My Gastric Bypass: Getting Real About Hair Loss

First, let me say… UGH!

Second, let me say… DOUBLE UGH!

Right, well now that I have that out of the way, I can get down to the topic at hand, hair loss.

Hair Loss
The view this morning when I looked over the side of my chair.  A graveyard of lost hair I’ve pulled off my shirt over the past day or so… and that is only this one particular spot in the house. Not even the tip of the iceberg.

I have to give a bit of a disclaimer here because the hair loss issue is nothing new to me. I started noticing that I was losing my hair many years ago. After a visit to the doctor I was told that yes I was indeed losing my hair and the cause was Androgenic Alopecia brought on by PCOS.

So that’s always been bad enough, but having had WLS I knew that hair loss was a definite possibility.  Not just a definite possibility but pretty much a given.  Still, being the delusional idiot that I am, I sort of tricked myself into thinking that because I was already losing hair that one would cancel the other out and it might just continue on like normal.

No such luck.

It happens to everyone, I was not a lucky exception, it is happening to me… and it SUCKS.

Hair loss after weight loss surgery is called Telogen Effluvium.  What is this?  Well here is what I found online about the subject:

What is Telogen Effluvium?

When excessive amounts of hair simultaneously switch from anagen (growth) into telogen (dormancy) and subsequently shed several months later, the phenomenon is referred to as a telogen effluvium. Rarely are more than 50% of the hairs on the head involved. Telogen effluviums can be acute or chronic. When the shedding lasts more than six months or persistently recurs, it is referred to as a chronic telogen effluvium. Chronic telogen effluviums have been reported mainly in women. No racial predilection exists. Although telogen effluvium can affect hair on all parts of the body, generally, only loss of scalp hair is symptomatic.

What causes Telogen Effluvium?

In order to cause a large number of hair follicles to simultaneously switch from the anagen (growing) phase into the telogen (resting) phase, the body has to undergo some systemic insult. A telogen effluvium is not caused by topical medications. But because there is a required time lapse of several months between the inciting cause and the excessive shedding of hair, the exact cause of the telogen effluvium is often not positively identified.

A typical and common case of telogen effluvium would be the episode of severe shedding of hair that may occur approximately 100 days after a woman has given birth. The inciting factor is probably the abrupt hormonal changes that occur at the end of pregnancy. All of the hair grows back within a year.

Other causes of telogen effluvium include illness, major physical trauma, menopause, crash diets, severe psychological stress, major surgery (especially with general anesthesia), hypo- or hyperthyroidism, anemia’s, acute and severe blood loss, heavy metal poisoning, etc. Chronic illness such as malignancy, and any chronic debilitating illness, such as systemic lupus erythematosus, end-stage renal disease, or liver disease can cause telogen effluvium. Immunizations also have been reported to cause acute hair shedding. Even jet lag and job changes have been reported to cause a telogen effluvium. In the United States, oral medications may very well be the most common cause of telogen effluviums. The list of medications associated with telogen effluviums is extensive and includes retinoids, beta-blockers, anticoagulants, SSRI’s, non-steroidal anti-inflammatories, calcium channel blockers, etc. In any and all cases, the common factor is metabolic or physiologic stress several months before the start of the hair shedding.

So basically it’s the same thing that happens in a lot of other cases where sudden hair loss is involved like after a pregnancy, etc but I have bolded the parts that I think apply… crash diets (while I don’t consider this a crash diet, the extreme change in eating pattern and lifestyle would initially have the same affect), psychological stress (who has WLS without some of that involved??) and major surgery with general anesthesia.

This is not something I could have avoided.  I knew full well going into the surgery that this was going to happen (regardless of how much I tried to fool myself into believing otherwise) and I made the decision to do it knowing that this was in my future.

Does that make it suck any less?  HELL.NO.  It really doesn’t.  Nothing prepared me for the shock of seeing so much more of my hair falling out throughout the day.

When I decided to write about my surgery and my experiences afterward, I made a promise to myself that I would share it all, even the really shitty bits.  For me, that’s what this is, a really really shitty bit.  I can’t say I’m entirely comfortable with sharing it, I find this a little embarrassing and it makes me sad, but it’s my reality… and who knows, if you are reading this and are considering having WLS it may be yours one day too.

