3.

Ask for: TSH, free T4, free T3, TPO antibodies, and thyroglobulin antibodies.

Low Iron and Ferritin Levels

This is one of the two things her 2024 blood test found. Her haemoglobin came back at 11.8%, her HCT at 39.4%, and her MCH (26 pg) pointed to iron deficiency.

<Img: iron and ferritin levels in 2024>

Here’s what has changed, when she took a blood test again in 2025.

• Haemoglobin 11.9 g/dL (12-15). A 0.1% increase compared to 2024.
• HCT: 34.7% (36-46). It’s a decrease when compared to the previous year. It indicates low red blood cells.
• MCH: 28.3 pg (27-32). It’s a 2.3 pg increase!

<img: 2025 iron levels>

She had been vegetarian her whole life, and plant iron is absorbed far less well than iron from meat. It took one test to find it.

Ferritin measures stored iron. Hair follicles are among the first tissues your body starves when those stores run low. This was one of the two things my wife’s 2024 blood test caught.
Your hair is the last part of your body to get nutrition and the first to get cut off when resources run low. Because hair is not vital for survival, the body prioritizes essential organs first.

Ferritin has a catch. Most labs mark anything above roughly 15 as normal, because that range was built to catch anemia, not to grow hair.

Many skin doctors want to see a good deal more than that before they rule iron out.

The right target is argued over, and the research is not settled, so treat any number you read online with care, including mine.

There is a second catch. Ferritin also climbs when you have inflammation or an infection. A normal-looking result can hide low iron if something else in your body is inflamed.

This is what my wife eats to increase her ferritin levels and treat anemia.
<Img: prickly pear>

For more information on what this is and how to safely eat it, you can refer to my ebook. Considering the length of this article, I have curated all-natural solutions that helped my wife in this ebook.

Ask for: ferritin, serum iron, TIBC, transferrin saturation, and a full blood count. If your periods are heavy, say so. That is the most common cause in women who still have periods, and it will not fix itself.

Low levels of vitamin D, B12, zinc, and Low protein intake

This was the other finding. Her vitamin D came back at 26.8, which is insufficient.

She lives in Tamil Nadu, one of the sunniest places on earth, and she was deficient in vitamin D. That is how much of our lives now happen indoors.

Hair follicles carry vitamin D receptors and seem to need it to cycle normally.

Low levels are very common, even in sunny countries, because most of us work indoors.

How to get enough Vitamin D?

The sun. It is a great source of Vitamin D and our biggest endocrine stabilizer in the health of human beings.

Midday sunshine is the best for Vitamin D synthesis.

In the morning and evening, the zenith angle of the sun is oblique; therefore, little Vitamin D will be produced in the skin.

The oblique angle is seen during winter; people are advised to swallow vitamin D3 supplements.

If you want to gain maximum benefit from the sun, sit in the sun between 12 PM and 3 PM.

Our ancestors spent their lives working the fields under the open sky from dawn to noon. Skin cancer wasn’t an epidemic for them; instead, natural sun exposure gave them robust health and hormonal vitality.

Here’s what full-spectrum sunlight actually does for the body:

• Hormonal Balance & Circadian Rhythms: Sunlight is the master biological cue for your pineal and pituitary glands. Light hitting the eyes sets your daily circadian rhythm, while UVB rays on the skin help regulate systemic hormone production.
• Stress Reduction & Mood Boosts: UV exposure triggers the pituitary-adrenal axis, stimulating natural endorphins and alpha-MSH, which help lower inflammation and lift your mood.
• Reproductive & Endocrine Health: Healthy sunlight exposure plays a key role in optimizing baseline hormone levels, vital for reproductive health and overall vigor. Many of our great-grandfathers effortlessly gave birth to 8 to 10 kids. But now there are fertility centers in each city.

Dr. Andrew Huberman, the renowned American neuroscientist, frequently emphasizes sunlight exposure as one of the most foundational habits for physical health, mental well-being, and performance on his podcasts.

Here’s one for you to watch.

