Telogen Effluvium (TE) - hair shedding On the average person's head approximately 85 to 90% of the hairs are actively growing, which is known as the anagen phase and the other 10 to 15% are resting, known as the telogen phase. Typically a hair strand is in the active growing phase for two to four years. Then that strand of hair enters the resting phase for approximately two to four months and then falls out and is replaced by a new growing hair. The average person naturally loses about 100 hairs a day. However, In a person who notices more than usual hair shedding the condition is called telogen effluvium( TE). Before I discuss this further, it is important to mention that TE rarely lasts longer than six months, although for some folk the condition may last longer. Typically in this condition, about 30% of the hairs stop growing and go into the resting phase before falling out. So if you have TE you may lose an average of 300 hairs a day instead of 100. There are a number of triggers that may cause TE such as shock, major physical and physiological trauma of surgery; high fever/severe infection, iron deficiency; certain prescription medications such as, anticoagulants, many anti-inflammatory drugs, NSAIDs, anti-depression drugs and other general health prescription medications. Sound familiar triggers to us joint replacement folk? There are also a number of other general health conditions not necessarily related to joint replacement surgery which cause hair loss which is not relevant to this article. Because hairs that enter the telogen phase rest in place for two to four months before falling out, you may not notice any hair loss until two to four months after the trigger that caused the problem. Each hair strand that is pushed prematurely by a trigger into the telogen phase and because hair on the scalp grows slowly (for the majority of people) your hair may feel or look thinner however, eventually it thickens as the new hair grows. Of course if there is continued stress, physical or physiological it may take longer and as with any recovery this can be distressing. Most cases of TE can be diagnosed based on medical history and an examination of the scalp and hair. If the hair loss has been occurring for several months, there may be visible thinning patches, but often the hair loss is not dramatic enough for a doctor to notice, but you may! One can test by gently tugging on some hairs on your scalp and if four or more hairs come out, you may have TE. Also, the hairs will look like hairs in the telogen phase — they will have a white bulb at the end that was in the scalp, and will not have a gel-like covering around that end of the hair. So what can one do if TE is noticed some months subsequent to surgery? This is where nutrition can help, it won't necessarily stop TE occurring due to the triggers. What we do know from various studies in protein-energy malnutrition, starvation, and eating disorders, nutritional factors appear to plays a role with persistent increased hair shedding. Hård, 40 years ago, demonstrated the importance of iron supplements in nonanaemic, iron-deficient women with hair loss. Serum ferritin concentrations provide a good assessment of an individual's iron status. Rushton et al. first published data showing that serum ferritin concentrations were a factor in female hair loss and, 10 years later, Kantor et al. confirmed this association. The role of the essential amino acid, l-lysine in hair loss also appears to be important. Double-blind data confirmed the findings of an open study in women with increased hair shedding, where a significant proportion responded to l-lysine and iron therapy. Foods rich in protein are good sources of lysine and iron. That includes meat (specifically red meat, pork, and poultry), cheese (particularly parmesan), certain fish (such as cod and sardines), nuts, eggs, soybeans (particularly tofu, isolated soy protein, and defatted soybean flour), spirulina, and fenugreek seed. Brewer's yeast, beans and other legumes, and dairy products and many nuts also contain lysine. It is important to note that excessive intakes of nutritional supplements may actually cause hair loss and are not recommended in the absence of a proven deficiency! Cheers, Poppet. Disclaimer: The information on dietary factors, foods, and beverages contained in this article does not cover all possible uses, actions, precautions, side effects, and interactions. It is not intended as medical advice for individual problems. Liability for individual actions or omissions based upon the contents of this article is expressly disclaimed. Consult a doctor or other health care professional for diagnosis and treatment of all medical conditions including the taking of supplements.