I’ve decided to take photos and share what it’s like because before my surgery I read a lot of people talking about hair loss but very few of them really shared.  Who knows what hair loss is to different people, how much they consider to be bad. I wanted to see photos and they were very few and far between.

Today I had Xander take these photos after I put the conditioner in my hair in the shower.

hairloss1hairloss2hairloss3

Yeah, not the most smiley photos but really, who would be smiling at a time like that?  I just congratulate myself on the lack of tears, because we all know what a weepy weeper I am.

To some women with longer hair this may look somewhat normal, but this is not what I have been losing in a day, this is what I have been losing while conditioning my hair.  It does not include the hair I pick off my shirt all day, the hair that disappears down the drain, what I see floating around on the floor, the hair all over my pillow in the morning or the pile I pick out of my brush every day.  Unfortunately, what you see in these photos is only a fraction of the hair I seem to be losing each day at the moment.  All of this comes out while conditioning my hair and I think I’m done shedding for the day, only to see gobs more come out ten minutes later when I’m coming my hair out after the shower, and then more again all over my clothes a few hours later.  It’s like a nightmare.

I am now almost three and a half months out from surgery and it has been like this for almost two weeks now.  I’m not sure how long it will last, if this is as bad as it will get or if it’s just the beginning. There is no way for me to know at this point… but what I do know is that it feels horrible.

I think this is especially bad for me because my hair was so thin to begin with.  Having already had problems with hair loss for other reasons, losing not only more, but a lot more at once, has left me scared to death that I’m going to go bald.

You can see in the photos that the hair on top is particularly thin, this is most noticeable when my hair is wet and it is worse on the crown.  The bulk of my hair loss from the alopecia happened on top but I notice now it is coming out from all over.  I can only hope that the bulk of what I lose now will be from the sides and back and that the hair loss on top will be minimal.  Otherwise, well… I’ve not decided what I will do yet.

From what I’ve read the bulk of the hair loss happens between 3-6 months after surgery so I am right on schedule. They SAY that after the 6-9 month point the hair starts growing back.  Will that be the case for me or will my alopecia interfere with that?  I honestly don’t know and I’m afraid to ask at this point because I’m not sure I would be ready to hear that none of it is going to come back.

All I have been able to think about when I look into the future after the surgery is going home to Canada in October and being a completely new woman.  Stepping off the plane and hearing my parents gasp when they see me at a weight I’ve not been in as long as any of us remember.  Now I’m realizing that I may be going home without a head full of hair, and how am I going to feel about that?  It sort of takes away from the initial excitement of showing off.  Not that my family will care, of course, but I will care.

I know, how vain, right?  There are people all over the world who have real problems, but these problems are real to me because they are mine.

I’ve tried really hard to stay positive through this experience.  After all, I did make the decision to do this knowing that all of these things were likely to happen.  Still, as I said, there is no preparing for the way you feel when they do finally happen.  I am hoping that no matter how it turns out with the hair loss that I will find a way to get through it with a smile on my face, whether it’s wearing a wig or getting creative with headbands… but I think there will always be an underlying insecurity and sadness that goes along with it.

There is one thing I’m incredibly thankful for, something that may be the ONE thing that gets me through this… and that’s having a husband that I know, without a doubt, will love me regardless.  I could be bald as an onion and he’d still go out of his way to try to make me feel beautiful and loved… so really, it’s not all that bad is it?  Not as long as I have someone like that by my side.

In the end, even with this hair loss speed bump that I am dealing with, I have absolutely zero regrets.  I feel like I need to add this after you spent the time reading me whine about it because while this may suck for me at the moment, there is so much more positive that I am getting out of my surgery and so many ways that it makes me feel wonderful.  This one thing does not cancel all of that out.

NO REGRETS!

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36 comments

  1. Thanks for the sincere advice. Keep sharing more content on hair care.

  2. Hi Tammy,
    I’m glad to hear that you eventually regrew the hair you lost from the surgery. You said that you had androgenic alopecia. I’ve heard that PCOS can sort of make it occur. Do you feel like the surgery, the weight loss and the rebalancing of hormones has sort of put an end to the androgenic alopecia? I know you said what you’d lost prior to surgery did not return but do you think you still have it and your hair is thinning still due to androgenetic alopecia?