Here’s a summary of what he insists:

• Morning: Get bright outdoor light as soon as possible after waking.
• Daytime: Get as much bright light (natural or indoor light) as possible during work hours to sustain focus.
• Late Afternoon: Catch the low-angle sun to lock in sleep preparation.
• Night (10 PM - 4 AM): Avoid bright light (especially overhead lights and screens) “like the plague,” as it acutely crashes dopamine levels and disrupts sleep architecture.

Now, tell me: when did you see the early morning sunlight? Do you even get sunlight exposure, first of all?

If not, I urge you to stick with nature’s rhythm. Wake up with the sun and see the early morning horizon light, as stated above, for one week and see how much better you feel throughout the day.

Note: Avoid sunglasses and sunscreen.

<img: me and my wife getting sun exposure for Vitamin D3>

Zinc, vitamin B12, and protein matter too. They matter more if you are vegetarian.

My wife’s vitamin B12 levels were low 166 pg/ml in 2025. The optimal range is (211-911).

<img: Vitaminb12_2025 report>

She was vegetarian her whole life. Plant iron is absorbed far less well than iron from meat.

B12 is hard to get without animal food. Daily protein is easy to fall short on without noticing.

Her hunch in 2018 that food was involved was not wrong. She just had no way to know which part of her food was the problem.

Then there is biotin, which is a real trap.

Biotin (Vitamin B7) only helps hair if you are short of it, and that is rare. Worse, a high dose throws off several common lab tests.

It can push your thyroid results the wrong way. It can also distort troponin, the test used to spot a heart attack.

If you take a hair supplement, check the label. Stop it for a few days before any blood test, and tell whoever draws the blood.

Ask for: vitamin D, vitamin B12, zinc, and take an honest look at how much protein you eat each day.

Note: You can check my ebook for how I increased my wife’s Vitamin D, B12, and Zinc.

Low levels of good fat

Optimal good fat levels are indispensable for hormonal production, balance, and signaling.

Low levels of healthy fats can directly trigger hair shedding and thinning through several distinct biological pathways.

Protective hormone disruption and Scalp sensitivity

The protective hormones (progesterone, estrogen, and testosterone) are synthesized from cholesterol and dietary fats. When essential fat intake drops sharply:

• Production Drops: Systemic hormone synthesis slows down, which can disrupt normal follicle growth cycles.
• Progesterone & Estrogen Deficits: Progesterone acts as a natural inhibitor of 5-alpha reductase (the enzyme that converts testosterone into hair-thinning DHT). When healthy fats drop and progesterone levels fall, the local ratio of active DHT on the scalp can rise relative to protective hormones, accelerating follicle miniaturization.

Inability to absorb fat-soluble hair nutrients

Your hair follicles rely heavily on Fat-Soluble Vitamins, specifically Vitamin A, Vitamin D, Vitamin E, and Vitamin K2.

• The Vitamin D Barrier: Vitamin D functions as a master regulator of the hair cycle, signaling follicles to transition from the resting phase (telogen) back into the active growth phase (anagen).
• Absorption Failure: Even if you eat foods rich in Vitamin D or take supplements, your intestines cannot absorb them efficiently without dietary fat present to form micellar complexes during digestion. A deficiency in Vitamin D is a primary trigger for telogen effluvium (diffuse shedding).

Loss of structural lipid barrier in follicles

Each hair follicle contains a sebaceous gland that secretes sebum, a specialized mixture of lipids, fatty acids, and squalene.

• Follicle Lubrication: Sebum creates a protective barrier that seals the cuticle, reduces friction, and keeps the follicle tube supple.
• Scalp Microbiome Balance: Essential fatty acids (like Omega-3s and Omega-6s) maintain scalp skin integrity. Very low fat levels cause the scalp barrier to dry out, leading to micro-inflammation around the follicle root that can constrict hair growth.

Inflammatory cascade & cell membrane weakness

Every cell membrane in your hair matrix is composed of a lipid bilayer.

• Cell Division in the Matrix: Hair matrix cells are among the fastest-dividing cells in the human body. Without adequate Omega-3 and Omega-6 fatty acids, new cell membrane production slows down.
• Pro-Inflammatory Shifts: Essential fatty acids (like EPA and DHA) produce anti-inflammatory signaling molecules (resolvins and protectins). Low levels lead to unchecked systemic inflammation, which can stress follicles and push them prematurely into shedding.

