The Thyroid Fixer with Dr. Amie Hornaman

Episode 584: Don't Blame Your Hair Loss on JUST Your Thyroid
Released: December 5, 2025

Episode Overview

In this episode, Dr. Amie Hornaman tackles the frequent misconception that “thyroid issues are the only cause of hair loss.” She breaks down the complex, multifactorial nature of hair thinning and shedding, especially in women, but also touches on causes in men. Dr. Amie offers a science-backed and practical guide to what’s truly behind hair loss, debunks ineffective remedies, and highlights strategies and treatments that actually work, from lab markers to nutrition and advanced therapies.

Key Discussion Points & Insights

The Multifaceted Causes of Hair Loss

• Not Just Thyroid:
  Hair loss is complex and often wrongly blamed solely on thyroid issues. Dr. Amie stresses that multiple factors must be considered before jumping to conclusions about the root cause of hair changes.

  “There are so many different reasons for hair loss and there are so many different treatments out there.” (00:00)

• Emotional Toll:
  Hair loss is emotionally devastating, especially for women. There’s even a kind of PTSD associated with showering and seeing hair fall out.

  “It’s already so devastating when a woman, especially a woman, loses her hair... there is literally PTSD from hair loss.” (13:23)

Thyroid Markers and Their Impact

• Essential Labs:
  Dr. Amie insists on comprehensive thyroid testing—free T3, reverse T3, thyroid antibodies—rather than only TSH & free T4. Optimal levels (not just normal) are what matter.

  “Look at how much active thyroid hormone you have... We want that free T3 in the upper quadrant of the range.” (17:05)

  • Low Free T3: Directly contributes to hair thinning.
  • Elevated Reverse T3: Puts the body into “survival mode,” halting hair growth.
  • Thyroid Antibodies: Even low levels indicate autoimmunity and can attack hair follicles (alopecia areata).

Hormones and Hair Loss

• Estrogen:
  Key for hair volume and thickness. Low estrogen (as in menopause) leads to thin “see-through old lady hair.”

  “When you look at your gram, she’s got her nice little gray hair within a perm, you can see her scalp. That is loss of estrogen.” (26:00)

  • Optimal estradiol: 50+ (US units), many women thrive at 80–200.

• Testosterone:
  Both high and low levels can cause hair loss in women and men.

  • High T (as from hormone pellets) can convert to DHT, causing patterns similar to male baldness.
  • Optimal total T for women: above 50 (US units).

• Dihydrotestosterone (DHT) & SHBG:
  DHT triggers male-pattern loss in men; in women, DHT causes diffuse thinning. SHBG “binds” hormones—high SHBG can be protective if DHT is high.

  “If you have an elevated DHT and you have an elevated SHBG, that SHBG is going to bind a DHT first.” (31:45)

Other Medical Contributors

• Low Ferritin/Iron:
  Ferritin should be 80–100, even higher for Hashimoto’s. Low ferritin mimics hypothyroidism.
  • Iron deficiency is a very common reversible factor.
• Protein Intake:
  Not enough protein = poor hair growth. Most women underestimate how much protein they consume.
  • Animal-based proteins and complete amino acids are critical.

  “Our heart needs 50 grams of protein to beat. If you’re not getting at least 50 grams, your body will steal it—from your hair, your muscles—for survival.” (37:18)

• Carbohydrates & Inflammation:
  Inflammatory carbs and high insulin (>6) create inflammation at the follicle.
• Stress & Cortisol:
  Stress (physical or emotional) can trigger dramatic hair loss 60–90 days later or even immediately in case of trauma.

  “Our hair responds to things that happened 60 to 90 days ago. Think back to 2020: 2–3 months after you had COVID, did your hair fall out?” (40:00)

• Digestive Health:
  You may not be absorbing protein efficiently—look for a protein marker ≥7.0 on your CMP.

Special Considerations

• Over- or Undertreatment of Thyroid:
  Both too little (hypo) and too much (hyper) thyroid hormone (e.g. in Graves’ disease) prompt excess shedding.
  • Starting T3 therapy can speed up the normal hair growth cycle, causing increased initial shedding which is typically temporary.