    I was recently diagnosed with PCOS. My doctor said it was either PCOS or AA contributing to my thinning hair. I’m truly hoping the gastric sleeve will put an end to the thinning hair once the hair shedding stops and hair starts to grow back from surgery. I don’t expect to ever have a lush head of hair again but am hoping to keep what I have. Thank you so much for your time.

    • Hi London,

      Ah the alopecia is awful, isn’t it? I feel like, as women, our self image is so closely tied to our hair. I know that for me it’s been a pain because I am constantly worried about the way the hair lies on the crown of my head and if my scalp is showing etc. I have no properly bald areas, just thin, and people tell me they’d have never noticed if I didn’t mention it, but it seems GLARINGLY obvious for me.

      Anyway, mine doesn’t seem to have changed since before my surgery. I had a phase where it got thin years ago and then it stabilized. I was so frightened after the surgery when more fell out, I was even researching hair pieces! I was -freaking out-! Then that hair that came out magically started coming back after about 3 months. From what I can tell, it was just the hair I lost after surgery that came back. So, I went back to where I started just before the surgery. I’ve not seemed to have lost any more since then, so I assume (hopefully I’m right) that I’ve lost all I’m going to from the alopecia and then next hair loss I will get will be from old age. haha A girl can hope, right?!

      I don’t think the surgery will turn back the clock on your current hair loss, but in my experience it hasn’t made it worse. Mine had already stopped falling out from the alopecia before I had the surgery, though.

      I’m not sure that was very helpful but I wish you the best of luck with your surgery! Fingers crossed that it helps with your hair loss situation, I know it’s just awful!

  3. I have alopecia also and I have been so great at hiding it em even though I move lost about half of my hair. But I really want this surgery. I really want to loose weight and keep it off but I don’t want to go bald. Is there anything we can do to keep the little hair we have left because I really want this surgery. I’m so distressed. Is there anyone out there that can help

    • Hi Sam, unfortunately, the hair thing is totally out of our control. Regardless of what anyone says about supplements or products, it is just a process our bodies go through after such major surgery. When I was losing my hair I was sure I was going to end up bald. It really didn’t turn out so bad though. Almost three months to the day from my surgery it just stopped, and then the hair I lost started growing back. I was also worried that the hair I lost from the surgery would just stay gone, but it didn’t. I am no worse off with my hair now than I was before surgery, if that makes you feel any better :)

  4. Hello Tammy read your story and it touched me considering I been having the same issue a tight now and the only reason I came across your post cause I’m was looking up different vitamins I can take for lots of hair loss…. I never had thick hair but had a hole lot more that what I have right now due to massive hair loss. Not sure if it is from me being on a low carb diet for 6 months then getting of about a month ago so I lost so much In a few weeks. So I was wondering if your hair has grown back to it lite it was normally before hair loss and how long it took and if you been taking any vitamins

  5. Okay first I want to congratulate you and tell you that you look great!!
    But also im curious about your Pcos symptoms. I too have regular but light periods. How “light were your periods?

  6. Do you have any updates. I’m struggling with same thing. And I just curious about your recovery.

    • Hi Sara, my hair loss stopped almost 3 months to the day it started falling out. All went back to normal after that, so don’t worry, it will turn around! :) I’m not sure if the fact that I had my hair cut made a difference or not, but it was just after that when it stopped falling out. I wrote about it here: http://www.breigh.com/wordpress/archives/8507

      • Hi Tammy,
        I too ‘am going through a bout of TE, induced by anxiety meds. It will be 3 months next week, October 8th. I’m at about 45% hair loss. I’m still able to conceal the loss for now, but I feel like if this continues another 3 months I’ll be looking at my scalp! I realize how vain it is to be so concerned about hair loss (especially when it’s temporary hair loss) but hair loss (IMO) is hair loss! I was and still am completely devastated that I had to endure this the last several months. The not knowing when it will stop (or if it will stop) is upsetting. I realize those who are enduring chemo will have another point of view on the subject. Please keep in mind that there are several types of hair loss. Anagen effluvium (due to chemo) which is temporary. Telogen effluvium (also temporary, and sometimes not temporary) can kick start Androgenetic alopecia, and can also go on to be chronic telogen effluvium (which can go on for years). Most of the time there are no obvious reasons for the TE. In my case, I ruled everything else out and know that it is in fact from the drug trazodone. But I’ve also come to find out that a low iron (ferritin) level can contribute to hair loss. In my case, my ferritin was 24 2 months ago. In order for hair loss to stop and regrowth to occur I have read that it must be 40-70 and higher.