Poor liver function

High insulin for a longer period affects your liver function.

Vitamins A, D, E, and K are fat-soluble.

If the liver is messed up, it won’t release adequate bile, and the digestion of fats will be impaired. This will, in turn, destroy the absorption of vitamins A, D, E, and K.

A dysfunctional bile duct compromises the release of bile salts to the gut.

The consequences of compromised bile production are:

• Gall stones
• Inflammation of the gallbladder
• Malabsorption of essential fats
• Poor absorption of vitamins A, D, E, and K
• Bloating
• Intolerance toward meat and eggs
• And finally, a leaky gut (The second root cause we have seen. Did you feel the connection?)

We have not had her liver markers checked yet. It is on the next panel.

Perimenopause

It doesn’t apply to my wife. She is 26, and her hair loss started at 16.

I am including it because it is one of the most common triggers in women generally, and because if you are over 40, this is probably your section rather than mine.

Oestrogen keeps hair in its growing phase for longer. In perimenopause, oestrogen falls away faster than androgen does.
So the balance tips towards androgen and the follicle loses its cover, even when your testosterone has not changed at all.
This usually starts in your forties, often years before periods stop. It is frequently the trigger that exposes a genetic tendency that was there all along.

Check ferritin, not just hormones. Periods often get heavier in your forties. Heavy bleeding drains iron, and low iron thins hair on its own. This is the most missed item here, and the easiest to fix.

Take the insulin work more seriously, not less. Insulin sensitivity falls at this stage. Muscle is where most of your blood glucose gets used up, and you lose muscle faster from here on. Lifting weights twice a week and eating enough protein will do more than any supplement.

Fix your sleep if perimenopause has wrecked it. Poor sleep raises cortisol and worsens insulin resistance. It feeds two drivers at once.

Ask about treatment rather than waiting. Hormone therapy is prescribed for menopausal symptoms. Some women see their hair improve on it. But it is not a hair loss treatment, and the evidence for hair alone is thin. Minoxidil and anti-androgens are covered further down, and both are used in this group.

Check your hairline too. Frontal fibrosing alopecia is most common around and after menopause. A hairline moving back as a band, or thinning eyebrows, means going back to that section.

Women do regrow hair at this stage. The oestrogen change is the one driver you cannot undo. It is rarely the only one running, though. Iron, insulin, thyroid and sleep can all still be dealt with, and they are often doing more of the damage than people assume. How much comes back depends less on your age than on how long the follicles have been shrinking.

Ask for: oestradiol, FSH and LH, alongside the thyroid and iron panels. Those tend to shift in the same window. One warning. Oestradiol and FSH swing wildly at this stage. A single result can land on a normal-looking day and tell you nothing. Keep a record of your periods and take it with you.

After a birth, or after stopping the pill

This was not my wife’s trigger. But if your hair changed within a year of giving birth or coming off the pill, read this one twice.

Pregnancy holds hair in its growing phase. A few months after the birth, all of that hair leaves at once.

Most women are back to normal within a year. It gets tricky when pattern hair loss was already quietly underway, because then the density never returns to where it started, and the postpartum shed gets blamed for all of it.

Stopping the pill does something similar by another route. Combined pills push SHBG up.

Come off them and SHBG drops, free androgens rise, and hair can thin for months. Some progestins are more androgenic than others, which is worth asking about before you switch.

Stress and Overeating

These two belong in the same section, because they run on the same loop.

Long-term stress raises cortisol. Cortisol pushes follicles out of their growing phase on its own.

Half of every month my wife is awake when her body expects to be asleep, and that alone raises cortisol and lowers insulin sensitivity the next day.

Cortisol also raises your blood glucose directly, since that is part of what the stress response is for. And it drives appetite, usually towards fast, easy, high-carbohydrate food.

Poor sleep, which stress tends to bring with it, makes all of that worse. One short night lowers your insulin sensitivity the next day and leaves you hungrier.

So you eat more, and more of what you eat spikes your glucose. Your pancreas answers with more insulin.