Approaching Hair Loss: What WORKS & What Doesn’t

What Actually Helps (44:00)

• Thorough Lab Work:
  Optimizing thyroid and sex hormone levels, treating deficiencies, personalizing therapies.
• Nutritional Optimization:
  Animal protein, sufficient iron (ferrous bisglycinate), amino acids, and collagen.
• Immune & Stress Support:
  Reducing inflammation, combating viral infections, addressing heavy metals, mold, or toxin exposure.
• Red Light Therapy:
  Quality red light panels (not cheap Instagram gadgets) show promise for hair follicle health.
• Topical Treatments:
  • Dermal rolling combined with copper peptide (GHK-Cu) serums, or injectable peptides (or sublingual GHK-Cu strips if needle-phobic).
• PRP Injections:
  Platelet-rich plasma injected into the scalp—effective, usually done by specialists.
• Supplemental Aids:
  • Iodine, supports hair strength, thickness, and overall thyroid/immune health.

Treatments to Be Cautious About (45:10)

• Minoxidil (Rogaine):
  Can be effective, but hair often falls out if you stop using it.
• Dutasteride/Finasteride:
  Oral DHT blockers—possible side effects, best not for long-term use.
• Gimmicky Instagram Products:
  Dr. Amie warns against cheap red light caps and overmarketed supplements.
• Nutrafol:
  “I’m not sold on Nutrafol... Just another supplement with a lot of marketing money behind it.” (45:49)

Notable Quotes & Memorable Moments

• On the emotional impact:
  “People don’t want to even wash their hair, going a week without washing because every time, they get a new bag of hair... hoping someone will listen.” (13:23)
• On practitioner expertise:
  “You cannot just see someone for your thyroid and have them ignore your hormones or have them half-ass your hormones. They better be a hormone and thyroid expert.” (05:42)
• Personal Experience:
  “I was dismissed, I was gaslit, I was misdiagnosed and I dropped thousands of dollars before I found an answer. That’s why I made it my mission...” (08:54)
• On protein: “If you’re a vegan, you are always going to struggle with your hair... You gotta look at their hair—frizzy and thin and kind of flying all over the place.” (35:20)
• On PRP: “PRP injections are very beneficial for hair loss of any kind... a one hit wonder like a PRP injection.” (44:36)
• On marketing scams: “Anything on Instagram that is gimmicky...cheap red light caps on Instagram—you want to stay away from those.” (45:32)
• On custom solutions: “You have to have a practitioner that literally asks you those four most important words—How do you feel?—and they listen to you and go deeper.” (32:12)

Key Timestamps

• 00:00: Introduction, episode overview
• 13:23: Emotional effects and stories of hair loss
• 17:05: Importance of proper lab work for thyroid
• 26:00: Hormones and their effect on hair (estrogen, testosterone, DHT, SHBG)
• 31:45: Case examples: Individualized treatment for high DHT/SHBG
• 35:20: Protein intake and hair health; reality-check for vegans/vegetarians
• 37:18: Protein and survival; heart needs 50g/day
• 40:00: Stress, trauma, and delayed hair loss
• 44:00: Review of effective treatments (red light, PRP, peptides, iodine)
• 45:10: Treatments to be cautious about; Nutrafol skepticism
• 46:08: Legal and medical disclaimer

Conclusion

Dr. Amie’s key message: Hair loss rarely has a single cause, and blaming only your thyroid is a major oversimplification. A truly effective, lasting fix requires individualized, whole-body assessment—labs, hormones, nutrition, stress, and more—plus a skeptical eye toward unproven products. Above all, optimization (not mere normalization) is the real goal.

For those considering action:
Check all the bases—thyroid, hormones, ferritin, protein, insulin, stress, and lifestyle. Peer beyond marketing claims, and work with a real thyroid/hormone expert (not someone who “half-asses” hormones) to get personalized solutions.

Episode hosted by Dr. Amie Hornaman. Show notes compiled for informational purposes; consult your healthcare provider for medical advice.