Alopecia Areata: A Deep Dive, Part 1

I’ve been talking about this for a while now: hair loss is a symptom of inflammation.


This is true no matter the diagnosis you’ve received – even if you’ve been diagnosed with alopecia areata as we’re going to talk about in this multi-part blog series.


Bald woman with henna wearing flowing clothing in dessert


Autoimmune hair loss – including alopecia areata, alopecia totalsis, and alopecia universalsis – are symptoms of inflammation. This should intuitively make sense when you consider that autoimmune diseases are categorized as chronic inflammatory conditions.


We know that there are many unique causes of inflammation (which we will call root causes) that can disrupt our hair growth process. These root causes of hair loss will vary person to person depending on factors such as your individual health history, nutritional status, toxicant exposure, and genetics.


But, one thing that all autoimmune diseases including alopecia areata will have in common is their strong link to gut health. Often, we are able trace root causes of inflammation back to their impact on our gut in order to understand the role that they play in the onset and worsening of autoimmune diseases (more on that in our next article).


An Increase in Autoimmune Diseases


The prevalence of autoimmune diseases has been rapidly increasing since World War II and have now risen to be the third most common category of disease in the US. It’s important to note that the increase in autoimmune conditions over this time period is likely related to the dramatic changes in our collective diet and lifestyle as well as exposure environmental toxins – not  just “bad genes” as some may like to believe.


Read: Autoimmune Diseases That Cause Hair Loss


Alopecia areata impacts minority women to a far greater extent than white women. In fact, women who are black or Hispanic may be as much as 2.63 – 5.23 and 1.94 times respectively more likely to be diagnosed with alopecia areata than a woman who is white. This illustrates two important points: 1) environmental determinants of health (e.g. air and water quality, exposure to environmental toxins, limited access to healthy food, etc.) are a critical area of focus when trying to rebuild our health, and 2) socioeconomic disparities disproportionately impact minority communities in the US which can contribute greatly to health disparities.


Autoimmune diseases are also more likely to cluster; meaning that when someone is diagnosed with one, there’s an increased risk that they would be diagnosed with additional autoimmune diseases. This was observed in a 2015 meta-analysis (a study of studies) where patients with alopecia areata were found to be 2.57 times more likely to also have atopic dermatitis (eczema) than the study’s control group, and patients with vitiligo were 7.82 times more likely to also have alopecia areata. A similar association between autoimmune thyroid and alopecia areata has also been observed.


There is also evidence to support alopecia areata as representing a non-GI related manifestation of celiac disease (which often goes undiagnosed). Even those with alopecia areata who do not have other issues associated with celiac disease (for example, gastrointestinal complaints, nutrient deficiencies) have been found to test positive for celiac.


The Tenets of Hair Health


Because hair loss is perceived as such a severe symptom it’s easy to want to discount our everyday habits or environments as not playing an important part in driving the underlying inflammation. ⁠


⁠But the faster we can accept the truth that how we eat, sleep, exercise, manage stress, and control toxins are having a dramatic impact on our health and the health of our hair, the faster we can regain our wellness. ⁠


⁠That’s because these are the tenets (aka the foundations) of hair health.



  • Get morning sunlight
  • Bedtime is 10:30 pm or earlier
  • Limit blue-light a few hours before bed
  • Keep your bedroom cool, pitch-black, and quiet

Reduce Stress

  • Limit stimulants like alcohol and caffeine
  • Meditate for 5 or more minutes each day
  • Drink about half your body weight in ounces of pure water each day
  • Eat healthy fats and proteins with each meal
  • Avoid overtraining (but don’t be sedentary either)


Woman sitting on pier doing yoga, facing a city-scape


Reduce Toxins


  • Eat enough total calories
  • Eat 1 gram of protein per 1 pound of lean body mass (or possibly more)
  • Go gluten-free
  • Eat 9-13 servings of phytonutrient-rich foods per day
  • Avoid refined or processed foods


⁠Any plan designed to help us feel and look our best needs to be centered on optimizing these foundational elements. ⁠These are the inescapable first steps. Simply put, you cannot co-opt your way out of a poor diet, unmanaged stress, huge burden or toxins, etc. ⁠


⁠Maybe you’re feeling a little overwhelmed looking at this list. If so, I’ve got some good news for you: even though people often overestimate how much they can get done in a day, they generally underestimate what they can accomplish in a year. What that means is that even though it will take time you can build these habits in, creating sustainable and lasting changes over time.


In my next article in this series, we’re going to start to look at the role that gut health plays in alopecia areata.


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