Expert: Leigh-Anne Persing, PA-C - 8/19/2008

Question
Hi, I'm hoping you can give me some advice regarding hair loss.  I suffered from anorexia for a period of around a year (although it wasn't severe throughout).  Although my BMI was never lower than 16, about 2 months into my weight loss I began losing my hair. I had extremely thick hair so for months I ignored the problem as it wasn't atall noticable to others.  I now realise how ignorant I was to not get help straight away; I allowed the problems to continue until the hair had thinned to such an extent that my confidence is now severely affected. 2 months ago I began improving my diet and my BMI is now just under 18.  I was vegan throughout my struggle with food but I have now relaxed this to return to a healthy vegetarian diet which I have followed since a very young age with no problems.
When my problems first started I was eating around 500 calories each day and lost 2.5 stone but I stabalised and maintained my weight (although it was far too low) for 9 months, eating around 1000 calories daily. I think the main problem was that I became afraid of eating any food which wasn't 'pure', leading me to eat vast amounts of fruit and veg which made up my daily calories.
I am now eating around 25000 calories daily (I'm not sure of the exact amount because I don't like to put too much emphasise on what I'm eating - now consuming food has just become routine and normal and I don't consciously think about my intake) and ensuring I have around 40-50g protein - I include plenty of foods like tuna,salmon, eggs, nuts, oats, wheat, houmous, beans, soy, tofu and cheese every day and many wholegrains.  I think my hair loss is telogen effluvium due to protein deficiency and perhaps iron deficiency.  
I have been eating properly for the past few weeks but my hair is continuing to fall. I'm not stressed and I'm not allowing myself to worry about it but it looks pretty bad and I need reassurance that it will sort itself out soon.
I would rather not consult my doctor as I haven't seen a doctor in the past 2 years as I haven't needed to. I am proud to have recovered and I am glad I did it of my own accord, without medical intervention.  Therefore I would be reluctant to go now and have an ED put on records.
I have started taking a good hair and nail supplement but I don't know what else to do.
What can you recommend to stop the hair loss and how long should it take before it stops falling.  There is a lot of hair being lost.
Thanks

Answer
Congratulations! I am so happy to hear that you have been able to recover... and have done so with your own willingness and willpower! There are couple of things that could be going on with regards to your hair loss. I don't believe that you told me your age, but are you menstruating? What is your weight? A BMI of under 18.5 is considered under weight. So, though you have made considerable progress, your body may still be under requirements for all your body's daily functions. If you are not menstruating that is a sign that your body is not getting enough nutrients, especially fat.It may also be a sign that your body is not producing enough estrogen, which can affect your hair, skin and nails. Along the same lines of hormone imbalances: Sometimes in the setting of an eating disorder thyroid hormones imbalances can occur and cause hair loss. Both of these hormones can be tested for by a simple blood test, which i know you said you would prefer not to see a physician. You know, you can reveal your concerns by scheduling an annual physical, which should be a part of taking care of yourself. There is no need to come right out and tell your physician that you are recovering from an eating disorder, but I would be truthful if he/she asks you about it.