Rheumatoid Arthritis and Hair Loss
Does RA Disease cause hair loss?
Hair loss is one of the things you frequently hear about in the RA community. Patients have two questions:
- What’s causing my hair loss?
- What can I do about it?
Hair loss can be a side effect of Rheumatoid Arthritis treatment
Some DMARDs (disease modifying antirheumatic drugs) list hair loss as a possible side effect. With methotrexate, hair loss can usually be mitigated by taking higher doses of folic acid. However, some Rheumatoid Arthritis treatments are still new enough that long term side effects might not be known.
What else could cause hair loss in people with Rheumatoid Arthritis?
People living with RA can have hair loss related to other common causes such as dietary deficiencies or hormonal imbalances. And it’s no coincidence this happens to them more frequently because living with RA increases the odds of having other such conditions. For example, RA patients are more likely to have an autoimmune thyroid disease as a co-morbidity and more likely to suffer from a variety of vitamin or mineral deficiencies secondary to the RA.
What helps hair loss with RA?
Some patients quit medications due to hair loss. Others have found supplements or shampoos that help such as biotin (a B vitamin). It would always be a good idea to run some basic blood tests with a primary doctor to see if a treatable cause can be found.
Can hair loss be caused by Rheumatoid Arthritis?
Most sources do not list hair loss as a symptom of Rheumatoid Arthritis. I’m still doubtful that the disease is to blame in a direct way since it’s rarely mentioned as a symptom. However, if RA is to blame, it would not be the first time the literature was wrong. (There are clear reasons for that syndrome, but that’s for another post.)
So, let’s approach this with an open mind.
- What is your experience with hair loss and RA? Some, none, temporary, permanent?
- Was any hair loss obviously connected to a medication side effect?
- What has helped you with a hair loss problem?
My experience with RA and hair loss:
While taking methotrexate, I had noticeable hair loss a couple of times, but it was temporary. I was very surprised when I was off methotrexate for a few months and the hair loss was worse than ever. I have a history of severe thyroid disease, so I tend to blame that, but there were no other thyroid symptoms.
Lucky for me, I started with enough hair for two people so I can make it look okay. Unless the wind blows. There are tons of shorter pieces all through my head where it’s trying to grow back. I take that as a good sign, even while the loss continues.
Recommended reading
- Solid points in a light-hearted tone: A Rheum Full of Contradictions
- Folic Acid with Methotrexate: the Debate
- How Rheumatoid Arthritis Pain Affects Women’s Lives
- Rheumatoid Arthritis Diet, Part 2: Ten Easy Tips
Since methotrexate was prescribed I was actually re-growing hair. I stopped taking it for a month, my RA got worse and surprisingly I was losing gobs of hair on my scalp and major thinning elsewhere. My scalp is more visible when I part my hair, my ponytail is about 2/3 smaller in diameter, so I am lucky I had really thick hair to start with. my RA symptoms are getting worse so more Methotrexate is being prescribed. I take multiple vitamins and minerals, and always have, so would really like to know what the secondary cause is, if not the RA.
My RA has had different symptoms besides joint and tendon inflammation and pain. I have vasculitis, lipid, and nerve involvement. With a flair, I have had skin peeling, as well as significantly more hair loss. I also may have had improvements in hair regrowth because of high doses of Vitamin D being added to reverse low D, and now that I am off of the supplement, my D has dropped again, and I have experienced more hairloss. I will get the D retested. I had believed my hair regrowth was due to the methotrexate, but I had the vitamin D prescribed at the same time. Two of my siblings and mother have Hashimotos, but my primary refuses to do thyroid testing, saying he would have to justify the cost of the blood test to insurance. I will ask my rheumatologist to test for it.
Ah
Vitamin D deficiency thats really interesting!
OMG you are joking..theres a link between RA and hairloss?
You know it sounds so vain but its one of the the few things that make me feel womanly and attractive is my mane 🙂 (cos my creaky hips are kind of a passion killer..haha)
I mentioned to the rheum about my “shedding” preceeding a flare then more throughout and his ears pricked up to it. I blamed the hydroxychloroquine, he as usual explained nothing!
