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Hair Loss/CTE due to low ferritin - hope of recovery?


Hi - First, thank you for your time and care in responding.

I'm a 40 year old female. I have had hair thinning going on for a number of years. Looking back, I believe it began when I went off birth control several years back, and became exacerbated the past two years. This coincided with a very stressful personal time, including the loss of my very loved father after his two year battle with cancer. I have never noticed extreme shedding, though looking back the floor was probably a bit more covered with hair than is normal. My hair loss became significant enough for me to pay attention to the past few months.

My DR diagnosed me with female pattern baldness, though to be honest I don't think she knew anything about what she was saying. A dermatologist then diagnosed me with "female pattern alopecia, and mild CTE." I had a mildly positive pull test, but she notes greater thinning at the scalp. I mostly notice thinning everywhere; a bit of recession at the hair line, but that's something I've always had. My ferritin was at a 22, and I'm slowly working to get that up.

I have two questions I would love your counsel on:
1) In the case of CTE, how much can I hope hair will grow back if the loss is due to ferritin? My dermatologist is fairly pessimistic.
2) I have been confused about who is best to help with a diagnosis. MD? Dermotologist? Endocrinologist? Who would you suggest, and how do I find someone good who has experience with women having hair loss?


A Dermatologist is the doctor who has specialized in SKIN, HAIR, and NAILS
Dr Leonard Sperling is a world authority on this very subject.  He is located in Bethesda. He may not be taking private patients but could perhaps refer you to one of the dermatologists near you that he has trained.

A ferritin of 22 will usually not cause shedding but certainly may be responsible for the hairs not growing back.

CTE due to any reason will cause thinning hair in women and bald spot in men to show up prematurely. I explain this in my book "Hair Loss Answers" which you can read for free online on my website. Click on the book and you will get the table of contents of the book.
Chapter2 deals with normal life cycles

From Chapter 4-- I describe a man who went bald at 22 because he used up his predetermined number of life cycles in the hairs on the top of his head.  Each hair has a pre programmed number of 5 year life cycles. If you use them up you can not get them back.

Stress can cause a type of hair loss called telogen effluvium. This condition is not caused by the general accumulated stress of ordinary interactions with people at home and at work, but rather by sudden severe emotional or physiological incidents. Severe stressful events can cause some or most actively growing hair follicles to prematurely shift into the regression phase, and then the resting phase, during which the hairs fall out easily.

There is usually a delay of a few weeks to a few months before the shedding is noticeable, but after this delay the shedding seems to occur quite suddenly. Because the shedding is delayed, this type of hair loss is often a mystery to the person suffering the condition. The stressful event that triggered it is frequently forgotten, and it is rarely thought to be connected with the “new problem.”

Examples of sudden severe emotionally stressful events include the death or terminal illness of a family member or close friend, marriage, divorce, and unexpected job loss. Severe physiological stressful events shock the body, and some examples are heart attacks, major surgery, and illnesses with prolonged high fever such as malaria, viral pneumonia, and severe cases of the flu.

In most cases of telogen effluvium, the hair follicles recover and soon shift back to the regular growth cycle.

However, repeated instances of telogen effluvium can result in premature hair loss in people predisposed to lose their hair late in life. The average growth cycle of a hair follicle takes about five years, but each follicle is “genetically programmed” for only a limited number of growth cycles. For example, if a particular hair follicle were “genetically programmed” for only ten growth cycles, after about fifty years that follicle would stop producing new hairs. When all the follicles at the hairline or crown of the head are “genetically programmed” this way, a receding hairline or bald spot appears after all the growth cycles for the follicles in those areas have been cycled through.

Each incidence of telogen effluvium uses up one “life” of the affected hair follicles. So instead of having a receding hairline or bald spot at age fifty, the hair loss may occur a few years earlier. This is not a significant issue if telogen effluvium occurs once or twice in a lifetime; however, accelerated hair loss can result from repeated severe stressful events, if each instance triggers a new round of telogen effluvium.

I had a patient who was totally bald when I met him at age seventy, and he had lost all his hair by age twenty-two. He had worked on the Panama Canal fifty years earlier, and for two straight years starting when he was twenty he suffered repeated bouts of severe fever from episodes of malaria. Each time he suffered from malaria induced fever he experienced telogen effluvium, lost what hair he had, and his hair follicles lost another “life.” After ten or fifteen malaria stress cycles, at the age of twenty-two, he had the hair he would have had at age seventy. Which unfortunately for him was no hair at all.  "

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Peter J. Panagotacos, <B>M.D.</B>


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website

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