I have struggled with hair loss, on and off, for most of my adult life.

So when you sit across from me and say “I think my hair is thinning,” I’m not pulling questions from a textbook. I’m pulling them from years of standing in my own bathroom, holding a smaller ponytail than I had the month before, trying to figure out what on earth was going on. The 50 questions I ask you? I’ve asked every single one of them about myself first.

This is the story of how I finally found my own root cause — and why it completely changed how I work up hair loss for the women who come to Flora.

I investigated everything. Truly everything.

If there’s a cause of hair loss, I’ve considered it on myself. I’ve had my thyroid checked more times than I can count. I’ve looked at hormones, stress, postpartum shifts, my cycle, my diet. I went through a phase of taking way too much biotin, convinced that was the missing piece.

Here’s the irony I wish someone had told me earlier: high-dose biotin doesn’t have strong evidence behind it for hair loss in the first place — the best placebo-controlled data shows no meaningful benefit unless you have a true biotin deficiency, which is rare. But it can actively interfere with lab results, including thyroid panels, throwing your TSH and T4 off enough to mimic a thyroid problem that isn’t real. So all that biotin I was taking “for my hair”? It may have been muddying the very labs I kept running to find my answer. (Most labs now recommend stopping biotin 48–72 hours before bloodwork for exactly this reason.)

That’s lesson one, and it’s the whole reason I built my practice the way I did: more supplements is not a strategy. Investigation is.

The mystery I couldn’t solve: the best hair of my life

Here’s the part that haunted me for years.

After I had my son, I went through the postpartum shed almost every mother knows — that dramatic handful-in-the-shower phase. Postpartum hair loss is its own thing; it’s driven mostly by estrogen dropping after delivery, and for most women it self-resolves. Mine did.

But then something strange happened. For about two years during his toddler years, I had the best hair of my life. Thick, full, growing. And I had no idea why. I wasn’t doing anything special. I couldn’t reverse-engineer it, which drove me a little crazy, because if I knew what caused it, I could recreate it.

It would take a second baby for the answer to finally click.

17 months postpartum with my daughter, I found it: ferritin

After my daughter, the shedding came back and didn’t fully recover the way it had before. This time I dug deeper — and the number that finally told the story was my ferritin.

Let me explain what that actually is, because it’s the most under-appreciated lab in the hair conversation.

What ferritin actually is

Ferritin is your body’s iron storage protein. Think of it less like the iron circulating in your blood right now and more like your savings account — it holds iron in a stable, non-toxic form inside your cells and releases it when your body needs it.(Cleveland Clinic / clinical overview) That’s why ferritin is the lab used to catch iron deficiency before you’re anemic. Your hemoglobin can still look “fine” while your reserves are quietly running on empty.

Why your hair cares so much about it

Here’s why this matters for hair specifically. The cells at the base of your follicle — the hair matrix keratinocytes — are some of the fastest-dividing cells in your entire body. To keep that pace, they demand a constant, heavy supply of iron and oxygen.(How iron deficiency contributes to hair loss) When your stored iron runs low, your body does something smart but frustrating: it triages. It sends iron to the organs you need to survive and pulls it away from the things you can technically live without — like growing hair.(London Dermatology Centre)

The result is that follicles get nudged out of their growth phase and into the resting (telogen) phase early. More resting follicles means more shedding and less density. Multiple studies have found that women with diffuse hair shedding (telogen effluvium) have significantly lower ferritin than women without it.(Serum ferritin & telogen effluvium, PMC)

“Normal” and “optimal” are not the same number

This is the line I repeat constantly, and I mean it from experience: your lab can call a ferritin “normal” while your hair is starving.

A lab’s reference range is built around preventing anemia, not around growing hair. Many of the studies linking ferritin to hair shedding use cutoffs well above the bottom of the “normal” range, and a lot of hair-focused clinicians aim higher than the lab floor when the goal is regrowth.(Clinical guide to ferritin in hair loss patients) So when someone tells me “I already had my iron checked, it was fine” — my next question is always: do you know the actual number? Because “fine for not being anemic” and “enough for your hair” can be two very different things.

