36 year old female hair loss, would iron supplements help or should I go down the Rogaine route? (photos)

Hello, please see below. There are multiple solutions to hair loss for women that are nonsurgical including:
Rogaine- There is a specific formulation for women
Supplements- This includes but not limited to Viviscal and Nutrafol which contain marine extract and anti-inflammatory substances to promote hair growth
PRP- Platelet rich plasma can promote hair growth and is a nonsurgical procedure in the office
Low level laser- Can promote hair growth in some patients
Regenerative medicine- There are additional growth factors which can be injected to promote hair growth
Seek advice from an expert or team of experts. 
Best,
Dr. Anil Shah

This needs an in-person evaluation. I suggest seeing a hair loss expert now to go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone which can help with hair regrowth and/or hair transplantation. See an expert. Best, Dr. Emer

Female pattern hair loss or genetic alopecia is the most common reason of hair loss in women and it is more common than it is thought to be. 25% of the women at the ages of 35-40, 50% of the women at the ages above 40 suffer from hair loss. 20% of the women with hair loss have a positive relative who suffered/is suffering from hair loss. Other reasons of hair loss are: Hypo- and hyper-tiroidism (hair loss may be one of the early signs of thyroid dysfunction, and hair loss stops after treatment); polycystic ovarian syndrome (an inherited ovarian disease, seen in 10% of the women during adulthood); pregnancy-related hormonal changes (temporary hair loss which can be seen during pregnancy stops after birth)..

The reason of the hair loss may related with factors other than genetic like connective tissue disorders, stress, anemia, lupus, medications, hormonal and seasonal changes, nutritional problems, severe diets, bulimia, protein/calorie deficiency, zinc and essential amino-acid deficiency, mal-absorption (intestinal and digestive problems), A-vitamin excess, general anesthesia, affective mood disorders.

Drugs that may cause hair loss in woman 

Anti-coagulants such as warfarin and heparin  
Epilepsy drugs, especially dilantin
Gout drugs, allopurinol and colchicum
Antihypertensive drugs, diuretics, beta blockers.... etc
So you may need dermatoscopy and ıf needed a skin biopsy and to have a full exam with an hair surgeon and/or endocrinologist , to find out any reason for hair loss.

One would really need to know your whole story and see your scalp up close to determine TE vs androgenetic alopecia. Many women have both. If you have miniaturized hair follicles on dermoscopy there is a good chance you have androgenetic alopecia. I would think the odds are quite good there is a component of androgenetic alopecia here but of course I would need to see the scalp to confirm. Certainly there is little harm with seeing what happens if you bring up your ferritin to 50-60 range. For most women, however, this does not solve the hair loss problem. In 2018, the Rogaine route remains the only FDA approved treatment. It gets downplayed alot as it does not help everyone. But it sure helps many.  This is in contrast to countless treatments I could list that help hardly anyone. Other options for androgenetic alopecia you may wish to review include laser, PRP amd antiandrogens.

Female hair loss typically involves multiple factors, including hormones, genetics, iron and nutritional components, etc.  You would likely benefit from iron supplementation and your goal should be to get your Ferritin level to 70 or above (under physician supervision, as too much iron can also be a problem).  Thyroid conditions, as well as medications to treat thyroid conditions can contribute to hair loss as well, but keeping your thyroid levels in the normal range are important.  If you have a family history of hair loss and miniaturization is noted on exam, it may be FPHL that has been accelerated by contributing factors such as low iron and hypothyroidism.  You may also benefit from Rogaine and making sure your other vitamins are adequate, such as vitamin D, vitamin B-12, and be sure you have adequate protein in your diet.  Good luck!

you can try both aand both can help with your hair loss. It is better to us minoxidil under a physician supervision. 

Female hair loss is a difficult analysis and requires many tests, not just thyroid testing. I simply can’t write a textbook on the subject on this site, but here’s a list of past posts that may help you understand what you’ve got going on:

1.     Female Genetic Hair Loss Is Different From Male Genetic Hair Loss

2.     Birth Control Pills and Hair Loss

3.     Woman With Thinning Hair After Family Tragedy

4.     Diseases Causing Women’s Hair Loss

5.     Female Hair Loss

The first step in evaluating hair loss in women, after a detailed history and physical exam, is to rule out any underlying medical causes of hair loss which can be treated. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, gynecological conditions and emotional stress. Furthermore, over 50% of women going through change of life hormone fluctuations (menopause) experience significant hair loss. It is also important to review the use of medications that may cause hair loss, such as (but not limited to) oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin, and prednisone. The following laboratory tests have been recommended to rule out the aforementioned medical conditions:

Some common blood tests for female hair loss:

·         Sex Hormone tests

·         SHBG (Sex Hormone Binding Globulin) used to test status of male hormones

·         Estradiol is a sex hormone

·         FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*

·         LH (Luteinizing Hormone) is a sex hormone

·         Free Testosterone

·         Total Testosterone

·         ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases

·         TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease

·         Test Iron status

·         TIBC (Total Iron Binding Capacity)

·         Ferritin

·         Iron
For thinning hair we offer Scalp Micropgimentation which works as an excellent cosmetic treatment for thinning in females.