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This post was updated on Oct. 21, 2014.

When you have a sluggish thyroid, feeling crappy and tired and irritable is difficult enough. But seeing your brush and bathroom sink filled with hair is devastating – it’s a visible manifestation of your imbalance. No one wants to lose hair, no matter what the cause.

And we’re not just talking scalp loss. Many people with hypothyroidism also see thinning of the outer third of their eyebrows.

[My best selling cookbook is now available: The Essential Thyroid Cookbook: Over 100 Nourishing Recipes for Thriving with Hypothyroidism and Hashimoto’s.]

This is a particularly touchy topic for me, as I’m pretty susceptible to hair loss. I have alopecia, so I get quarter-sized bald spots from time to time. Luckily, they make these things called bobby pins. And my spots always grow back eventually – usually soon after the spot appears. Some people aren’t so fortunate. My lovely sister has no hair.

[Go here for more information on alopecia.]

Back in 2008, when my thyroid was haywire, I lost a ton of hair – mostly diffuse loss (allover thinning), along with a few of my usual spots. Totally scary. Starting with a curly, thick head of hair to begin with was certainly helpful, and most of it has grown back – I’m told I still have quite the mop.

What a lot of doctors don’t know – or don’t share with their patients – is that thyroid drugs are often the cause of hair loss. (I’ve never taken thyroid drugs.) That’s right, what you’re taking for your hair loss (and other thyroid symptoms) might be exacerbating your shedding. It’s a clearly stated side effect in Synthroid patient literature, but you’ll rarely hear a doctor offer this warning. In fact, if you’re losing more hair, you might get your dosages increased.

Below are a few natural strategies for halting hair loss that have worked for my clients and myself. Please keep in mind that for many, their hair loss is related to an autoimmune condition and hormone imbalances, like androgens. Below are some basics, but many people need additional support in the form of immune modulation and right-sizing thyroid, adrenal, androgenic, and blood sugar hormones.

1. Take evening primrose oil (EPO). This is probably your single best strategy. Many people who have experienced extensive hair loss will tell you that taking EPO made a huge difference in not only the slowing and eventual stopping of excessive loss, but it helped their hair regrow. It has also been reported to improve hair texture – people reported less straw-like, brittle hair. Dr. Andrew Weil states, “Take 500 mg of either twice a day. Be patient. You won’t see results for six to eight weeks.”
2. Take biotin (Vitamin B7). It has been shown to regrow hair and also eases the stress response (it’s a B vitamin, after all); stress can exacerbate hair loss. See #5 below.
3. Get plenty of Omega-3 fatty acids in your diet. Sources include flax seeds, walnuts, hemp seeds, safe seafood (salmon, mackerel, anchovies, tuna, sardines), and grassfed animal products, including wild game. I believe that taking a high quality, mercury-free, third party tested fish oil is one of the most important supplements we can take.
4. It’s estimated that 90% of women with hair loss are deficient in iron and lysine. Lysine helps the body absorb iron, and it’s difficult to get the lysine we need from our diet. Eggs and meat, including fish, are the only sources of lysine, and it may be necessary to supplement, whether you abstain from meat and eggs or not.
5. Take an HCl (hydrochloric acid) challenge. See #1 on this post. There is a strong link between low stomach acid and hair loss. 
6. Lastly, don’t stress about it. Believe me, I know this is easier said than done. But stress is also a cause of hair loss. Know that it’s highly unlikely that you’ll ever go bald, so be patient and go easy on yourself.