Telogen effluvium (hair loss) from going Paleo?

Answered on September 25, 2015
Created September 25, 2015 at 12:14 AM

I switched to eating Paleo in March. I started off with 1-2 months strict paleo but then relaxed the rules a little bit and was  probably 80% paleo. In 2 months I dropped 10 lbs (from 135lbs to 125lbs for a height of 5'6") which caused my thyroid drug dose to be slightly too high and lead me to be slightly hyper. I've had hypothyroidism for about 10 years and take a combination of T4/Synthroid and T3/Cytomel. I've been trying to get to the right dose since March and I think that I'm finally there after multiple dose changes. The reason why I'm here is that since August I've been losing my hair like crazy and my doctor actually diagnosed me with Telogen Effluvium which is basically very sudden and massive hair loss. It's very scary and stressful. I'm trying to figure out what may have caused it and I'm wondering if it's due to the paleo diet. There are other factors too. I broke up with my long term boyfriend in March and was agonizing for a few weeks. I also stopped birth control in June but went back on once the hair loss started.

i wanted to know if anyone experience TE from the paleo diet. Does paleo create any deficiencies that could be a trigger for TE?

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2 Answers


on September 25, 2015
at 09:47 PM

Hi, I calculated what my calorie in stake should be and its 1800 calorie which seems high. I definitely don't think I was eating enough when I went Paleo. And I probably went way too low carb. I am just not a big fan of sweet potatoes so it's been hard getting enough carbs. I might add white potatoes and rice to get more carbs into my diet. I know that I also just need to eat more calories in general, although my weight has been pretty steady since losing the 10 lbs.

I definitely try to avoir gluten as much as possible.




on September 25, 2015
at 10:44 AM

This is most likely caused by not eating enough, or being under high stress, has almost nothing to do with how strict you're eating paleo, whether 50% or 80% or 100%.

How much and what are you eating daily?  Sadly the way to measure this is in calories which is the best measure we have at the moment, even though it should be used as a way to control food intake, you must at least meet your daily calorie needs, or you'll introduce another stressor into your life which will make your health go down.

Start here: http://www.bmi-calculator.net/bmr-calculator/

Plug in your numbers and what you'll get back is your Basal Metabolic Rate.  This is the number of calories you need to just lie down in bed all day unconscious without any activity whatsoever.  Take that number and look at http://www.bmi-calculator.net/bmr-calculator/harris-benedict-equation/ - multiply your BMR by your level of activity.  At minimum, if you're not very active, multiply that number by 1.2, if you're an athlete (you should not be with your current level of stress) multiply by 1.9.

If you under eat, you'll prevent fat loss, and increase stress levels to very high levels, and will experience things like hair loss.

You'll need to get that much energy from fats and carbs in your diet to be healthy and function at your level of activity.  Figure out what your carb/fat ratio is based on what you eat and adjust as needed. 

Protein should be fixed at 3 palm sized portions of meat per day.  (You can substract whatever number of calories this represents from the above number.)  This works because your palm is a fixed sized for your body and the amount of protein you're going to need isn't going to vary much.  If you undereat protein your body won't be able to make repairs.  If you over eat protein will be converted to glycogen, but in very large amounts it can become toxic due to too much ammonia.

In terms of what you eat, you should eat some carbs, at least 20-20%, more ideallly 30%-40% of your energy calories because if you go too low carb, you'll signal cortisol to convert protein from muscle tissue or from food intake into glycogen via gluconeogenesis.  Because this signal is cortisol, it will add to your stress levels, which are already probably very high, so do eat some carbs every day.

You very likely do not want to skip breakfast, and will likely need to eat 50 grams of protein every morning within 30 minutes of waking to cut down on the high stress.  You can do other things to lower your stress such as looking into phosphatidyl serine, and ensuring you get enough high quality uninterrupted sleep.

Stress can be a very good thing, in this form it's called eustress.  You however do not want chronic stress.  Take some time out to deal with this every day, whether it's meditation, or going to a wooded park and just enjoying the quiet, whatever works for you. 

Avoid chronic cardio exercise, things like riding a bike, treadmills, stairmasters, etc. anything over 30m that you do more than 3x a week.

You did mention your thyroid, this part is critical.  If you're not making (or converting) enough T4->T3, your adrenals will increase their output to make up for the difference.  Conversely, if your adrenals are too low, your thyroid would normally make up for the difference, this would explain part of the issues with high stress.  The amount of thyroid hormone you'll need will vary with your stress levels, so you may see this go up or down again once you stabilize your stress.

The thing about paleo isn't about calories or quantity or how much carbs or fats you should eat.  It's about eliminating harmful/toxic sources of food, which if normally consumed, will also increase stress levels and lower your overall health if you eat them. 

Most people who go paleo experience fat loss because their health improves, not just because they eat less food.  Their cravings, no longer perverted by high sugar and artificial flavor intake return back to normal, and go away, and become actually useful.  Without modern food like products, our cravings indicate what foods we should eat based on micronutrient need. One of the best things you can do is to make all your own food, including any snacks.  (Needing snacks is a sign that you're not eating enough at meals, or at least not the right things.)

If you're not eating 100% paleo, it means you're consuming things that aren't fit for human consumption, such as grains and soy.  While many people tolerate these, and can survive on them, they won't thrive on them in the long term.  There's nothing these foods contain that can't be found elsewhere, and without the toxins along for the ride. 

Many autoimmune conditions are caused by gluten, gliadin, and friends.  Most hypothyroidism is actually Hashimoto's Thyroiditis, which is an autoimmune disease.  It's well known that gluten and gliadin signals zonulin which opens up the tight junctions in the gut lining allowing undigested proteins to enter the bloodstream, causing an immune response, and over many years eventually causing an autoimmune response, such as antibodies attacking the thyroid.

I don't know your exact situation, but these are common syndromes.  It's unwise to consume foods that trigger autoimmune events, so 80% paleo is not enough.

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