PCOS Hair Loss: What’s Really Going On (and How to Support Regrowth Naturally)
Hair loss can be one of the most discouraging symptoms of PCOS. It can chip away at confidence fast, and it’s a real signal that something is out of balance in the body. I have personal experience with hair loss (driven both by my PCOS and an autoimmune condition), so I understand how alarming, scary, and embarrassing it can feel to experience this.
The good news? Once you understand why it’s happening, you can take targeted steps to help support regrowth!
Before we move on, I do want to say that there are many different types of hair loss, and many different causes. This blog will not cover everything. As a dietitian, I will be covering the most common causes of hair loss in PCOS from a nutrition and lifestyle lens.
Prefer to watch/listen to a video instead of reading this blog post? I’ve got it all over on YouTube! Check it out here!
Why Hair Loss Might Happen in PCOS
PCOS hair loss (sometimes called androgenic alopecia) is usually tied to having elevated levels of androgens (hormones like testosterone and dihydrotestosterone, or DHT). But there’s more to the story than just “too much testosterone”, so let’s break down some of the bigger potential key players that can contribute:
1. High Androgens (Testosterone + DHT)
Many women with PCOS make more androgen hormones than they should. Why does it impact your hair? Well, those androgens can bind to receptors in hair follicles in your scalp, causing them to shrink over time. This results in your hair becoming thinner, finer, and growing more slowly. It often shows up as a widening part or overall thinning on the crown, not necessarily specific bald spots.
2. Insulin Resistance
This is a BIG one. Elevated insulin levels (which are very common in PCOS) can actually stimulate the ovaries to make more testosterone. So if you’re dealing with a lot of blood sugar spikes or skipping meals, it can make hair loss worse. Supporting steady blood sugar is one of the most effective ways to bring androgen levels down naturally. What can get challenging with this piece, though, is that while insulin resistance can cause higher levels of testosterone, testosterone makes insulin resistance worse. So it’s a bit of a vicious cycle, and sometimes you really need to treat both at the same time, even though the insulin resistance is the root cause.
3. Inflammation & Nutrient Deficiencies
Women with PCOS have been found to have higher levels of inflammation in the body, which can affect everything from ovulation to hair follicle health. Therefore, addressing inflammation is key to not only supporting your PCOS overall, but also any hair loss. Also, there are some common nutrient deficiencies found in PCOS, and these nutrient gaps can absolutely impact hair growth. Those nutrients include:
Iron (ferritin) – sometimes women with PCOS can actually have too much iron, but there’s also the possibility for iron deficiency, and low stores can cause hair shedding
Zinc – this mineral is needed for the process of hair follicle growth, and serves as a blocker to hair follicle apoptosis (death of hair follicle cells)
Vitamin D – this nutrient plays a role in a variety of processes in the hair cycle
B Vitamins (especially biotin, B12, and folate) – these nutrients actually aren’t commonly found to be deficient in women with PCOS, but they all play an important role in hair protein production, and biotin can increase the strength of hair
Protein – this is not a common deficiency, BUT hair is made up of protein, and inadequate amounts of protein, or poor absorption of it, could absolutely impact hair quality/growth
4. Thyroid Issues
Women with PCOS are more likely to have thyroid dysfunction, and even mild hypothyroidism can slow hair growth or cause hair shedding. In my opinion, it’s always worth ruling this out with the big role that thyroid hormones play in your hair’s growth cycle. This could also be contributing to your other PCOS-related symptoms like weight gain or fatigue!
5. Stress & Cortisol
High stress levels raise cortisol, which can indirectly throw off your sex hormones and insulin sensitivity. But stress can also trigger something called telogen effluvium — a type of temporary shedding that happens a few months after a major stressor. That major stressor could be a stressful event in your life, an illness, or even a significant change in your diet, exercise, or sleep.
Labs to Consider for Hair Loss in PCOS
If you’re noticing more hair in your brush or shower drain than usual, it’s time to get curious about what’s happening under the surface. Here are some labs to discuss with your provider or dietitian:
Hormones
Total testosterone
Free testosterone
DHT (expensive, but could be helpful!)
DHEA-S
SHBG (sex hormone binding globulin)
Estradiol, LH, FSH (taken on day 3 of your menstrual cycle)
Blood Sugar & Metabolic Markers
Fasting CMP (gets you fasting glucose)
Fasting insulin
HbA1c
Fasting lipid panel
Nutrients & Other Key Markers
CBC
Ferritin, Iron, TIBC
Vitamin D (25-OH-D)
Vitamin B12
Folate
RBC Zinc
Homocysteine
hsCRP or cardiac CRP
Thyroid panel: TSH, Free T4, Free T3, and TPO antibodies
These can help identify whether your hair loss is mostly driven by androgen excess, thyroid function, nutrient gaps, or blood sugar issues — and from there, you can address the right root causes.
Supporting Hair Regrowth Through Nutrition
While it’s not an overnight fix, food really can make a difference here, and I’ve seen tons of clients see an improvement in their hair by upgrading their nutrition!
1. Focus on Protein
Hair is made of keratin, a type of protein. So you can bet that eating an adequate amount of protein is going to impact the quality of your hair! A general rule of thumb is to aim for 20-30grams of protein per meal, but some people might need much higher levels than that. Protein is a huge topic, which is why I created my PCOS Protein Playbook.