From there, the chain is the same one from the top of this section. High insulin lowers SHBG. Low SHBG frees up more testosterone. More free testosterone means more DHT reaching the follicle.

Weight gained around the middle then makes your cells less responsive to insulin, which tightens the loop again.

This is not about willpower, and it is not about your body size. It is about how much insulin your body makes across a day.

Stress changes that from both ends. It changes what you reach for, and it changes how your body handles it once you have eaten.

What to do?
Zinc lowers cortisol. But you should be cautious about the limit.

Zinc and copper compete for absorption, so sustained high zinc intake causes copper deficiency, which brings anaemia and neurological problems, and copper deficiency can itself cause hair problems.

The safest zinc intake for adult women is 8 mg/day. Anything more than that would cause you trouble.

Alternatively, you can use ashwagandha to lower your cortisol. According to a study, a 300 mg daily dose led to a statistically significant reduction in serum cortisol levels by day 60 (P < .05).
You can use magnesium supplements for better sleep.

Dr. Andrew Huberman suggests magnesium glycinate, the body calmer, for systemic body and muscle relaxation and better sleep onset.

It helps lower core body temperature and activates GABA receptors, making it easier to fall asleep physically. Unlike other forms of magnesium, such as magnesium oxide or citrate, it is very gentle on the stomach.

He also suggests magnesium L-threonate, the brain specialist, to help quiet racing thoughts, reducing 2 AM mental awakenings rather than making you physically sleepy.

Magnesium L-threonate raises magnesium concentrations directly inside cerebrospinal fluid, supporting synaptic plasticity, working memory, and cognitive recall.

Choose Magnesium Glycinate if: You suffer from muscle cramps, high physical anxiety, or general insomnia, or if you want a cost-effective daily magnesium supplement.

Choose Magnesium L-Threonate if: Your primary goals are overcoming daytime brain fog, enhancing focus and memory, or silencing an overactive mind at bedtime.

According to a Mayo Clinic article, women between the ages of 19 and 30 take 310 mg per day, and women over 31 years of age take 320 mg per day. You can actually stack both based on your doctor’s suggestion.

What do all these eleven causes have in common?

Read those eleven drivers back to back and something starts to show through. They are not eleven separate problems. Most of them meet at the same place.

Let me be careful here, because this is where health writing usually overreaches. Your genes are your genes.

Autoimmune thyroid disease is autoimmune. Oestrogen falls in your forties, whatever you eat.

But trace each driver back and see how many roads pass through insulin.

And insulin levels rise primarily because your body releases the hormone to process glucose from food, especially carbohydrates. Other triggers of high insulin include poor sleep.

Insulin resistance is the first driver, and it works by lowering SHBG so more free testosterone reaches your follicles.

PCOS runs on the same fuel. High insulin tells the ovary to make more androgen and tells the liver to bind less of it.

Poor liver function is largely an insulin story too. Fructose is processed almost entirely by your liver, and a steady load of it turns into fat stored there. A liver under that kind of pressure makes less bile, and without bile you cannot absorb vitamins A, D, E, and K properly.

That failure of absorption lands straight on driver six. You can swallow vitamin D every morning and still stay deficient if your liver and gut are not moving it into you.

Leaky gut is fed by refined sugar and ultra-processed food, which sit at the top of the trigger list. Damaged gut lining then raises inflammation across your whole body, and inflammation makes your cells even less responsive to insulin. The loop closes.

Low ferritin gets pulled in through that same inflammation. When your body is inflamed, it produces more hepcidin, a hormone that blocks iron absorption and locks away the iron you already have. You can eat iron and still run low.

Low good fat is usually the same diet described from a different angle. A day built on refined carbohydrate and seed oil is a day with very little of the fat your hormones are made from.

Stress and overeating drive the loop directly. Cortisol raises your blood glucose, then sends you looking for the fastest carbohydrate in the house.

