159 The Incidence of Depleted Iron Stores in North American Females Presenting with Hair Loss

C.Haycox. Virginia Mason Medical Center, Sequim, WA, USA and Dept. of Medicine (Dermatology) University of Washington, Seattle, WA, USA.

Iron deficiency is recognized as a cause of diffuse, non-patterned alopecia, but may also co-exist in other causes of hair loss. A retrospective study of 53 North American females presenting to a specialty hair disorders clinic, complaining of either increased shedding or progressive thinning, was performed to determine the incidence of depleted iron stores, reflected by low serum ferritin, in these women. The women were 42 +/- 15 years of age and complained of thinning or shedding for a duration of 3.3 +/- 4.15 years. A diagnosis of androgenetic alopecia (AGA) was made in 55% (29/53) and the remaining 45% (24/53) had a diffuse, non-patterned alopecia (DA). Of the women with AGA 76% (22/29) also had depleted iron stores reflected by ferritin less than 50. Of the women with DA 83% (20/24) had ferritin less than 50. Of the women with ferritin less than 50 only 11% (5/42) had abnormally low peripheral iron studies: Either abnormal serum iron, total iron binding capacity, or percent saturation. 17% (7/42) of these women with ferritin under 50 had an associated fingernail dystrophy such a thin, brittle, slow-growing nails with or without distal onychoschizia, 10% (4/42) had some history of anemia, and only 5% (2/42) were strict dietary vegetarians. In this study of North American women presenting with hair loss the majority had depleted iron stores, even those in whom another clear reason for hair thinning, such as AGA was readily identifiable. However, only a minority of women had abnormal peripheral iron studies, or other clinical clues of iron deficiency such as a history of anemia, vegetarianism or nail dystrophy. Since aggressive iron replacement therapy can correct the associated hair growth abnormality, this study suggests that it is vital to look for depleted iron stores in all women presenting with increased shedding or progressive thinning, regardless of co-existent diagnoses such as AGA.