Part 1 of 2
HAIR HEALTH SERIES· EXPERT INSIGHT
As a lover of high, messy buns, it's disheartening to have observed my buns get noticeably thinner and smaller. Was it my snatched look? Or maybe the chronic stress that caught up to me? Chasing all the hair obsessions and trends of the past definitely didn't help in attaining any modern good-hair-day feelings. Facing that thin, dull hair daily just adds more stress, and here we are in a vicious loop.
I've tried everything under the sun. And while Western medicine is extraordinarily good at identifying what's wrong, it's less practiced at asking why. Eastern medicine, on the other hand, has long taken a different view. The body is a whole system in constant conversation with itself, so when something shows up on the surface, something deeper is usually asking to be heard.
Hair loss is a good example of where that gap matters.
Most people start by wondering if it's a nutrient deficiency or a thyroid issue. And the most popular - is it the wrong shampoo? Dr. Jawaher Kadhem, a Licensed Naturopathic doctor and founder of Sidra Healing in Bahrain, trained to look at the whole picture, says there's one cause that's often skipped. "Many patients come in with a chief complaint of hair loss, and their initial concerns usually center around nutritional deficiencies, anemia, or thyroid disorders. Interestingly, many of these underlying issues can themselves be influenced or exacerbated by chronic stress." The stress, in other words, is often upstream of everything else.
What stress actually does to your follicles
I think many of us are well-versed in the fight-or-flight state our bodies shift into when they perceive a threat. The heart rate climbs, blood pressure rises, and the functions that aren't immediately critical, such as hair growth, are deprioritized.
A key messenger in this process is norepinephrine. "It increases alertness and helps raise heart rate and blood pressure so the body can react quickly to stress," Dr. Kadhem explains. It also narrows certain blood vessels, directing circulation toward vital organs and away from the scalp. In the short term, that's useful. Chronicly, it becomes a problem.
"Hair follicles rely on a steady oxygen and nutrient supply to remain in the growth phase. When that environment is disrupted by ongoing stress, more hairs can prematurely shift into the shedding phase." — Dr. Jawaher Kadhem
That shedding has a name: telogen effluvium. "A sudden increase in hair loss is often due to telogen effluvium, a condition commonly triggered by a significant stressor," Dr. Kadhem says. In more severe cases, chronic stress can trigger an autoimmune response where the immune system begins attacking the follicles themselves, a condition called alopecia areata. "I have seen cases where periods of significant or chronic stress appear to trigger the onset of autoimmune symptoms, including alopecia areata."
Acute stress versus chronic stress
The distinction matters more than most people realize. "Acute stress is something the body actually handles very well," Dr. Kadhem says. "The stress hormones rise quickly to give us energy and focus, and then they shut off once the threat passes." Acute stress can actually serve us well. Chronic stress, however, is a low-grade stress and a different physiological state entirely. "Stress hormones like cortisol remain elevated for long periods of time. When the body stays in that state chronically, it can start to disrupt normal hormonal balance, and that's where we begin to see negative health effects over time."
For women, hormones make it more complex
Women's hormones don't remain constant, which changes how the body responds to stress at every life stage. "They absolutely compound each other," Dr. Kadhem says. "Even within the menstrual cycle, a stressor that feels manageable in the follicular phase may feel much more overwhelming in the luteal phase as hormones shift."
The stakes rise further during major transitions, such as after having a child and during perimenopause. "Postpartum involves one of the largest hormonal drops a woman will ever experience, which can shift the nervous system and contribute to stress-related hair shedding." In perimenopause, emerging research shows increased cortisol sensitivity, making some women more vulnerable to the physical effects of stress, hair loss included.
The delay that confuses everyone
The timing is perhaps the most disorienting part of hair loss. "I wish patients understood that stress often builds over time," Dr. Kadhem says. "When we start seeing physical manifestations like hair loss, it usually means the body has been under stress long enough for it to show up physically." Recovery follows the same slow logic. "Chronic stress can affect digestion and how well we absorb nutrients, which are both important for healthy hair growth. Part of recovery is giving the body time to rebalance and rebuild."
In part two of this series, Dr. Kadhem walks through what actually supports that recovery, from the lifestyle foundations that move the needle to what you should and shouldn't be putting on your scalp.
Dr. Jawaher Kadhem is a Licensed Naturopathic Doctor at Sidra Healing. This article is for informational purposes and does not constitute medical advice.