Driver	How insulin reaches it
Insulin resistance	The driver itself
Leaky gut	Refined sugar damages the lining. Inflammation then worsens insulin resistance
PCOS	Insulin drives ovarian androgen and suppresses SHBG
Thyroid	Mostly its own condition. Each makes the other worse
Iron and ferritin	Inflammation raises hepcidin, which blocks iron absorption
Vitamin D, B12, zinc	Poor bile and gut damage block absorption of what you eat
Low good fat	Same diet, seen from the other side
Liver function	Fructose is handled by the liver. Excess becomes stored fat
Perimenopause	Oestrogen falls on its own. Insulin sensitivity falls alongside it
Birth and the pill	SHBG crash lands harder on an already insulin-resistant body
Stress and overeating	Cortisol raises glucose and drives you towards sugar

Three things on this list are not caused by sugar.

Your thyroid antibodies, your falling oestrogen, and the follicle sensitivity you were born with. High insulin makes each of them worse. It did not start any of them.

So the honest version is this. Insulin is not the cause of everything on the list. It is the junction that the most roads run through.

That matters for a practical reason. You cannot fix eleven things at once. Nobody can.

But if one lever moves seven or eight of them, that is the lever to pull first, and everything else gets easier afterwards.

Which brings us to the problem we ran into next.

You cannot feel your insulin. There is no symptom that tells you it just went up.

A fasting insulin test helps enormously, but it is one moment on one morning, and it says nothing about the other fifteen waking hours.

I needed to see what my wife’s food was actually doing to her, meal by meal, across a normal day. Not what the internet says rice does. What rice did to her.

So we put a continuous glucose monitor (CGM) on her arm and started logging everything.

The CGM experiment we did

I just want to reiterate why I put a CGM on my wife with hair loss.

The logic behind why someone with hair loss needs to put a CGM: glucose spikes → insulin response → suppressed SHBG → more free androgen → more DHT at the follicle

Note: you should consider this as an experiment. This is not a treatment for your hair loss.

The Setup

I have chosen Ultrahuman CGM for my wife. Because, I have used it between Oct 18, 2024 to Nov 1, 2024.

It cost me 7,000 INR (about $83 USD) back then for 15 days.

<Img: My Ultrahuman Streak>

I don’t have diabetes at all. Since I’m a health conscious person and a tech enthusiast, I tried it.

If you ask me why Ultrahuman, I would say I initially chose it because of my friend’s suggestion.

But later, I find that the application they have created is very insightful with an easy to use user interface (UI). I personally liked the application and the personalized insights that it gives based on an individual’s unique biology.

While traditional CGMs like Dexcom (Stelo/G7) and Abbott (FreeStyle Libre 3/3 Plus) are designed primarily for clinical diabetes management and medical treatment, the Ultrahuman M1 CGM and its successors are engineered specifically for holistic metabolic health, biohacking, and athletic performance optimization.

Actually, Ultrahuman owns the software application, not the sensor itself. Yes, they use the FreeStyle Libre sensor from Abbott.

Ultrahuman combines Abbott’s gold-standard FreeStyle Libre sensor with its own powerful software, giving us decades of proven hardware accuracy alongside a world-class digital health experience.

Recently, Ultrahuman uses GlucoRx Vixxa 2 CGM too apart from FreeStyle Libre.

If you are from the US or Europe, you can use Ultrahuman too. With their regional hubs, you will get fast delivery.

If you don’t prefer Ultrahuman, you can use Abbott’s FreeStyle Libre 3 too. But I don’t know about the software application experience of Abbott!

The setup is pain-free and easy.

The package comes with a launcher to insert the CGM into your body.

You can watch the above video for the installation.

Now, let me tell you what I have measured on my wife.

• Foods and their insulin responses
  • Portion
  • Baseline
  • Peak
  • delta (Δ)
  • Time to baseline
• The response of the same food and different sequencing
• Exercises and their effect on insulin

Foods	Portion	Baseline	Peak	delta	Time to baseline	Notes

The response to the same food but with different sequencing

Take Away

That is the end of Part 1.

I hope you now have something my wife did not have for eight years: a clear idea of what is happening to your hair, and why.

That understanding is the whole thing. It is what let us find her trigger and deal with it, and her hair has been growing back since.

Part 2 will have her results. Her photos after 90-100 days, and what changed in her bloodwork after three months of eating as per my protocol and moving every day.

Put your email below and I will send it to you when it is ready.

You now know the root causes and where they all meet, which is enough to build your own protocol from scratch.