        Anyway, I had a question for you Tammy…I think you told many of your readers you had TE for 3 months? Did you notice the hair loss gradually subsiding? Or was it a spontaneous thing? Since it will be 3 months next week I’m wondering if at this point the hair loss will gradually stop or if I’m doomed for this to go on for another 3 months or longer.

        • Hi Jen, I noticed a drastic difference at almost exactly three months. Now, whether it was because of the time frame, I don’t know, because I also got a haircut at that time. I cut my hair from below my shoulders to chin length and it seemed like the hair loss just stopped. I don’t know if the haircut played a part or if it was coincidence that it was the three month point and that’s when it was going to slow down anyway, but it came to a screeching halt. I’ve heard from a few friends that also had WLS that they had a similar time frame, so I really think it shouldn’t be too long for you. I know it probably feels like you are going to end up completely bald, it’s so freaking scary… but hopefully it will slow down and turn around for you soon!

          • Thanks for your response! So you didn’t notice gradual slowing down? Just spontaneous? A dermatologist I saw when I noticed this happening almost 3 months ago, told me it would be a gradual slowing. That hasn’t happened yet. I’m still loosing probably 100-150+ daily. It will be 3 months on Thursday the 8th. I’m just fearing the worst at this point. It’s also so irritating when people tell me it’s due to stress. I’m a highly anxious person and I’ve had a head full of thick hair my entire life. I’ve also read about so many women that have chronic TE. It’s scary to think I could be one of them. I’ve cried the 1st 2 months straight daily because of all the hair that I am loosing. I’m almost at 50% hair loss…and I had A LOT of hair to begin with. I’m finding it hard to believe it will just spontaneously stop on the 8th. But who knows!

        • Btw, I wish I could say that the hair loss stopped after I cut my hair! I actually cut mine 6 inches and it’s still falling out like it has been. I think you got lucky in that you’re hair loss was coming to an end. I hope I can be so lucky soon. :(

          • I can totally understand why you are afraid, but honestly I think one of these days you’re just going to suddenly notice a big change. Well, maybe not suddenly as you are very aware of it, but it will change.

            Mine wasn’t very gradual, it really just seemed to change right around the time of the cut, but everyone is different. One thing I can say from my time in the WLS groups, though, is that it is never as bad as people imagine it’s going to be. The fear when you are going through it is a lot worse than the actual outcome.

            I started out with Androgenic Alopecia before the hair loss from the WLS even began, so I was already at a loss. I was absolutely convinced I was going to be bald by the end. So much so that I started researching wigs and hair pieces. I was devastated. It turned around, though and I was nowhere even close to bald at the time.

            Your fears are totally understandable, it’s a truly horrible thing to experience, especially as a woman. Our hair is such a part of who we are and it’s so connected to our self confidence and sense of self. To see it falling out is absolutely frightening.

            I think you need to try to stay off the internet, stop reading about it and go about your business. Again, I know it’s difficult… but your doctor is right to a degree. The stress isn’t going to help and may be prolonging the situation. I know you are an anxious person by nature but TE happens because of unusual stress / trauma to the body. It turns around once your body adjusts. If you are in full on panic mode, it’s possible it is causing the problem to go on longer.

            Try to take comfort from those of us who have been there. It won’t end up as bad as you imagine it will… just take a deep breath, stop Googling and give your body a bit more time to bounce back.

            *hugs* It will be ok!

  7. Try chemo….then let’s talk about hair loss.

    I respect everyone who wants to change their lifestyle by having gastric bypass ….but hair loss is a side effect of this elective surgery. U have to be ready for this…prepare for worst..pray for the best..

