Whether you have been noticing a slow increase in how much hair you’re losing, or it happens suddenly, excess hair loss can be distressing. We’ll cover some of the more common reasons for increased hair loss and some steps you can take that may help.  

How IBD can affect hair loss 

Telogen effluvium 

Telogen effluvium is an excess amount of temporary hair loss. It usually occurs around 1–6 months, with an average of 3 months, after a physically or emotionally stressful event or time period, such as a flare-up of IBD symptoms. This will usually resolve on its own as if the triggering event has also passed.  

Nutrient deficiencies 

Nutrition can have a large impact on our hair, so deficiencies in various nutrients can cause hair loss. These deficiencies can happen by not getting enough in our diet, or by poor absorption of nutrients due to IBD flares, diarrhea, or surgery that removes large portions of the small intestine.  

Some of the nutrient deficiencies that can cause hair loss (in general and people with IBD) include: 

• Protein 
• Iron 
• Zinc 
• Vitamin D 
• Some B-complex vitamins (riboflavin, biotin, and niacin) 

Medication 

Hair loss is a relatively rare side effect of many types of IBD medications. However, it may be more common with methotrexate as the mechanism of this drug targets rapidly dividing cells and can affect hair follicles. 

Other autoimmune diseases 

Having an autoimmune disease like Crohn’s disease or Ulcerative Colitis increases your risk of developing another autoimmune disease. Some autoimmune conditions have symptoms of hair loss such as alopecia areata or Hashimoto’s disease.  

Androgenetic alopecia 

If hair loss persists and other causes are ruled out, you might be dealing with androgenetic alopecia, aka male or female pattern baldness. This is influenced by your genetics, so if your parents or grandparents experienced this type of alopecia, you may be as well.  

What you can do about it 

Preventing telogen effluvium 

Since hair loss can happen in the months following an IBD flare, the best way to prevent it from happening is trying to get into and maintaining disease remission. Taking your IBD medications as scheduled is key. If you are still struggling with flares, discuss with your doctor or Care Team how your treatment might be adjusted. 

If stress seems to be causing your telogen effluvium, it’s highly recommended to speak to a counselor to help you cope. Learning more about stress and stress management can also be helpful. Need more resources? Reach out to your Care Team for more information. 

Discuss with your healthcare team 

If you are experiencing more hair loss than normal, make sure to discuss it with your doctor or Care Team. They can do tests to help rule out possible nutritional deficiencies or conditions that may cause hair loss. You can also discuss medication adjustments as needed. 

Optimize your diet 

Following a balanced diet that includes whole grains, nuts & seeds, fruits, and vegetables is important for getting the vitamins and minerals needed to prevent hair loss (and for many other things!). During IBD flares, it can feel tricky to eat these foods, so make sure to check out these tips for eating during a flare.  

There are some additional foods to consider including in your diet that are high in the nutrients of concern for hair loss.  

• Protein: poultry, fish, seafood, eggs, firm tofu, tempeh, edamame, beans & other legumes, Greek or Icelandic yogurt, cottage cheese 
• Iron: poultry, eggs, fish, liver, clams, oysters, mussels, lentils, white beans, edamame, black beans, garbanzo beans, pumpkin seeds, oats 
• Zinc: dark meat poultry, shrimp, chickpeas, lentils, pumpkin seeds, sunflower seeds, cashews, yogurt, quinoa, oats
• Vitamin D: some fish (salmon, trout, tuna, herring, cod, sardines), foraged mushrooms, egg yolks 
• Riboflavin: poultry, salmon, eggs, dairy products (milk, yogurt, cheese), almonds 
• Biotin: eggs, salmon, oats, almonds, peanuts, walnuts, oats 
• Niacin: poultry, fish, avocado, whole grains (wheat, brown rice), peanuts, potatoes   

Reach out to your dietitian if you aren’t sure how to get started.  

Supplement with caution 

If you are diagnosed with a vitamin or mineral deficiency, you can discuss with your healthcare provider or Care Team about using a dietary supplement. For example, if a blood test came back showing you were experiencing an iron deficiency, you would want to most likely take an iron supplement. However, taking supplements without knowing you’re deficient may be problematic.

Vitamin toxicity is a concern with high-dose supplements and getting too much of certain nutrients such as vitamin A, vitamin E, and selenium could make hair loss worse. Often, hair loss supplements will contain very high doses of biotin, which can also potentially alter the results of some blood tests.  

Key points 

• Hair loss can be caused by multiple reasons including IBD flares, stress, other conditions, nutrient deficiencies, or genetics. 
• There are some steps you can take to reduce hair loss including managing your stress, taking medications as recommended, and getting adequate nutrition. 
• Be mindful of dietary supplements claiming to regrow hair – certain nutrients can be toxic in high amounts and biotin may alter blood test results.