Inside this guide, you’ll find:
How to calculate protein needs (without overcomplicating it)
A comprehensive list of protein-rich foods and exactly how much protein they provide
How to go about tracking protein in a way that feels good to you
The importance of taking time to reflect
When striving for more protein becomes an unhealthy goal
Where to start if you’re feeling overwhelmed
Protein powder, bar, and drink recommendations for when you need to supplement
High-protein recipes that are practical, satisfying, and easy to make
By the end, you’ll know how to confidently hit your protein goals in a way that supports your PCOS and helps you feel your best without restriction or stress.
2. Balance Your Blood Sugar
As mentioned above, insulin resistance can increase androgen production, one of the causes of hair loss. Working on habits that will help lower blood sugar spikes can then help reduce excess androgen production! There’s a lot to know about blood sugar balancing, and this is something I teach extensively in my ROOTS program, which is a program all of my clients get access to when they sign up. BUT below are some basic tips to get started with!
Don’t eat naked carbs! Pair your carbs with protein or fat. If you don’t fully understand what foods fall into these categories, this is something I also teach my clients!
Don’t skip meals. Seriously! Don’t do it!
Choose slow-digesting carbs like oats, beans, lentils, potatoes or winter squash over processed floury carbs like crackers, pretzels, and breads.
Move after meals - take a 10-15 minute walk outside or around your home after eating
Eat the food on your plate in this order: non-starchy veg first, protein second, and carbs last
3. Add in Micronutrient and Inflammatory Support
The quality of our diet really matters, and unfortunately, so many of us rely on processed foods and takeout for quick meals. Sometimes I think clients are surprised by the amount of processed foods they might consume throughout the day when they really think through what they are eating, even if we might consider it “healthy”. Protein bars, beef sticks, meal replacement shakes, granola… while they do bring some benefit, they are still processed. It’s time we get back to really focusing on eating more whole foods again to get more micronutrients and anti-inflammatory foods in our diet.
Focusing on foods rich in the micronutrients discussed previously is especially key:
Iron: oysters, clams, mussels, beef, lentils
Zinc: oysters, hemp seeds, pumpkin seeds, cheese, beef, lentils
B vitamins: eggs, salmon, poultry, dark leafy greens (like spinach and kale), chickpeas
Vitamin D: salmon, fortified milk, or sunlight exposure
Foods that are rich in anti-inflammatory compounds are also great to add in:
Omega-3 rich fatty fish: salmon, herring, mackerel, sardines, anchovies, tuna, trout
Omega-3 rich plant foods: walnuts, chia seeds, hemp seeds, flaxseeds
Dark leafy greens (kale, spinach, chard, collards)
Berries, pomegranate, apples
Cruciferous vegetables (broccoli, cauliflower, brussels sprouts, cabbage)
Legumes (beans, lentils)
Sweet potatoes, beets, winter squash (butternut, spaghetti, acorn, kabocha, delicata, etc)
There are many more foods beyond what’s provided above that give us those micronutrients and anti-inflammatory compounds, and I provide clients with extensive lists and recipes to help them get what they need!
4. Consider Targeted Supplements
Supplementation can absolutely help, but you really want to base it on labs and your specific needs/symptoms because you CAN take too much of something. For example, way too many B vitamins can cause neuropathy issues, and too much iron when it’s not needed can increase oxidative stress in the body. It’s important to be smart and safe when it comes to supplementation. That being said, a few can be especially helpful, and I recommend working with a health professional to decide what you need most, with the correct doses.
Inositol – can improve insulin sensitivity
Zinc – helps lower androgens and supports follicle repair
Vitamin D – can lower testosterone and support hair follicles
Iron (only if ferritin is low) – essential for oxygen delivery to follicles
Spearmint tea – gentle anti-androgenic effects; 3 cups daily may help over time
Omega-3’s/fish oil - reduce inflammation
NAC – can improve insulin sensitivity and decrease testosterone
Saw palmetto – inhibits 5-alpha reductase, which turns testosterone into DHT (a more potent form of testosterone)
Reishi – can lower androgens
Licorice – can lower androgens
White peony – can lower androgens
Other things not necessarily specific to PCOS that could support hair regrowth: vitamin C, vitamin A, vitamin E, collagen, LustrivaTM
Again… always test before supplementing, and ideally work with a practitioner to choose the most ideal forms and doses.
Final Thoughts
Hair loss in PCOS isn’t just a surface issue. It’s your body’s way of telling you something is off on a deeper level.
By balancing blood sugar, getting adequate micronutrients, managing inflammation through nutrition, and checking in on key labs, it’s completely possible to slow shedding and even start seeing regrowth.
And remember: this takes time. Healthy hair cycles run on a 3–6 month delay, so don’t get discouraged too quickly. Stay consistent with your nutrition and lifestyle, and your future self (and hairline) will thank you.
If you live in any of the states listed below and are looking for a dietitian who specializes in PCOS and hormone health, I work with clients virtually to help them achieve regular periods with less pain, hair loss, bloating, and fatigue so they can regain control of their cycles, improve fertility outcomes, and protect their future health against PCOS-related risks.
Schedule a free discovery call today!
I work virtually with clients in Minnesota, Illinois, Wisconsin, Iowa, North Carolina, South Carolina, Idaho, and Oregon!