    Chemo is not choice….it’s a fight for ur life…without it u die….with it…u live but loose every single hair on ur entire body.

    I learned alot going through treatments….beauty is very skin deep…or aka…within ur being.

    Hug yourself…love urself
    ….

  8. I am 10 months out from surgery.my hair loss started a month after surgery and goin. Strong. Is It from not getting enough protien in my diet. ?. I take. 10 to 20 thousand. Grms of biotin. Not working. .I’ve just come to the conclusion Im goin to be a bald headed. Skinny grandma.

    • Hi Lola! Be strong! haha I know it’s SO scary and frustrating but it will turn around. I don’t think any amount of protein, biotin or anything else is going to stop it falling out, it can only improve the health of your hair when it decides to start growing back. It WILL happen though. I was convinced I was going to be as bald as an onion but it never got to that point and now my hair is back to how it was before surgery. Also, how long is your hair? For some reason I found cutting my hair shorter (above the shoulders) made a difference. It may have been a huge coincidence but it was within days of getting it cut that the loss just stopped suddenly. May be something to consider if you have longer hair! Good luck!

  9. Thanks so much for sharing! I am 14 weeks out from surgery and my hair is falling out like crazy. I realize it’s normal, but still SUCKS.

  10. Thank you, thank you, thank you for sharing your experience Briegh! A significant factor in my decision to have surgery (I had a sleeve gastrectomy) was the hope that reaching a healthy weight would help regulate my hormone issues, caused by PCOS, which have been responsible for my thinning hair in the past five years. I had surgery sixteen weeks ago, but a month ago is when I started noticing significantly large amounts of hair in the drain during showers and then more and more falling out during the day. I knew the hair loss was coming, but when I look in the mirror now, all is see is what is missing. The thought that this will continue for a few more months has me desperate for information on what comes after that. You said that you are seeing regrowth now and I’m just wondering if your doctors have said anything about your weight loss having stopped/reversed the hair loss from your PCOS as well.
    It is incredibly encouraging to hear that your hair issues have improved with time. I’ve lost 46 lbs so far and even if every curl in my head is gone in the next two months, having this surgery is still the best thing I’ve ever done for myself. Thank you again for sharing the good, the bad and the ugly of your experience with WLS!

    • Hi Anne!
      I had WLS because I needed to lose the weight for IVF. I was diagnosed with “PCOS-like symptoms” but they don’t really diagnose PCOS the same here in the Netherlands. I had unexplained infertility, hair loss but had very regular, but short menstrual cycles. The surgery didn’t really change anything in regards to my cycle, to be honest, and I never did get pregnant… but I don’t regret the surgery for a second.

      As for the hair loss, there were times I was quite literally afraid I was going to end up bald. I even started researching wigs, I was that afraid. In the end it was all for nothing as the hair loss stopped as suddenly as it started, almost 3 months later. It comes out so much that you feel like there’s no way you won’t end up bald, but I don’t know anyone that has ended up that extreme. I have since had all of the hair I lost after the surgery grow back, but it didn’t reverse the hair loss I had from the Androgenic Alopecia. As far as I can tell, at least for me, that has been permanent. It’s mostly on my crown, the hair is thinner there. After my surgery it was thinning out all over, which was frightening… but that has thickened up again. So hair-wise, I’m pretty much back where I started before the surgery, but not worse off at all.

      The hair loss lasted almost exactly 3 months for me. I don’t know if it was coincidence or not but when I cut my hair shorter (from below my shoulders to chin length) it seemed to almost magically stop. Whether it had just run its course or if the hair cut somehow made a difference, I have no idea.

      Hope that helps, good luck with your journey!

      • Hi, thank you for sharing your expirience.I’m am going through the same thing as you.. I already have hair loss and hair thinning. And I’m considering getting surgury. There wasn’t anyone out there sharing if they had hair loss before surgury and if they did, did it grow back? No one, I couldn’t find anything. So thank you you now at least I can make the decision on having surgury with the peace of mind that yes I will have horrible hair loss on top of the one I already have ,but at least I know it will eventually go back to my normal hair.