If you would rather not spend the time working it out, the ebook has everything my wife is doing now, written out in order.

One thing worth saying about it: there are no medications in the ebook, and no hair products. The whole protocol is built on natural rhythm and real food.

<img: a glimpse of our routine — ghee, cumin water>

FAQs

1. Which hormone causes hair loss in women?

Three hormones decide what happens to your hair: DHT, estrogen and progesterone. DHT is the one that damages the follicle.
Estrogen and progesterone protect it, so hair loss follows when they fall and DHT is left unopposed.
So, the main hormone behind pattern hair loss in females is dihydrotestosterone (DHT), which is a potent androgen derived from testosterone.
To really understand what’s happening with DHT, we have to talk about 5-alpha reductase; the enzyme that acts like a switch, turning testosterone into DHT.

2. What are the most notable investigational hair growth therapies currently in clinical trials?

There are four leading hair growth therapies currently in clinical trials:
1. Clascoterone 5% (Topical)
This is a liquid applied directly to the scalp. It blocks hair-thinning hormones right at the root without spreading throughout the body. It recently completed Phase 3 clinical trials.
2. PP405
PP405 is a topical gel designed to reawaken resting stem cells in the hair roots. It helps dormant follicles start growing new hair again. It has completed early Phase 2 human trials. Some researchers started calling it a minoxidil killer.
3. Exosome and Stem Cell Therapies
These treatments use natural signals from stem cells. They aim to lower scalp inflammation and repair damaged tissue. Researchers are still working to find safe, standardized dosage rules.
4. 2-Deoxy-D-Ribose (2DDR)
2DDR is a natural sugar compound. It stimulates the growth of new blood vessels in the scalp to nourish hair roots. It is currently in early animal and lab studies.

3. What is the ICD-10 code for female pattern hair loss?

Every diagnosis has a code attached to it. Doctors and insurers use them, and the one written on your file tells you what your doctor actually concluded.
There is no code specifically for female pattern hair loss.
It is coded as androgenic alopecia, normally L64.9 (androgenic alopecia, unspecified) or L64.8 (other androgenic alopecia). L64.8 also covers FPHL alongside PCOS. L64.0 is used when a medication causes it.

Code	What it means	Where it fits
1.64.9	Androgenic alopecia, unspecified	The code most often used for female pattern hair loss
L64.8	Other androgenic alopecia	Also used for FPHL, including FPHL alongside PCOS
L64.0	Drug-induced androgenic alopecia	When a medication is the cause
L65.0	Telogen effluvium	The heavy shedding described earlier
L65.1	Anagen effluvium	Chemotherapy and similar causes
L65.9	Nonscarring hair loss, unspecified	Hair loss with no diagnosis reached
L63.9	Alopecia areata, unspecified	The patchy autoimmune type
L66.12	Frontal fibrosing alopecia	Scarring. Sits under lichen planopilaris
L66.9	Cicatricial alopecia, unspecified	Scarring hair loss, type not named

4. What does L65.9 mean on my report?

L65.9 means nonscarring hair loss, unspecified. It is used when hair is falling out, and no cause has been established yet. If that is what is on your paperwork after a consultation, you have a placeholder rather than a diagnosis, and it is fair to ask what would move you off it.

5. Is there a separate ICD-10 code for frontal fibrosing alopecia?

Yes. L66.12, sitting under lichen planopilaris. FFA has its own code because it scars the follicle and is managed differently from female pattern hair loss. If your hairline is moving back as a band and your eyebrows are thinning, this is the code to raise with a dermatologist.

6. Why do women with hair loss try CGM?

Hair loss in women is frequently tied to metabolic dysfunction and insulin resistance. Consuming high-glycemic foods triggers rapid insulin spikes, which in turn can elevate androgen levels and disrupt the hair growth cycle.
A CGM helps women identify dietary root causes by providing real-time glucose data. For those struggling with sugar cravings or metabolic addiction, actionable visual feedback transforms abstract health warnings into immediate visibility.
Seeing personal glucose volatility in real time helps bridge the gap between knowing sugar is harmful and taking concrete steps to stabilize metabolic and hormonal health.