The real twist: I don’t absorb iron well

Finding low ferritin was only half the answer. The harder question was why mine stays chronically low — and we’re still putting that puzzle together. What we do know is that I don’t absorb iron well when I take it orally. My current best theory points to a gut issue at the root of it, which is exactly the kind of “the symptom isn’t the cause” rabbit hole I love and hate in equal measure.

But this finally solved my two-year mystery. During my son’s toddler years, I’d been taking a postnatal vitamin with iron — but only intermittently. Not every day. At the time I thought I was just being inconsistent. It turns out that inconsistency may have been the secret.

Here’s the science I didn’t know then. When you take iron, your body releases a hormone called hepcidin that essentially closes the gate on absorbing more iron for the next day or so. Take iron every single day and you’re often fighting your own hepcidin — absorbing less of each dose. But space the doses out, and hepcidin settles back down, so each dose absorbs better. Randomized studies have shown that alternate-day iron dosing actually produces greater total absorption than daily dosing in iron-depleted women.(Alternate-day vs consecutive-day iron, Haematologica) (eClinicalMedicine RCT, 2023)

So my “best hair of my life” wasn’t random at all. My accidental every-few-days iron habit was likely the most absorbable way I could have been taking it. I’d stumbled into the right protocol without understanding it — and once I understood it, I could finally rebuild it on purpose.

Where TED comes in — and why I genuinely love it

While I work on the internal side — the ferritin, the absorption, the gut piece — I’m not willing to just wait and watch my density disappear. That’s where TED comes in.

TED came onto my radar in recent years, right around when I was pregnant with my daughter, and it’s become one of my favorite tools for exactly this kind of patient. TED uses ultrasound-based, needle-free delivery — acoustic sound waves and air pressure temporarily open channels in the scalp so a nourishing growth serum can reach the depth where your follicles actually live, without ever breaking the skin.(How Alma TED works)

Here’s why I reach for it. I see it delivering the kind of density and regrowth results we associate with microneedling paired with growth factors — PRP, PRF, exosomes — but without the needles, the pain, the bleeding, or the downtime, and without the risk of physically traumatizing the healthy follicles you’re trying to protect.(Alma TED vs PRP comparison) Microneedling works by creating controlled injury; TED skips the injury entirely. For someone whose follicles are already stressed, that distinction matters to me.

It’s the perfect complement to the internal work: fix the supply chain from the inside, support the follicles from the outside.

The thing I most want you to take from my story

Hair loss isn’t a diagnosis. It’s a symptom — and it can have a dozen different drivers hiding underneath it, often more than one at the same time.

I spent years throwing supplements at mine before I understood that. My answer turned out to be ferritin and absorption. Yours might be ferritin too — or it might be your thyroid, your hormones, a postpartum shift, a medication, a stressful season, or something we haven’t named yet. The only way to know is to investigate, not guess.

That’s the whole philosophy behind how we work up hair at Flora: the right labs, the real numbers, your full history, and a plan built around your root cause — then the right treatments, like TED, to support regrowth while we fix what’s underneath.

If you’ve been blaming your shampoo, your stress, or just “getting older” — let’s actually look. I had to find my answer the long way. You don’t have to.

This is my personal story and clinical perspective, not individual medical advice. Iron supplementation isn’t right for everyone — too much iron can be harmful — so please get your own labs and work with your provider before changing anything.

Sources

• Serum Ferritin Levels: A Clinical Guide in Patients With Hair Loss
• The Diagnostic Value of Serum Ferritin for Telogen Effluvium (PMC)
• How Iron Deficiency Contributes to Hair Loss
• Alopecia & Iron Deficiency: Low Ferritin Explained — London Dermatology Centre
• Ferritin and Iron: Why Low Levels May Be Behind Fatigue and Hair Loss
• Iron absorption is greater with alternate-day than consecutive-day dosing (PubMed)
• Alternate day vs consecutive day oral iron — RCT, eClinicalMedicine 2023
• Biotin for Hair Loss: Teasing Out the Evidence — JCAD
• Biotin Deficiency in Telogen Effluvium: Fact or Fiction? (PMC)
• Postpartum Hair Loss — Johns Hopkins Medicine
• Alma TED Hair Restoration: How It Works — Charles Medical Group
• Alma TED vs PRP — Metrolina Med