Its superficial but i do feel a little lump in my throat evertime im in the shower and i feel long strands of hair all over my fingers as im rinsing my hair then have to clear the matted clumps out from clogging up the plug hole when i get out * long sigh * Is nothing sacred any more…?
The joy of RA! Hair loss! yay!
I have hair loss which my rheumy says is due to arthritis. I’m a 28 year old woman and my hair started falling a month before my second flare which was in November 2014. It fell out when I washed and then loads on my pillow at night. at first I thought it was a lot but wouldn’t make too much difference now I can see my scalp in places I’ve never seen before. I was told that any cell can be affected by RA including the follicle holding hair in to the scalp.
Am due to start methotrexate despite wanting to get pregnant, I don’t have children yet and am very reluctant to take methotrexate due to wanting children as well as hair loss. Anyway I will take it.
Although my GP and rheumy have looked at me as though hair loss is not important compared to not walking and pain etc. but actually it makes me look unwell and I don’t want to look unwell. RA changes every piece of life over time I don’t want it taking another piece of my identity which is what my hair is. I would say self esteem and identity are essential to mental wellbeing which is health.
Wishing everyone peace and wellness thoughts x
Just found this wonderful blog. New to RA as diagnosed 8 months ago. On 10 mg of Mtx and 1 mg of FA a day. Was not told not to take FA on day I take Mtx .
Rheummy told me to on increase FA to 2mg (milligrams) daily was afraid this was too much. But after seeing most of you take much more I guess I will increase it. BTW anyone have severe dry eyes? appreciate any comments on eyes. Kind of scared about my eye sight in the future with RA. wish you all the best. Good to have someone to talk to about all this..M
I have RA and have been taking Enbrel and now Humira for over two years. Still have pain in hands and numbness. Also pain and burning in feet. Shoulders hurt and sometimes hips. Doctor gave me Methotrexate, which seems to work, but am experiencing hair loss. I really hate this. As if the pain and discomfort aren’t enough, now I’ve got to look terrible, too. I was not prescribed folic acid, so have been taking over the counter folic acid, 2 or 3 -800 mcg’s. Nothing seems to work well. I reduced my Mx dose to 5 mgs because it seems to work ok, but I realize the higher dose probably works better. I eat mostly organic, not junk food, am not over weight and stay active. Still have fatigue and pain.
I am on Embrel .25 mg shots twice weekly and was on 25 mg injections MTX. I started losing my hair about 6 months after being on the max dose of MTX. I noticed that after my MTX injections the next day my joint pain would be so much worse. I mentioned this to my Rhemy and he discounted it. I finally took myself off the MTX about 4 months ago and have noticed no change in my overall RA or my hair. My hair is still very thin and has become super fine, almost like little baby hair. I also noticed my scalp itched and I developed flaking. I read an article that mentioned everyone has yeast on their scalp and these meds can allow the yeast to flourish causing hair loss and flaking. I now use Head and Shoulders and Ketoconazole every other day and my hair is doing much better.
Forgot to mention you might want to be tested for the MTHFR 1298 A/C and 677 C/T gene. If you have a mutation you may not be able to process folic acid. I have the 1298A mutation and have to take L-Methylfolate not folic acid.
I just went to a Rheumatologist and one of the questions she asked me was” do you have hair loss?! My answer Yes! I started losing it above the temple at the hair line both left and right! She sent me to their in-house lab and took 12 vials if Blood; her suspicion after doing my checkup was RA. Also Lupus… what shampoo is good for hair loss? I would also like to know if anyone has tried Karenique ? Probably misspelled lol Thank you
I need to do a longer post on that Sandy, but I haven’t tried that one. Taking Biotin (a B vitamin) orally helps the hair grow faster, so that can help it fill back in faster. There are shampoos with biotin too, and Nioxin is the best selling hairloss shampoo that claims to make the scalp and hair healthier.
Just to be sure your bases are covered, is she keeping an eye on thyroid levels – probably the most common cause of hair thinning in women. Best of luck to you.