This could be a B-vitamin deficiency, an endocrine problem, a stress response or even heavy-metal poisoning. Cindy was starting to think about investing in a wig. At age 45, she was single with a career in research that she enjoyed. Lately, she had taken to not leaving the house without a hat or scarf on her head. Naturally shy, the prospect of dating or socializing was even more agonizing now since over the past 18 months the hair on her head, once quite thick and lustrous, was noticeably thin. She used to enjoy brushing and “fixing” her hair, which she had considered one of her best features. She came to me quite depressed about her on-going hair loss, because the problem was progressing. I confirmed she had not recently had a Hepatitis B shot series. An article appeared last year in the Journal of the American Medical Association (278:117-8, 1997) linking the Hep B vaccine to increased incidence of alopecia (balding) in women. No, she hadn’t had the Hep B series. I asked if she had ever had cancer and...

The Spectre of Balding Women – Caroline, a new mother in her mid-twenties, came for help in a state of deep depression. The first words out of her mouth were “I’m turning into my mother…” When I asked her what that meant, she said that both of them were moody, irritable with their loved ones and, the symptom that was upsetting them most of all, going bald. While many women (and men) will exaggerate the extent of their hair loss, there was no doubt that Caroline’s once-lush mane was noticeably thin and dry; her scalp was scaly and visible at the forehead and temples. I asked her if there was a history of thyroid problems in her family. She confirmed that there was not, and that both she and her mother had recently evaluated their thyroid status by blood test, because either over- or under-active thyroid function can cause hair thinning. However, I kept with my hunch that there was a hormonal component to this puzzle.