  11. I’m 6 months out from GBS and the hair loss is killing me!! It started 3 months ago and hasn’t let up. I’ve been taking Biotin since before the surgery, Silica, and am now using Nioxin and Rogaine….nothing is helping. My protein levels are fine. Please tell me it grows back….I’m panicking.

    • Hi Cindy! It does stop, don’t worry! I thought I was going to be completely bald in the end but it really didn’t go that way. Mine started at 3 months and lasted until about six months. Unfortunately nothing you take will make any difference in how much you lose. It’s just your body’s way of dealing with the shock of surgery. The Biotin will help your hair be healthy when it grows back, but nothing will stop it from falling out or stimulate regrowth, that will all happen in its own time. Don’t worry, it will be ok!

  12. I am going through the same thing right now about 3.5 months out from surgery and the hair is just everywhere! I have the same hand covered hair scenes as you and i don’t feel so worried anymore! Thank you so much for sharing i can breath..

  13. It will be four years since my surgery in Jun and my hair is still coming out even worse than it started. If I didn’t know better I’d think I had chemo, it’s coming out really bad and it’s just a matter of time before I will have to wear a wig.

  14. I am scheduled for surgery next month, but I was wondering if you have had any hair regrowth? I’ve been experiencing hair loss already due to my thyroidectomy. A lil freaked out,….

    Thanks!

    • Hi Karli! Congrats on your upcoming surgery! :) I certainly do have regrowth, sticking up all over my head haha I’d say it’s annoying but I’m so happy it’s there I don’t care. While it seemed like a lot of hair coming out at the time, and as you read… I was scared I was going to go completely bald… it didn’t turn out nearly as bad as I was expecting. That’s pretty amazing considering I already started having already had hair loss before the surgery. It looks like so much hair that you are wondering how on earth you have any left, but it turns around and the regrowth does come! :) Good luck with your surgery and if you have any other questions don’t hesitate to ask! :)

  15. Bonny Sommerdorf

    Biotin is really great for the hair. You can always have very strong and thick hair if you consume high amounts of biotin. *`”,:

    Enjoy your weekend! http://www.foodsupplementdigest.com“>

  16. Biotin is supposed to help with hair loss. I take vitamins that have biotin in them (Bariatric Advantage) and I take a biotin supplement separately. So far so good but I am only 2 mos out. So it could all change.

  17. I’d say just cut your hair short and no one will notice except you. Usually that’s the way it goes. You’re going to be slim and you’ll have a cool haircut. It’s all good. You look great!

  18. I think you are awesome… you know that. And it doesn’t matter if you have a full head of hair or not… in fact I think you could pull off a GI Jane look ;-). What I did notice… Your nails are looking awesome!!!! Mine have been sooo brittle I have no idea what’s going on here! Also… you have wrist bones! And your face is so small!! You are just looking fantastic! Don’t worry about what others think… it’s nothing a hat can’t cover and it will grow back. Big hugs xxx

  19. It does suck…and i really didn’t expect it after your surgery! You are opening people’s eyes, Tammy…and that’s a good thing!
    And……i know how it feels to wash your hair and have handfulls of it…look at your pillow and see it covered with hair. I know what it’s like to be as bald as a billiard ball…and even now, more than 6mths after my last chemo, i barely have 1/2 inch of hair on my head. Ya, i’m doing ok, and you’re losing weight at an enormously fabulous rate…but that doesn’t take away the pain of losing hair….let’s be honest, no one can REALLY understand till you’ve been there….
    …..here’s to hoping that over half a year we’ll both be thin, fabulous and with headfulls of gorgeous, thick hair! Loads of hugs.

  20. Oh hon. I’m so sorry. I love you and don’t give a crap about whether you have hair or not, you know that right? But I know that doesn’t make it any better. This does suck and this was known to be a risk. I guess the question now is, will it come back? Can you do anything? Do you just wait it out now?

    you are allowed to have any feelings of vanity or otherwise that come to the surface but I do know your family and friends are ALSO going to love you regardless of hair and are DEFINITELY going to see the weight change on you and be proud of you.

    I’m glad you are being open about it and moreso I’m glad that you have no regrets. Because that would suck worse. At the end of the day wouldn’t it be MORE awesome to be a “normal” weight, get preggers and have a baby and not have or have less hair?

    xxxxx

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