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Hair loss or thinning is a common and important issue, especially in those who have chronic fatigue syndrome or fibromyalgia. If you’re experiencing hair loss in a generally thinning way (diffuse), then treating: nutritional deficiencies and an underactive thyroid are especially important.

Low iron is a key nutrient for hair growth, and standard testing misses most cases of iron deficiency. In fact, despite the fact that most physicians consider a ferritin blood test (the best measure of iron deficiency or excess) over 12 to show adequate iron, a recent study in patients with chronic illness and even mild anemia (a description fitting most people with CFS) showed that a ferritin under 100 was diagnostic of iron deficiency!

In addition, for those with Restless Leg Syndrome (RLS) and a ferritin under 60, iron can be more effective than the medication Requip, and can eliminate RLS as well as your iron levels optimize.

In CFS and fibromyalgia patients, as in any chronic illness, a very common cause of unusual hair loss is a condition called “Telogen Effluvium.” This is when the normal cycles of natural growing and falling out of the hair follicles become jolted out of their usual random phase due to illness. In this condition, a severe physical stress — such as pneumonia or a CFS flare up — can produce unusual hair loss which doesn’t begin until 3–9 months later. This type of hair loss is reversible, although it can take 3– 9 months. It often grows in more quickly than this, but it’s better to be pleasantly surprised than to feel disappointment and abandon the needed RX too quickly.

To treat hair thinning:

1. Optimize overall nutritional support. The Energy Revitalization System vitamin powder is excellent for this, plus take a 29 mg iron tablet for 6–12 months (until the ferritin is over 100). Do not take iron if the ferritin is over 200 (and have your doctor check for iron excess called hemochromatosis, which is easy to treat but life threatening if missed). 2. Optimize thyroid function—even if your thyroid labs are “normal.”

Treating with the S.H.I.N.E. Protocol overall will also help hair growth as well as dramatically improve the quality of life in CFS and fibromyalgia. Please note that the above applies only to stress-induced hair loss, which is evidenced by widespread thinning. Other patterns have a different cause. For example:

1. Autoimmune issues. In this condition, hair loss appears as multiple coin-shaped bald spots called alopecia areata.

2. Male pattern baldness. If present in a woman, this suggests elevated testosterone and DHEA. If these are present, and a fasting morning insulin blood test is over 10 (showing insulin resistance), this would suggest the presence of PCOS (polycystic ovarian syndrome). This improves by treating the insulin resistance with the medication metformin (very safe and helpful in PCOS) and eliminating excess sugar.

Jacob E Teitelbaum, MD

Jacob Teitelbaum, MD, is a board certified internist and Medical Director of the national Fibromyalgia and Fatigue Centers and Chronicity. He is author of the popular free iPhone application "Cures A-Z," and author of the best-selling books

Dr. Teitelbaum knows CFS/fibromyalgia as an insider — he contracted CFS when he was in medical school and had to drop out for a year to recover. In the ensuing 25 years, he has dedicated his career to finding effective treatments.

Website: www.EndFatigue.com